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The Big Ds: Diabetes, Depression, and the D Vitamin

Since alliteration helps us to remember connections, we’re lucky that diabetes, depression, and the D vitamin all start with the same letter. We aren’t lucky that diabetes and depression are so closely connected, as I wrote in my essay on “Diabetes and Depression” here a year ago. But we’re in luck that vitamin D might treat both conditions, killing two birds with one stone, as our less technologically powerful ancestors used to say.

“About 70 percent of the population of the United States has insufficient levels of vitamin D,” says Adrian Gombart, a principal investigator with the Linus Pauling Institute at Oregon State University. “This is a critical issue as we learn more about the many roles it may play in fighting infection, balancing your immune response, helping to address autoimmune problems, and even preventing heart disease.”

People with diabetes may have even lower levels of vitamin D, according to a review last year in The Diabetes Educator. People at risk of diabetes and the metabolic syndrome (or syndrome x) also have low vitamin D levels.

Recent research found that 19 percent of people with type 2 diabetes probably suffer from major depression and an additional two-thirds of us have at least some depressive symptoms. People with diabetes are twice as likely to be depressed as other people.

Likewise, people with very low levels of vitamin D circulating in their blood are much more likely to be depressed that those with normal levels. This is the result of new research presented at this month’s American Heart Association Scientific Conference 2009 in Orlando, Florida.

Heidi T. May, M.D., and six of her associates from Utah’s Intermountain Medical Center started by testing a hypothesis. They wanted to see if the dramatic increase in depression during the past century and the reduced exposure to vitamin D from the sun were connected. We get less sun now as we spend more time indoors and cover ourselves ever more effectively with sunscreen whenever we go out.

The researchers studied 8,680 people who had both a cardiovascular event — heart trouble — and a measured level of vitamin D. Only those with a diagnosis of depression upon hospitalization satisfied their definition of depression.

Then, they divided the people into three groups based on their vitamin D levels. A normal level, they decided, was more than 30 ng/ml (other researchers like Dr. Neil Binkley set the normal level higher, at 40 ng/ml or even more). A low level was 15-30 ng/ml. A very low level was less than 15 ng/ml.

After following their subjects for more than a year, the researchers found that those who had very low levels were one-third more likely to develop depression than those with normal levels. The association was even stronger among those with no prior diagnose of depression.

Tellingly, the association was also especially strong in December, January, and February. Even Utah, where the people they studied live, doesn’t have as much direct sun in winter.

Everyone needs to know his or her levels of vitamin D. Those of us who have diabetes have an extra reason, and anyone who also gets depressed doesn’t need to think twice.

The first step is to have a lab test your levels of vitamin D. You can order a standardized test through your doctor or get one directly from GrassrootsHealth. This is a blood spot test kit to be used at home, unless you are unlucky enough to live in New York. GrassrootsHealth tests my levels every six months.

The second step is to decide how much vitamin D to take. “New evidence indicates that the intake should be 2,000 IU per day,” GrassrootsHealth says. “Intake of 2,000 IU/day is the current upper limit of the National Academy of Sciences, Institute of Medicine, Food and Nutrition Board. New evidence also indicates that the upper limit should be raised substantially. The levels that are needed to prevent a substantial proportion of cancer would also be effective in substantially reducing risk of fractures, type 1 childhood diabetes, and multiple sclerosis. Greater oral intakes of vitamin D3 may be needed in the aged and in individuals who spend little time outdoors…”

Others recommend a much higher level, 5,000 IU per day or more, as I wrote in my most recent essay here. As I also wrote in that essay, vitamin D seems to treat a huge range of conditions. Now add depression to that long list.

This article is based on an earlier version of my article published by HealthCentral.

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  • benefits of vitamin d3 at

    When it comes to the how vitamin D benefits your overall health in a lot more ways than is commonly known. The ‘sunshine’ vitamin, as it is sometimes called, is commonly known for its effect on strengthening the bones and joints in the human body by aiding the absorption of calcium. It also helps the body build up immunity. Our bodies can produce vitamin D on it’s own, if we have enough sun (at least an hour a week). Alternatively, it is often added to certain foods such as milk, egg yolks, fatty fish, sardines, mackerel, tuna and salmon. These vitamin d rich foods are known to be a significant source of omega 3 fatty acids. Cod liver oil capsules are one of the most common nutrient and Vitamin D dense supplements. I’ve found that adequate vitamin D levels are absolutely essential for maximized living. I hope that is helpful to you.

  • Dale Hubbard at

    I would like to know what is a good brand of D3 their are so many to choose from?

    • David Mendosa at

      Dear Dale,

      Personally, I use one of the big brands, NOW. I know that it works, because I have had my level of D3 tested and it is right were predicted from the amount I take. I buy 5000IU capsules from iHerb.com


  • isaac at

    Other than bone fractures, keep in mind that prospective, randomized, placebo controlled trials still need to be done here. Correlation does NOT equal causation. And oral vitamin D may not be the key. Perhaps there are pleiotropic effects of being in the sun and vitamin D just happens to be a good marker for that sun exposure.

  • Scott at

    We work with healing depression and diabetes without medication . One of the findings is that sunscreen blocks vitamin D. The uses of sunscreen in the 1990’s caused vitamin D lack.
    15 minutes in the Sun gives you a days supply of vitamin d. Sunscreens are NOT natural!
    Here is a way to help diabetics http://ezinearticles.com/?Borderline-Diabetes?-Why-You-Must-Know-the-New-Normal-Blood-Sugar-Levels&id=3610925

  • Bill at

    I follow Dr. Art Ayers on his excellent blog:

    This is his reply to my comment.

    Dr. Art Ayers said…
    I think that your experiences with vitD are rather common. It is difficult to get over the hump to beneficial levels of vitD. I think that also reflects an inability to produce vitD in the skin as a result of residual chronic inflammation. When that level is passed, then the sense of well being is one of the symptoms and the serum level rises.

    Only time will tell, but I’m going with my considered decisions on health and lifestyle.
    Arthur de Vany and his approach is my aspiration.

  • Bill at

    I’m 55 and I’ve been on a paleo diet for 3 years and will be for life. Also just starting HIT muscle work, guided by Doug McGuff and Body by Science as a means to gain lean muscle and strength.
    Vitamin D3, 6000iu per day for 9 months. 25(OH)D levels @ 54.7 ng/ml.
    I upped the dosage to 10,000iu and within 2 weeks, my mildly painful shoulder has greatly improved. I want to in the 70-80 ng/ml range. Sense of well being has also had a boost and more motivated.
    In my opinion vitamin D3 is the most important supplement to take.

    • David Mendosa at

      Dear Bill,

      I’m with you totally! I have been taking at least 10,000 IU of vitamin D daily for a year or two. During that time I also noticed that my mildly painful shoulder no longer hurts even with my pack. But until you wrote I never realized that the vitamin D could have been why!

      Best regards,