Vitamin D and Omega-3 have a larger effect on depression than antidepressants
337 points
2 hours ago
| 40 comments
| blog.ncase.me
| HN
isoprophlex
2 hours ago
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Because it's common to hate on antidepressants, I've always personally had a bias against them.

For the past 15-20 years, november thru february are basically a writeoff due for me due to seasonal affective disorder. Cold showers, exercise, no alcohol, strict sleeping rituals. Vitamin d. I can still sleep 11 hours and feel like reheated cat shit.

Enter citalopram. "It will take up to six weeks to dial in" they said. Within four days I felt like the inside of my head was designed by Apple in their glory days. My mind became an orderly, well lit, tastefully designed space... instead of a dimly lit crack den. I'm more emotionally available, no longer tired, less cranky. I felt cozy. I could cry with joy because I could finally understand emotionally why people like the Christmas season.

I won the SSRI lottery I guess, the side effect are sweaty feet, vivid dreams and a dry mouth. That's all.

This just goes to show that for me, they're extremely effective.

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ghusto
58 minutes ago
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The hate on antidepressants is not because they're not effective, but rather that they're abused by psychiatrists. Ideally, a professional will prescribe them as a necessary helper to becoming (more) mentally healthy whilst tackling the root cause. Most of the time however, it's more of a "here, take these indefinitely".

It's like if we took sleeping pills every time we had trouble sleeping. Having said that, I just realised I have the impression that's exactly what people do in the USA?

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PurpleRamen
5 minutes ago
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Most forms of depressions have no "root cause" you can fix. Sometimes they have amplifiers or triggers, you might be able to work around, but that also demands first to reach a point where the patient is able to work on something.
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paufernandez
41 minutes ago
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Agree. But sometimes there is no "root cause", the brain is still a mystery. If you had been depressed even when you knew there was nothing to worry about, you would see it differently, because then you deduce that the black cloud is produced within.

Chemistry trumps psychology. Good enough chemistry enables cognitive treatments. But to fix the wrong chemistry you need chemistry.

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citrin_ru
14 minutes ago
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If you view a world at a certain angle there is always something to worry about: 1. World in not perfect, it doesn't confirm to how we want it to be (and could not even in theory given that different people want it to be different) 2. The future cannot be predicted with 100% accuracy so even if all is perfect today you can worry that it will turn bad in the future.

When looking at the same reality one persons sees the situation as OK and another as a an endless and hopeless disaster it is hard to tell who is right. A depressed person would tell that most people around him are wrong and are optimistic only because they don't understand how bad all is.

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ajross
6 minutes ago
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This is the "people with anxiety should just stop being worried" attitude that failed to help for centuries. Whether or not you believe SSRI's are clinically effective, denying the existence of mental health disorders is not helping.

No, anxiety and depression aren't simply a matter of perspective.

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lossyalgo
33 minutes ago
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Also they are often prescribed as a life-long solution, instead of a temporary stop-gap to get through some bad state of mind while, as you said, "tackling the root cause". At some point they will potentially stop working which requires switching meds and often the next one won't work as well, plus, leaving the user stuck with withdrawal symptoms for unspecified amount of time (potentially years) and anti-depressant pushers don't usually warn about this, or even acknowledge it when confronted with "since stopping I have symptom x, y, z".

Source: multiple friends, family and forums (while researching how to help friends & family get off of various SSRIs).

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braiamp
27 minutes ago
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> but rather that they're abused by psychiatrists

Doctors of all countries have been under a lot of pressure by patients and health administrators to "fix the issue and quick". The last thing that your doctor wants is giving you pills so you go away, but that's what the context very strongly incentivize. You want doctors to stop abusing pills, stop asking them for immediate fix. Give them less patients, more time and more resources to deal with the health of the population. Also, prevention.

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Forgeties79
1 minute ago
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> The hate on antidepressants is not because they're not effective, but rather that they're abused by psychiatrists.

I’m sure it happens but what leads you to believe this is some rampant problem currently?

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chasil
16 minutes ago
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Every time I have a yearly physical, my GP will ask if I have feelings of depression.

I know this road leads to SSRIs at the very least, so I always reply in the negative.

The parent comment hints to me that this might be a mistake. I do not want to become accustomed to an antidepressant, so perhaps my course of action was correct.

I was measured low on Vitamin D, which I've hopefully corrected, and I haven't always eaten fish regularly. Perhaps I should pay more attention to that.

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drumdance
2 minutes ago
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There are also SNRIs, which don't have the sexual side effects. I've done mostly SSRIs but in the last few years I've been on an SNRI called Pristiq and it's the best by far.
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staticassertion
13 minutes ago
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> I know this road leads to SSRIs at the very least, so I always reply in the negative.

Seems odd. Your doctor can't force you to take anything. If they say "do you want to try X?" just say "No". Not giving your doctor full medical context seems like a mistake - for example, maybe depression would be indicative of another issue, or maybe people who are depressed really shouldn't take a specific medication.

To each their own, and perhaps you have other reasons, but this seems like a less than ideal solution to a very trivial problem if the goal is just to not take an SSRI.

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hypeatei
54 minutes ago
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> like if we took sleeping pills every time we had trouble sleeping

Yes, that's normal in the US. I have multiple family members who take Ambien (zolpidem) before bed every night.

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lazide
52 minutes ago
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Which knowing the side effects of Ambien is pretty bonkers.
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isoprophlex
55 minutes ago
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you're not wrong that pharmaceutical crutches are overused. but as an outsider to these problems my 'ambient impression' was always one of haha antidepressants are for suckers. well, in my specific case, so what if i'm a sucker... they're super effective in fixing what appears to be a defective winter brain.
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michaelsshaw
54 minutes ago
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> It's like if we took sleeping pills every time we had trouble sleeping. Having said that, I just realised I have the impression that's exactly what people do in the USA?

I'm not sure if it is common but I've definitely taken my fair share of my dog's trazodone.

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kyleblarson
7 minutes ago
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I had disk issues in my lumbar spine that caused nearly unbearable pain and terrible quality of life. Tried everything: PT, OTC painkillers, epidurals, massage, nothing worked. Was prescribed pragabalin and duloxotine. Duloxotine is an SNRI that also treats nerve pain. That combination helped some but I was sleeping 11+ hours per day and generally felt like my head was in a complete fog, was pretty much useless with work. I had been trying to avoid surgery but finally had 2 procedures in 2024 that helped immensely. Weaning off those 2 drugs was no fun: sweating constantly, anxious, headaches for about 2 weeks. Extremely happy I went the surgery route and stopped those meds. I can't imagine living day to day feeling like that.
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mvcosta91
1 hour ago
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“God, I see what you’re doing for others, and I want that for me.”

I had a very similar experience, except it killed my libido, so I chose to endure the suffering of Winter rather than live with emotional numbness.

Still, I strongly recommend it for people flirting with the abyss. It was life-changing for me while I was raising an autistic 2yo during the pandemic.

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sixtyj
53 minutes ago
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I have switched to lamotrigin, it helps to balance mood as I had bad mood in months with less sunshine. Lamotrigin is not an antidepressant, previously it was used for epilepsy stabilisation but now it is prescribed for mood swings. (This is not a medical advice.)
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deskamess
6 minutes ago
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It is still prescribed for epilepsy. I am actually hoping for some medication stories if anyone/someone they know has ADHD and epilepsy. It's for a juvenile, but your stories can be for any age. Or pointers to any resources about the combo.
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jonasdegendt
48 minutes ago
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> I had a very similar experience, except it killed my libido

Did you, as well as the other people seconding this, have any libido left in the first place? I got on Sertraline because I was depressed, and it actually brought my libido back, by virtue of just bringing me back to a better emotional baseline.

All to say, if it had affected my libido, it'd have been a NOOP anyway in my case.

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cael450
40 minutes ago
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Villazodone was created partly to address that. Once I switched to that, I had no libido-related issues again.
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rco8786
1 hour ago
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> except it killed my libido

Similar experience. Apparently pretty much ubiquitous with SSRIs

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isoprophlex
1 hour ago
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i'm sorry this happened to you, this was of the reasons i held off trying them for so long. ubiquitous indeed, also on this front I got lucky...

please people, take my post for what it is: anecdotal evidence. SSRIs can basically give you any possible side effect, including destroying your libido.

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bflesch
49 minutes ago
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Stupid question: Did it really kill your libido or just reduced/removed the hyper-sexuality which could very well be a coping mechanism for past trauma?
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rco8786
15 minutes ago
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I don't relate at all to the latter part of your question, so be process of elimination it must be the former :)
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bflesch
51 minutes ago
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I have no experience about antidepressants myself so please excuse my stupid question.

When I hear people say "it killed my libido" I always think about the fact that hyper-sexuality can be a trauma response, and if your body is healing the hyper-sexuality is most likely also reduced.

It's like when you have a disease and then read the side effects of a medication and notice that a lot of the side effects are basically also something that can happen when your overall condition is improving but still some people report them as adverse effects and then these are added as side effects to the package label.

For example you take antibiotics but bacteria can have toxins in their body, and when the bacteria disintegrate you get more sick from the released toxins. It's called the Herxheimer effect: https://en.wikipedia.org/wiki/Jarisch%E2%80%93Herxheimer_rea...

When I started methyl-B12 supplementation I also had inflammation in sinuses for weeks but it was just from my immune system starting up again and being able to attack long-standing inflammation. Someone else would've put "fever", "headache" and "stuffed nose" onto the side effects medication label of methyl-B12.

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subscribed
12 minutes ago
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Stupid question - why do you keep suggesting that having a libido equals hypersexuality?

Is this your trauma speaking, or do you automatically associate any sexual needs with a pathology?

You've done it twice in this thread alone.

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michaelsshaw
1 hour ago
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Libido can be supplemented with Wellbutrin. Works great, even better than before.
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biofox
45 minutes ago
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SSRIs saved my life. No exaggeration. They might be overprescribed, only effective is some individuals, and they certainly have their share of side effects, but they're still the gold standard treatment for clinical depression and anxiety.
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sheikhnbake
1 hour ago
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Same for me with buproprion. Night and day difference. Made me wonder how different my life would be if I had been diagnosed appropriately when I was a kid.
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compounding_it
1 hour ago
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As someone who tried citalopram escitalopram and sertraline, along with venlaflaxine and fluvoximine, I would suggest doing a pharmacological test for psychiatric medications.

I am an intermediate metabolized for the first three and the ones I was on most long. It did not suit me and made my orgasms go from ‘wtf’ to ‘that’s it?’ And they are still not normal 2 years after discontinuation.

I am still depressed and anxious to the point of serious consideration of these medicines to save myself, but you can save yourself the experimentation by doing a simple test and avoiding those medicines.

Anxiety depression panic attacks are something I wish more people studied along with sexual health.

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anonymous344
54 minutes ago
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look my other comment for niacin
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krzat
1 hour ago
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If a drug has an 1% chance of 100% effect, it will look pretty weak in those studies.

IMO it's pretty clear that depression is a symptom of many independent issues, so it's really lame that we don't have a more accurate way of diagnosing it.

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compounding_it
1 hour ago
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The goal is to tackle it in every way. The medicines are supposed to be supportive and not the solution. More often than not people treat it as a solution.

Thats why they are eventually tapered and discontinued once you are able to be on your own.

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dizhn
23 minutes ago
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I still think you should have tried eating a banana first.
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graemep
27 minutes ago
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If it is SAD have you tried bright daylight balanced lighting?
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isoprophlex
25 minutes ago
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Yeah, I have an extremely bright lamp designed to tread SAD that I sit, or well used to sit, in front of every morning. Daylight responsive led strip in my home office. And a pair of glasses with blue LEDs for on the go. It did... 10%? of what citalopram eventually did for me.
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luxuryballs
15 minutes ago
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I experienced this but ended up getting off of them after developing some back/hip issues but I didn’t think it was related, it wasn’t until I quit the citalopram that my shoulders were suddenly relaxed and the hip “looseness” or constant need to be adjusted back into place went away, like everything tightened back up, it is really strange, then I looked up how SSRIs can impact this and even bone healing, decided I couldn’t risk my body falling apart.
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petesergeant
1 hour ago
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Yah. Measuring the effects of these drugs with a single effect size number is ridiculous. They work exceptionally well for some people (myself included). It seems as well that SSRIs work much more reliably on anxiety disorders than on depression.

Getting on them can be a ball ache (or entirely painless; escitalopram was easy on and easy off, Wellbutrin was a nightmare to get on, but also easy off), but entirely worth a shot for anyone symptomatic.

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DimitriBouriez
25 minutes ago
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- The "Apples to Oranges" Comparison Trap The author is comparing figures drawn from disparate studies. Antidepressants: These are tested in massive, highly controlled trials. The more rigorous the study, the stronger the placebo effect becomes, which mathematically "dampens" the drug's efficacy rating (scoring around 0.3). Supplements (Vit D / Omega-3): Often tested in smaller, sometimes less rigorous studies, or on highly specific populations (e.g., people with severe deficiencies). This artificially inflates their scores (sometimes > 0.5). The Reality: Placing these two figures side-by-side on the same graph without context is a major methodological flaw.

- Publication Bias Negative studies on vitamins often end up in the trash (no one publishes "Vitamin D did nothing"). Negative studies on antidepressants are required to be reported to health authorities. Result: Vitamins appear "magical" in meta-analyses because we are only seeing the success stories.

- Current Medical Consensus (What is actually solid) Vitamin D: It does not cure depression on its own. However, a Vitamin D deficiency exacerbates depression. Correcting it helps, but it acts as "support," not a miracle cure. Omega-3 (EPA): This is the stronger candidate of the two. There is a genuine consensus regarding their anti-inflammatory effects on the brain, BUT primarily as an adjunctive treatment (alongside medication/therapy), not as a replacement.

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buddhistdude
6 minutes ago
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was this written by an LLM?
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r1ch
2 hours ago
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Please do not take 5000mg/day of Vitamin D. The author confuses IU and mg which is very dangerous.
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josalhor
2 hours ago
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I also noticed that. Opened issue: https://github.com/ncase/blog/issues/4
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Aldipower
2 hours ago
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That would be 5g. At this point everyone should notice that something is off. :-D 5000 mg of vitamin D3 = 200,000,000 IU (200 million IU)
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AdamN
11 minutes ago
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xi_studio
2 hours ago
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More often written as 200,000 IU as 5000mg of D3 is not written as 5,000,000mcg

The author simply (and terrible mistaking) typed [mg] instead of [UI] in the first paragraph: if readed entirely, the author correct this typo in every other sentence

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Xunjin
2 hours ago
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Still it needs proof reading and definitely a BIG WARNING that anyone who reads the article should first talk with their doctor before trying any "recommendations". Some of these "recommendations" could literally kill someone.
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hermannj314
40 minutes ago
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I bought the once weekly 50,000IU bottle on Amazon and am currently taking 4 a day and I am ignoring all growing signs of vitamin D toxicity because I read this guys blog and never once ever decided to consult another source, including later paragraphs in that same blog because there was no warning. Without a warning, you should blindly follow all medical advice you read online.

That is that pathway to death you are worried about?

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deltoidmaximus
6 minutes ago
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I was going to say, wouldn't following through on this mistake require you to not just spend a ton of money on pills but also take tons of them a day? I'd like to think this would give even the dumbest of people pause just because of the practicality aspect.
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amai
55 minutes ago
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Why didn't the author notice? AI slop?
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sschueller
1 hour ago
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If you don't have an underlying condition it is way better to get the Vitamin D from the sun in 10-30min increments per day after which you are saturated for the day. Overdose is not possible via the sun (excluding sun burns of course).

> A single, optimal sun exposure session might produce the equivalent of 10,000 to 25,000 IU from a supplement, but it will not keep increasing with more time in the sun. That's your max per session.

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arethuza
1 hour ago
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From NHS Scotland:

"In Scotland, we only get enough of the right kind of sunlight for our bodies to make vitamin D between April and September, mostly between 11am and 3pm."

https://www.nhsinform.scot/healthy-living/food-and-nutrition...

Personally I found that taking Vitamin D supplements made quite a bit of difference - and I spend a fair amount of time outside (~3 hours each day).

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matsemann
22 minutes ago
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And in Norway we often don't see the sun during certain months, due to it only being up for a few hours in the middle of the day (when we're working). And even if I was outside I would be covered in clothes.

We have a saying here to take cod liver oil all months ending with R (in Norwegian that's September to Februar) to get both omega 3 and the vitamin D.

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mixedbit
44 minutes ago
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In winter, even on a sunny day, only tiny fraction of your skin is exposed to sun. 10-30 min of sun when you are wearing tshirt and shorts is much different from 10-30 min of sun when you are wearing long sleeves, gloves, and a scarf.
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pbhjpbhj
27 minutes ago
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It's not really the exposed skin that's the issue. At higher latitudes the ultraviolet (UVB) gets scattered by the longer path through the atmosphere and so even if you were naked you still wouldn't be getting enough.
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nimonian
9 minutes ago
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Next time I get sunburn I'm calling it a vitamin D overdose
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austinjp
1 hour ago
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Check local/national advice. In many places it is officially advised to take vitamin D supplements, especially in winter or if you have a darker skin tone.
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RobotToaster
24 minutes ago
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> it is way better to get the Vitamin D from the sun in 10-30min increments per day

spoken like someone who has never lived in the UK

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bflesch
46 minutes ago
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Your suggestion sounds a bit detached from reality of many people.

In many countries it is physically impossible to get enough vitamin D from the sun, even if you go out naked.

Also did you ever notice that the cheap apartments in many places are facing north and do not have a balcony, and of course do not have a private garden? Now you are reduced to going to a park which in the "cheap" areas is also not a good spot to chill for 30 minutes.

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INTPenis
1 hour ago
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Agreed, but I live in Sweden so I take vitamin D supplements every winter.

During the spring, summer, fall months I barely need it since I'm outside so much with my dog.

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pjc50
1 hour ago
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.. how do you calibrate this against a cloudy sky? It's pretty dark up here at 56 degrees north, and on top of that it's been overcast for days.

It also sucks a lot when it's dark before starting work, dark after leaving work, and during the day rather cold to be exposing skin to the sun.

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Ensorceled
1 hour ago
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This is nonsense advice for pretty much anybody that is shovelling snow right now.
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bflesch
45 minutes ago
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Why don't you just travel to the south during winter? /s
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consp
2 hours ago
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Isn't the oral intake pretty much negligible anyway? I remember getting a vitamin d supplement in a syringe (to be put on bread, from a physician) containing a very large dosis.

I'm not stating the dosage is wrong. Looks like it is anyway.

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abelitoo
1 hour ago
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Oral has felt very effective for me. I take a daily supplement that has roughly 100% of the recommended daily dose of everything. I split it in half.

For D3, it is 25mcg / 1000 IU / 125%

After splitting in half it's 12.5 mcg / 500 IU / 62.5%.

I take with some fat-containing food to allow ir to absorb which is usually breakfast (yogurt, some nuts, some kind of fruit, oats), and it's a night and day difference in my mood (how easily I can control my temper if already agitated, how easily I brush off annoying stuff, takes the intensity off of my reactions and mood during conversations).

I did a blood test before starting, and if normal is between 30 - 70, I was at 10. Dr prescribed megadose of D2, followed by daily D3, but I skipped on the megadose and went straight to D3 -- makes me wonder if a megadose would build up my stores since D is fat-soluble and make it so I could miss a day and not notice.

All of the above is anecdotal from me, a self-professed cave dweller, but it's been a couple of years now, and I still notice the difference. Also, what I heard from people in Boston is that 90% of them are on a vitamin D supplement. My friend from there laughed at me when I was raving about it, saying "yeah, literally everyone here is on it".

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moritzwarhier
2 hours ago
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It is easily possible to overdose on oral Vitamin D tablets and damage your body.
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voisin
1 hour ago
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Source? There have been many articles on HN showing the RDA to be ~10x too low (something like 5,000 IU) and that the daily safety limit to be significantly higher than that (something like 30,000 IU).

Edit: for clarity I am not saying it is impossible to overdose on oral tablets, but rather that with most tablets 400 IU to 1000 IU and the safe limit so much higher than these, it seems like it would be extremely unlikely for someone to be taking 30+ tablets daily. Not impossible, but not easy either.

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moritzwarhier
1 hour ago
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> Source? There have been many articles on HN showing the RDA to be ~10x too low (something like 5,000 IU) and that the daily safety limit to be significantly higher than that (something like 30,000 IU).

First: the RDA and the safety limit are not the same, and an RDA in a country being too low does not mean that the maximum safe dose is wrong.

And it certainly does not mean that there is a higher risk in under-dosing than overdosing when taking the RDA (which already includes recommendations for supplementing if you spend most of your time indoors).

I'm not a scientist, so I only know what physicians told me and what's explained in news publications or by consumer advocacy non-profits.

Here are a study (which I didn't read) and the NHS's advise on Vitamin D toxicity:

https://www.ncbi.nlm.nih.gov/books/NBK557876/

https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...

The study says:

> Most cases of vitamin D toxicity resolve without serious complications or sequelae. However, in some instances, severe hypercalcemia can lead to acute renal failure requiring hemodialysis. Cases of permanent renal damage due to vitamin D toxicity are rare.

Which sounds good, but I don't think it supports that there is no risk of oral Vitamin D overdose.

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neRok
1 hour ago
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The first link makes the problem sound like it can happen to anyone, but then when you tease out the details;

* Toxicity resulting from lack of monitoring is frequently seen in patients requiring high doses to treat ailments like osteoporosis, renal osteodystrophy, psoriasis, gastric bypass surgery, celiac, or inflammatory bowel disease.

* Patients who are on high doses of Vitamin D and taking inadvertently increased amounts of highly fortified milk are also at increased risk for vitamin D toxicity.

* According to the latest report from America's Poison Centers (APC), there were 11,718 cases of vitamin D exposure recorded in the National Poison Data System. More than half of these cases were in children younger than 5 years.

* The clinical signs and symptoms of vitamin D toxicity manifest from hypercalcemia's effects.

* Clinical management of vitamin D toxicity is mainly supportive and focuses on lowering calcium levels.

* Isotonic saline should be used to correct dehydration and increase renal calcium clearance.

A lot of those point to people drinking too much milk! (enriched milk)

* People with osteoporosis thinking "I better drink more milk for strong bones" when they are already on supplements/medicine.

* Kids drinking lots of milk and presumably not drinking any water - hence the dehydration.

PS: There are a lot of people out there that don't drink any water, and stick to juice or milk or soda, etc. They are not always fat, but that doesn't mean they don't have issues.

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ifwinterco
1 hour ago
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Why would you not be able to overdose orally? It's not like it stops absorbing past a certain dose, and there is such a thing as too much (especially if vitamin k2 is lacking)
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perching_aix
1 hour ago
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That's a bit of a non-sequitur, isn't it? The debated point is how oral intake as a delivery method can pan out specifically (and its limits), not the dosage limits of Vitamin D in general. Think consuming a drug vs injecting it.
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bulbar
57 minutes ago
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I do know somebody taking way more than 30k/day though.

Seems to be a thing in conspiracy theories "they try to hide those simple tricks from you (drinking bleach, ivamectin, 100k D3, ...)

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ndr
1 hour ago
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I would say it's almost impossible with typical packaging. What makes it easy?
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cloudhead
2 hours ago
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So 5000 IU is the recommended amount?
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neRok
1 hour ago
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This was linked on here a couple of months ago: [The Big Vitamin D Mistake [2017]](https://pmc.ncbi.nlm.nih.gov/articles/PMC5541280/)

> A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.

> This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.

> ...

> Since 10 000 IU/d is needed to achieve 100 nmol/L [9], except for individuals with vitamin D hypersensitivity, and since there is no evidence of adverse effects associated with serum 25(OH)D levels <140 nmol/L, leaving a considerable margin of safety for efforts to raise the population-wide concentration to around 100 nmol/L, the doses we propose could be used to reach the level of 75 nmol/L or preferably 100 nmol/L.

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zelphirkalt
2 hours ago
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According to what I read in a newspaper article, the recommended dose is much lower, at 800.
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moritzwarhier
2 hours ago
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According to the internet, it is way higher, probably over 9000.

Edit because the comment might be to shallow for HN: I sympathize with the struggle against depression and, after first-hand experience, share the skepticism against the widespread prescription of antidepressants and the methods of evidence presented for it.

Very serious and important topic.

Regarding Vitamin D, I am also supplementing in the Winter, but I have not read the article, which says it has an estimated reading time > 10min. I use one 1000IE (0.025mg according to the package) tablet a day max.

I'll bookmark this discussion page to read TFA later maybe.

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voisin
1 hour ago
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It’s important to take Vitamin D, as a fat soluble vitamin, with dietary fat during a meal. Something about bile production and absorption.

Also important to take it with Vitamin K.

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moritzwarhier
1 hour ago
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Yes, I remember that and have Vitamin D+K combo tablets with calcium.

Seems like it would be best to increase time spent outdoors though.

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energy123
1 hour ago
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There's likely significant individual variation in bioavailability. I would start with 2-5K/day, then measure and iterate.
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johnisgood
1 hour ago
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It depends. I have MS and I take 10k IU. My cousin who also has MS takes 20k but gets regular blood tests for it.
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Liquix
2 hours ago
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5000 IU is very high, might be beneficial during the winter for folks with very fair skin. but most probably shouldn't take that much every day
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bloak
2 hours ago
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You mean very dark skin?

It's my understanding that northern Europeans evolved fair skin in order to cope with the lack of vitamin D in their diet.

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Flatterer3544
2 hours ago
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You got it backwards, it would be more beneficial in areas with few hours of sun for darker skin folks, since they do not absorb as much Vitamin D as fair skin folk do.
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cies
1 hour ago
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absorb or create?

i understand it as: absorbing is in the intestine, generating D happens in the skin when exposed to the sun

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HPsquared
2 hours ago
[-]
That's equivalent to about 10 minutes of sun exposure. Not very much when you look at it that way.
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zelphirkalt
2 hours ago
[-]
That comparison doesn't work. Only 10-20% of the vitamin D we intake is delivered through food and the body cannot process more sourcing from food. Even if you take more you will not benefit in an unlimited way, processing more. The skin is much better at generating/making/doing it.
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smallerfish
1 hour ago
[-]
The skin is definitely much better, but a higher than "recommended" dose is definitely (anecdata) effective at bringing up and maintaining the measureable Vitamin D3 level in your blood if you are under the recommended range. It's an important metric to track in your regular blood tests.
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graemep
2 hours ago
[-]
I think you mean for those with very dark skin, not fair?
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lossolo
1 hour ago
[-]
I was taking 2x2000 IU with almost no sun exposure and then did bloodwork. My level was 77.8 ng/mL. The lab's reference ranges listed 30-50 ng/mL as optimal, 50-100 as high, over 100 as potentially toxic, and over 200 as toxic.
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koakuma-chan
1 hour ago
[-]
I used an LLM to summarize and it told me 5000 IU.
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phoronixrly
54 minutes ago
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Wow, so what value is there in LLM slop exctracted from already dubious self-medication advice?
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perching_aix
50 minutes ago
[-]
They're saying that it successfully filtered out the bit where the author told people to overdose by 40000x. I guess that's the value.
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phoronixrly
47 minutes ago
[-]
There would be value if it pointed out the mistake instead of hallucinating a correction.
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pulvinar
31 seconds ago
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GPT5.2 does catch it and warns to not trust anything else in the post, saying no competent person would confuse these units.

I wonder if even the simplest LLM would make this particular mistake.

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nialv7
34 minutes ago
[-]
yes, once i saw that i stopped reading. if the author can't get that right i am not going to trust anything else they say.
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RandomTeaParty
2 hours ago
[-]
Is "IU" another case of xkcd 927?
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grumbelbart2
1 hour ago
[-]
No, it's to make it easier to dose different kind of biologically active substances. They can have significantly different "recommended weight to eat of this per day", IUs make that sort-of comparable and easier to remember.

https://en.wikipedia.org/wiki/International_unit

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zelphirkalt
2 hours ago
[-]
Only recently again I read in the newspaper, that most products are overdosed. There is a typical number that the vitamin D products usually show, and in the article it said, that only up to 800 IU is safe, and everything above is an overdose. There are many products out there with 2000 UI or maybe even more. Beware.

EDIT: Wow, the HN-local doctors at it again. Imagine getting downvoted for sharing information from newspaper article (and honestly labeling that info as such), that probably was written by someone consulting medical professionals. But hey HN will know better!

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krona
2 hours ago
[-]
Being at the beach (in summer) for a half an hour will produce 10,000 and 25,000 IU for the average european.

See: Vitamin D and health: evolution, biologic functions, and recommended dietary intakes for vitamin D (293 citations)

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SoKamil
1 hour ago
[-]
Could you cite that claim from the paper?
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poizan42
25 minutes ago
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Not OP, but the paper says on page 8

> An adult in a bathing suit exposed to 1 minimal erythemal dose of ultraviolet radiation (a slight pinkness to the skin 24 h after exposure) was found to be equivalent to ingesting between 10,000 and 25,000 IU of vitamin D (Fig. 6).

Doesn't say 30 minutes, but it may be 30 minutes depending on your skin colour and the local strength of the sun.

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zelphirkalt
18 minutes ago
[-]
I think the OP's interpretation of this is wrong. Just because someone was found to have an equivalent of ingesting so and so much, after UV radiation, doesn't automatically imply that it a good idea to ingest any amount of vitamin D. Ingestion is different from exposing skin to UV/sun. The paper probably doesn't state, that ingesting that much will make a person absorb that much from that ingestion, nor does it state, that ingesting some equivalent amount will be safe and without side-effects.

So the paper may be well researched or whatever, but the interpretation of it is questionable.

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zelphirkalt
1 hour ago
[-]
So? What's your claim here? Are you claiming that our skin works the same way as our digestive system? That would be a ridiculous claim. And fyi, many people get a proper sunburn, if they stayed in the sun for 30 min straight without protection, at least in summer. So your 30 min statistic doesn't really tell us anything about something being healthy or not.
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krona
1 hour ago
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I've given you everything you need to find out for yourself. Your incredulity on this is a self-confession.
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zelphirkalt
1 hour ago
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What you have given is rather a comparison, that doesn't stand up even the slightest scrutiny, and an improper citation. I am not gonna read a whole paper on a whim. Cite properly, with proper hyperlink, and at least a page number, and I will consider looking at it.
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lynx97
1 hour ago
[-]
Before I take medical advice from a newspaper, I might as well ask my local esoteric nut.
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Ensorceled
57 minutes ago
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Can you provide a link to the newspaper article at least while whining about the downvotes?
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zelphirkalt
5 minutes ago
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I would like to, but I cannot, since it is a region-local newspaper that comes as actual paper, that only has a paid online offer, to which I have no access, nor could I post a link to that. If I went through recent paper form newspaper, I could get a photo of the text in German, but then I would (A) need to spend that time, and (B) need a place to upload pictures, without having to make an account, and only then get back to you with a link. To be honest, I am too lazy to do that, just to justify a comment on HN.
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weird-eye-issue
2 hours ago
[-]
Misinformation. Do more research.
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AndrewDucker
2 hours ago
[-]
If you have useful information to share, please do so. Telling people "Do more research" adds nothing to the conversation.
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woadwarrior01
2 hours ago
[-]
Examine.com's page on Vitamin D has a table on tolerable upper levels segmented by age ranges.

https://examine.com/supplements/vitamin-d/

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viraptor
2 hours ago
[-]
Neither does "I read in the newspaper, that most products are overdosed" to the honest.
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spoiler
2 hours ago
[-]
While (I think) I agree with you on the facts here, I don't think this type of dismissive comments are that useful either.

Can you give the replyee some pointers, for example? Link to articles or studies that show a different view?

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weird-eye-issue
2 hours ago
[-]
Just Google it. There's tons of research on this so I don't know why I need to provide a specific link when this is common knowledge.

But also here is something to think about: your body will produce more D3 than that by being in the sun for just several minutes. So if you consider such a low dose of D3 an overdose then you better steer clear of the sun!

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zelphirkalt
1 hour ago
[-]
> But also here is something to think about: your body will produce more D3 than that by being in the sun for just several minutes. So if you consider such a low dose of D3 an overdose then you better steer clear of the sun!

This is another superficial statement, that displays shallow-at-best understanding. Staying in the sun and producing via the skin, and intake via food are 2 separate pathways. You cannot just make wild assumptions about one of those pathways from stuff you know about the other pathway.

And actually: Yes, you shouldn't stay in the sun for too long without proper protection. Having the sun shine on your skin is not some inherently healthy thing. It too comes with acceptable dosage and overdose. Symptoms of overdose are commonly known as getting a sunburn.

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weird-eye-issue
1 hour ago
[-]
Thanks for clearing that up for me.
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johnisgood
1 hour ago
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The problem with "Just Google it" that you can find a lot of bullshit on this.
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weird-eye-issue
1 hour ago
[-]
You can find scientific papers on Google if you know how to use it.
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zelphirkalt
10 minutes ago
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You can find scientific papers on a lot of search engines, not only Google.

The problem with that is, that you still need to know how to interpret any results and statements within the supposedly scientific papers. If you are not a statistician, you might overlook methodology mistakes. If you are not an expert in the matter of the paper, you might not realize some side condition, that makes some statement or result of the paper irrelevant for your individual situation.

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johnisgood
1 hour ago
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I do, but surprisingly a lot of people do not.
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nilslindemann
2 hours ago
[-]
Hi, Mr. wolf language.
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Xunjin
2 hours ago
[-]
It's unbelievable crazy what the author suggests, even say "10,000 IU if you're feeling daring / have darker skin / live in less sunny climates.".

Just a simple look at the side effects of high dosages:

Safety and side effects

Taken in typical doses, vitamin D is thought to be mainly safe.

But taking too much vitamin D in the form of supplements can be harmful and even deadly. Taking more than 4,000 IU a day of vitamin D might cause:

    Upset stomach and vomiting.
    Weight loss and not wanting to eat.
    Muscle weakness.
    Not being able to think clearly or quickly.
    Heart rhythm issues.
    Kidney stones and kidney damage.

https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...
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smallerfish
1 hour ago
[-]
To my understanding Vitamin D is regularly underdosed. Several points:

1) There are lots of studies that correlate Vitamin D production with sunlight exposure. For example, https://pubmed.ncbi.nlm.nih.gov/20398766/ this one lands on 1/4 of a MED = 1000 IU. Of course now we have a MED definition problem, but we're roughly talking single digit numbers for a white person in midday sun in NYC to reach 1/4 of a MED.

2) If you also supplement with Magnesium, a lot of your side effects go away. Vitamin D3 depletes Magnesium absorption.

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Bender
1 hour ago
[-]
FWIW just anecdotally I took 160,000 IU per day for a few months along with 800mcg to 2mg of K2 MK-7 and about double the suggested amount of magnesium citrate. I slowly titrated up to that amount over a few months. I am not suggesting anyone else do that as I had a specific purpose slow action TPA when combined with many protease so to speak but just my own experience I did not have any of those issues. I don't know how they came up with them so I figure they are just guessing like they did with the toxic level of selenium which has a funny back story. I am back down to 5000 IU a day. Years later still none of those issues. But that is just me.

I did have one issue related to magnesium however. If I did a very high dose of magnesium taurate and a couple of other chelated forms I would have trouble catching my breath after physical exertion similar to chronic high doses of iodine. Not the end of the world but it was unnerving.

Don't anyone else do what I do. I experiment on myself more than scientists experiment on mice minus the whole dissection bit. I am just continuing some experiments from the 1900's but as I understand it AI will be learning all of those soon. Fascinating stuff really.

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leetrout
49 minutes ago
[-]
I respond well to magnesium oxide and magnesium citrate in capsules but the chelated magnesium gives me heart palpitations or makes them more frequent if I am already having them. I hadn't noticed shortness of breath since the palpitations would have outweighed that.
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nxobject
2 hours ago
[-]
Be careful - many studies in the Vitamin D meta-analysis *enrolled patients already taking antidepressants.* [1] Reporting effect sizes without specifying "on which population?" is misleading.

(As an aside, Cohen would be the person not to tell you to assign qualitative values to effect sizes. They are as arbitrary as any other threshold used by working statisticians.)

[1] https://www.cambridge.org/core/journals/psychological-medici...

EDIT – that is, please don't draw the conclusion that you can substitute supplements for antidepressants. The meta-analyses don't seem designed to examine that hypothesis, and I doubt anyone would ever participate in a such a trial. In general (and as a working biostatistician), I would be very, very, very cautious applying estimates of average effect to myself, you, or any other individual person in a field as murky as psychiatry. That's why even the stingiest American health insurance plans still have an incredibly large range of antidepressants in their formularies.

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rollulus
5 minutes ago
[-]
Anecdotal, and even meta-anecdotal, but hey: four months ago I started to supplement omega 3 thanks to this hyperbolic HN comment: https://news.ycombinator.com/item?id=45169875

Unlike the commenter, I didn’t suddenly turn into a chess grandmaster, but I did notice that my winter blues didn’t show up this year, the first time in a decade!

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vegancap
2 hours ago
[-]
I found this to be the case. Tried Sertraline for a while, gave me headaches and made me feel sick. Then as part of a new gym plan, started taking Omega 3+VitD daily, and I just felt a sense of calm and peace after a few weeks. The massive uptick in exercise probably also helped. I also felt quite an extreme uptick because I was a vegan for 10 years, and found out I had basically zero Omega 3 in my blood. I suspect one of the main reasons my mental health declined was due to the lack of Omega 3.

Disclaimer, not saying vegans should stop being vegans, just make sure you find a good supplement, and make sure you understand the difference between EPA/DHA Omega 3.

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hshdhdhj4444
2 hours ago
[-]
All my nutrient numbers improved when I became vegan because nearly every one in the US/UK is deficient in VitD, Omegas and B12.

Fortunately today’s vegan communities are much more aware of this so I started taking these supplements right up front and all my blood markers improved dramatically since when I consumed meat/dairy.

It’s annoying to hear some push back against this when it’s as simple as taking relatively safe supplements (just make sure you talk to a doctor, and not a social media influencer, about how much you should take, and if you get a chance to regularly check your bloodwork don’t miss out).

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johnisgood
1 hour ago
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Why did you become a vegan if apparently even non-vegans are deficient in B12? Do you supplement B12? Since B12 is mainly found in meat, and B12 deficiency is irreversible.
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tefkah
9 minutes ago
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why do you think the reason for them becoming vegan has something to do with B12 levels? likely they became vegan for different reasons, became much more aware of the importance of B12 and started taking a supplement.

every vegan should supplement b12, so they probably do too

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dvh
2 hours ago
[-]
> as part of a new gym plan

There's your answer

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serpix
2 hours ago
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Omega 3 comes from algae, which might be okay for some vegans.
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tefkah
7 minutes ago
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Unlikely any vegan would have any moral qualms about algae, given that they’re not animals. Maybe you were thinking of oysters/clams/bivalves?
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hshdhdhj4444
2 hours ago
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What vegans would not be ok with algae?
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buddhistdude
1 hour ago
[-]
algerians
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brushfoot
2 hours ago
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> I was a vegan for 10 years, and found out I had basically zero Omega 3 in my blood

I see your disclaimer, but just for more context, vegans can get Omega 3 without taking pills per se. Flax seeds are an excellent source. I often add a spoonful to a bowl of oatmeal or as a pancake topping along with fruit sauce and granola.

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canucker2016
1 hour ago
[-]
Grind the flaxseed before eating them so your digestive system can access more of the nutrients in flaxseeds.

from https://www.bhf.org.uk/informationsupport/heart-matters-maga... :

  Eating ground flax seeds gives you more benefits than whole seeds, as whole seeds remain undigested and pass through the system.
from https://www.peoplespharmacy.com/articles/must-you-grind-flax...

  Most people can’t chew flaxseeds effectively, so they grind them first or swallow them whole. (They are tiny.) Nutrition experts do recommend grinding them first to release the fiber and the beneficial fatty acids. Flaxseeds are helpful for constipation and may lower cholesterol as well.

  Ground flaxseed goes rancid easily, however, so it should be kept in the freezer until you are ready to use it. If you buy it ground, you wouldn’t have to use the blender or coffee grinder to break those seeds up before you have breakfast.
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mistercow
1 hour ago
[-]
Flax seeds are a very tedious and inefficient way to get omega-3 as a vegan, particularly because they contain ALA, a short chain omega-3, which our bodies are extremely inefficient at turning into long chain fatty acids.

Just get an algae oil based DHA+EPA supplement.

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pydry
2 hours ago
[-]
Flaxseeds are probably the most flavorless things I've ever tasted.

Chia seeds taste ok but you need to prep them by soaking which is a pain (or experience bloating).

All other seeds have more omega 6 than omega 3.

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grvdrm
2 hours ago
[-]
Funny - I feel the opposite about chia. Soaked and plumped is when I hate them. Dry on salads/etc. or just submerged in an active bowl I'm eating is when I like them most - the crunch adds texture to what I'm eating.
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legulere
2 hours ago
[-]
> A 2014 systematic review concluded that vitamin D supplementation does not reduce depressive symptoms overall but may have a moderate benefit for patients with clinically significant depression, though more high-quality studies were determined to be needed.

https://en.wikipedia.org/wiki/Vitamin_D#Depression

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nayroclade
2 hours ago
[-]
The meta-analysis cited in the article is from 2024 and specifically mentions the Shaffer et al. 2014 review cited by Wikipedia as being low quality:

> Some of the available reviews, owing to the limited number of trials and methodological biases, were of low quality (Anglin et al., 2013; Cheng et al., 2020; Li et al., 2014; Shaffer et al., 2014).

https://pmc.ncbi.nlm.nih.gov/articles/PMC11650176/

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legulere
36 minutes ago
[-]
If you're not in the respective fields it can be pretty difficult to distinguish good from bad research. I am not able to do so.

If you (or your close ones) don't suffer from depression, then I guess it's best to ignore it until scientific consensus has formed. That will for sure show up on wikipedia. As far as I can see as a layperson there is a lot of correlation with Vitamin D that breaks down in interventions and Vitamin D is recommended mostly for babies and elderly people. On the other hand I see Vitamin D pushed as a miracle drug not unlike Vitamin C used to some decades ago and regular reports of overdosing of supplements leading to organ failure.

If you're suffering from depression, you should talk to your doctor. They will be able to help you to weigh potential benefits with risks

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afpx
1 hour ago
[-]
Therefore what to do? I have seen these Hacker News vitamin D ads appear every few months for the past 15 years, or so. I always seem to have a vitamin D deficiency, so it reminds me to take supplements. I take them for a few months, hoping to see a change, but I don't feel any benefit. Then, I forget to take the supplements until the next time I see an ad. How to know if they're actually doing something useful?
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Palomides
48 minutes ago
[-]
you could make a decision informed by actual information, i.e. your blood levels
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phoronixrly
51 minutes ago
[-]
Until you see an article like this which calls for '5000 mg' of supplementation, decide that you didn't take enough and overdose...

HN and dubious self-medication advice go hand-in-hand. Please consult a medical professional instead of a bunch of ad-tech devs.

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b800h
2 hours ago
[-]
Can I just add: In addition to this, if you struggle with anxiety or have some sort of ADHD, then try cutting out caffeine entirely. Not just switching to "decaf" (which isn't), but cutting out tea and coffee, and switching to an alternative like Barleycup.

Doing this has had a massive positive effect for me, and combined with decent nutrition and daily exercise, has been wonderful.

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parag0ne
1 hour ago
[-]
Agreed, anyone that already struggles with something like this should quit caffeine. My life is so much better off of it, but I struggle to stay off of it because I'm addicted to the 2hr productivity boost vs the all-day steadiness when you're not on caffeine. Things that improve for me were: No sense of urgency for every single thing. Significantly improved confidence. Word things better and speak better in general. No hard crash later in the day. All my scattered thoughts become cohesive. No more random heart palpitations.

All of these likely got better due to the overall effect of decreased anxiety and not making ADHD worse. I'm not myself when on caffeine. Nikola Tesla quit all caffeine/other stimulants for a reason.

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marginalia_nu
43 minutes ago
[-]
Downside with going completely off caffeine is you get so tired and unfocused and it lasts for ages.

I tried doing this for almost a full year, and while the improved sleep and generally improved mood was fantastic, and even toward the end it was so much harder to get any focused work done.

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jofzar
1 hour ago
[-]
> Not just switching to "decaf" (which isn't)

Going to argue here, this is wildly bad advice. Decaf practically has no caffeine, it has 2-7 mg from what I can tell which is less then chocolate. 2-7mg is like impossible to notice and might aswell be water with how little there is.

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dddw
1 hour ago
[-]
Agree, althouh quiting it altogether might simply help with establishing the new habit.
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binsquare
2 hours ago
[-]
I did the same thing and experienced the same effect.

I'd add that my ability to sleep naturally was negatively affected as side effect of medication. I tried a various combos to induce sleep and found the best solution to just be... exercise.

No caffeine, exercise, sleep lead to a significantly reduced anxiety and more.

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haght
52 minutes ago
[-]
Very true! I recently found out that i am extremely sensitive to caffeine, and one cup at 6 pm makes me unable to fall asleep at night until 4 am. Trying to cut off the caffeine entirely now.
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tripledry
2 hours ago
[-]
How long would you say it takes to feel the effects after switching? I did this a couple of years ago and as far as I remember the only real effect was my energy levels were more stable.

I gave it maybe 2-3 months and decided it's not worth it.

Tempted to give it another shot!

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voidUpdate
1 hour ago
[-]
I wish I could cut down on my caffeine intake to help my ADHD. Unfortunately, I already have basically zero caffeine intake (apart from diet coke sometimes)
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grvdrm
2 hours ago
[-]
Fascinating.

Can you describe what else you tried? Other supplements? Any other non-food/supplement techniques like journaling, breathing, etc.? Any therapy and other similar human interventions?

After all those - is it / was it still the case that cutting caffeine drove the best outcome?

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parag0ne
54 minutes ago
[-]
Not OP but I'll share my experience. For me, I have to quit caffeine for those to even become an option. Otherwise I get my short burst of productivity then everything shuts down after and I don't want to do a thing, everything feels "impossible" or like it doesn't matter at all.

Things like journaling / breathing / etc calm the nervous system while caffeine stimulates it. I would say caffeine is counterproductive to those practices.

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grvdrm
32 minutes ago
[-]
Thanks for sharing.

I briefly quit caffeine once but it as well before any realization of anxiety. So, hard to extrapolate forward from that experience.

What feels different to me (compared to you) is this: sometimes I'll drink 2 cups of coffee in the morning and be awake but useless. Sometimes totally productive. Caffeine in some form is there - recently sometimes substituting coffee for a Celsius.

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bamboozled
2 hours ago
[-]
I love coffee so much, I'd prefer to deal with the anxiety, and I do suffer from it.
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buddhistdude
45 minutes ago
[-]
Or the addiction just makes you think that this is good for you when actually you'd feel better without it?
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ramon156
2 hours ago
[-]
You can also get decaf beans, or try to see if you can get used to tea. I do both right now and I feel a lot better
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xenospn
1 hour ago
[-]
As someone from the Middle East, just thinking about not drinking coffee makes me lose my will to live. It’s like asking me to wear sunglasses on a cloudy night.
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RobotToaster
26 minutes ago
[-]
One flaw in this analysis is that the source he cites for antidepressant effectiveness didn't include tranylcypromine (or any MAOI class drugs), which the STAR-D trial found was one of the most effective antidepressants.

(The STAR-D had a cumulative remission rate of 67%, I don't know how to convert that to the format he used)

Otherwise I agree that vit D and omega 3 are underrated for depression, it would be interesting to see if they have a cumulative effect with antidepressants.

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cardanome
2 hours ago
[-]
With depression it is important to find the cause of it.

You might be depressed because you life objectively sucks. Then you symptoms are good and healthy and a signal to make changes in your circumstances.

You might actually have a good life but still feel depressed because there is a chemical imbalance in your brain. (Very simplified). That is when drugs come in.

It might be just a seasonal thing and you need to go outside more and take some supplements.

You might have some other undiagnosed issue. You might have ADHD, autism and other things that cause you to struggle and develop depression as a side effect.

So find out what works and what doesn't work for you.

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tock
1 hour ago
[-]
You mean relatively sucks. Else every single human ancestor would have to be super depressed too given the standard of life in the past.
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cardanome
47 minutes ago
[-]
Objectively in the sense that there are actual causes in you life that distress you and cause your symptoms instead of thinking your life is shitty because you are depressed. Of course being able to determine if it is your depression talking or if things are objectively bad isn't easy and people often need outside help from a therapist for that. Plus it isn't really clear cut in practice.

On a sidenote, I know that knowing that it is "just your depression talking" is also a pretty hard pill to swallow and not always helpful. Personally I have a lot of fears that I know are irrational but that doesn't make them any less real.

And even if your problems are external, sometimes you need to focus and your inner self first, find some strength and help so you can tackle the external problems later. But for other people "working on yourself" can be avoiding the actual problems they need to work on.

And yes happiness is always relative.

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sambuccid
42 minutes ago
[-]
I guess there are different types of "life sucks" that can or cannot contribute to depression, my current understanding is that a lot of it depends on whether you feel you have some control over the situation or if you think you have absolutely no power over it
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citrin_ru
36 minutes ago
[-]
Isn't people in the past had less control? There were dying from infections and not only had no vaccines and drugs they didn't understand how infections are spread. They also suffered from various natural disasters not having a protection a modern civilization gives us.
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citrin_ru
1 hour ago
[-]
> You might be depressed because you life objectively sucks

The problem with this that to a bad situation different people react differently - some trying to do what they can to improve the situation or at least don't make it worse and some give up and let situation to slip and become worse and worse (becoming a self fulfilling prophesy). It's not a choose one makes I think (it's likely a biological predisposition) but the difference is still exists.

People prone to depression genuinely believe the main (only) reason for a depression that the life sucks and as a result they avoid medical help and don't do anything which could help them.

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xnzakg
1 hour ago
[-]
The problem with the "your life objectively sucks" option is when you end up too depressed to actually bother doing anything and just give up. That's another case where drugs can help.
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ajkjk
1 hour ago
[-]
That's the sorta standard socially accepted way of thinking about this. but uh... to a lot of people it doesn't ring quite true.

For example: if your life objectively sucks, why aren't you doing anything about it? Some people whose lives suck fix their lives, and other people get depressed and do nothing; what's the difference? And: all of us know somebody who appears to have a good life and therefore their depression is presumably a chemical imbalance thing but if you're being honest the vibes in their life are a bit off, actually, like you can tell they're not really getting everything they need out of it, that they're clearly good at masking (for example people who are clearly not thriving in their relationships) .... in which case sure medication could help but you can't shake the feeling that facing the reality of their life would help a lot more.

However! Questioning this stuff becomes a bit of a moral minefield. "Believing" in the chemical imbalance theory is part of why it's medically helpful. If your life has sucked for years and you could find no way of fixing it and then SSRIs helped, then you basically need to believe that it really was a chemical imbalance, because believing that it might not be threatens to take away the thing that's making your life work. So much so that I would bet at this point there are already readers of this comment who are ready to angrily reply to my preceding paragraphs, because the model I just described threatens their existence. (If so, wait a sec and read the rest...)

On the flip side, for some people not believing in the chemical imbalance model for some particular case might be important. Maybe they want to feel responsible for their life being bad, so they will be motivated to do something about it, and being happy due to drugs would make them feel complacent and okay with years passing by at a shitty job or something. Or picture someone whose parent has gone their whole life unable to take them seriously as an adult, which as a result means the child and parent have a bad relationship, and then picture the parent complaining about depression and taking medication for it. This can be really infuriating: the child thinks about the parent, "your life sucks because of the tension created by not treating people around you with respect, and you're so incapable of recognizing this even when it's told to your face regularly that you're taking drugs to feel better despite not fixing the problem". Now ascribing depression to medical problems seems like avoidance, and having people write off your frustrations and say that you're just depressed and need to take a drug for it is frustrating.

Just saying: the two narratives really get tangled up. I don't really know what to do about it, but I do think that some harm is done by harping on the concept of a "chemical imbalance". A lot of the issue is avoided if you just think of the drugs as helpful but don't choose any model (with its moral implications) for what exactly it is they're helping with. Just treat them as a tool for making you feel better.

Also, I suspect that people who have an intuitive aversion to mental health drugs are probably way overindexing on that intuition. I definitely did this for a long time, as did some friends I knew growing up. Turns out whatever your issues you can sometimes just deal with them sooner than later if you accept that doctors might be onto something. (Actually I think the reason people get stuck avoiding medication for so long is precisely that they feel like they're not allowed to be skeptical of them... which makes them kinda plant their feet in the ground and refuse to be open to it. That's kinda why I'm typing this long comment, to tell anyone reading that it is a reasonable thing to feel. And now that you know that maybe try them anyway..?)

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Liquix
2 hours ago
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can vouch for a diet high in fatty fish along with supplementation of D3 + cofactors (K2, A, magnesium, zinc, copper, boron). sample size of one but noticeably improves mood and energy levels.

recent evidence [0] suggests there's not much of a link between serotonin and depression, and therefore the effects of SSRIs are either placebo or an as of yet unexplained mechanism of action. IMHO it seems much more likely that modern lifestyles (excessive screen time, poor diet, lack of socialization, no connection to nature, no spirituality, etc) have more of an effect than serotonin levels.

[0] https://pubmed.ncbi.nlm.nih.gov/35854107/

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daoboy
2 hours ago
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My physician prescribed Vitamins D and B12, so a quality Omega 3 is the only supplement I currently purchase.

After an absurd amount of trial and error with every over-the-counter, trendy supplement over the last couple of decades (and lord only knows how much money), these are the only ones that seem to make a subjective difference on my quality of life and an objective difference in my bloodwork.

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amai
1 hour ago
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Coincidence? "Vitamin D is currently the only Essential Vitamin or Mineral which appears to have deficiency rates at a similar level to Magnesium"

https://examine.com/supplements/magnesium/research/#nutrient

Dai (2018): Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial https://pubmed.ncbi.nlm.nih.gov/30541089/ "Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. "

So it might well be that general deficiency in Vitamin D is caused by the deficiency in magnesium status. This would also be an explanation why we see Vitamin D deficiency in sunny Africa: https://theconversation.com/think-vitamin-d-deficiency-is-no...

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brushfoot
2 hours ago
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And better than taking pills for the former, add hemp hearts or flax seeds to your cereal. One serving of hemp hearts has 10 grams of protein and 12 grams of Omegas 3 and 6. Flax seeds are lower in protein but an even better source of Omega 3 in particular.
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code_biologist
2 hours ago
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Never going to advocate against eating whole foods if they taste good! But beware, the ALA omega 3 fat in flax and plant sources is not the DHA and EPA omega 3 fats used by animal cells, and so it's not as potent as what's in fish.

The main problem with ALA is that to have the good effects attributed to omega-3s, it must be converted by a limited supply of enzymes into EPA and DHA. As a result, only a small fraction of it has omega-3's effects — 10%–15%, maybe less. The remaining 85%–90% gets burned up as energy or metabolized in other ways. So in terms of omega-3 "power," a tablespoon of flaxseed oil is worth about 700 milligrams (mg) of EPA and DHA. That's still more than the 300 mg of EPA and DHA in many 1-gram fish oil capsules, but far less than what the 7 grams listed on the label might imply.

https://www.health.harvard.edu/heart-health/why-not-flaxseed...

Also, beware of omega 6 fats. Seed oils (corn, soy, canola) used in commercial food products are incredibly omega 6 dominant in terms of polyunsaturated fat content. Consequently, the ratio of omega 3 to omega 6 fats we consume has plummeted as food production has industrialized. Omega 3 fats are precursors to generally anti-inflammatory signaling compounds, whereas omega 6 fats are precursors to pro-inflammatory signaling compounds. The bias in fat intake leads to more pro-inflammatory signaling in the body, and a lot of alt health types have alleged this is a major causative factor in the obesity epidemic.

This is important for depression, because chronic brain inflammation as a cause of depression was one of the going hypotheses at least a decade ago when I last looked into all of this. Upping omega 3 intake is an intervention that can address chronic inflammation, which is potentially why it improves some cases of depression.

Pretty much nobody in the west needs more omega 6s these days. I hear even farmed salmon eat primarily corn and soy based feeds these days, meaning their fat ratio is skewed much more heavily toward omega 6 than wild salmon and fish.

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cube2222
2 hours ago
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I'm not an expert, but I've done a bunch of reading on this previously, and also skimmed the article which also mentions some parts of this.

First, when taking omega 3 supplements, you generally care about increasing the ratio of omega 3 to omega 6. Hemp hearts have much more omega 6 than omega 3, so they're not very effective for improving the ratio.

Second, hemp hearts contain ALA, while what you generally want to improve is EPA and DHA (this is also covered in TFA). The body can convert ALA to EPA and DHA, but it's not efficient.

So all in all, if Omega 3 for the article's stated benefits is what you want, this is not the way. I recommend looking into eating more fish, or if you want a vegan route, algae-based supplements. [0] is a decent source from the NIH about foods and their Omega 3 content, split by ALA/EPA/DHA.

[0]: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthPro...

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brushfoot
2 hours ago
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The ratio of Omega 6 to 3 needs to be below 4:1 to be a good source of Omega 3, and hemp hearts are at 3:1, so they're listed as a good source of Omega 3.

Flax seeds are even better just for Omega 3 at 1:3, but hemp hearts have other benefits, like more protein, which is why I called them out. That said, I eat a fair amount of flax seeds as well.

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cube2222
1 hour ago
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Just to reiterate, both of those (hemp hearts and flaxseed) only contain ALA, while what you're generally looking for is EPA and DHA. TFA also explicitly mentions it's only talking about EPA.

This is not to say that they're unhealthy of course.

EDIT: see the sibling comment by code_biologist, it's much more comprehensive than what I've written.

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samsartor
40 minutes ago
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Several people in my family have a MTHFR gene mutation that screws stuff up, including causing problems with anxiety+depression. But a simple B12 shot every couple of weeks does wonders.
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elAhmo
1 hour ago
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To many people without relevant expertise give medical advice online.

I remember a similar case with levelsio who was advocating people to take melatonin and discussing how much grams is good vs bad. When I said that people shouldn't take medical device from someone who was successful in building web apps, he blocked me.

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HisNameIsTor
17 minutes ago
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Wrong unit in text, right? Graphs shows UI. 5000 UI would mean 125µg of D-vitamin. Which is a bit smaller than 5000 000 µg from the next
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dingdingdang
1 hour ago
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Confusing mg and IU units up front really do NOT inspire confidence on the topic and conclusion as a whole.
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tiffanyh
44 minutes ago
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Before anyone goes out and overdoses on Vitamn D (since lots of multiple vitamin include too much), see this article on toxicity from too much Vitamin D

https://www.ncbi.nlm.nih.gov/books/NBK557876/

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cwillu
22 minutes ago
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Juxtaposing with the quoted passage from the post: “Because vitamin D is potentially toxic, intake of [1000 IU/day] has been avoided even though the weight of evidence shows that the currently accepted [limit] of [2000 IU/day] is too low by at least 5-fold.” --https://www.sciencedirect.com/science/article/pii/S000291652...
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alastairr
1 hour ago
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While I agree with the general point

Vitamin D is toxic (and ultimately fatal) at high doses, which is why the 'suggested' dosages of between 400IU and 1000IU are so conservative. You may need more, but you should get a blood test.

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bell-cot
48 minutes ago
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THIS. And not just for Vitamin D. Not everyone absorbs / metabolizes / excretes vitamins or minerals in the same way. Learning whether or not you're an outlier can be done either the safe way, or the dangerous way.
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lynguist
48 minutes ago
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For a single time fix (“rewire brain to be healthy again”) you need psychedelics (psilocybin has seen multiple studies where its effect is way better than psychopharmacological drugs). A single dose can make you healthy for a year to come, potentially also for life as you’re no longer a potential victim to it ever again.
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shellkr
1 hour ago
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This made me think of Pauling (https://en.wikipedia.org/wiki/Linus_Pauling) who was a famous scientist and big proponent of high-dosage C-vitamin. He claimed it could cure everything from a cold to heart disease and cancer. Later studies did though not find any benefit of high-dosage C-vitamin and that potentially had a higher risk of prostate cancer. Pauling died of prostate cancer.

Edit: This may also be of interest: https://en.wikipedia.org/wiki/Orthomolecular_psychiatry

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comrade1234
1 hour ago
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Before you start taking crazy amounts (or any amount) of vitamin D just get a blood test. It's simple. As part of my insurance I can get a bunch of different blood tests, but I did have to pay about $50 extra to add the vitamin D test.

Based on the test I was just a tad under where I should be and so now I am taking 800 IU per day. I may stop in the summer when I get more sun.

I read somewhere that too much vitamin D has similar effects as too little (permanent hair loss, anemia, etc) but that may have just been on a blog similar to the linked blog on this submission.

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mda
49 minutes ago
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I would take these articles about vitamin D with a grain of salt, there is a big vitamin D supplement and testing market and most of the studies about the miracles of it are dubious at best
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buddhistdude
38 minutes ago
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including the mentioned meta-analysis? if yes, can you explain why you think that it's dubious?
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lqstuart
2 hours ago
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The only problem here is that "going from an F to a C in mental health" is vastly different than "going from a C to an A." It's very well known and well documented that antidepressants have very little effect on mild depression compared to say, exercise, but that F grade of depression tends to be a different beast with different causes.

That's not to suggest that exercise etc isn't great, just that society has come a long way in destigmatizing mental health and just being like "oh just take fish oil" to someone dealing with that kind of depression, either through shitty genes or childhood trauma or whatever, can be really harmful.

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zvqcMMV6Zcr
1 hour ago
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> So why are all the official sources still so paranoid about Vitamin D

It is fat soluble vitamin, together with A, E and K. That in itself makes in more risky in terms of overdose. I didn't hear of any cases outside kids eating jars of vitamin gummies but it does happen.

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torcete
1 hour ago
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I would add that the issue with Omega-3, is the imbalance between Omega-3 and Omega-6. It turns out that many of the food products have been manufactured with Omega-6 rich oils and that is causing some issues. One can ingest Omega-3 supplements, try to eat foods rich on that fatty acid or reduce foods with lots of Omega-6 in order to restore that balance.
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running101
2 hours ago
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Chia seed and flaxseed high in omega3
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grvdrm
2 hours ago
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+ great for fiber. I load up chia as much as I can throughout the day.
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code_biologist
1 hour ago
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Chia is awesome for making pudding out of random liquids. I have to restrain myself from eating a batch of coconut milk cinnamon chia pudding in a single sitting.
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freehorse
2 hours ago
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ALA, not EPA, though, and it is unclear how much of it is converted then to EPA in the body. Afaik only EPA has shown antidepressant effects.
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rustyhancock
2 hours ago
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These are always tricky, vitamin D deficiency and low fat diets clearly cause depressive symptoms.

Does that mean vitamin D treats depression in general?

When most people talk of depression they aren't even using talking about major depression.

We live in a world that in many ways is comfortable but crushing. Is that depression? Or just harmful levels of understandable unhappiness? Are they different?

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CafeRacer
1 hour ago
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I eat so much vitamin d and omega 3 i should be shitting fish shitting sunshine... and yet, cold baltic winters with only a few hours of sun still make me depressed.
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anonymous344
56 minutes ago
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can only say, if you have depression or mental problems: NIACIN. not the niconinamid or whatever which is a scam. do not drink alco or smoke! kidneys will suffer.
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fleebee
2 hours ago
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Please talk to a doctor if you're curious about this instead of following this advice. Megadosing vitamins and supplements comes with risks not addressed by the author.
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elif
1 hour ago
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Here you go HN commenters. Last month when I made the observation that "from what I've read recently, I've started to get the impression that the explosion in mental health problems (depression, autism rates etc) has more to do with the western diet than genetics"[0]

Y'all called me MAHA and down voted me into the negatives. Please, insult your own analytical ability by doing the same here. This time I'll just revel in your ideologically confined science denial this time.

[0] https://scitechdaily.com/simple-three-nutrient-blend-rapidly...

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Cipater
31 minutes ago
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A study proposing that diet can affect the expression or severity of some autism-related behaviours is not the same thing as claiming “80% of what people consider autism is actually just the western diet's effect on normal brain chemistry."
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lynx97
2 hours ago
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Can confirm. Since I take 20000 IU vitamin D every sunday, my winter depression is gone.
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trhway
2 hours ago
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then it would suggest why depression gets worse in colder and less sunny part of the year. That even has its own name - Seasonal Affective Disorder (SAD).
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shimonabi
2 hours ago
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Over the last few months, I’ve increasingly come to believe that depression is not caused by a chemical imbalance. After trying ten different antidepressants with no success, I found far greater improvement by changing my patterns of thinking.
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vijaybritto
1 hour ago
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My dad if he was alive would have shouted "I told you so"
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defraudbah
2 hours ago
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wait till they discover sex, drugs and alcohol :)
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meindnoch
2 hours ago
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Yeah, I call bullshit. Tried both, and SSRIs are a godsend.
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Iolaum
2 hours ago
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Your body makes Vitamin D when in sunlight. Could it be that sunlight - and the whole being outdoors situation - is the thing that helps rather than vitamin d levels?
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zipy124
37 minutes ago
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In most northern countries like the UK, there is simply not enough UVB in the winter to make any Vitamin D through sunlight.
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Ensorceled
49 minutes ago
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It's going to be sunny this morning, but also -14 and also I'm too far north for adequate Vitamin D synthesis in winter. But thanks for the advice.
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rini17
2 hours ago
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There's a research that winter sunlight in northern latitudes just does not convert precursors to vitamin D. Even when it's shining, no matter how long you are outside.
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7952
1 hour ago
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And I guess you need uncovered skin which can be tricky in a cold winter.
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notTooFarGone
2 hours ago
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What drove you to write this comment? There are enough countries where sun is an exception in winter and this is a valid problem.

Comment is neither helpful nor is it funny.

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xi_studio
2 hours ago
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Sunlight alone don't help, it helps just because our body makes Vitamin D during the sunbathing process.

So sunbathing is one of many way of integrating Vitamin D in our body not THE way.

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account42
2 hours ago
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Well if you'd be so kind to move the earth so that we get enough sun during winter then that'll solve the problem.
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NoPicklez
2 hours ago
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It could be, but the same effect can be observed in people who dont change their outdoor habits but take vit D and omega 3 supplements
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