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Treating Seasonal Mood Changes. Part One - Light Therapy and Vitamin D


Time to check in with your Neurotransmitters.



It’s that time of year. The days are getting shorter, the sky is getting darker. If you are one of the many people affected by the changing seasonal light patterns, you may be starting to feel physical symptoms such as:
  • Feeling more tired or feeling a need for more sleep.
  • Feeling “blue”, sad, or even depression.
  • Increased food cravings, especially carbohydrates.
These seasonal physical symptoms are thought to be caused by changes in your neurotransmitters. Neurotransmitters are brain chemicals that communicate information throughout our brain and body. Think of neurotransmitters as “brain hormones”. Proper balance of neurotransmitters is essential to regulate hunger, mood, cravings, energy, motivation, and self-image.

Learn more from my earlier blog “Get to Know Your Neurotransmitters”.


As our daylight dwindles are you getting tired and grumpy?

b2ap3_thumbnail_CarinNielsen_LightTherapy225.jpgReduced exposure to sunlight in the fall and winter can be a major factor contributing to symptoms of seasonal depression, cravings, and fatigue. With light therapy (also called phototherapy), a light device (which is most often a light box but also available as a light visor) emits a full-spectrum light resembling sunlight. Light therapy is felt to work by regulating and improving the production of the neurotransmitters serotonin and dopamine (key chemicals in regulating mood, energy and food cravings).

For best results using light therapy:
  • Your light box or device should emit 10,000 lux (a measurement of light intensity).
  • You should sit with your face near the light, eyes open but not looking directly into the light.
  • Aim for 30 minutes daily, preferably in the morning.
Want to learn more about light therapy? Check out this article by Dr. Andrew Weil.


b2ap3_thumbnail_CarinNielsen_Sunshine125.jpgVitamin D - the “Sunshine Vitamin”
Vitamin D is often referred to as the “Sunshine Vitamin”, however is not actually a vitamin at all! Vitamin D is a hormone that is produced in the body when your skin is exposed to sunlight. That being said, as the daylight hours lessen, so does your ability to produce Vitamin D. As a physician who has been routinely checking Vitamin D levels in my patients for many years, I can tell you that I rarely see an “optimal” Vitamin D level in the winter months without Vitamin D supplementation.

You may be aware of the numerous well-studied benefits of Vitamin D - including it’s role in bone strength, fracture prevention, healthy immune and nervous system function,and even prevention of certain cancers - but did you know that Vitamin D was also important in regulation of mood? Several studies have suggested that the symptoms of seasonal depression may be due to changing levels of Vitamin D3, which may affect serotonin levels in the brain (a key neurotransmitter in mood and appetite regulation).
My Vitamin D recommendations:
  • Have your blood levels of 25 OH Vitamin D measured. While a number greater than 30 is considered “normal”, aim for an “optimal” level closer to 60.
  • If supplementing with Vitamin D, choose Vitamin D3, and take with a meal containing fat for best absorption.
  • While supplementing, recheck 25 OH Vitamin D levels approximately every three months.
Want to learn more about Vitamin D? Check out this article by Dr. Mark Hyman.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone imbalance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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There goes our daylight - Do you know your Vitamin D level?

Last week I had a follow-up visit with a male patient in his early 40s who had come to see me for muscle aches and decreased muscle stamina with exercise. He was having soreness on a daily basis, particularly in his upper thighs.  Laboratory workup had revealed significant Vitamin D deficiency. He reported at his follow up visit that after only 3-5 days of high-dose Vitamin D supplementation, his muscle symptoms were noticeably improved.

He was surprised to hear that I see this quite frequently, both Vitamin D deficiency and other patients with similar symptoms of muscle aches that improve when Vitamin D intake is increased. My medical practice is in Northern Michigan, and Vitamin D deficiency is quite common. I have been checking Vitamin D levels routinely on my patients for many years, and I rarely find an "optimal" level, let alone a level that isn’t deficient!


Why is your Vitamin D level important?

Did you know that Vitamin D is actually a fat-soluble hormone?  Your body produces Vitamin D in your skin when exposed to sunshine or ultraviolet light. Knowing that, it’s not surprising that north of the 45th parallel Vitamin D deficiency is quite common!

Vitamin D is necessary to absorb calcium, it helps to regulate the levels of calcium and phosphorus in the body, and together with these minerals works to maintain bone strength and integrity. The benefits of Vitamin D intake on bone health and reduction of osteoporosis is well documented by randomized controlled trials and evidence has also linked Vitamin D intake to reduced falls in the elderly.

A growing body of research suggests that Vitamin D intake may be linked to reduced risk of cancer (specifically breast, prostate and colon cancer), depression, autoimmune disease, and heart disease, although further studies are needed to verify these results.  Vitamin D deficiency has been linked to chronic muscle aches and pains, and (as described above) I have observed numerous patients with chronic diffuse muscle pain (especially in the thighs and forearms) get relief when restoring their Vitamin D levels to normal.

Do you know your Vitamin D level?

When testing your Vitamin D level, it is important to order the correct test. There are two tests for Vitamin D – 1,25(OH) Vitamin D or 25(OH) Vitamin D. 25(OH) Vitamin D is the best test as it is the best marker of overall Vitamin D status. 

A level below 30 ng/dl is considered deficient. In my practice we first look to raise levels above 30 into the “normal range”, and then look to get levels in the “optimal range” (those of you who are clients of mine know that this is a frequent topic of conversation, what is normal for one person may not be normal for another, and therefore when interpreting test results we strive for the optimal level for best health). Opinions vary as to “optimal” Vitamin D levels.  I strive to get levels to at least 48 ng/dl, as a comprehensive review of evidence from various studies found this level to be optimal for cancer prevention.

How do you raise your Vitamin D levels?

There are two types of Vitamin D: Vitamin D3 (cholecalciferol – which is the type of Vitamin D synthesized in your skin when exposed to sunlight), and Vitamin D2 (ergocalciferol – found in Vitamin D fortified foods and synthesized by plants).

Vitamin D3 is better utilized by the body than D2, and is the preferred source for supplementing. Vitamin D3 is found in eggs, organ meats, animal fat, cod liver oil, and fish.  It is also available in both liquid and capsule supplements.  If you are considering supplementing with Vitamin D speak with your physician about what dose is most appropriate for you.

Can I get too much Vitamin D?

Yes!  While Vitamin D toxicity is rare, it can happen if you over-supplement. Unlike many water-soluble vitamins, Vitamin D is fat-soluble and excess intake will store in your fatty tissues. Excess Vitamin D intake has also been linked to kidney stone formation.

For more information, or if you are interested in having your Vitamin D levels tested, contact our office at 231-638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it..





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