Vitamin D and Mood Disorders Among Women: An Integrative Review

Pamela K. Murphy, CNM, MS, IBCLC; Carol L. Wagner, MD


J Midwifery Womens Health. 2008;53(5):440-446. 

In This Article

Overview of Vitamin D and Its Effects on Disease Processes

Findings in published articles using the Nurses Health Study (NHS) database suggest there is an increased incidence of colon and breast cancer in postmenopausal women who have low vitamin D levels.[27] Garland et al.[4,28] conducted a pooled analysis of two studies with 1760 participants and found that women with serum 25(OH)D levels of more than 52 ng/ml had a 50% lower risk of breast cancer compared to women with levels less than 10 ng/ml. Giovannucci,[29] in a literature review of colon cancer risk associated with vitamin D, found that higher UVB exposure and dietary supplement intake of vitamin D has an inverse relationship with the incidence of colon cancer.

The risk of developing autoimmune disease such as multiple sclerosis (MS),[30,31] rheumatoid arthritis,[32,33] or type I diabetes mellitus (DM)[34,35,36,37] is reduced in persons with adequate levels of vitamin D. Hypponen[35,37,38] found, in an epidemiologic study in which confounders such as UVB exposure and diet were not controlled for, that children who consumed 2000 IU of vitamin D daily during their first year of life had 80% less risk of developing type I DM compared to those who took less than this amount. In a cohort of women from the NHS and NHS II, the risk of developing MS was reduced by 40% for women who consumed 400 IU of vitamin D daily.[30,39] In a follow-up study, for every 20 ng/mL increase in serum 25(OH)D among 444 white participants, the risk of developing MS was reduced by 41% (odds ratio, 0.59; 95% confidence interval, 0.36–0.97; P=.04).[30,39]

Historically, bone health maintenance has been attributed to adequate levels of vitamin D. Chronic vitamin D deficiency leads to serum calcium deficiency, which in turn can cause osteoclastogenesis, dissolving the skeletal matrix, releasing calcium into the blood stream and thereby decreasing BMD.[16,40] Bone disorders, including rickets and osteoporosis, are associated with serum 25(OH)D levels less than 10 ng/mL and 25 ng/mL, respectively.[7]

Several studies have suggested that there is an association between vitamin D deficiency and many mood disorders, including major depressive disorder, seasonal affective disorder (SAD), premenstrual syndrome (PMS), and other depressive disorders not otherwise specified. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV),[41] a major depressive disorder is diagnosed when a person exhibits at least five of the following symptoms during a 2-week period most of the day, nearly every day: 1) depressed mood; 2) loss of interest or pleasure in daily activities; 3) significant weight loss or gain; 4) insomnia or hypersomnia; 5) psychomotor agitation or retardation; 6) fatigue or loss of energy; 7) feelings of worthlessness or inappropriate guilt; 8) diminished ability to concentrate or make decisions; or 9) recurrent thoughts of death with or without plans for suicide. The client must experience either depressed mood or loss of interest or pleasure for a diagnosis.[41]

PMS symptoms include markedly depressed mood during the last week of the luteal phase that reside within a few days of the onset of menses.[41] SAD symptoms are similar to those of major depressive disorder, but they occur and then resume spontaneously during a particular time of year.


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