Vitamin D Deficiency Causing Depression & Fatigue

Vitamin D is a fat-soluble vitamin that is essential for absorbing enough calcium and phosphorus for the body. It is needed for bone growth, mineralization and remodeling. According to the Office of Dietary Supplements, a vitamin D deficiency causes the bones to become brittle, thin and misshapen. Vitamin D also plays an important role in maintaining healthy immune and neuromuscular function in the body, and a deficiency can cause symptoms of fatigue and depression.

Significance

According to Merck Manuals Online, vitamin D is initially stored in the liver and present in two forms: vitamin D2, or ergocalciferol, and D3, or cholecalciferol. These forms are not active in the body, but need to be converted by the liver and kidneys to calcitrol, the active form of vitamin D, which promotes the absorption of calcium and phosphorus through the intestine. Vitamin D is called the sunshine vitamin because although it is present in few foods, the body will manufacture it when exposed to sunlight. It is found naturally in fatty fishes and fish oil, egg yolks and fortified foods, such as cereals.

Deficiency Symptoms

It almost impossible to obtain adequate amounts of vitamin D through foods, so most vitamin D deficiencies result from the body not being exposed to enough sunlight. According to Vitamin D Deficiency Symptoms, a vitamin D deficiency can be especially troublesome in women, and certain symptoms, such as depression, mood changes and worsening of premenstrual syndrome, might be seen only in women. Other symptoms are excessive fatigue, daytime sleepiness, muscle weakness and vision problems. Children can develop a softening of the bones called rickets; in adults, osteomalacia or osteoporosis can occur. A vitamin D deficiency might play a role in the development of colon, breast, ovarian and bladder cancer.

Testing
Initially, blood tests are performed to determine the levels of calcium and phosphorus in the body. According to LabTestsOnline, if the levels of calcium and phosphorus are low, the level of 25-hydroxyvitamin D might be checked to confirm a vitamin D deficiency. Low blood levels of 25-hydroxyvitamin D indicate inadequate exposure to sunlight and dietary vitamin D.

Treatment and Prevention

The treatment for a vitamin D deficiency includes getting more exposure to the sun and adding a supplement of vitamin D to the diet. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, it takes just 15 minutes in the sun without sunscreen a few times per week to manufacture enough vitamin D. Consult a physician about how much vitamin D supplement to add to your diet.

Risk Factors

According to the Office of Dietary Supplements, some people are more at risk for developing a vitamin D deficiency. Breastfed infants might not receive adequate amounts of vitamin D through breast milk. People over 50 have decreased abilities to manufacture vitamin D through the skin and kidneys, and elderly, home-bound people might not get enough sunlight. Those with darker skin have larger amounts of melanin, which can reduce the amount of vitamin D absorbed from sunlight. Those with fat malabsorption or who have undergone gastric bypass surgery also are at risk.

Why You Need More Vitamin D

A few years ago, vitamin D was nothing more than calcium's wingman, a secondary nutrient that helped the bone-building mineral make its move from the belly to the bloodstream and eventually plant itself in the skeleton. Well, no offense to C, but new research suggests that vitamin D may be one of the best vitamins of all for your body. The lab guys have uncovered up to 2,000 different genes—roughly one-sixth of the human genome—that are regulated by the nutrient. That means almost everything your body does relies on it.

"It affects cell death and proliferation, insulin production, and even the immune system," says Michael F. Holick, Ph.D., M.D., director of the vitamin D, skin, and bone research laboratory at the Boston University Medical Center.

Translation: Low vitamin D will result in your body working far below its potential. And you're probably not getting anywhere near the right amount. Here's why you'll be hearing a lot more about it and how you can score what you need to avoid a vitaimin D deficiency and make your body function at its absolute max.

Nutrition's New MVP
What's most remarkable about vitamin D is the sheer number of health issues it's been linked to. In the past few years, studies have shown that a lack of the vitamin may be the primary culprit in depression, heart disease, pregnancy problems, birth defects, skin and other cancers, and multiple sclerosis.

Even if you don't suffer from any of these conditions, getting more D may still be what the doctor ordered. "Many of my patients report a dramatic improvement in their feeling of overall well-being after they increase their vitamin D levels," Holick says. And a number of experts, including those from the Harvard School of Public Health, have urged the government to raise its recommended daily amount of vitamin D for adults from 200 IU to at least 1,000 IU, possibly more.

Why We're D-ficient
According to a report in the Archives of Internal Medicine, experts believe that up to 77 percent of Americans are vitamin D deficient (defined as having blood levels of less than 30 nanograms per milliliter).

So why do we come up so short, especially since vitamin D is one of the few vitamins our bodies can actually make? Sunlight converts a cholesterol-like substance naturally found in the skin into D. Problem is, thanks to UV rays and skin cancer, soaking up sun to make more D would do you more harm than good. For your skin to make enough, you'd need direct midday summer sunlight on a huge portion of your body for 15 minutes a day—risking serious sun damage.

Besides, it wouldn't help much, Holick says. If you live north of Atlanta, it's impossible to get enough D from sunlight between October and March, no matter how exposed you are. And it's tougher for people of color to make D—the melanin in dark skin decreases vitamin D production by up to 90 percent.

To make matters worse, D is missing from the food we eat, says Beth Kitchin, M.S., R.D., assistant professor of nutrition sciences and patient educator in the Osteoporosis Treatment and Prevention Clinic at the University of Alabama at Birmingham. Only certain kinds of fish and fortified dairy have enough D to brag about, and it would be hard to consume enough of both in one day to get 1,000-plus IU.

Easy to Swallow
There's a simple way to get your D up without baking in the sun. It's not often that nutrition experts say it's better to get a vitamin from a pill than from food, but D is an exception. "In this case, supplements are the easiest, cheapest, and safest way to make sure you're covered," says Laura Armas, M.D., assistant professor of endocrinology and a researcher in the Osteoporosis Research Center at Creighton University in Omaha, Nebraska.

Can you OD on it? It's possible, but extremely unlikely. Vitamin D is fat-soluble, which means you won't pee out the excess as you would a water-soluble vitamin like C. This used to worry experts, who thought that D could easily build up to toxic levels. But further study has found that our bodies can handle a lot more than previously understood. "You'd have to ingest 10,000 IU every day for six months before you'd even begin to approach problem levels," Holick says. It's much more likely you're not getting enough, he says. A few ways to get your D intake up to par:

• Take a daily multivitamin or a vitamin D supplement that provides at least 1,000 IU. In addition, Holick says, drink two glasses of skim milk per day.

• When buying supplements or fortified foods, make sure the label reads "D3." This is the same type the skin makes, but some companies still use D2, a plant-based form of the vitamin that the body doesn't metabolize as easily.

• Get your blood levels measured, especially if you have a family history of heart disease, cancer, or depression. If you are extremely low, your doctor might recommend higher doses of D.