The 9 Best Supplements for Depression of 2021, According to a Dietitian

Your Guide To Vitamin D: Benefits, Best Sources And More

The 9 Best Supplements for Depression of 2021, According to a Dietitian

Most of us think of vitamin D as the “sunshine vitamin” you get from a few blissful minutes outside in the winter months—or longer when the weather’s warm. But despite being able to absorb vitamin D from the sun, 35% of adults in the U.S. are deficient in it. That’s a problem because vitamin D serves is vital for bone health and may improve your immune system as well.

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Here’s everything you need to know about vitamin D—including how to get more of it right now.

Vitamin D is a fat-soluble vitamin available via ultraviolet rays (mainly the sun), a few foods and supplements.

Vitamin D’s main purpose is to regulate calcium and phosphate to keep your bones, teeth and muscles strong and healthy.

A vitamin D deficiency can lead to  rickets in children and osteomalacia—the softening of the bones—in adults.

Meanwhile, preliminary research suggests getting enough vitamin D is associated with a lower risk of certain diseases, such as heart disease, type 2 diabetes, and improved mental health.

The top health benefits of vitamin D include:

Strong Bones and Muscles

Vitamin D helps regulate calcium and phosphate in the body, which are key to bone and muscle health. People who are deficient in it are at higher risk for developing osteoporosis, a condition in which bones become weak and brittle. Don’t forget your teeth are bones, too—so enough of the nutrient also means stronger teeth.

Improved Immunity

There’s a lot of buzz around the role vitamin D may play in strengthening your immune system and preventing certain diseases heart disease, type 2 diabetes  and cancer. A large 2020 study by University of Chicago Medicine researchers even found a link between vitamin D deficiency and the lihood of becoming infected with COVID-19.

But Dr.

Marilyn Tan, an endocrinologist and clinical associate professor at Stanford Medicine who has studied vitamin D extensively, notes that the majority of the research around disease prevention (including COVID) is preliminary.

“We think vitamin D plays some role in immunity, but it’s not a very clear and defined connection,” she says. “We know for sure that it has a role in preventing osteoporosis and bone loss, but that’s really it.”

Supported Mental Health

Some research suggests inadequate levels of vitamin D are linked with depression and that getting enough of it may improve overall mental health. However, again, the research is too preliminary for doctors to prescribe vitamin D as a treatment for depression, anxiety or another mental health issue.

“Anecdotally, I have had many patients who feel much better mentally once we get their vitamin D levels up to their goal, but it’s not every patient,” she says.

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Here are the top ways to get enough vitamin D.

The Sun

The sun is one of the most obvious and natural ways to get vitamin D—when your skin is exposed to sunlight, it makes vitamin D from cholesterol present in skin cells.

Unfortunately, UV exposure is also correlated with skin cancer, so you should always weigh risks and benefits when it comes to spending time in the sun.

A United Kingdom study of 120 white people found that just 13 minutes of summer sun exposure three times a week is enough to keep vitamin D levels within a healthy range.

While most evidence suggests you don’t need very much sun exposure to boost vitamin D sufficiently, Tan cautions against spending extra time in the sun.

Due to the skin cancer risk, she recommends a supplement instead for people with low vitamin D.

Vitamin D-Rich Foods

While not as efficient as the sun, your daily diet can help you get much-needed vitamin D, too. Eating vitamin D-rich foods can be especially helpful if you don’t get much sun exposure or  have darker skin and therefore don’t make as much vitamin D naturally.

Unfortunately, not many foods are naturally high in vitamin D—but there are some. “Salmon is a good option, as it also contains omega-3 fatty acids in addition to vitamin D,” says research neuroscientist Nicole Avena, Ph.D.

, an assistant professor at Mount Sinai School of Medicine in New York City. “Other foods are often fortified with vitamin D and include cereals, milk, yogurt and orange juice.

But it can be tough to get all the vitamin D you need from food alone.”

The recommended daily amount (RDA) of vitamin D from the National Institutes of Health is:

Infants, 0 to 12 months: 400 IU (10 mcg) a day

Children and adults, 1 to 70 years old: 600 IU (15 mcg) a day

Adults, 71 and older: 800 IU (20 mcg) a day

While there are a handful of foods fortified with vitamin D, few foods contain vitamin D naturally. Those that do are usually animal-based.

the numbers above, you can consume the RDA of vitamin D by eating about 4 ounces of salmon, 13 eggs or a little over ½ a tablespoon of cod liver oil.

If you follow a vegan diet, getting vitamin D from food is going to be more difficult than if you eat animal products. So, in addition to making sure you’re getting mushrooms in your diet, look for fortified plant-based milks and talk with your doctor or registered dietitian nutritionist about taking a supplement, experts suggest.

Fortification of staple foods, or commonly consumed foods, is one of the simplest and most practical ways to combat micronutrient deficiencies, notably vitamin D, according to research in the journal Nutrition.

Yes, it is possible to overdo vitamin D. What makes vitamin D different from other common vitamin supplements is that it’s a fat-soluble vitamin. When you ingest too much of a water-soluble vitamin, such as vitamin C, your body will eliminate excess via urine, says Tan. But the same can’t be said for vitamin D.

“It’s very hard to have vitamin D toxicity from sun exposure or diet, but when people start taking supplements—whether through vitamin D drops or a prescription—it can get to very high levels,” says Tan. “Too much vitamin D can cause calcium buildup and lead to kidney stones and other problems.”

In general, a toxic dose of vitamin D is more than 4,000 IU a day—a level that may actually hinder bone health rather than help it, according to a 2019 study in JAMA.

In fact, vitamin D toxicity can result in hypercalcemia, a condition marked by an above-average amount of calcium in the blood, which can lead to nausea, vomiting, muscle weakness, neuropsychiatric disturbances, pain, loss of appetite, dehydration, polyuria, excessive thirst and kidney stones.

There are a number of vitamin D supplements available. And while it’s often important to get certain nutrients from food, this rationale doesn’t apply to vitamin D, according to Tan. “The way we get vitamin D naturally is from UV exposure,” she says. “This is controversial, because UV exposure has risks as well.”

To know if you need a vitamin D supplement, you first need a blood test to determine your vitamin D level. How much you might need to supplement depends on this number, says Tan. Only take a vitamin D supplement if recommended by your doctor the outcome of this blood test, and take only the recommended amount.

People who could be at risk for vitamin D deficiency include:

  • People who live in climates with less sunlight.
  • People who don’t naturally get much sun exposure.
  • Older populations who require more vitamin D daily.
  • People with darker skin, as they don’t synthesize vitamin D from the sun as easily.

When looking at nutrition facts or vitamin D supplement options, you may notice vitamin D listed in two forms: D2 and D3.

  • Vitamin D2 (ergocalciferol) is found in plant-based sources mushrooms and yeast.
  • Vitamin D3 (cholecalciferol) is found in animal-based sources salmon, eggs and milk.

Research suggests D2 and D3 are equally effective in boosting vitamin D levels. Both are well-absorbed in the intestines, says Tan, who recommends and opting for whatever is most easily available.

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Sizar O, Khare S, Goyal A, Bansal P, Givler A. Vitamin D Deficiency.Treasure Island, FL: StatPearls; 2021.

Vitamin D. National Institutes of Health. Accessed 4/13/2021.

DeLuca H.The metabolism and functions of vitamin D. Advances in Experimental Medicine and Biology.1986;196:361-75.

Sahay M, Sahay R. Rickets—vitamin D deficiency and dependency. Indian Journal of Endocrinology and Metabolism. 2012;16(2):164–176.

Giovannucci E, Liu Y, Hollis B, Rimm E. 25-hydroxyvitamin D and risk of myocardial infarction in men: A prospective study. JAMA Internal Medicine.  2008;168(11):1174-80.

Martin T, Campbell R. Vitamin D and diabetes. Diabetes Spectrum. 2011;24(2):113-118.

VDSCP: Vitamin D Standardization-Certification Program. Centers for Disease Control and Prevention. Accessed 4/13/2021.

Anglin R, Samaan Z, Walter S, McDonald S. Vitamin D deficiency and depression in adults: Systematic review and meta-analysis. Cambridge University Press. 2018;202(2).

Sunyecz J. The use of calcium and vitamin D in the management of osteoporosis. Therapeutics and Clinical Risk Management. 2008;4(4):827–836.

Zhang Y, Fang F, Tang J, et al. Association between vitamin D supplementation and mortality: Systematic review and meta-analysis. British Medical Journal (BMJ).  2019;366:l4673.

Aranow C. Vitamin D and the immune system. Journal of Investigative Medicine.  2011;59(6):881–886.

Meltzer D, Best T, Zhang H, et al. Association of vitamin D status and other clinical characteristics with COVID-19 test results. JAMA Network Open. 2020;3(9):e2019722.

Rhodes, L, Webb A, Fraser H, et al. Recommended summer sunlight exposure levels can produce sufficient (> or =20 ng ml(-1)) but not the proposed optimal (> or =32 ng ml(-1)) 25(OH)D levels at UK latitudes. Journal of Investigative Dermatology. 2010;130(5):1411-8.

FoodData Central. U.S. Department of Agriculture. Accessed 4/13/2021.

Simon R, Borzelleca J, DeLuca H, Weaver C. Safety assessment of the post-harvest treatment of button mushrooms (Agaricus bisporus) using ultraviolet light. Food and Chemical Toxicology.  2013;56(278-289).

Vitamin D fact sheet. National Institutes of Health. Accessed 4/13/2021.

Burt L, Billington E, Rose M. Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength. Journal of the American Medical Association (JAMA).  2019;322(8):736-745.

Holick M, Biancuzzo R, Chen T, et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. The Journal of Clinical Endocrinology and Metabolism.  2008;93(3):677–681.

Jäpelt R, Jakobsen J. Vitamin D in plants: a review of occurrence, analysis, and biosynthesis. Frontiers In Plant Science.  2013;4:136.

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The 7 Incredible Health Benefits of Vitamin D

The 9 Best Supplements for Depression of 2021, According to a Dietitian

In the past year, much attention has been brought to vitamin D in light of the pandemic with some research emerging that vitamin D might help safeguard people from severe cases of COVID-19. But beyond its potential protective role in the ongoing war against coronavirus, vitamin D is also a boon for overall immune health.

So how can you make sure you’re getting enough of this essential nutrient? Vegans or those who are predominantly plant-based, in particular, need to pay close attention to their diet to make sure they’re getting enough vitamin D.

“Vitamin D is one of the fat-soluble vitamins (along with vitamin A, E, and K) that is naturally present in a handful of foods, fortified into other foods, or available in supplement form,” says Mackenzie Burgess, R.D.

, nutritionist and recipe developer at Cheerful Choices.

“For the average adult, you should be getting 600 IU or 15 mcg/day to hit the Recommended Dietary Allowance (RDA),” she adds, noting that it’s also possible to get vitamin D from being outside in the sunshine as the sun's UV rays help convert vitamin D to its active form in the body.

“Researchers suggest about 10-30 minutes of sun exposure daily to meet your vitamin D needs,” she says, cautioning that vitamin D becomes more of a concern in the colder months with less time outside and less exposure to the sun. Take note that we always recommend wearing sunscreen when you're outside, even on cloudy days, to reduce your risk of sun-damaged skin.

For those over 70, it is 800 IU daily and some experts think our vitamin D needs are much higher, such as the Endocrine Society, which says people may require 1,500-2,000 IU per day.

Also worth noting: “A person’s ability to manufacture vitamin D [from UVB sunlight] decreases with age, so by the time people enter their senior years, their bodies make as little as 40% of the vitamin D made in childhood,” shares Elizabeth Somer, M.A., R.D.

, author of Food and Mood, and medical advisory board member to Persona Nutrition, a personalized nutrition program. “As a result, dietary/supplemental intake becomes increasingly more important with each passing decade with every season and all year long.

Plant-Based Foods With Vitamin D

Mushrooms are the only plant-based food that contains vitamin D naturally, and while plant-based milk, orange juice, cereals, and the may be fortified with vitamin D, it may still be tough to get enough vitamin D from food sources alone. That’s why a supplement may be your best bet: “When choosing a supplement, look for one that is third-party tested to ensure the best quality.

Look for either a USP or NSF label on the bottle. Vitamin D supplements can range from 200 IUs and 10,000 IUs,” offers Burgess “The amount to take may vary from person to person but in general, Vitamin D3 is typically preferred because it’s converted more efficiently than vitamin D2. When in doubt, talk to your doctor or dietitian about the best vitamin D supplementation for you.

” More specifically,

Now that we’ve got the three bases of vitamin D sources covered—getting direct sunlight, food, and supplements—let’s dive into the health benefits of vitamin D.

1. It can support immunity

“Vitamin D is known to have positive effects on the immune system. It can strengthen aspects of the immune system that are able to fight off colds and flu,” says Dr. Nicole Avena, Ph.D.

, Assistant Professor of Neuroscience, Mount Sinai School of Medicine and Visiting Professor of Health Psychology, Princeton University, who penned the book What to Eat When You’re Pregnant. These days, vitamin D is making headlines because of its potential impact on the severity of coronavirus.

“It has been found that people who are vitamin D deficient are more ly to catch COVID-19, and the mortality rate in this population is also higher. Patients treated with high doses of vitamin D while having the coronavirus needed less intense treatment in order to return to health,” says Avena.

Of course, all this research is new and emerging, so that’s worth keeping in mind when evaluating the strength of these findings.

2. It helps with bone formation and maintenance

For bone health, you’ll want to ensure you’re getting enough vitamin D, too. “Vitamin D is responsible for assisting with calcium absorption in the small intestine and helps the body maintain adequate serum calcium levels.

Because of this, it’s necessary for bone growth and remodeling [the lifelong process where mature bone tissue is removed from the skeleton and new bone tissue is formed] and helps reduce the risk of bones becoming thin or brittle,” says Somer.

“A vitamin D deficiency in children can result in rickets, and in adults is seen as osteomalacia and osteoporosis,” she adds.

3. It may help with depression

Time in the sunshine each day keeps the doctor away? There’s a growing body of evidence that vitamin D may help with depression.

“Almost all cells in the body have receptors for vitamin D, which implies this vitamin is important for many more functions than just bone,” explains Somer.

“For example, recent research suggests vitamin D is important in the prevention and treatment of depression,” she continues, pointing to this meta-analysis of vitamin D deficiency and depression in adults.

Expanding on Somer’s words, Trista K. Best, MPH, RD at Balance One, says: “Vitamin D has been shown to significantly improve and prevent depressive symptoms.” She notes that this is an especially important benefit during the winter months when we have limited exposure to the sun.

4. And with Seasonal Affective Disorder

Another important link between vitamin D and mood: Low levels of vitamin D have been found in people with Seasonal Affective Disorder, or SAD, a type of depression that’s typically linked to the fall and winter months.

“One study reported in the 2014 issue of Medical Hypotheses found a link between vitamin D deficiency and SAD. Lack of this vitamin appeared to be a contributing factor in the development of this depression,” comments Dr. Carrie Lam, M.D.

, “The lack of seasonally available sunlight seemed to be the primary factor in the development of SAD. This may be because vitamin D is involved in the synthesis of serotonin and dopamine, neurotransmitters involved in the development of depression. Low levels of these chemicals are associated with depression.

When there is less vitamin D being produced by sunlight, lower levels of these chemicals can lead to SAD.”

5. It may reduce your risk of certain cancers

File this under impressive: “Research has shown breast cancer cells grow faster in an environment with low levels of vitamin D.

This research from the Stanford University School of Medicine indicates a significant and direct link between the amount of vitamin D circulating in the body and the expression of ID1, a gene that is known to be involved in tumor growth and metastasis of breast cancer,” explains Lam, citing this study.

Vitamin D deficiency may also play a role in the development of prostate cancer. “The journal Clinical Cancer Research published a study in 2014 showing a link between low levels of vitamin D and prostate cancer.

Prostate cancer is the most frequently occurring cancer in men and the second most common cause of death for American men,” says Lam. “This study showed that low levels of vitamin D led to aggressive growth of prostate cancer in European-American and African-American men.

In the study, 667 men between ages 40 to 79 underwent prostate biopsies. African-American men with low levels of vitamin D had an especially increased risk of testing positive for prostate cancer.”

6. It may lower your risk of heart disease

Protecting your heart is another important reason to ensure you’re getting adequate vitamin D. “Low levels of vitamin D have been associated with increased risk of heart disease,” says Lam.

Research shows 70 percent or more of those who underwent a coronary angiogram [a type of procedure to detect blockages in the coronary arteries] had a low level of vitamin D,” she continues, adding that the American College of Cardiology says that more severe heart disease has been found in patients with vitamin D deficiencies.

7. It may help you slim down

“Vitamin D may also help with weight loss efforts,” says Best. “One study showed vitamin D may reduce appetite in such a way that weight loss resulted,” she continues, referencing this study on calcium plus vitamin D supplementation and fat mass loss in females who have very low calcium intake.


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