Vitamin D and the Effect on Mental Health

Original Editor - Kapil Narale

Top Contributors - Kapil Narale  

Introduction

It is known that sunlight, warm temperatures, and the spring and summer seasons are associated with positive feelings and happiness. Dark, gloomy environments, associated with misery and fear, was associated with rickets. This is when Vitamin D was discovered. Vitamin D was discovered and identified in the 1920s. This was used as a remedy and treatment for rickets, which occurred with minimal sunlight exposure. As a prevention measure more sunlight exposure was needed. The prevention of rickets, encouraged the necessity of increased sunlight exposure.

Calcitrol is the active Vitamin D hormone, which affect the neurotransmitters and neurotrophic factors that may lead to mental disorders. Vitamin D receptors and metabolites are present in the Central Nervous System. Vitamin D deficiency can be a cause for mental disorders.

Vitamin D

Vitamin D has many beneficial physiological functions, including the balance of calcium, and the metabolism of bone, muscle, and energy. Extreme minimal levels of Vitamin D may lead to poor physical performance. It can also have a negative effect on the muscles of the lower limb responsible for postural control, and with exercise and grip strength. Immunity can also be affected.

The majority of Vitamin D is produced when the ultraviolet B rays from the sun have an interaction with the skin. Infact, 90% of Vitamin D comes from this interaction. It is evident that Vitamin D has an effect on muscle physiology, since Vitamin D receptors are present in muscle cells. It is seen that vitamin D supplements help improves neuromuscular performance, as well as improving muscular strength and postural control.

There is an association of suicide with low levels of Vitamin D in areas where there is minimal exposure to the sun. It is seen that there is an increased risk of suicide where there is an even lower concentration of Vitamin D. When concentrations of Vitamin D is increased due to supplementation, cognitive function and mood are improved. Vitamin D also affects the function of the Central Nervous System. As noted below, Vitamin D is involved in the processes of over 1000 genes within the brain.

Vitamin D deficiency is seen to be prevalent during the Winter time, due to increased covering of the skin, and from working indoors.

Calcitrol and Vitamin D

The main function of calcitrol is its involvement with the synthesis and degradation of neurotransmitters, plays an important role in regulating various neurotrophic factors, and is an antioxidative defense mechanism for the brain.

Calcitrol binds to a specific ligand, the Vitamin D receptor (VDR), which affects the gene expression of various target genes. VDR is located within the Central Nervous System (CNS), and the necessary enzymes and receptors spread throughout the human brain. the Vitamin D endocrine system acts within the CNS.

Calcitrol activates the gene expression of tyrosine hydroxylase, which increases the use of dopamine, adrenaline, and noradrenaline. It may advance the activation of cholinergic function, accelerating the activity f choline acetyltransferase and reducing the activity of acetylcholine esterase.

Calcitriol helps enhance nerve growth factor (NGF) and glial derived neurotrophic factor (GDNF). It also helps increase the activity of neurotrophin-3 (NT-3), and decrease neurotrophin-4 (NT-4). NGF is important for the prenatal development of the brain, and it may prevent degradation of the cholinergic system in Alzheimer’s disease. It can be noted that NGF, NT-3 and GDNF can be factors for depression and schizophrenia. GDNF can act as a treatment with Parkinson's Disease, and dependence disorders.

Vitamin D defends the brain against oxidative damage. It increases the gene expression of the enzyme aiding in the function of the most important antioxidant in the brain, glutathione, and helps increases the levels of this antioxidant.

It is seen that alterations in the Vitamin D supply in the brain, can interfere with brain functions directed to psychiatric and neuropsychiatric behaviours. There can be disorders developed on a seasonal basis. The lack of vitamin D exposure can lead to a delay in early rain development, and even brain degeneration in the elderly.

It is noted that Vitamin D causes a more positive and happier mood in healthy adults, in the Winter months.

Developmental Vitamin D Deficiency and Adult Schizophrenia

There is a possibility that a deficiency of Vitamin D, due to poor nutrition, during pregnancy can lead to schizophrenia. There may be a link between a deficiency in Vitamin D in fetal development or early childhood, and severe mental illness such as schizophrenia later in life. Interestingly, individuals born during the Winter months have a greater risk of developing schizophrenia.

It may also occur in individuals who grew up in areas where exposure to the sun is limited.

Vitamin D deficiency and Autism Spectrum Disorders

There is a possibility that Vitamin D deficiency in early years may lead to the development of autism spectrum disorder. The prevalence of autism increased in the US when individuals were recommended on avoiding exposure to the sun. There may be more children with autism born in areas where there is more rain than sun. This was mainly noted in Washington State, Oregon, and California.

Seasonal Disorders

With Seasonal Affective Disorder, it is recommended that individuals travel to southern parts of the country or continent, where there are warmer temperatures and sunnier conditions, to help mitigate depressive types of symptoms. These symptoms would generally occur at the same time of the year.

Possible Negative Effects

With an increased exposure to sunlight and solar radiation, there is a possibility of skin cancer, especially malignant melanoma, in the long term. With the change of minimsing exposure to sunlight, there was a noted increased prevalence of major depressive disorder in the US and Europe, especially among children and adolescents. There can also be an increased prevalence of autism spectrum disorder.

Applicability to Clinicians

Clinicians of medical professionals are prone to mental illnesses. About 20% of doctors experience mental illnesses during their careers. Male and female doctors both have a higher risk of suicide compared to the general public. Surgeons who are middle aged are most likely to seek help from their GPs/family doctors with symptoms of depression, anxiety, and burnout.

Due to the mental and physical demand of the type of work that clinicians perform, it is essential that they take advantage of supplements to increase the stores of vitamins and minerals in the body. It is interesting to note that the mental demands of Doctors can be comparable to that of Olympic Athletes.

Clinicians are prone to experiencing Vitamin D deficiency due to working indoors, and very minimal exposure to natural light. Clinicians like surgeons who need fine muscular and postural control would need to keep their Vitamin D levels at an optimal level, not experiencing a deficiency, and can benefit from a supplement.

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