Vitamin D and Depression (2020) | Hacker News Reader

Vitamin D and Depression (2020)

ncbi.nlm.nih.gov

296 pointspmoriarty211 comments

Daily morning and afternoon exposure to bright light might actually be more important to reducing depression than direct vitamin D supplementation. Low vitamin D might just be an indicator that you are not getting enough sunlight. Sunlight also affects melatonin and serotonin levels, and synchronizes your Circadian rhythm. Not sure why that article doesn't talk about Seasonal affective disorder (SAD), and how bright light therapy is considered an effective treatment for it.

Anecdotally agree with this. I have vitamin D deficiency, was given 50,000 IU a week vitamin D to get it up. Never worked.

Went to the beach one week and got blood tested again and my vitamin D levels climbed significantly. Now I make it a point to get outside and sunlight

A lot of modern "problems" can be solved this way. The term koyaanisqatsi comes to mind, life out of balance.

Had super low Vit D. Was stuck in bed for a year. A few months of Vit D and a few other diet and supplements changes and I was out kayaking every weekend.

My experience anyway

What dose and diet changes did you do?

3,000u daily. Switched to AIP diet.

Six months earlier had started. Started magnesium, b12, fish oil, Vit E.

Now I take a 5000u/k2 combo.

Now on LDN in addition That seems to be the final major piece to fully normal life.

AIP diet: autoimmune protocol diet.

https://www.healthline.com/nutrition/aip-diet-autoimmune-pro...

The heaviest man in Mexico was bedridden for years. He was depressed, but besides being humongous, and trapped in a bed; one of his biggest complains was muscle aches.

A doctor gave him vitamin D supplements and he said the pain went away.

It made a bit of sence to me, but the amount of food this guy consumed daily was staggering. I just wouldn't think a person would be deficient in D with the amount of animal products this man consumed. I just assumed even though he never saw the light of day for 15 years.

My point is it just suprised me.

Antidotially, I have been depressed (dysthymia--low level) for a good 30 years, and found sunlight didn't help me. I don't eat a lot, but i'm not a vegetarian either.

I actually feel better during the winter. I do have allergies though.

According to my doctor, all he ever said about depression is "All my patients are different. Oh, my fee will be $----. Your depression is situational.". I know he is partially right. (He doesn't overcharge me compared to the horror stories I have heard here. I just believe most psychotropic drugs should not require more one office visit, especially if you are on a low dose, and not abusing them.)

> was given 50,000 IU a week vitamin D to get it up.

It should have gone up significantly. I wonder if your body has a problem with Vit D absorption. I was put on the same dose of vit d for a treatment and I felt it within 20 minutes.

Is vitamin D fat soluble? If so, pretty sure it needs to be consumed with fat. That's partly why it's common in milk.

It is fat soluble, but it doesn't need to be consumed with fat. It's believed that that will help improve uptake, though. (I don't, I take it in the mornings long before my first meal and that seems to be effective for me based on my test results.)

https://www.jandonline.org/article/S2212-2672%2814%2901468-3...

"The mean peak (12-hour) plasma vitamin D-3 level after the dose was 32% (95% CI 11% to 52%) greater in subjects consuming fat-containing compared with fat-free meals (P=0.003)."

It's common in milk because it helps with calcium absorption.

This is correct:

https://www.bones.nih.gov/health-info/bone/bone-health/nutri....

Takes months to rise your vitamin D levels.

This. It is amazing how long blood pressure pills, cholesterol pills, and vitamins take to make a budge in your blood tests.

>Went to the beach one week and got blood tested again and my vitamin D levels climbed significantly.

Well, I think I just justified my beach vacation. Thanks!

The point was that sunlight does more than raise vitamin D, not that it's better than supplementation at raising vitamin D.

In rare cases, hypovitaminosis D can be a symptom of heavy metal toxicity. If someone is getting adequate vitamin D intake but levels are still low then it can be worth testing for metals levels.

https://www.tandfonline.com/doi/abs/10.1080/07315724.1994.10...

Came here to say this:

VD may be it, or even indirectly a measure of 'not getting outside' enough.

Even the sunlight may not be it, literally a walk in the woods might be providing the effect.

Or rather 'spending too much time in our own minds' etc..

Bright, direct light seems to be a major component, which is not what most people think of being in the "woods." See:

https://news.ycombinator.com/item?id=31306477

I am thinking the same, and in a midst of self experiment where I ensure I get a decent dose of just seeing the world in bright daylight. Week into it and my sleep feels pretty solid. Easy to avoid daylight when working indoors all day.

Latitude matters though. The farther north you are the more time in the sun you’d need. In some far north places, the sun you do get is not strong enough to get any Vit D.

http://web.archive.org/web/20210302053343/https://jaoa.org/a...

https://www.grassrootshealth.net/document/sunshine-calendar/

Indeed, the UK which is further north than the majority of Canada's population has effective vitamin D from the Sun only from March to September. Spring Equinox to autumn equinox basically. The sun is too low even though it might be much warmer than lower latitudes!

Yurp. I live in the south of England and even here I take vit D for pretty much that time period or I end up with little to no energy. I always make sure to go outside as much as I can, but when the sun is coming up at 8am and has gone down by 6pm it's pretty hard to get enough daylight and also work.

Worse in Edinburgh. Sunset is at 4pm for god's sake.

Greetings from Reykjavík Iceland

In the Southern Hemisphere (yes, people do live south of the equator) this advice is complicated by the ozone hole causing the risk of skin cancer to be much higher than in the northern hemisphere.

Sunlight’s effects on body chemistry also have a damping effect on inflammation. It’s a funny thing.

Sunlight has an impact on many chemical processes in and on the body. One example: Our skin is coated with a bunch of chemicals. There’s a number of different acidic chemicals. These are known as the “acid mantle”: https://en.wikipedia.org/wiki/Acid_mantle

One of these substances is urocanic acid. The body manufactures it as the trans-isoform. UV light – as in sunlight – causes it to change into cis-urocanic acid. (Ultraviolet-induced isomerization.)

Cis-urocanic acid fits a certain serotonin receptor – type 5-HT2A. Cis-urocanic acid is a 5-HT2A agonist. That receptor is known to be profoundly immunomodulatory.

It’s super interesting! There are some recent papers on it like “ Cis-urocanic acid, a sunlight-induced immunosuppressive factor, activates immune suppression via the 5-HT2A receptor” – https://pubmed.ncbi.nlm.nih.gov/17085585/

“Molecular basis for cis-urocanic acid as a 5-HT2A receptor agonist” – https://www.sciencedirect.com/science/article/pii/S0960894X0...

This is absolutely fascinating. I think people take me as a crackpot when I point to these papers. These are just simple and solid papers from molecular biology :)

You, sir, just blew my mind. I have some reading material to go through. This is fascinating indeed!!

I’m so glad to be able to share these papers with someone!

I have no formal higher-level education in biology btw. Just high-school level or so?

And I had no idea this was a thing – I just found one of these papers purely by accident.

I don’t even remember what I was digging for on Google Scholar. I think it was something related to psoriasis. (It runs in the family.)

I think I might have been trying to look for any hints on whether I was really seeing my psoriasis skin condition improve after starting to take ADHD medication. – And yes, I do believe that is the case, and that it’s related to serotonin.

I feel a little like this might be construed as oversharing – it’s a story about science and I don’t know how to tell it in another way :)

So I got a diagnosis of ADHD at age 39½. A carefully done and clinically sound diagnosis. Many things in my life now make a lot more sense than they did. Whatever ADHD actually is. I turn out to be somewhat of a poster child?, for “internal” ADHD. I respond very well to a small dose of lisdexamfetamine. (Vyvanse in the US. Elvanse over here.) When I started taking it, old friends would say things like”uh… What happened to you? You’re so… composed? serene?” “–Ah, yes. It is all the amphetamine I am taking.”

And I give them one to try? because it’s so mild? And this friend is a lot like me so it can’t be that crazy? And they spend 24 hours with a clenched jaw and can’t sleep for a whole night. Biochemistry is wild.

And after a few weeks I thought my skin condition was improving. It didn’t make any sense. Didn’t even occur to me that it could be the ADHD medication. But then I tried reading about the compound on wikipedia, what it does, what receptors it acts on. And then start looking for papers with kind of random keywords on Google Scholar? Because I didn’t know what I could be looking for or the words for it? And that’s how I found out about cis-urocanic acid. I think mostly because “cis-urocanic acid” seemed like an odd and funny name for a thing. And as I learned later, word-for-word, cis-urocanic acid does have a really odd and funny meaning. It means “this-side dog-pee acid”. “Uro-canic” because that’s where they found it for the first time. And “trans urocanic acid” means “the-other-side dog pee acid”.

And I’m at the computer just going “wh… what? Huh? Lol?”

And yes, as far as I understand it, the lisdexamfetamine does help my psoriasis, and because of some part of its influence on the serotonin balance in my body. Amphetamines are serotonin-releasing agents. I am fascinated by the papers on that part of it but it’s also clear that I can’t speak with any confidence. As I understand it, the ever-so-slight serotonin “venting” caused by amphetamine might do a few things that cause this effect: Slightly downregulates pro-inflammatory serotonin receptors, slightly activates anti-inflammatory serotonin receptors, and sliiiightly reduces the amount of serotonin in the average blood platelet’s payload. (“Wh… what? Huh??”)

And yeah, on the way there I finally learned why my skin is clearer and less inflamed in the summertime. And why the UV phototherapy for psoriasis works. And the medically prescribed trips to the suntanning clinic in the Canary Islands for the patients with really bad psoriasis? Yep, that’s a thing, and it works, and I don’t think they ever really knew why, and urocanic acid is probably a big part of the reason it does, and even if those papers are out, I bet that the dermatologists don’t know about them because there’s just so much science out there.

And we have no idea how easily accessible it is. My dermatologist probably doesn’t know about Google Scholar? And certainly not sci-hub. Or the amazing discussion between scientists one can find on Twitter.

Funny thing right!!

I'm glad you're getting to the bottom of your health issues. Sounds like you're on the right track.

I'm fascinated by it because of my history:

I've had acne my whole life. Starting at 11, I'm 39 now. Still have it. I've tried every medication known to man. Nothing works. Dermatologists can't explain it, they just give me the same canned answer "You produce too much sebum". "Ok, how can we control that?". "We're trying".

I take two showers a day to try to ward off the sebum oil from clogging my pores. I wash my face, hands, and all multiple times a day and wipe with clinical strength salicylic acid (6% instead of 3% you can get over the counter).

Still, nothing works. Except one thing which could have adverse affects on me later. The Sun.

When I get a tan, all my acne clears up for a brief while. Maybe that's the cis-urocanic acid doing it's thing. Maybe it's the sun burning that sebum and sealing the pore. I'm not sure. I'm pretty sure I'll get skin cancer if I continue this line of "treatment" but I'm out of options. It's ridiculous.

It's on my face, my arms, my back, my ass, my legs, my chest and has been since middle-school. I'm ready to just graft the whole body.

So thanks again as I have some other avenues to discuss with my doctors as well as some research to show them.

I assume you looked into Accutane treatment? It has worked wonders for multiple people I know.

I was on Claravis for 8 months with no improvement. Still looking for a remedy, even if just temporary.

I will say that initially Accutane worked. For the first few months it cleared up the acne on my face but after a few more months it came back with a vengeance.

> That receptor is known to be profoundly immunomodulatory

Any change for a layman's explanation on what that means? This seems super fascinating but admittedly above my understanding.

immunomodulatory (immuno-modulatory) = modulates (i.e. controls) the immune system

It’s actually quite reasonable and intuitive that an integral part of our environment i.e. the sun is beneficial or at least has modulatory effects on ourselves. It’s too much a reductionist approach to think sunlight -> bad because of it’s immediate associations with some types of skin cancers.

Anecdata: I grew up in LA. I was always relatively healthy. Moved to NYC. Developed autoimmune disease by my 6th year in NYC.

I often wonder if I would have developed the disease if I had stayed in LA.

I think changing location does have a huge effect. Personally when I go to LA or SF (from Texas) I get sick 100% of the time, without fail.

For some reason I was often sick when I lived in Stockholm (Sweden). A friend there mentioned having the same problem.

Stockholm Syndrome?

people in the past would grab a small jar full of dirt from home and drink it whenever countering some ailment, I actually think that'd still work due to the recent researches on gut bacterial and it's influences on immune system and all...

Who, where, and when? Not doubting just curious about the practice.

I never heard or read about this and I used to read about past practices a lot. Who, when and where? I mean, which social class, which place and period and how prevalent it was?

There is actually real science behind this idea of drinking your home dirt (I'm not sure if its apocryphal or anecdotal). The reason many people experience stomach upset or constipation while on vacation is because their gut micribiome is unaccustomed to the new environment.

And yet lots of dermatologists will tell you to avoid sunlight.

The medical community is full of contradictions.

Everything in moderation.

EDIT: Except lava.

At first I read "except Java"

Lowercase L looks like capital i in some fonts.

Clearly it's Iava, the Latin word for Java. Quidquid Iava quondam scribum, omni currum, sed delenda est.

sed delenda est? sed sed editor consuetus textorum est!

Still true

The floor might be lava.

Until recently not going out much wasn’t a big factor.

I’ve been feeling sicker than usual lately. Stupid amount of rain in NSW. Went out yesterday morning on a bright sunny day and suddenly I felt much better.

>> The medical community is full of contradictions.

We added iodine to salt to prevent deficiency, then decades later told everyone to avoid salt. I've found iodine to be a huge piece of the puzzle - certainly not a panacea but one of several go to solutions.

The American Heart Association recommends no more than 1500 milligrams of sodium per day.

Because sodium is being added to packaged and processed foods, the average American was getting way more sodium than the recommended amount. And given the number of obese people and those with hypertension who are salt-sensitive, lots of people were getting way more sodium than was healthy for them.

There's also ample evidence that 1500mg is too low. https://www.webmd.com/food-recipes/news/20140402/cdc-salt-gu....

Unlike white sugar which seems to be bad for humans in nearly any amount, salt is an essential nutrient. I suspect it was so demonized as an attempt to deflect blame off of other food additives such as sugar. Low sodium diets may make sense for people with high blood pressure, but it isn't something that everybody should be doing.

It seems grossly irresponsible to only highlight the dangers of high sodium while ignoring the dangers of low sodium diets.

It's not the total amount of sodium but the concentration of the dose of sodium which will affect your blood pressure.

see https://www.youtube.com/watch?v=LbSic4Oo8ME&t=420s

So if your food tastes salty, you should drink more water to dilute the concentration (and hopefully you won't drink so much water to induce hyponatremia - it's a balancing act).

Later in the above-mentioned YouTube video, the doctor mentions that drinking water before you get that thirsty feeling is better for you.

By the time you get the thirsty feeling, your body has switched over to converting glucose to fructose, etc.

I recently listened to a great podcast [1] on the importance of salt and its role in proper brain functioning—the host is a tenured professor of Neurobiology and Ophthalmology at Stanford.

Part of the into: Additionally, I examine research findings suggesting that some individuals might benefit from increased intake of sodium and other electrolytes (magnesium and potassium) to enhance mental performance, lessen anxiety, and offset dizziness. Yet, other people may need less sodium. I discuss how you can determine your optimal sodium intake and why sodium intake levels need to be uniquely tailored to an individual’s lifestyle.

[1]: https://hubermanlab.com/using-salt-to-optimize-mental-and-ph...

I'm a little shocked at only 2 mentions so far of Huberman on this topic. As you know he goes into great detail here, and a panoply of related health issues.

I don't feel like I tried to do a low salt diet, but I don't eat pre packaged foods and normally cut out skipped salt just because it had such a bad rap.

Recently I started drinking a homemade electrolyte and if I miss it for a few days I can really tell. Increasing my salt and potassium has made my head feel better, I don't get dizzy standing up quickly, I got rid of the always thirsty feeling and my circulation is better (fingers aren't cold all the time).

Why did I make this change? My wife had a bunch of tests. The heart doctor said everything was great and to increase salt in the diet. We eat the same and many of the things I listed were mentioned in her appointment - so I figured it would likely be good for me.

Pass the salt.

Is salt added to processed foods iodated?

Of course not

Usually and in most places, probably not [1].

Some processed food manufacturers have started using iodized salt in some of their products in recent years at least where I live, though. (Northern Europe)

I don't know if that's an entirely a local thing or a wider thing e.g. in the EU. AFAIK the local soil here isn't that rich in iodine and so produce doesn't end up containing as much iodine either. The local food authority ended up recommending that iodized salt be used not only in schools etc. but also in bakeries and the food industry. Apparently some have followed suit, although not to a full extent.

A quick look at some store-bought packaged bread and the package of a frozen baguette I ate last night shows a bit more than half of them have or had iodized salt. That includes, perhaps a little surprisingly, the store-brand frozen baguette. The few other packages I have at hand don't indicate iodized salt but I've heard its use in the food industry has increased from the practically zero it used to be.

So, the answer might be a resounding no or a less resounding one, depending on where you are.

[1] Source: general impression of what I've read and heard, so basically a hunch

Well, the basis for the AHA recommendation is probably bogus. So there's that issue as well.

I … have never in my life heard of salt contributing to obesity. I’ve struggled with being severely overweight. I’m medically monitored for hypertension, both because of my weight history and medication which should increase my blood pressure. I struggle now to keep weight on. Salt is not a factor.

Salt was said to contribute to high blood pressure, not obesity. Congrats on taking control of your health!

> I struggle now to keep weight on.

What was the change you made?

At around 1h16m, Dr. Rick Johnson talks about how the human body on a high salt diet can convert glucose to fructose.

https://www.youtube.com/watch?v=LbSic4Oo8ME&t=4590s

If you're eating a high glucose/carb diet, the body will convert glucose to fructose. Enough fructose will switch your body from fat-burning to fat-storage mode => obesity.

Hypertension (high blood pressure) can be caused by high uric acid levels.

Foods high in fructose and purines (beer, anchovies) will increase uric acid.

I sound like a spokesperson for this video, but watch the video for how fructose (and high purine content food - beer, anchovies et al.) causes high uric acid -> high blood pressure and gout: https://www.youtube.com/watch?v=LbSic4Oo8ME

But most of that salt does not have iodine added.

Cranberries are how I get iodine into my diet. Not-from-concentrate Cranberry juice from TJs, primarily.

Didn't know cranberries contained it. How much every day do you drink ?

Not a lot, 3-4 oz. covers all of your daily iodine needs and then some. I have it with my breakfast because having it later in the day can affect your sleep quality. I learned about this from listening to Stan Efferding talk about his "Vertical Diet."

> The medical community is full of contradictions.

Looking after our physical and mental health via modulation of multitudes of interrelated bodily systems and their unique chemistry and biology is a massive multivariate optimisation problem.

However, there are reasonable heuristics we can use as a guide for better outcomes, for example, "spend more time in nature" - it's probably no coincidence that doing so is reasonably good for us given we've effectively evolved over many millenia to make the most of "being in nature".

Human biology is made up a number of interacting systems, negative and positive feedback loops and other biochemical pathways.

If you focus on individual mechanisms, it looks like contradictions, but as a whole it makes sense.

Sunlight is beneficial for vitamin D production, but harmful when it comes to UV damage.

Both can be true and not contradictory.

And in terms of evolution it makes sense. A lack of vitamin d early in life could effect reproductive success. Skin cancer in your fifties not so much. There just isn't selective pressure.

Another factor to layer on as well!

As humans developed, evolution didn't have to create the optimal system, just a system that gets the organism to reproductive years. After that? Irrelevant.

That could point to the challenge of fixing diseases of aging. A good analogy is programming - if the program you came up with uses 8 bit variables, and that limitation causes problems later, well, you're going to have to start from scratch to fix it.

I think that's about excessive sunbathing, which is a thing in certain circles, and certainly was a few decades ago. These days everybody is sitting inside with their games and streaming services, and I think it would do a lot of people a lot of good to go outside a bit more often. Just don't spend it at the baking in the sun all day long at the beach.

Sunlight exposure also stimulates nitric oxide production, which is important for circulatory system health.

Ah!! This is interesting. Many thanks!

Sometimes I order random supplements on a whim. I don’t remember why I ordered arginine.

It turns out that it very clearly and obviously helps my fiancee’s type 1 diabetes blood sugar control – like, a lot! We have a blood glucose meter and you can kind of just see it on the graph. Takes a while but the blood sugar just kind of obeys control a bit better if she takes arginine.

And it turns out there are a bunch of papers out on that too. I had no idea.

‘Effects of adding L-arginine orally to standard therapy in patients with COVID-19: A randomized, double-blind, placebo-controlled, parallel-group trial. Results of the first interim analysis’ – https://scholar.google.com/scholar?q=arginine%20diabetes&btn...

And it turns out that arginine supplementation seems to help in hospitalized COVID-19 patients. For reasons which make sense – including nitric oxide production and cardiovascular function.

https://pubmed.ncbi.nlm.nih.gov/34522871/

Sunlight having an effect on nitric oxide production could be very important and useful for us to know! To help us manage her blood sugar and that whole biological picture. Thank you very much!

Oops!, please note: I pasted the title of the paper behind the second link… up there by the first link which is a Google Scholar search for “arginine diabetes”. And it’s too late to edit. Apologies!

Thank you for this fascinating comment! I can't wait to read through all of your links.

I just went over 8 years without seeing the sun (jail). I wonder what the long term effects are?

Probably not good, and just one of the reasons why incarceration should be an absolute last resort.

Welcome out!

And when incarceration does happen, it should be in a humane prison where inmates get to go outside and do some normal activity. In too many parts of the world, prisons seem to be designed to be utter hellholes meant to destroy people.

Gahdam, they never put you on the yard?

First 5 years was in a facility with no windows or access to the outside. Last 3 had windows that were too dirty to see out of but some feeling of sunlight came in. That facility had outside, but was allowed out probably 5 hours in total. I burned instantly after all that time without sunlight!

Had a consult with a sleep doctor, he stressed the importance of getting out for morning light for at least 30 minutes with no sunglasses.

Why no sunglasses?

Morning light hitting your eyes has a significant psychological impact. Sunglasses cut way down on that. It’s discussed in one of Huberman’s sleep related podcast episodes if you’re interested

Would wearing glasses, specially blue light blocking glasses make sun's effect on your circadian rhythm less pronounced?

That's interesting. I have Myopia and I permanantly put glasses with Bkue light blocking. I always had trouble with my circadian rythm and very often I find it extremely hard to have a fixed sleeping schedule, let alone sleeping early. I wonder if that has smthng to do with it. I also live in a northern country where the sun is a very rare event, especially during the winter.

If I owned a health insurance company I'd be subsiding rents for people to move to apartments with better sunlight. It would very directly save money.

I'd also cut premiums and copays for people who exercise regularly and track it.

Maybe even give free national park passes and gym memberships to patients.

All this stuff costs pennies compared to the cost of the various treatments that people are needing these days.

> Daily morning and afternoon exposure to bright light might actually be more important to reducing depression than direct vitamin D supplementation.

I don't understand how this is even a question. It's like people have no idea what's doing them good. Sure, I understand that scientific evidence is helpful, but this isn't particularly rocket science?

The difference between being in the sun and taking vitaminD is perceivable. Taking vitaminD doesn't make one feel better even to a fraction of how one feels after hours in the sun.

Good example of correlation and not causation.

I think you are definitely onto something here. I used to take 10k IU vitamin D a day and still felt meh, but getting a bright ass white light (2300 lumens) in my room has uplifted my mood, increased wakefulness, and boosted my general productivity alot. I used to have a warm Phillips Hue and I couldn't do any work in my room without wanting to nap.

Sunlight direct on the retina either without any obstructions or only through eyelids loads an enzyme necessary for serotonin production. The required amount of sunlight on the retina to reduce depression is 3 or more 20-30 minute sessions. It is actually harder than it might seem to get that much every week.

My first winter in NYC was very rough and I didn't understand why at first. I got a blood test at the doc and he said my vitamin D was very low. I committed to walking in the sun at least a half hour a day, weather permitting, and I never really had issues again. Part of the issue was I was spending a lot of time walking outside but not in sunlight due to the tall buildings. Just my anecdotal 2c

I live in Seattle and have been depressed for a while. I had my Vitamin D3 levels checked via blood test, and they were really low. Started taking 5,000 IU per day, and I feel exactly the same as before.

Did you do another blood test to check if the levels changed?

In this and the GP we have Vitamin D and depression in a nutshell.

Check your diet. Just because you take vitamin d supplements doesn't mean it gets absorbed into your bloodstream.

5000 IU is really too much. At best 2000, 2500 IU is good.

5000 isn't too much when you're catching up from a deficiency.

I took 15k IU daily (at the advice of my doctor) for several months at one point to get my levels back up. I don't remember the numbers, but my levels were extremely low.

No, 5000 IU per day is generally considered the highest non megadose. Make sure it is good quality (D3, USP in the US), and it should be fine. Some people say also to take K2 (also make sure it's USP in the US), but I'm not sure the exact supposed mechanism of protection from adverse effects from D3. Something about preventing calcium from leaching from the bones and accumulating in the blood, I think.

"Vitamin D controls the absorption of calcium into the blood. Vitamin K2 controls where that calcium ends up.

"Over-supplementation of vitamin D3 without ample vitamin K2 leads to problems of excess calcium.

"If calcium isn’t laid into bone, it will find itself in other tissues, like your arteries. Calcium in the arteries is BAD. It contributes to atherosclerosis and vessel stiffness."

https://dralexrinehart.com/articles/the-vitamin-d-and-vitami...

It really depends on the person. You just need to monitor your blood levels

I use 60,000 to 90,000 IU's per day and have been doing so for years. The most I have taken in a 24 hour period is 140,000 IU's. There is no way I could have started off at those levels however. It would have induced major hypercalcemia had I done that prior to mobilizing all the stored/misplaced calcium in my gut and vasculature. I am not suggesting anyone else do this. One must have a specific need when doing this.

I only mention this to say that one can go well above the RDA/RDI that are highly contested to be far too low for modern diets, environmental inputs and lifestyles.

> Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day. [0]

I think you may be poisoning yourself.

[0] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...

That would certainly be true had I done that from day one as I had mentioned. Their documentation as with most medical documentation is based on the lowest common denominators. They will not risk explaining why one might do what I am doing.

It seems true without qualification.

What you're saying here has a lot in common with "woo", I hope you realize.

I suppose time will tell. I've been doing this a number of years. I will check back in a few more years to see how things are going. Honestly the cholecalciferol levels are the least taboo of the biohacking I do with myself. The more risky testing I did was to see how high I could go on the tocotrienols, tocopherols and fibrinolytic enzymes before I ran into bleeding.

Aren't you concerned that your data is super subjective as you're collecting it on yourself?

It sounds like there are a ton of confounding variables possible, not to mention your own personal biases in interpreting any potential causality.

It sounds like there are a ton of confounding variables possible, not to mention your own personal biases in interpreting any potential causality.

Absolutely 100% this. For years I was following the scientific method, reading countless papers on PubMed, binge watching videos from micro biologists and eventually reached the conclusion that if I continued down that path my progress would be paralyzed by the scientific method itself. To use those methods properly in a controlled manor would take thousands of years that I simply don't have.

In summary, I have long since dropped the scientific method on the cutting room floor and instead use the "shoot in the dark" or "shotgun" methodologies. I don't have to tell you this comes with many risks, but I have weighed the risks and benefits and concluded that this was the right path for me. Anecdotally I am very pleased with my progress. I have reversed many chronic health issues. I look and feel decades younger than I did a decade ago. That is of course my own biased opinion of which I hold in high confidence. I would never expect anyone else to do what I am doing nor would I try to convince anyone that I am doing the right thing.

As for the original topic of vitamin D3 which isn't a vitamin at all, I stand by my words that the RDA is far too low for most people today given the lack of sunlight exposure, the poor diets, the high levels of stress and inflammation from bad diets and so many more factors. I should add the disclaimer that I am a doctor though most doctors are not really trained in this and what little training they receive in medical school is crammed into their heads and lost as fast as they gained it.

> I stand by my words that the RDA is far too low for most people today given the lack of sunlight exposure, the poor diets, the high levels of stress and inflammation from bad diets and so many more factors.

You aren't qualified to make this statement, doctor or no, especially considering it's in direct contradiction to consensus medical advice.

I agree with you. That is why even after decades of digesting NIH studies, weeding out the epidemiological studies given that to your point most are highly conflated and confounded I have concluded that nobody is qualified to make statements on this topic. Either way time will tell who took the right path. My morbid goal is to outlive all the grandchildren of the people that are my age so that I can give talks on how science has been tainted. Sorry I know that is morbid.

> especially considering it's in direct contradiction to consensus medical advice

The RDA, in general, is not necessarily the same as current consensus medical advice. In fact, ISTR that it has actually been clearly established that the RDA for Vitamin D was, given it's premises, based on erroneous calculations, and that there is broadly accepted clinical evidence that it is too low, but the government just hasn't acted to update it.

We're not talking a few thousand IU above RDA, the person I replied to is 10x higher than the "Tolerable Upper Intake Level":

> The Tolerable Upper Intake Level is the maximum daily intake unlikely to cause harmful effects on health. The UL for vitamin D for adults and children ages 9+ is 4,000 IU. [0]

[0] https://www.hsph.harvard.edu/nutritionsource/vitamin-d/

the 600 IU RDA is clearly a mistake in an earlier publication. it should be 10x that.

The dose they claim to be taking is 100x that, not 10x.

No, 600 IU (15mcg) is the actual RDA. There's a lot of belief that it's an error, but it's not a typographical error.

The actual RDA is not correct.

It is more correct than the research that shows otherwise.

If you skin produces dozens of thousands of IU while staying 20 minutes in the sun, and the RDA is not even a tenth of that, I'd rather wage the RDA is completely wrong and misplaced.

Your skin doesn't do that.

Type 1 skin is 2000 IU's per hour if completely exposed to the sun though someone may call the cops. Type 5 skin is 500 IU's per hour but all of this is moot if one does not have sufficient precursor elements for the D3 process to occur. This involves vitamin D2, C, collagen and a few other elements. I don't remember the whole chain off the top of my head. I'm lazy and just take pills.

That's a crazy amount. I had a very low blood test started supplementing with k2/5000 vitamin d several years ago and my blood levels have been fine ever since.

How much K2 are you taking?

100mcg for each initial 5000 IU's for the day but I stop at 800mcg of K2 MK-7 regardless. I sometimes also take K2 MK-4 in addition to that. I also get a small amount of K2 from eggs.

Unless you are a doctor that has been monitoring the poster, you have no idea if that is true. My blood levels are consistently deficient when I’m not taking 10,000 IU/day (and this is with a fair amount of daily sun exposure.) People have widely varying needs.

It can take a while for your Vit-D levels to rise, even with supplementing 5k IU per day... I would check your levels again.

And, of course, Vit-D is not the only contributor to depression so it might be good to see a GP and/or get a general blood panel done.

I have never felt an affect from oral vitamins in any situation.

Sitting in the sun however seems to do more than just “increase vitamin d levels”. The sensation is just overwhelmingly lovely. It seems to reduce cortisol, makes you feel tired in a euphoric way. Animals love to warm their fur in shafts of sunlight too.

Perhaps we should be thinking more in terms of joyful activities in general and less trying to biohack.

That narrative might work for you, but the bio-hack narrative might work for others.

Maybe the takeaway is to go into things with a positive attitude but also take a personal inventory and adapt if something that is supposed to work doesn’t work for you.

> Animals love to warm their fur in shafts of sunlight too.

Indeed. My dog always lies in the sun for a while when he goes outside. Once he's warm enough, he moves to the shade. Animals know.

My blind cat always seeks sun spots as well!

100% the same for me as well. When I sit in the sun I feel invigorated, I Feel a rush of pleasant feelings throughout my body.

I take vitamin D regularly, 4000iu+, and I don’t feel anything remarkable. With the sun it’s almost an instant jolt of joy.

Yes sunlight makes me extremely tired, like if I go for a walk or a picnic or something I'll end up far more exhausted than anything else can explain. I wonder if it's some kind of overcompensating effect due to my typical lack of it.

Seattle is extremely damp and temperate, so you see a lot of mold and allergens there year round.

If redressing your vitamin D levels doesn't fix it, look for hidden mold and/or allergies.

Since you're in Seattle, check out bright light therapy as well.

Anecdotally, I had to bump up to 10,000 IU to see a difference.

did you get blood work done again though after taking the 5K IUs for a while? it's possible that the supplementation didn't bring your Vit D levels to within range and you need 10K IUs+. Of course, I'm not suggesting this would necessarily help with your depression, but just pointing that you gotta be scientific/anecdotal when it comes to supplementation/blood panels

10k IU's a day is what it took me. I found that value almost by accident, while starting to follow Stan Efferding's Vertical Diet, which recommends that as a part of a suite of daily vitamins (it is much better than the name belies). IMO anyone who works a desk job should take 10k IU's daily. I fell out of the habit during covid quarantine and my levels (and my mood) were dangerously low when I came out on the other side.

5k IUs is well beyond anything your body has a use for, and in fact is above what your body can tolerate! [0]

> RDA: The Recommended Dietary Allowance for adults 19 years and older is 600 IU daily for men and women, and for adults >70 years it is 800 IU daily.

> UL: The Tolerable Upper Intake Level is the maximum daily intake unlikely to cause harmful effects on health. The UL for vitamin D for adults and children ages 9+ is 4,000 IU.

So it's possible your 5k IUs were causing you more harm than good.

[0] https://www.hsph.harvard.edu/nutritionsource/vitamin-d/

Those numbers are wrong by an order of magnitude, because the original estimation was based on faulty math. The actual dose needed to bring serum levels up for most people would be far higher.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210929/

I'm going to go ahead and trust Harvard Medicine over a single study that has since gone largely uncited, and was published in "Nutrients" which carries an h-index of 115 (Nature, for example, carries an h-index of 1226) [0][1].

[0] https://www.scimagojr.com/journalsearch.php?q=19700188323&ti...

[1] https://www.scimagojr.com/journalsearch.php?q=21206&tip=sid&...

You should never judge an article by where it was published (some exceptions of course), only in the quality of the work. Impact factors are loosely a measurement of significance of the work, in terms of how broadly applicable they are to the fields of science. It is absolutely not a strict measure of the expected quality of the article.

Also, for what it's worth, most of the articles referenced in the Harvard Medicine review referring to dosages are from before 2010, so they may be out of date.

And why should I trust you? You've given a decree, "Thou shalt not judge a paper based on where it was published!" and then don't give any reasons why that would be the case.

Also, I'm not qualified to judge a paper by its work quality, I need to rely on the experts in the field for that, and a decent proxy for that judgement is where a paper gets published, so by looking at where a paper was published, I am judging a paper by its quality.

Sorry, I thought my reason was clear from my comment. I did not intend it as a decree you should follow blindly. I’ll expand on my explanation.

Impact factor is not a measurement of an individual article’s quality. It is a summary statistic, a rough measurement for how frequently that particular journal gets cited in other journals.

By judging an individual article by the impact factor of its journal, without reading the article and determing its quality yourself, you bias yourself to whatever those results might be one way or another with a statistic not intended to relay any information about the journal article itself.

You are right that it is a decent proxy where higher impact tends to have better journal quality (anecdotal, but I have observed this for sure) but I got annoyed when you claimed an article published in a low impact journal had no merit. That is simply not the case.

You can have the best, high quality scientific study ever about a highly specific thing, but because it is so specific you won’t have the broad impact that would get into one of the top tier journals. But with your viewpoint, that study would get thrown out the window.

Highly doubt 5k IUs is the issue. Some select quotes from "Vitamin D Is Not as Toxic as Was Once Thought: A Historical and an Up-to-Date Perspective" by Michael Holick in Mayo Clinic Proceedings [0]:

> Ekwaru et al recently reported on more than 17,000 healthy adult volunteers participating in a preventative health program and taking varying doses of vitamin D up to 20,000 IU/d. These patients did not demonstrate any toxicity, and the blood level of 25(OH)D in those taking even 20,000 IU/d was less than 100 ng/mL.

> The evidence is clear that vitamin D toxicity is one of the rarest medical conditions and is typically due to intentional or inadvertent intake of extremely high doses of vitamin D (usually in the range of >50,000-100,000 IU/d for months to years).

[0]: Holick, https://www.mayoclinicproceedings.org/article/S0025-6196(15)...

[1]: Ekwaru et al, https://pubmed.ncbi.nlm.nih.gov/25372709/

[0] is an editorial and [1] seemingly went unpublished, other than in PLOS One, which means it goes through a very different peer review process than most other journals (that is, no peer review on its content, only on its methodology).

That assumes your body is absorbing all of it. I suspect a lot of people's aren't, hence the high doses. I have found for example that 1000iu in the form of drops under the tongue has dramatically more effect than 1000iu in the form of a chewable tablet.

The "tolerable upper limit" for vitamin D is set absurdly low.

I have perused the literature on D toxicity and each case involved someone taking at least 100k IU per day, and usually way more than that. I take 50k IU per day every winter and have never had an issue. Blood calcium levels normal, etc

5k IU is an average dose and will absolutely not cause harm.

> "I have perused the literature"

...and you are?

> 5k IU is an average dose and will absolutely not cause harm.

This is wildly irresponsible to post, and should be removed from HN.

Are you sure? 5k being a safe average dose seems to be corroborated across the internet and the abstracts of some papers I've seen.

And yet, not a single reputable journal will publish those papers, the medical community won't change the recommendations, and those studies go unreplicated.

It seems like there's an undereducated underground on the Internet that has the hubris to think they know more than the medical consensus, so what you're seeing are the effects of that hubris, nothing more.

Turns out Vitamin D is the anti-vaxx of computer nerds. Pretty hypocritical, but unsurprising.

>...and you are?

Someone who is wholly uninterested in the credential theory of epistemology. Back to reddit with that, please.

> This is wildly irresponsible to post, and should be removed from HN.

You don't seem to know what the TUIL actually means. The tolerable upper intake level of a substance is not the actual safe upper limit, it just guarantees that a certain level is safe. In the case of vitamin D, the actual safe upper limit is likely an order of magnitude higher, which was even acknowledged by the people who, very conservatively, set the TUIL at 4k IU.[0] If 4k IU is completely safe (which it is), then there is nothing at all irresponsible about suggesting that 5k IU is completely safe (which it is), unless that extra 1000 IU somehow accomplishes some deleterious effect, which it doesn't.

That extra 1000 IU between 4k and 5k is simply insignificant. To put all these numbers in context, the body synthesizes the equivalent of anywhere from 4k-12k IU per day from sunlight,[1][2] and possibly 20k+ IU if you're sunbathing with most of your skin exposed.[3] So really, a 5k dose is in the low to moderate range. If 5k IU of vitamin D is scary or irresponsible, then getting even a little sun exposure is really scary and irresponsible!

[0] https://pubmed.ncbi.nlm.nih.gov/17209171/

[1] https://doi.org/10.1093/ajcn/61.3.638S

[2] https://doi.org/10.1016/j.jaad.2007.03.004

[3] https://pubmed.ncbi.nlm.nih.gov/18290718/

> Someone who is wholly uninterested in the credential theory of epistemology.

So nobody qualified to answer this question? That's what I expected. In medicine more so than in nearly any other field, qualified experts should be the only people to express opinions publicly, considering the potential negative outcomes.

You really shouldn't be giving medical advice on any website, Reddit or Hacker News. This is on the same level as anti-vaxx shit, I hope you realize.

This, more than Reddit, is a place where qualified people discuss topics. If you'd like to wildly speculate, that sounds more like what happens on Reddit.

To answer a bunch of questions: Yes, I had bloodwork done later showing my D3 level in the typical range. Whether that was due to the supplement, or diet, or lifestyle I can't say. I take 1 pill (USP certified) on average 2-3x per week. So not every day.

I've got treatment resistant depression and have tried probably everything else you're about to suggest. The only thing that kind of helped was dihydrotestosterone, but that is now illegal in the US. Also tianeptine and vorinostat, but also very hard to get in the US these days.

I have TRD too and tried so many things. It sucks.

Also in Seattle, also recovered from treatment resistant depression. I recommend looking into TMS. I wish I had done it much sooner.

Wish you luck, it’s been an especially gloomy year here.

Tried it through Neurostim in Bellevue. Didn't work. Waiting for the Stanford SAINT protocol to be approved.

Did you try vorinostat yourself to treat depression, or was it coincidental? I never heard of that for depression, but looking at the mechanism it can make sense-- some HDAC inhibitors have powerful effects on mental issues

"I've got treatment resistant depression and have tried probably everything else you're about to suggest."

I bet you haven't tried MDMA therapy.

I've run into this too. It's worth noting that there are a few different types of vitamin D.

ergocalciferol

               - vitamin d2 derived from plants

cholecalciferol

               - vitamin d3 from sunlight

               - vitamin d3 derived from lanolin washed from lambs wool

               - vitamin d3 derived from lichen

I've tried a few different types, many don't seem to make me feel any different. Liquid vitamin d3 [0] seems to work well at doses above 5k IU.

[0] https://www.amazon.com/Designs-Health-Emulsi-D3-Emulsified-V...

I wasn't depressed but had low energy levels. I started taking 24,000 IU a day and within two weeks I had way more energy, constantly elevated mood and just felt happy overall. I recently lowered the dose to 12,000 IU per day. I did blood test before that and I had super low Vitamin D3 levels and I live quite far up north.

wildly speculating from an evolutionary perspective - it reasons that we'd evolve such that our moods are better in light - otherwise there would be another push to stagnate vs become exposed to more - such that evolution can do it's thing - evolution tends towards evolution after all -

I finally got a chance to move south and this was the first winter I didn't spend being weird and existential about everything. Just kind of enjoyed life.

In the northeast during wintertime, it's impossible to accumulate enough vitamin D from sunlight, especially not from such a short period of time, fully clothed.

Even if you were not fully clothed, there's so little UV making to you because of the sun's low angle and distance.

How did you narrow down the issue to sunlight exposure? Seems plausible that, being new to NYC as you say, there could have been an adjustment period that you eventually moved past?

Not trying to dismiss your experience. I just haven’t experienced making one small change in my life and seeing significant benefits.

If you were walking around outside in the winter and this helped, that's pretty good evidence that sun exposure is beneficial for you outside of vitamin D production.

In the winter months in NYC, the UV intensity is too low to cause vitamin D production in the skin.

That was most likely seasonal affective disorder (SAD, or winter blues). I've had a bad winter once something like 20 years ago, and it was so bad that I'm still obsessed with proper indoor lighting. tl;dr of it is that you want soft, yellow light in the evenings, and full spectrum, much more powerful than you think in the rest of the day, especially mornings.

I'm a remote worker. After an early morning standup I go outside and do yardwork in a big yard for a half hour to an hour, whenever I can. This is a pleasure that I've come to defend fiercely. When I sit back down at the keyboard my improved attitude and energy are such that I believe I make up that time in productivity before lunch. Don't know how much of that benefit is from increased vitamin D, from the forest bath, or from the exercise oxygenating my neurons. I doubt I could replace it with a pill.

Interestingly the fix to my seasonal affective disorder was a move a couple years ago into an apartment with no blinds and tons of sun in the morning (our previous place had black out blinds). We never got to adding blinds, and we have no intention to at this point—I wake up with sunrise naturally nowadays around 6am and haven’t had SAD since.

I’m of the impression that black out blinds are generally poor for sleep hygiene (unless you’re in a really bright place and they’re a necessity), as they disrupt some of the most natural and most potent zeitgebers available. That isn’t to say that a knowledgeable and enterprising person couldn’t employ black out blinds when crafting their sleep environment, but most people won’t balance the different influencing factors thoughtfully.

Depends, they can hide streetlight too which can be disturbing sleep pretty intensely...

Vitamin D supplementation didn't affect my depression. Going for walks to get more sunlight made it worse.

I understand that not everything works for everyone and I wish those around me, including my doctor, did as well so they'd stop blaming me when their "cure" doesn't work on me.

Would you mind sharing in what ways going for walks made it worse for you?

I found going for walks during lockdown to be depressing. Always the same few streets (yes I'd try various directions but it doesn't take long to have walked down every street within 30 minutes of you). My mom lives in the suburbs. She goes for walks but they are hardly uplifting "same walk I've made 400 times before" type of thing. I'd even say walking makes more feel more alone then when I'm at home alone because at least at home I can watch TV/movies/play game and write comments to strangers on HN.

I thought the walk was most beneficial in nature, but of course in a forest you don't get much sun exposure.

Sunlight and gardening have had such a dramatic impact on the way that I feel, it's unbelievable.

For me sunlight and some light exercise everyday were a game changer. I had tried Vitamin D supplements (1000 IU daily) before but there was barely any noticable effect.

I don’t think that’s enough, I needed 5k daily before it started working. My blood tests all come back in the correct range now.

Good to know.

I was diagnosed with low VitD and they said I should take like 1k-2k, but I didn't feel much.

Careful with high doses of hormones like Vitamin D -- it can have other deleterious downstream effects. https://www.devaboone.com/post/vitamin-d-part-2-shannon-s-st...

1000 is actually way below what you need probably, my doc put me on 2500 a day and it wasn't enough, I've moved to 5000 and been "normal" level ever since for several years for my annual checkout/blood/urine tests. If you have brown/black skin it can be even more, but better to start low and figure out what is enough under observation of a doctor.

Yes, probably. I didn't feel comfortable with a higher dose without doctor supervision.

> If you have brown/black skin it can be even more

My skin happens to be very light so sunburn is more of a concern. The evening hours are pretty safe though.

In Norlisk, Russia, the children get doses of Ultra voilet light to combat the lack of sunlight.

https://allthatsinteresting.com/norilsk#8

Off topic, but perhaps of interest to anyone dealing with depression. Twenty five years or so ago, someone recommended that I try St. John's Wort. I had a negative reaction - bad skin rash - but the Mayo Clinic mentions that some studies show it "can be effective for treating mild to moderate depression."

https://www.mayoclinic.org/drugs-supplements-st-johns-wort/a...

It has plenty of drug interactions. Might as well just try a SSRI if you’re going that route.

Yup. I'm one of the lucky ones for whom SSRIs work.

I feel amazing being outside, clear blue day, no clouds, green everywhere.

I take photos on these days and use em as a wallpaper on my big monitor, so even in winter time I can remember these times.

I recently wondered if bad dental hygiene can increase or cause more depression.

Since oral hygiene can cause bad stuff in the stomach, maybe it can also lead to bad stuff in the digestive system...

Dental problems do cause depression. Health problems in general. Or is depression to cause health issues?

Mens sana in corpore sano.

I live pretty far north. For months at a time here there is basically no sunlight. Sometimes people try to sell you artificial light of one kind or another. Do they work?

Some UV lamps have been shown to help the body make Vitamin D. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846322/

I would recommend checking to see if you're actually getting low Vitamin D level during the winter and talk to a doctor to get their opinion on best treatment.

My understanding is that 10000 lux bulbs are accepted treatment for SAD. I live in a dull country and bought one despite not suffering from SAD. Anecdotally I find it great to help wake up in the dark winter mornings.

Try for cheap! Buy a floodlight ($15?) and use it as your main light when eating breakfast, for example.

For me this had a huge impact - I use it as above my computer desk at home.

> Overall findings were that there is a relationship between vitamin D and depression, though the directionality of this association remains unclear.

Vitamin D really seems to be a good example of correlation does not imply causation. I’m looking forward to when the Vitamin D hype ebbs off and when we know what Vitamin D actually helps with.

Too lazy to look it up in my notes now, but as far as I understand: 1) Vitamin D is low in people with all kinds of bad conditions, including depression but also heart issues/etc. 2) Supplementing vitamin D is usually not found to do anything to improve these conditions, or the effects are ambiguous, limited and minor.

Clearly there's a 3rd variable. For lack of better options I call it "sun magic".

Well, this might be uncomfortably relevant to my family. My son prefers to do nothing but lie in bed all day. At first we thought it was just puberty, but at some point, I realised that his lack of activity could also be a sign of depression. Had him tested, turns out he has vitamin D deficiency.

He's taking vitamin D pills now, but I'd honestly prefer if he'd just go outside every once in a while.

I’m from Portugal. I’ve been living in Germany for 3 years. Last winter I was feeling very tired when walking, even dizzy. Doctor said I got very low levels of vitamin D. I never felt depressed, though.

These types of studies are where I'd love to see frequency domain trials. I've been seriously down multiple times, got back on vitamin D, and Whoosh feel better.

Up here in Alaska I take 10,000 IU a day of Vitamin D. Doctors up here (at least the good ones) push it.

Could it also be linked sunlight? Exposure to sun light creates vitamin-d.

Maybe the relation is not as direct as we might think at first.

Maybe the vitamin D deficiency is keeping people from going out more, which makes them feel isolated, not engaged fully with their friends and family which, in turn, pushes them to depression if they're prone to it.

And that may explain why it seems that, as the writers of this paper mentioned, when some of the subjects get vitamin D the depression goes away. This can be caused by the effect of the intake on their ability to gain their more active way of life.

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