Anxiety and Vitamin D

Most people agree, especially if you live in an overcast climate like we do in the Pacific Northwest, they feel happier on a sunny day than a gloomy day. Why is this? There is a definite relationship between the sunlight and our mood. Many people know humans get vitamin D from the sun. Is it perhaps this vitamin D that makes us happy? If so, what other things does vitamin D do?


Let's first talk about some myths of vitamin D:

• People in sunny climates usually have normal or above average vitamin D.

Answer:  MYTH

The truth is, no matter where you live, you are likely to have a deficiency in vitamin D if you're not already supplementing. What's more, even if you aren't frankly "deficient", you are likely to have sub-optimal levels. Although vitamin D is made in the skin when the skin comes in contact with sunlight, most of the time we aren't getting the right type of sun rays or even getting the right part of our body in the sunlight in order to make the vitamin D.  

• I probably get enough vitamin D from my food since I eat a well-balanced diet.

Answer:  MYTH
Unless you eat mushroom-covered cod steak with cups of fortified milk all day long, you most likely are NOT getting enough vitamin D from your diet. Vitamin D is not readily found in fruits and vegetables, like most other vitamins. For that reason, most people need to supplement with vitamin D.

• Vitamin D is toxic at high doses.

Answer:  MYTH (probably)
Although vitamin D is a fat-soluble vitamin meaning that it stores in your fat cells, high vitamin D status tends to optimize immune function, decrease pain, decrease allergies, and support healthy cognitive function. The only negative side effect I've seen with high vitamin D levels is increased calcium absorption which increases risks of things like calcium kidney stones. I generally target about 70-100 ng/ml as  the ideal range for my patients' vitamin D levels. 

• My vitamin D is within normal limits; I don't need to supplement.  

Answer:  MYTH  (probably)

The truth is, the normal reference range for vitamin D is quite wide - for most labs it's 35 - 100 ng/ml.  What I've seen in most of my patients is they feel the best when their vitamin D levels are as close to 100 as possible (between 70-100 ng/ml ideally). So, unless your vitamin D is already very close to 100 ng/ml, you might feel even better with more vitamin D. 


Ok, so maybe I need to take vitamin D…now what can it do for my anxiety?  
One thing we do know is that vitamin D acts in the body a bit more like a hormone than like a true vitamin. That is to say, vitamin D is responsible for signaling more than it is used as a cofactor for different processes to occur, like most other vitamins.  
Many are aware of the relationship between vitamin D and mood issues like depression or seasonal affective disorder (SAD). Most people aren't aware of the connection between vitamin D and the frustrating feeling of anxiety.  It may make sense that if vitamin D can send a signal to your brain that it is happy (i.e. not depressed), then it may also be able to signal to the brain that it is content (i.e. not anxious).  
In fact, that's exactly what happens.  


Vitamin D and Neurotransmitters

Just as a lack in the production of serotonin is one reason why a person may experience depression, an overall imbalance in the neurotransmitters is one reason a person may experience anxiety. One of the roles of vitamin D in the body is to assist in the release of neurotransmitters, such as serotonin, dopamine, and norepinephrine. Although the exact mechanism of vitamin D deficiency triggering anxiety is not well understood, it seems to be most related to this effect of the vitamin D in signaling appropriate release and metabolism of the neurotransmitters.  


Joe, the anxious teenager

Joe, youngest of 4 (and the only male child) was in the midst of his freshman year in high school. His mom and he came to see me with a chief complaint of anxiety and chest tightness.  For a 15-year-old, this is a pretty rare complaint in my practice. The boy was not athletic, preferred technical work over anything outdoors, and lived in the PNW. We checked his vitamin D levels at the first office visit: they came back at the lowest I had ever seen - 9 ng/ml!!!  

I couldn't believe it!  

We started oral doses of 20,000 IU daily + a weekly dose of 100,000 IU to help raise his vitamin D levels. After a month of oral supplementation, his vitamin D level rose to 34 ng/ml. More important though, he reported less anxiety and sleep had even improved.  


How much vitamin D is recommended daily?

If you ask the FDA, the Recommended Daily Intake (RDI) for vitamin D is 400 IU - yes four HUNDRED. Every doctor has his/her own opinion about the best daily dose of vitamin D, but in general, most doctors recommend at least 2000 IU daily for adults.  This dosing can be much more liberal if a full health assessment has been made.  


One last thing…

There is usually more than one thing contributing to a person's anxiety. Most of the treatment plans I put together for people have a few items geared towards modulating anxiety. Almost always, though, vitamin D is one of the first things on the list.