Even well-done observational studies cannot definitively prove that a person’s blood level of vitamin D contributes to their mental status or stability.
In February scientists reported that vitamin D was associated with a reduced risk of suicide attempts among U.S. veterans. The study compared more than 600,000 veterans who took various doses of vitamin D with an equal number of those who did not ingest the supplements. Taking vitamin D, they concluded, was linked with a 45 to 48 percent overall reduction in the risk of visiting a hospital for a suicide attempt or intentional self-harm.
Still, even well-done observational studies cannot definitively prove that a person’s blood level of vitamin D contributes to their mental status or stability. Vitamin D status may instead simply tag along with some other behavior or genetic factor that is more influential.
Low vitamin D is more likely to be a marker for illness than a cause of it, he and others say. That’s because low vitamin D levels are common in people with any health condition that dissuades them from spending time outdoors—the sun is an important source of vitamin D—or from eating a vitamin-rich diet. “If you have an illness like depression or maybe vulnerability to suicide, and then you change your behaviors, you get less vitamin D because of your changed behavior,” McGrath says.
Randomized trials are not foolproof. Some, such as McGrath’s, may not have lasted long enough to show effects. In other cases, the trial might simply have missed the window for when supplementation is critical, Lee says. “[Randomized controlled trials] are the gold standard of evidence, but you could do something at the completely wrong time point, and it won’t matter,” Lee says.
None of this means that vitamin D deficiency in the womb is a risk factor for schizophrenia. But several observational studies hint that it could be. In a 2018 study, McGrath and his colleagues measured vitamin D levels in 2,602 blood samples from newborns from a repository in Denmark. Some of these children later developed schizophrenia, and the researchers found that low vitamin D was associated with an increased risk of that illness.
The randomized trials that would help settle the issue are probably not imminent. Such trials are tricky to conduct in pregnant people. They also present logistical problems for a condition such as schizophrenia that manifests decades later, McGrath says. So researchers continue to work on the circumstantial case.
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