By Karen Kier, Pharmacist on behalf of the ONU HealthWise team

Christopher Brian Bridges (aka Ludacris) is a famous rap artist who has a 2017 song titled Vitamin D.  One of the lines in his lyrics is “You missing so many key nutrients in your life.” 

What nutrients could we be deficient in and what is the controversy?  

As of April 2023, it is estimated that about 35% of the United States population is deficient in vitamin D.  Vitamin D plays an important role in maintaining bone health, heart health, and reducing the risks of some cancers.  It is a vital nutrient.  

Vitamin D deficiency is more common in the northern portion of the United States due primarily to sun exposure. The sun’s ultraviolet B rays are a key component in converting cholesterol to active vitamin D.  For Ohio, these rays would be active from March through October.

The link between skin cancers and sun exposure is an important aspect in understanding vitamin D deficiencies. The benefit of the sun for vitamin D is hampered by the risk of cancers related to sun exposure.  With more of the United States using sunscreens due to this risk, less vitamin D conversion is occurring. 

Some smaller studies have evaluated a relationship between vitamin D and mental health.  No large-scale studies had evaluated the impact of vitamin D on depression.  A large study was completed and presented at the American Society of Nutrition conference held on June 29 to July 2, 2024.  

The researchers analyzed data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES).  The study involved 4,641 adults and the focus of the research was to evaluate if there was an association between vitamin D and depression. 

The scientists used a screening tool for depression called the PHQ-9 questionnaire, which is a validated tool used both in research and in clinical practice to determine if a person is depressed and to determine the severity.  Blood levels of vitamin D were evaluated and compared to the PHQ-9 scores.  The researchers evaluated both mental health and physical functioning.  

The scientists reported their results at the NUTRITION conference in Chicago.  They found a significant association between vitamin D levels and depression.  Adults with depression had much lower levels of vitamin D intake than those without depression.  The adults with depression had lower intake of vitamin D from food sources.  The authors stressed the importance of including vitamin D rich foods in the diet. An additional benefit to increasing vitamin D intake was improved physical functioning.  

So how do we improve our health with vitamin D, but not increase our risk of skin cancers?

Some foods rich in vitamin D include fatty fish, egg yolks, orange juice, tofu, liver, mushrooms and fortified milk and cereal.  Besides dietary intake, vitamin D can be purchased as an over the counter vitamin supplement.  The recommended daily allowance for vitamin D is 600-800 IU per day.  For those with deficiencies in vitamin D, there are prescription vitamin D supplements available from your prescriber.  Ask your pharmacist for help in selecting a product. 

What is the fuss?

Some healthcare providers are objecting to the new Endocrine Society clinical practice guidelines for vitamin D.  The guidelines no longer recommend getting routine vitamin D blood levels to see if someone is deficient even in states known to have higher rates of the condition. It is important to talk to your healthcare professional about whether they should test for vitamin D levels.  

In light of this new data showing an association between vitamin D and mental health, the importance of the vitamin is more essential than ever! 

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