alt Hacker NewsVitamin D and Omega-3 have a larger effect on depression than antidepressants
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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.
Please do not take 5000mg/day of Vitamin D. The author confuses IU and mg which is very dangerous.
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.
I saw a thing from HealthyGamerGG youtube[1] that he said one of the things about depression is that it causes/influences one to avoid the things that would make their life less depressing.
eg just to paint the picture: you're depressed so you don't get out of bed, therefore you don't go do your workout, therefore you lack endorphins and look in the mirror and see squishy, you're sad about how squishy you are and so you get more depressed. You're more depressed so you also don't do your dishes, when you do get out of bed you are depressed you feel like a slob and you're squishy, so you get more depressed...
Whereas adding anti-depressants, and other virtuous cycle things like vitD/O3, exercise et al. Give the boost necessary to _make your life less depressing_ ...
So if you know someone who's depressed, it might be helpful to help them make their life less depressing too. (in addition to all the best medical advice!)
[1]- he's a real Dr... Dr. Alok Kanojia (Dr. K), a Harvard-trained psychiatrist (MD, MPH) specializing in modern mental health
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.
The first thing I would do in case of depression is to make sure that the patient's energy levels are good and that mitochondria and other energy-related biochem phenomena work as expected.
I know first-hand that low energy-levels and lacking energy production mechanically lead to depression.
Also, look at how people (children also) experience the world and their relationships and their stresses when they are tired (or even just hungry) compared to when they are fit...
Fix those, and the depression might be gone.
This is not bashing against anti-depressants, they play their role to. But in some cases, energy-management is key.
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.
> 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.
At this point, I mostly avoid prescribed medications and don't take very many things at all regularly. Mostly because I've had some of the worst interpretations of the side effects of most medications I've ever been on. These include hospitalizations and side effects I'm still dealing with years after (looking at you Trulicity/Ozempic)...
I'm usually able to reason or force my way through depression and the like, but have had a few deep bouts in my life. The medications have ranged from ineffective to building a tolerance quickly, to just plain worse than the symptoms being treated. Nothing like missing your highway exit multiple times back and forth because you get lost "in" the drive on medication, or having 140 browser tabs open and losing 5 hours of work time.
Everyone is different. I am amazed at how much western society has so many hormonal issues that come down to the lack of quality or appropriate fatty acid intake and a lack of something as simple as more outdoor/sun time. I think the "low fat/cholesterol" advice for most of the past half century combined with the increase in snacking and junk foods have been massive disservices to humanity as a whole. I wouldn't be surprised if some of the effects are multi-generational in the making either.
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.
I can only provide anecdotical evidence, which is ... not evidence, really.
Within my peer group of people on the spectrum (which very often comes with a depression, which is logical) we've discussed Vitamin D studies for years. And multiple of us decided to give it a try for a couple of months. And neither those who tried it INSTEAD of an SSRI, nor those that took both (SSRI + D) could report any measurable difference.
I have a theory on why is that: It is known that low levels of Vitamin D is one likely cause for depression - in Northern Europe, where during winter time people do not get enough sunlight, that correlates very clearly with the suffering of depression.
But potentially it simply does not work the other way round: I moved to near the equator, and I therefore basically have sunlight shining out of my butt, but still am depressed. It makes sense that in this case Vitamin D makes no difference at all.
In summary my theory would be: Vitamin D only has an effect on a depression that was caused by a lack of Vitamin D.
As a neurologist I cannot be persuaded. Their is a huge placebo and confounding component in the spectrum stress-depression. There are syndromes where AD drugs make wonders, literally saving lives, and others where they are useless. But taking 150000 IU of vitD per month definitely doesn't have the effects it promises.
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.
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.
Anecdotally, I've been taking a 5,000 IU vitamin E supplement this winter. Seattle area, indoor desk job, I am a vampire. It does seem to help, I would rate it as going from a C to a B grade. I'd prefer not to use antidepressant medications to fix a problem that for me is mostly caused by living at a different latitude than I grew up in.
Do be aware that not all vitamin E supplements actually contain the dosage that they are labeled at, and that inclues both no-name brands and some big name brands. I'm having trouble finding a good reference on google due to AI and SEO pollution. But I recall Nature Made was labelled accurately and that is what I buy.
My wife on the other hand has struggled with life-long anxiety/depression even when living in Atlanta. For her a fairly low dose of lexapro enables her to live her life like a normal person. We wish we could get her mother to give it a shot for a few weeks, as she now can see a lot of similarities in both their personality traits that were affected by a life of untreated anxiety.
We also have cat that would probably have been put down for fear-biting of people and attacking our mild and mellow dog until we got his aggression under control with kitty prozac. I kid you not, it's a transdermal fluoxetine cream we put in his ear each day. Without the constant anxiety stimulus in the way, his real personality came through and he is actually very sweet. To me at least. Still bites my wife, but not hard anymore, just enough to keep her alert.
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.
Super interesting, just sad that Omega-3 supplements are one of the main drivers of unsustainable Krill overfishing https://seashepherd.org/2025/02/25/protecting-the-oceans-vit...
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.
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...
Confusing mg and IU units up front really do NOT inspire confidence on the topic and conclusion as a whole.
Why does this keep popping up?
"Evidence does not support the use of vitamin D supplementation for the prevention of cancer, respiratory infections or rheumatoid arthritis. Similarly, evidence does not support vitamin D supplementation for the treatment of multiple sclerosis and rheumatoid arthritis or for improving depression/mental well-being."
https://pmc.ncbi.nlm.nih.gov/articles/PMC4907952/#:~:text=Bo...
Vitamin D toxicity is absolutely real, causes hypercalcemia, and can occur even at the 4,000 IU dose. I would really recommend you be getting regular bloodwork done if you go beyond that. Here’s a fun podcast on a case study. https://www.barbellmedicine.com/podcast/episodes/episode-381...
Most commonly from lanolin, a grease extracted from sheep's wool.
It's processed into (7-DHC), the same compound in human skin.
7-DHC is bombarded with UV light, triggering a chemical reaction that creates Vitamin D3.
You might want to take magnesium with Vitamin D, because taking vitamin D depletes magnesium. Not sure if it's strictly necessary, but if you're already low on magnesium it might be an issue. I once got tinnitus (which lasted a few months) when supplementing Vitamin D, the only explanation I've figured is that my magnesium was very low, which can cause tinnitus. Might be something else too, who knows.
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.
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.
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!
I was an RA at the RAND Corp who put together literature reviews for mental health interventions like this. The Vitamin D result is implausible. If true it would be the biggest breakthrough in the history of psychiatry.
This is the referenced meta-analysis: https://www.cambridge.org/core/journals/psychological-medici...
The largest N study (N=18,353; more than half of the entire 31 study sample) included is https://jamanetwork.com/journals/jama/fullarticle/2768978, which found: "Risk of depression or clinically relevant depressive symptoms was not significantly different between the vitamin D3 group...and the placebo group."
The highest dose study (100,000 IU/week) included is https://pubmed.ncbi.nlm.nih.gov/30532541/, which found: "...the treatment response or BDI scores did not differ significantly between groups."
The paper/supplementary materials doesn't include a simple table of the depression outcomes for the 31 included studies, which is a glaring omission.
I think someone just messed up here. Maybe missed a decimal place?
For a more realistic perspective, here's another careful meta-analysis of RCTs of Vitamin D for depression that found null result: https://www.sciencedirect.com/science/article/abs/pii/S08999... (granted, 2015). And another from 2025 that found a .36 effect size, which is plausible and still fantastic: https://www.frontiersin.org/journals/psychiatry/articles/10....
I don't mean to dissuade people from trying these given the low risk profile, just don't expect to go from a C to an A.
I have seasonal affective disorder and was taking a medication that sort of helped, but was causing mood swings if taken even slightly out of rhythm, increased my blood pressure, and was just generally not that effective, but it was better than nothing. Last winter I switched to vitamin D (it was already uncovered in blood tests I had a deficiency, which is what turned me onto it - when I started taking it, I felt a lot better) and omega 3 and I won't go back. I wish someone had told me a decade ago, probably would have saved a lot of damage to my organs (another reason I got off of it)
I used to have very rough winters. Despite the fact that I ate well and was outside 2+ hours every day. I got my blood tested and I had very low vitamin D, two tiers below normal. This was the first winter being on Vitamin D, and my energy and hunger levels stayed normal. I never crashed or had extreme hunger or trouble sleeping.
Getting Vitamin D from food is a fools errand, and since sunscreen and protective clothing slow vitamin D from the sun drastically, it's in most people's best interest to get it tested.
This is all in a book called The Depression Cure by Stephen S. Ilardi (https://bookshop.org/p/books/the-depression-cure-the-6-step-...)
I read this years ago and it's fascinating. Looks like it's been updated for a second edition last year.
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.
Hey OP, kudos for being so engaged in the discussion + making edits and not just firing the link off and then going AFK. Makes the comments more interesting and (I think) the actual work better.
I’ve personally found meditation, exercise and healthy food intake are more effective for self regulation and coping with tough emotions over medication and supplements.
Each human being is unique, as is the recipe for sustained positive metal health.
I think it’s helpful to consider and experiment with different ideas and strategies.
I strongly disagree there is one single solution that can provide significant lift for a large population.
I used to take a supplement with 10k vit D units. Made by a reputable company here in Europe.
I did a blood test for vit D metabolites (oh 25 or something). It turned out I was deficient.
The doc gave me 8k units as a prescription drug. In theory weaker. After 2 months I was no longer defiecient (kinda borderline). After 4 months the doc decided to go down to 4k iu.
Now I wonder why some experts are telling people to take 10k iu? Is it because the supplements are crap and contain 10% of what they claim? (I've been taking vit K as well)
If you look at the studies on which this post is based, you find out that the (very) positive effect of a Vitamin D supplement is only short-term.
The effect after taking the Vitamin longer than 24 weeks is not significant anymore.
I am taking so much Vitamin D and I can confirm!
It is depressing ... :(
(Note: my own real therapy is to do what is fun. That is, humour. This can occur via social interaction; it can also happen to some extent by studying human behaviour via ... youtube videos! There are some surstromming videos that are just epic display of human behaviour. If aliens ever arrive here, I'll show them the Top 3 videos there. Either they will laugh too - or flee from this strange planet.)
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.
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.
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.
A useful way to look at the effects of vitamin d and omega-3s: supplementation isn't really a hack, it's more that their removal is a handicapping of our "normal" state. Our evolutionary conditions would have been more rich in both of those things. Also see light exposure during the day, proximity to green space, etc.
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.
I had sleeplessness that eventually led to depression and gastritis. I took medication for two years to recover. The root cause was a vitamin D deficiency my level was 8 ng/mL, which was far below the required range. There was a period when i was only able to sleep with medicines. Now coming back to normal life.
Precision Medicine is the way, and maybe we will get there one day Too many effective agents are averaged away because the population for whom it is effective is just a subset of the population with the targeted symptom.
On mobile a padding would make reading better. Add px-4 if you use tailwind in the article body.
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.
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
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?
Vitamin D and Omega-3 are the two supplements that consistently appear to be super powerful in small studies and then fail to do anything significant at all in larger studies.
Pause for a moment and consider the mere plausibility of the claims in the first few paragraphs: The effect size for antidepressants is 0.4, but the effect size for Vitamin D is 1.8? Are we to believe that Vitamin D supplements have an effect size 4.5X larger than antidepressant drugs, and nobody noticed this massive discrepancy until now?
Effect size is also a favorite metric in this vein of supplement-over-pharma writing because it’s so commonly misunderstood and it’s so easy to find small supplement studies that have outlier effect sizes.
To put it in context, even common OTC pain meds can have effect sizes lower than 0.4 depending on the study. Have you ever taken Tylenol or Ibuprofen and had a headache or other pain reduced? Well you’ve experience what a drug with a small effect size on paper can do for you.
Please be very careful when someone tries to tell you that supplements are miraculous and pharmaceutical drugs don’t work at all. I know too many people who delayed trialing SSRIs for years due to internet driven fears and lost many years of their lives to depression based on content like this. People with cabinets full of dozens of supplement bottles that were chosen based on studies, too. Then they finally decided to try real antidepressant medications and wished they’d done it sooner.
As much as I wish we could all just cure depression by taking a simple Vitamin D supplement that has 4.5X higher effect size than antidepressant drugs, this claim just isn’t passable.