The association between vitamin D serum levels, supplementation, and suicide attempts and intentional self-harm

Abstract

Objectives The purpose of this study is to determine the associations between Vitamin D supplementation, 25(OH) blood serum levels, suicide attempts, and intentional self-harm in a population of veterans in the Department of Veterans Affairs (VA). Methods A retrospective cohort study of US Veterans supplemented with Vitamin D. Veterans with any Vitamin D3 (cholecalciferol) or Vitamin D2 (ergocalciferol) fill between 2010 and 2018 were matched 1:1 to untreated control veterans having similar demographics and medical histories. Cox proportional hazards regression was used to estimate the time from the first Vitamin D3 (cholecalciferol) or Vitamin D2 (ergocalciferol) prescription fill to the first suicide attempt or intentional self-harm. Analyses were repeated in stratified samples to measure associations by race (Black or White), gender (male or female), blood levels (0–19 ng/ml, 20–39 ng/ml, and 40+ ng/ml), and average daily dosage. Results Vitamin D3 and D2 supplementation were associated with a 45% and 48% lower risk of suicide attempt and self-harm ((D2 Hazard Ratio (HR) = 0.512, [95% CI, 0.457, 0.574]; D3 HR = 0.552, [95% CI, 0.511, 0.597])). Supplemented black veterans and veterans with 0–19 ng/ml vitamin D serum levels were at ~64% lower risk relative to controls (Black Veteran HR: 0.362 [95% CI: 0.298,0.440]; 0–19 ng/ml HR: 0.359 [95% CI: 0.215,0.598]). Supplementation with higher vitamin D dosages was associated with greater risk reductions than lower dosages (Log Average Dosage HR: 0.837 [95% CI: 0.779,0.900]). Conclusions Vitamin D supplementation was associated with a reduced risk of suicide attempt and self-harm in Veterans, especially in veterans with low blood serum levels and Black veterans.

Structural diversification of vitamin D using microbial biotransformations

“…Most individuals with vitamin D deficiency are asymptomatic (Nadeem et al 2018 ). However, individuals with a moderate vitamin D deficiency can experience symptoms including intense bone pain, fatigue, myalgias, arthralgias, and weakness (Sizar et al 2023 ), increased susceptibility to microbial infections (Chalmers et al 2013 ; Ryz et al 2015 ), hair loss (Saini et Mysore 2021 ), depression, and mood changes (Lavigne et al 2023 ; Guzek et al 2021 ). In pregnant women, reduced vitamin D levels are associated to higher risk of cesarean delivery, gestational diabetes, pre-eclampsia, and preterm delivery (Płudowski et al 2023 ).…”

Exposure to a Vitamin D Best Practices Toolkit, Model, and E-Tools Increases Knowledge, Confidence, and the Translation of Research to Public Health and Practice

“…Researchers have hypothesized that health disparities could be eliminated for those of African ancestry if optimal 25(OH)D concentrations were achieved and maintained [63]. Areas of particular global and public health interest include the costeffectiveness of addressing vitamin D deficiency/insufficiency in prenatal outcomes, including increased maternal morbidity and mortality [64][65][66], and mental health, including the risk of opioid addiction [67], the risks of depression and suicide [68][69][70][71][72][73][74][75][76], and childhood behavioral problems [77], as well as COVID-19 [78] and HIV transmission [79]. Cancer, all-cause ≥40 ng/mL Women with concentrations ≥40 ng/mL had a 67% lower risk of cancer than women with concentrations <20 ng/mL (HR = 0.33, 95% CI = 0.12-0.90).…”

Wellness and burnout in cardiac surgery: not black and white

“…1). The current research landscape describes heightened rates of burnout among surgeons attributed to long operating hours, frequent on-calls, performance pressures, work-life conflict, and the physical demands of surgery [1 ▪▪ ,2–4,5 ▪ ,6 ▪▪ ]. Surgeon burnout impacts both intraoperative and perioperative care, leading to increased medical errors, malpractice suits, and overall inferior patient outcomes [1 ▪▪ ,2,7].…”