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23
Jan

High Dose Vitamin D Therapy for Seasonal Affective Disorder (S.A.D.)

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Vitamin D InjectionsAs part of my illness I have suffered greatly with Seasonal Affective Disorder, known also by its appropriate acronym - SAD. I notice large seasonal variations in my mood, energy levels and other symptoms and also day to day variations depending on the weather. Even a cloudy or rainy day in summer can make me feel depressed and sluggish.

I have recently tried high dose vitamin D treatment after seeing studies that showed very positive results and wanted to tell you about what it has done for me. First though I want to talk a bit about my experience with SAD.

There was a time before I knew about SAD and realised I had it when I felt suicidal each year from October to March. All I felt was total despair and spent most of my time in bed. If I hadn't still been living at home with my parents I wouldn't have been able to cope and who knows what would have happened. As it was I stubbornly fought a mental battle against thoughts of ending my life and managed to pull through.

 Thankfully after a few years I saw the pattern and realised what was going on. The first treatment I heard about for SAD was bright light therapy. This is usually one of the first treatments recommended by doctors (along with antidepressant medication) and involves sitting in front of a special 'light box' for a certain period of time each day, usually 30 minutes to 2 hours depending on the light box and severity of the patient's symptoms. Light boxes are designed to provide light bright enough to mimic the effects the sun has on the body; namely suppressing production of the sleep hormone melatonin and stimulating production of the mood enhancing neurotransmitter serotonin (along with a number of others).

 

» Learn more about SAD light boxes

 

Unfortunately for me, although studies suggest light boxes are very effective as a treatment for SAD and I heard many sufferers recommening them, they did little to reduce my symptoms. I experienced a moderate energizing effect but my mood was still very low.

The first thing that really made a difference for me  was the simple measure of waking up earlier in winter. My sleep pattern had been to go to bed about 2-3am and wake up at 12-1pm (a shift common in ME/CFS, SAD and other environmental illnesses). One year as October approached I began going to bed between 11pm and midnight and waking up at 9am. The difference this made to my mood was astonishing. Although during that winter there was still a noticeable difference to how I felt in summer I no longer felt the heavy weight of despair and didn't have a single suicidal thought. Further to this getting outside during daylight hours in winter and letting the suns rays directly enter the eye also made a positive difference.

So if you suffer from SAD and spend your days in bed asleep or with the curtains closed try waking up earlier and getting outside as much as possible. Like me you may be amazed by how much your mood improves.

Now on to vitamin D. The sun not only affects the physiology of our bodies (and our mood) by the action of bright light hitting the retina of the eye but also by triggering the production of vitamin D in the skin as its rays strike uncovered areas. You may be surprised to learn that "vitamin D" is actually not a vitamin at all; its active form is actually a form of steroid hormone. As a result it has powerful effects on the body beyond aiding in the absorption of calcium and prevention of osteoporosis for which it has traditionally been known. The thing that is important to SAD sufferers is that vitamin D is required for the production and activation of the mood elevating neurotransmitters serotonin, dopamine and noradrenaline/norepinephrine.

When exposed to certain wavelengths of UVB rays from the sun the skin produces vitamin D3 (cholecalciferol). This is the most active form and is also found in oily fish and animal products. Plants contain the vitamin D2 (ergocalciferol) form which is less well absorbed and utilised by the body. Vitamin D3 is also widely available in supplement form.

After seeing studies suggesting people low in vitamin D were more likely to develop depression and SAD and that vitamin D supplementation could alleviate the symptoms of SAD I began to suspect it would also benefit me. A few small studies had shown that doses of 800-2000iu per day were enough to help those with SAD so last winter I supplemented 2000iu every day but gained little benefit. However, I then came across research which used much higher doses - 100,000iu in one single dose.

I discussed using higher doses with my nutritionally orientated doctor and she said she had used doses of 25,000-50,000iu D3 per week with her ME/CFS and SAD patients with great success.  This works out at roughly 3500-7000iu per day. Vitamin D3 has been shown to be non-toxic at these levels and well tolerated as the body converts it to the active hormone (1,25-dihydroxycholecalciferol) in the liver and kidneys as needed.

I started with a 25,000iu dose and within hours the effects were obvious. My mood, even on an overcast day, was noticeably brighter. It was a strange sensation in that I felt as if it was summer even on a cloudy day in the depths of winter. I found this mood elevation lasted for 3-4 days before starting to really tail off. Taking 50,000iu lasted the maintained the improved mood for the whole week so I now intend to take this dose weekly during the winter.

So it seems I have found the missing piece of my SAD puzzle. The combination of getting as much sunlight as possible and taking high dose vitamin D3 is highly effective at relieving my symptoms and making me feel like I do during the summer months when the sun is doing all of the work.

If you suffer from SAD then I highly recommend you try adding vitamin D3 to your treatment regimen. It may be that 800-2000iu per day may be all you need in which case regular capsules of 1000iu from the healthfood store will be fine. These are very inexpensive. If you require higher doses like myself then getting the concentrated form and taking it weekly or every other week may be a better option. There are a few suppliers on the internet (no prescription required) or you may have to get it through your doctor.

SAD is a terrible thing to experience so I hope this information helps those of you who are suffering.

Here's to brighter and happier winters!


Additonal Resources:

SAD Treatment and Vitamin D (@ EiR)

15 Amazing Health Benefits of Vitamin D (@ jenreviews.com)

 

High Dose Vitamin D Therapy for Seasonal Affective Disorder (S.A.D.)Dynamic Neural Retraining Program (DNRS)

 

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  • Hi Tom,

    I find one big weekly dose gives me a bigger initial lift but can also overstimulate me and lead to disturbed sleep after a few days before the effects tail off. Daily dosing for me works best to keep things stable. I am very sensitive to anything stimulating however. Other people do fine with weekly dosing or, as one study showed, a single massive dose (by injection) at the end of summer. Daily dosing is probably the safest bet for most people. Remember to tell your doctor if you're taking vitamin D ;)

    Comment last edited on about 5 years ago by Maff
  • Hi BB, I'm assuming you mean vitamin D not vitamin E! Glad to hear it has worked so well for you. From my own experience it really is the most effective treatment aside from natural sunlight. Doctors are generally unaware of things like this and are advised to offer antidepressant drugs instead, or at best bright light therapy. There is a lack of research into vitamin D use for SAD but the studies that have been done have shown very favourable results so hopefully more quality research willl be conducted and doctors will take note as it could save SAD sufferers a lot of misery!

  • Hey folks,

    I hope an increased dosage was beneficial Nina. It would be great to hear how you have been getting on this winter. Sorry I didn't reply sooner - there has been lots of work to do re-designing the site!

    Sascha - The way the body regulates vitamin D concentrations is more complex than just how much body fat you might have so I don't think that would affect a person's risk of suffering from SAD directly. Of course I could be wrong and would welcome people posting research that has looked at such an association, interesting thought. Also, BMI isn't the best indicator of body fat as lean individuals with a lot of muscle often have "high" BMIs - but I'm getting off topic! What I have noticed with high dose D3 is that there is a strong initial effect that lasts 3-4 days and then this starts to wear off, so taking 3000-4000IU/day may give a more even improvement. Also, D3 can be quite stimulating because of its effects on the neurotransmitters so if adrenal fatigue is an issue, as it is for me, this may need addressing to avoid overstimulation. Obviously discuss taking D3 with your doctor as well, particularly if you are taking any medications.

    Comment last edited on about 5 years ago by Maff
  • Kirsten - My problems are mainly yeast related as well and problems with the gut can have a huge impact on mood as they interfere with the absorption and metabolism of nutrients required for neurotransmitter and hormone synthesis and also create toxins that are absordbed and effectively poison the brain. These effects can also result in increased sensitivity to seasonal changes in my experience. Great to hear the probiotics help and that the extra sunlight in Florida did also. Cod liver oil might not be the best option as it contains a lot of vitamin A which can be toxic in high doses. It is possible to obtain vitamin D3 in powdered form so you might want to search for a supplier in the US. Sorry I can't give you a specific link (I obtain powdered vitamin D from my doctor here in the UK).

    Andra - Basically D2 is the plant form of vitamin D, while D3 is the animal form and the same substance that is produced in the skin when exposed to sunlight...hence D3 is better utilised by the body and should therefore be the better supplemental form.
    Great to hear you find this website useful. I am about to have the site re-designed and upgraded with new features. I suspect a mobile version would be complex and expensive to launch (I run the site effectively singlehandedly!) but I will certainly look into it.
    SAD is about as apt as acronyms come but I do take your point about it trivialising the condition. It can be a lot worse than it sounds! Same with chronic fatigue syndrome from which I also suffer.

    Comment last edited on about 5 years ago by Maff
  • Hi Timo,

    Carbohydrate and sugar cravings are definitely associated with depression and SAD. Increasing blood glucose levels with these foods increases the transport of the amino acid tryptophan into the brain where it used used to synthesise serotonin - which improves mood. These cravings can therefore be seen as one way in which the body tries to restore normal serotonin levels. It's also worth noting that serotonin is the precursor for melatonin, the "sleep hormone", whose normal diurnal production is disrupted in SAD.

    I obtained my vitamin D3 powder from my doctor and the tub is unfortunately unlabelled. Perhaps you can approach your doctor about using vitamin D3 as well. There is some good research to support its use. Take a look at the SAD Treatment page for some of these.

    Good luck!

    Comment last edited on about 5 years ago by Maff
  • You're welcome Rae. If my experiences can help anyone I am happy to share!

  • Hi Tracey,

    Glad to hear you're having such good results with D3. My reaction after taking my first megadose was also "wow!". It's great to feel like your true self again isn't it!

    I also experience overstimulation if I take to much and the 10,000 IU/day you have been taking is very high. Perhaps you would do just as well at around half of this and be able to sleep better. A normal sleep pattern is also important in SAD so it's all about getting the balance right ;)

    Thanks for your positive comments and I hope you continue to enjoy bright sunshine-filled moods :)

    Comment last edited on about 5 years ago by Maff
  • Hi Happy Days,

    You are correct, I don't just suffer from SAD....it is just another complication of my primary illness chronic fatigue syndrome (ME/CFS). And, yes I suffer depressive symptoms year round and problems with adrenal fatigue and underactive thyroid function - which all of course contributed to the severity of the symptoms I experienced as a result of SAD.

    Having said that, depression is a serious illness and is certainly enough to keep sufferers in bed without any other medical conditions being a factor. SAD can be just as serious as severe major depression or other depressive disorders.

    It's great to hear that meditation has worked so well for you. I too meditate daily (mantra meditation) and certainly find it helpful in lifting my mood (along with other benefits) but it is not enough alone for me. I feel the best approach to SAD includes the use of a number of therapies including waking as early as maintaining a sleep pattern to maximise natural light exposure, getting outside as much as possible, vitamin D, bright light therapy, negative air ionization, exercise (if possible), other nutritional and herbal remedies.....and meditation. There are no doubt more and the trick is finding what works for you but thankfully in most cases something will no matter how despairing you may feel.

    Comment last edited on about 5 years ago by Maff
  • Hi lowegian,

    I'm glad you have had some positive results with vitamin D3 so far. It was exactly the same for me. I took a dose of 25,000IU as I mentioned in my original article and I quickly felt a lot more "normal". It was as if it had suddenly changed from winter to summer.

    I too have problems with overstimulation however. This is likely due to the fact that vitamin D3 increases both serotonin, which is involved (along with melatonin) with the mood changes associated with SAD, but also the catecholamine neurotransmitters (e.g. dopamine, noradrenaline). All of these are stimulatory neurotransmitters and can be too stimulating when levels are too high.

    The trick as you can imagine then is to get the balance right and it sounds like you are attempting to do this at the moment. Hopefully you will find a dose that keeps the SAD at bay without causing side-effects due to stimulation. We must remember that nutritional supplements can have side-effects just as medications can/ Although certainly in my experience, vitamin D3 is a far more effective treatment for SAD than any SSRI or other antidepressant drug so is worth persevering with.

    In answer to your questions....

    1. Vitamin D is fat soluble which means the body stores it for use as needed. You therefore can take a large dose once a week and your body will store it and convert it to its active metabolites as and when this is required. This is in contrast to water soluble vitamins such as vitamin C which needs to be taken many times a day to maintain high blood levels as it is simply excreted in the urine if the body doesn't need it immediately. The advantage of taking vitamin D weekly is simply....that it's easier ;)

    2. Yes, my symptoms worsen with weather changes as well and this seems to be a common feature of SAD. I notice it the most in summer actually. An overcast day in summer really drops my mood and motivation! In these cases I may take an extra couple thousand IUs that day for a boost.

    I would be negligent if I didn't suggest you have your vitamin D levels checked at least once or twice throughout the winter if you are going to stay with this long-term. Hopefully your doctor would be receptive to the idea. There is good body of evidence for using vitamin D in SAD and other forms of depression so there shouldn't be a problem.

    Do let us know how you get on and good luck :)

    Comment last edited on about 5 years ago by Maff
  • I have a serious problem with SAD as well. Have coped with it through medications in the past. However, the medications have lost their efficacy as I have developed tolerance to them. I noticed that I was having the problem with medications last Spring and this Fall the problem is even worse.

    Therefore, I happened upon your blog through google search on alternative treatments and it was not much of a decision to give D3 a chance. I have been using it for only two weeks, so I will report back my results at a later date in addition to this post.

    I noticed a positive effect with 10,000 IU/day, but it too made me feel very stimulated, so I backed it down to 4,000 IU per day. That seemed to work well for the past two weeks. If fact, I felt almost normal which almost miraculous for me during this time of year. However, yesterday I was very anxious (bad stress headache, loss of sleep, etc.), so I am going to increase the dose to 10,000 IU's again and then plan to back down if the symptoms are under control.

    I do have a couple of questions if you do not mind answering.

    1. Your blog seems to imply you take your weekly D3 all in one shot. Is that the case and what advantages or disadvantages is there between weekly and daily dosages?

    2. My symptoms seem worsen with the advent of weather changes in combination with the lack of sunlight from Fall through late Spring. Do you have a need to adjust your dosages throughout the Winter season as well?

    Undecided if D3 will work longterm for me, but I will give it a "go" and report back.

    Thanks,
    Iowegian

    Comment last edited on about 5 years ago by Maff

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