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The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients
Medicine: November 12, 2021 - Volume 100 - Issue 45 - p e27747 doi: 10.1097/MD.0000000000027747
Torrisi, Michele Psy D; Bonanno, Lilla MSc, PhD∗; Formica, Caterina Psy D; Arcadi, Francesca Antonia MD; Cardile, Davide Psy D; Cimino, Vincenzo MD; Bramanti, Placido MD; Morini, Elisabetta MD
Post-Stroke depression affects between 12% and 72% of patients who have suffered a stroke. The association between low serum levels of 25-hydroxyvitamin D (25(OH) D) and increased risk of depression is reported in both stroke and non-stroke patients. Similarly, high 25(OH) D levels might be associated with greater functional improvement during rehabilitation program.
We wanted to investigate the effects of an intensive rehabilitation on poststroke outcomes. We wondered if the daily rehabilitation of motor and cognitive functions could also have an effect on mood and functional abilities in addition to or as an alternative to vitamin D supplementation.
We conducted a 12-week, randomized trial, double blind, parallel, monocentric clinical trial of 40 patients undergoing intensive neuro-rehabilitation treatment at a specialized care facility for ischemic or hemorrhagic brain stroke. Participants were randomly assigned, in a 1:1 ratio, to 1 of 2 parallel groups: in the experimental group, 2000 IU/day of oral cholecalciferol was administered; in the control group patients were not taking vitamin D supplementation. Patients underwent a text evaluation to investigate psychological and motor outcomes.
Significant intra-group difference in outcomes measures was found but not between control group and experimental group. In the vitamin D group, we highlighted significant differences between T0 and T1 in calcium (P < .001), vitamin D (P < .001), in Montgomery Aasberg Depression Rating Scale (P = .001), and in Functional Independent Measures (P < .001). In the health control group, we found a significant difference in calcium (P = .003), vitamin D (P < .001), Montgomery Aasberg Depression Rating Scale (P = 0.006), in general self-efficacy (P = .009), and in Functional Independent Measures (P < .001).
Our results show that the beneficial effect on mood and functional recovery is mainly due to neurorehabilitation rather than vitamin D supplementation.
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VitaminDWiki
Probably far less depression if had started with a loading dose
Overview Loading of vitamin D Without starting with a loading dose,
daily dosing often takes >3 months to provide any benefit
A few relevant stroke studies
- Stroke patients getting weekly 50,000 IU Vitamin D did better – trial March 2021
- Stroke patients need more than 2,000 IU of vitamin D (found this time in Japan) – RCT June 2019
- Stroke rehabilitation (and prevention) requires Vitamin D actually getting to cells – March 2020
- Overview Stroke and vitamin D
- Improved recovery from ischemic stroke with Vitamin D (300,000 IU injection) – RCT June 2018
- Vitamin D levels drop after ischemic stroke – Dec 2017
- Stroke patients need even more vitamin D than the typical patient
- Ischemic Stroke risk reduced by 2.5 if have good level of vitamin D – meta-analysis Feb 2018
- Having high vitamin D greatly reduces both getting a stroke and the subsequent depression
Stroke and Depression
- Nerve cells and Vitamin D – many studies
- Water-soluble form of vitamins are needed for some health problems
- Post-stroke depression not reduced by 2,000 IU of vitamin D (not a surprise) – Nov 2021
- Depression is associated with stroke if low vitamin D or winter – Nov 2018
- Depression following a stroke is 2.7 X more likely if low vitamin D – Sept 2018
- Omega-3 and Vitamin D each treat many mental health problems - April 2018
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- No longer depressed, but risk of stroke is still 1.7X higher (did not consider low vitamin D) – May 2015
- ALL of the top 10 health problems of women are associated with low vitamin D
- Post stroke depression 9X more likely if low vitamin D – Dec 2014
- Stroke patients with low vitamin D were 10X more likely to become depressed – Aug 2014
Intervention of Vitamin D for Depression
- Depression cost-effectively reduced by 50,000 IU of Vitamin D monthly (Iranian teens) – July 2023
- Infants getting an additional 800 IU of vitamin D for 2 years had 60% fewer psychiatric symptoms at age 7 – RCT May 2023
- Anxiety and Depression decreased in senior prediabetics with weekly 25,000 IU of Vitamin D – RCT Sept 2022
- Depression decreased by Vitamin D (12th study in VitaminDWiki) – RCT Nov 2022
- Overweight needed more EPA (4 grams) to fight depression – RCT Aug 2022
- Omega-3 did not prevent depression (they failed to reduce Omega-6, which blocks Omega-3) – RCT Dec 2021
- Weekly Vitamin D plus daily Magnesium is great (reduced depression in obese women in this case) – July 2021
- Depression in psychiatric youths reduced 28 percent after just 1 month of vitamin D – RCT Feb 2020
- Yet another study confirms Depression is treated by weekly Vitamin D (50,000 IU)– RCT Dec 2019
- Depression decreased after vitamin D (50,000 IU weekly to elderly in the case) – RCT Oct 2019
- Vitamin D - no cure for depression (when you use only 1200 IU) – Aug 2019
- Depression reduced in Diabetics with 3 months of 4,000 IU of vitamin D – RCT July 2019
- Vitamin D treatment of diabetes (50,000 IU every 2 weeks) augmented by probiotic – RCT June 2018
- Women had better sexual desire, orgasm and satisfaction after Vitamin D supplementation – Feb 2018
- Vitamin D depression RCT canceled: too many were taking Vitamin D supplements, etc. Feb 2018
- Depression in adolescent girls reduced somewhat by 50,000 IU weekly for 9 weeks – July 2017
- Perinatal depression decreased 40 percent with just a few weeks of 2,000 IU of vitamin D – RCT Aug 2016
- Just 1500 IU of Vitamin D significantly helps Prozac – RCT March 2013
- Reduced depression with single 300,000 IU injection of vitamin D – RCT June 2013
- 40,000 IU vitamin D weekly reduced depression in many obese subjects – RCT 2008
- 50,000 IU Vitamin D weekly Improves Mood, Lowers Blood Pressure in Type 2 Diabetics – Oct 2013
Meta-analyses of Vitamin D and Depression
- Depression reduced by 8,000 IU of Vitamin D daily – meta-analysis Nov 2024
- Depression 1.6 X more likely if low Vitamin D, taking Vitamin D reduces depression – umbrella of meta-analyses – Jan 2023
- Depression in seniors greatly reduced by Vitamin D (50,000 IU weekly) – meta-analysis June 2023
- Depression reduced if take more than 5,000 IU of vitamin D daily – umbrella meta-analysis – Jan 2023
- Depression reduced if use more than 2,800 IU of vitamin D – meta-analysis Aug 2022
- Depression is treated by 2,000 IU of Vitamin D – 2 meta-analyses July 2022
- Depression treated by 50K IU Vitamin D weekly (but not 1,000 IU daily) – meta-analysis Jan 2021
- Mental disorders fought by Omega-3 etc. - meta-meta-analysis Oct 2019
- Depression less likely if more Vitamin D (12 percent per 10 ng) – meta-analysis July 2019
- Anxiety severity reduced if more than 2 grams of Omega-3 – meta-analysis Sept 2018
- Less depression in seniors taking enough Omega-3 – meta-analysis July 2018
- Unipolar depression treated by Omega-3, Zinc, and probably Vitamin D – meta-analysis Oct 2017
- Depression is associated with low Magnesium – meta-analysis April 2015
- Clinical Trials of vitamin D can have “biological flaws” – Jan 2015
- Slight depression not reduced by adding vitamin D if already had enough (no surprise) – meta-analysis – Nov 2014
- Anti-depression medication about as good as big increase in vitamin D – meta-analysis of flawless data April 2014
- Depression might be reduced by vitamin D – meta-analysis March 2014
- Low vitamin D and depression - Study and meta-analysis, April 2013
- 2X more likely to be depressed if low vitamin D (cohort studies) - Meta-analysis Jan 2013
Depression is reduced by Vitamin D, Omega-3, Magnesium, etc.
- Low vitamin D is associated with most types of depression, Including: Seasonal Affective Disorder. manic depression, bipolar disorder, dysthymia, Depression during/after pregnancy, Seniors, Suicide
- Depression substantially reduced by Vitamin D, Omega-3, Magnesium, etc – many studies
- Depression 1.6 X more likely if low Vitamin D, taking Vitamin D reduces depression – umbrella of meta-analyses – Jan 2023
- Depression: Low vitamin D in the strongest of 11 risk factors – Jan 2023
- Yet another study confirms Depression is treated by weekly Vitamin D (50,000 IU)– RCT Dec 2019
- Depression treated by Omega-3 (again) – meta-analysis Aug 2019
- Supplementing with Vitamin D (or getting more sun) decreases most types of depression as well as drugs
- Omega-3, Magnesium, and St. Johns' Wort also decrease depression
- Speculate that some combination (Vit D, Omega-3, Mg, St John's) will decrease depression even more
- Note: Both Omega-3 and Magnesium increase the amount of vitamin D which gets to tissues
- Antidepressants reduce cellular Vitamin D, increasing fractures, CVD, etc. - Oct 2022
- There are
268 items in the Depression category in VitaminDWiki Some recent publications
- Depression in seniors greatly reduced by Vitamin D (50,000 IU weekly) – meta-analysis June 2023
- Depression reduced if take more than 5,000 IU of vitamin D daily – umbrella meta-analysis – Jan 2023
- Post-partum depression and low Vitamin D - many studies
- Depression: Low vitamin D in the strongest of 11 risk factors – Jan 2023
Post-stroke depression not reduced by 2,000 IU of vitamin D (not a surprise) – Nov 2021(Cached) Printer Friendly Follow this page for updates5479 visitors, last modified 13 Nov, 2021, This page is in the following categories (# of items in each category)