Sober Day #33- Vitamin D deficiency and Alcohol Use Disorders

Vitamin D (the one we get from sun exposure on our skin) deficiency is wide-spread in the US, and its lack is associated with occurence and worsening of all sorts of chronic inflammatory diseases.  For example, if you plot the average vitamin D levels on a US map, levels get lower and lower as you go further north- which makes sense if you consider the sun exposure and intensity increases as you head south.  The decreasing levels as you head further north correlate with increasing ER visits for asthma. 

This study finds that lower vitamin D levels are associated with more alcohol-use problems in an Asian population.  It's not much of a stretch to guess that the same pattern occurs in the US.  The association, of course, does not prove or disprove causality.  Does low vitamin D predispose to alcohol overuse?  Or does alcohol overuse cause vitamin D deficiency?  Or is there even a direct connection between the two, or might they be totally independent variables?  

What action to take while waiting for more data to answer these questions?  I suggest that each of us should check our serum vitamin D levels, a simple blood test.  If we are indeed low, taking enough vitamin D to bring our levels at least halfway up the range of normal levels (i.e., at least 50-60 nmol/L) will have all sorts of health benefits, and might make (this is a stretch, not fact) early sobriety easier.  (More to come in future posts about other baseline blood and other testing that might be useful in early sobriety).

Abstract

BACKGROUND:

Mounting evidence suggests that deficiency of vitamin D may be associated with major health problems, including alcohol-use disorders (AUD) and major depression (MD). This study aimed to identify the vitamin D status of Nepalese inpatients with an AUD. We explored socio-demographic and alcohol-use related correlates and the relationship between vitamin D deficiency and comorbid MD.

METHODS:

A cross-sectional study was conducted on AUD inpatients (N=174) at eight alcohol/drug treatment centres around Kathmandu. Structured questionnaires were administered to assess the socio-demographic and alcohol-use parameters and to establish DSM-IV diagnoses of AUD and MD. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) concentration of <50nmol/L.

RESULTS:

The prevalence of vitamin D deficiency was 64%. Higher age, having a stable job or business, shorter time since last alcohol intake and winter serum samples were related to having lower 25(OH)D levels. Several features of AUD severity were associated with low vitamin D levels: guilt about drinking, using alcohol as eye-opener, and history of relapse after alcohol treatment (p≤0.03). Patients with a comorbid major depression, in particular secondarily depressed cases, were less likely to have vitamin D deficiency (X(2)=6.8; p=0.01).

CONCLUSIONS:

This study confirms high rates of vitamin D deficiency in alcohol treatment sample and shows a positive association between vitamin D deficiency and severity of alcohol-use disorders. Competing risk and other confounders may help explain the vitamin D status among patients with alcohol-use disorders and comorbid major depression.

Neupane SP, Lien L, Hilberg T, Bramness JG.  Vitamin D deficiency in alcohol-use disorders and its relationship to comorbid major depression: A cross-sectional study of inpatients in Nepal.  Drug Alcohol Depend. 2013;133:480-5.