May 24, 2012 -- John Cannell, MD
Psychosis, or loss of touch with reality, is difficult to see in any loved one but is particularly difficult to deal with if it’s your teenager. Dr. Barbara Gracious and colleagues recently discovered that of 104 teenagers assessed at an acute mental health clinic, the teenagers with the lowest vitamin D levels were more likely to be psychotic. In what must be a tribute to video games and the like, 72% of the teenagers had vitamin D levels lower than 30 ng/ml and 34% had levels lower than 20 ng/ml.

The magnitude of the vitamin D effect was not minor; if the teenager had low vitamin D levels, he or she was almost four times (OR=3.5) as likely to be psychotic.

Gracious BL, Finucane TL, Freidman-Campbell M, Messing S, Parkhurst MM. Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study. BMC Psychiatry. 2012 May 9;12(1):38. [Epub ahead of print]

I was disappointed with their usual call for more studies instead of the needed call to treat vitamin D deficiency now. Compare Dr. Gracious’s approach to that of Dr. Mats Humble’s approach at Sweden’s Karolinska Institute. Dr. Humble and colleagues assessed 117 mental health outpatients of all ages and found that teenagers had the lowest levels. Teenage females had vitamin D levels of around 20 ng/ml and, in another nod to video games, teenage Swedish males attending a mental health clinic had average vitamin D level of around 10 ng/ml.

Humble MB, Gustafsson S, Bejerot S. Low serum levels of 25-hydroxyvitamin D (25-OHD) among psychiatric out-patients in Sweden: relations with season, age, ethnic origin and psychiatric diagnosis. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):467-70. Epub 2010 Mar 7.

Dr. Humble also found that depressed, psychotic and autistic patients had the lowest vitamin D levels and anxiety patients had the highest levels. Instead of just calling for more trials, he treated the deficient patients with up to 4,000 IU/day of cholecalciferol or, in other cases, up to 70,000 IU weekly of ergocalciferol, which resulted in “considerable improvement” in psychosis and depression.

No doubt, Dr. Humble is busy conducting a randomized controlled trial. At least I hope so. Moreover, I hope he is using pharmacological doses of vitamin D, not physiological doses. That is, I hope he is using 10,000 IU/day and not 5,000 IU/day, although some may claim 10,000 IU/day is physiological.

I predict the day will come when using 50,000 IU/day for ten days in very ill people with a vitamin D responsive disease, such as sepsis, congestive heart failure, and perhaps psychosis, to name but a few, will be commonplace. Now, 50,000/day is a pharmacological dose, which simply means the vitamin D is being used as a drug and not as a supplement for good health.

These stats are scary!

I take 50,000 IUs of vitamin D (dry D3) every day, but I likely do not absorb it all since I've had weight los surgery. I work to keep my level of D3 at 80+. And I have my infant on vit D supplementation (the amount in baby formula is not sufficient, IMO, and we're not out in the sun much since I burn extremely easily and hate the heat!). I have D supplements for my husband, too, but he's a bigger baby about taking them than our actual baby is!

I read that and I wonder if that's my niece's issue. I try to get her mom to pay attention to stuff like this, but her daughter is grown and doesn't pay much attention to her mom. The daughter doesn't believe she's got any issues anyway. *sigh* That's the worst part about thinking disorders, the afflicted don't recognize there's a problem.