Vitamin D and Mood Disorders Among Women: An Integrative Review

Sources of Vitamin D

Vitamin D is metabolized from dietary sources and from ultraviolet B (UVB) sunlight. However, the majority of women in their childbearing years who reside in the United States have vitamin D insufficiency and/or deficiency that results from lower amounts of UVB exposure because of lifestyle preferences, work schedules, and fear of skin damage and cancer.^[8,9] Protective clothing and sunscreen are often used as barriers to UVB exposure, which prevent the skin's ability to manufacture adequate levels of vitamin D. Darker skin pigmentation also limits the skin's ability to manufacture vitamin D from UVB exposure. Therefore, dietary sources of vitamin D are essential in attaining adequate levels of vitamin D to meet daily requirements.

Only a few foods contain vitamin D naturally; these include oily fish (salmon and mackerel), cod liver oil, irradiated mushrooms, and egg yolk.^[10,11,12] Foods fortified with vitamin D may include milk, orange juice, yogurt, cheese, cereal and breads, although the amounts of vitamin D vary, and several servings need to be consumed to meet the minimum daily requirement of vitamin D.^[6] Dietary supplements can either contain vitamin D₂ or vitamin D₃. Vitamin D₃ is thought to have greater efficacy in elevating serum 25-hydroxyvitamin D (25[OH]D) levels compared to vitamin D₂.^[13]

The dietary intake of vitamin D that is required to obtain optimal levels of serum vitamin D to maintain many body functions is debated by leading researchers.^{[1,14,15,16,17]} Currently, the Institute of Medicine has established the adequate intakes (AI) of vitamin D at 200 IU/day for adults up to 50 years of age, 400 IU/day for adults aged 51 to 70 years, and 600 IU/day for adults over 71 years of age.^[11] A recent risk assessment of vitamin D revealed that these AIs are too low to maintain optimal vitamin D status and concluded that the safe upper limit of daily vitamin D intake should be 10,000 IU/day.^[14]

Cite this: Vitamin D and Mood Disorders Among Women: An Integrative Review - Medscape - Sep 01, 2008.

Research Studies Evaluating the Association of Vitamin D and Mood Disorders
Type of Mood Disorder	Author, Year	Type of Study	Sample	Measurement Instrument	Key Findings	USPSTF Rating
Major depressive disorder	Eskandari et al., 2007	Comparative descriptive	n=131; 21–45 years old; 121 white F, 10 nonspecified race	DSM-IV	25(OH)D significantly lower in women with MDD compared to controls (27±10.1 ng/mL vs. 34±14.4 ng/mL; P<.002)	Fair
Mood disorder	Wilkins et al., 2006	Comparative descriptive	n=80; =60 years old; 50 F, 30 M; 70 white, 10 AA; 40 with mild Alzheimer's, 40 non-demented	Depressive Features Battery; Depressive Symptoms Inventory	Vitamin D deficiency significantly associated with mood disorder (Wald X₂=7.66; df=2; P=.022)	Fair
Major depression	Schneider et al., 2000	Comparative descriptive	n=56; 18–85 years old, healthy; 12 F, 19 M; major depression: 14 F, 11 M*	DSM-III-R	25(OH)D serum levels not correlated to participants with major depression	Fair
SAD	Gloth, Alam, and Hollis, 1999	Randomized clinical trial	n=15; 15–61 years old; 14 F, 1 M; all white; all diagnosed with SAD	Hamilton Depression Score; SIGH-SAD; SAD-8	Increase in 25(OH)D significantly associated with improvement in depression scale scores (r²=0.26; P=.05)	Fair
PMS	Thys-Jacobs et al., 1995	Comparative descriptive	n=46; 28–42 years old; all white F	Self-recorded diary of PMS-related symptoms	PMS group had significantly lower 25(OH)D levels than controls (19.5±7.5 vs. 25.3±8.3 ng/mL; P<.02)	Fair
Seasonal mood changes	Harris and Dawson-Hughes, 1993	Randomized clinical trial	n=250, 43–72 years old, all white F	POMS questionnaire	POMS scores were not correlated with 25(OH)D serum levels	Fair

25(OH)D = 25-hydroxyvitamin D; AA = African American; DSM = Diagnostic and Statistical Manual of Mental Disorders; F = female; M = male; PMS = premenstrual syndrome; POMS = profile of mood states; SAD = seasonal affective disorder; USPSTF = U.S. Preventative Services Task Force.
*Study included because half of participants with major depression were female and therefore the study met the inclusion criteria.

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Vitamin D and Mood Disorders Among Women: An Integrative Review

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