Vitamins, Dietary, & Treatment Advice for Seasonal Affective Disorder (SAD):
This is a quick read to help you make informed decisions
and choose between the different types of B12, and to give you some natural
options to fight off SAD.
B12 and B Complex:
Did you know there is a direct relationship between low vitamin B levels and depression? You can read more about it at https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/vitamin-b12-and-depression/faq-20058077.
Here is a fairly complete look at vitamin B12 and the recommended daily allowances by the NIH: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/#h3.
There are several forms of B12:
Cyanocobalamin is a synthetic form of vitamin B12. It is the cheapest form, and must be converted by the body into methylcobalamin or adenosylcobalamin before the body can use it. Studies show this form is basically absorbed at the same rate (sometimes less, sometimes more) as methylcobalamin, but is not retained in the body as long as methylcobalamin or hydroxocobalamin. Another thing to note is that during the process of cyanocobalamin conversion, cyanide (hence cyano) is separated and excreted through the urine. The amount of cyanide is not proven to be harmful, but I prefer to stay away from this form of B12 because I’m just not into adding cyanide to my diet. The poison, the extra conversion process, and the limited retention make this form less desirable to some people.
Methylcobalamin is a naturally occurring form of B12, and it can be found in foods and supplements. It is retained longer by the body than cyanocobalamin, and is sometimes injected intramuscularly. This form, along with adenosylcobalamin, may have some instability in acidic or alkaline conditions*, which is why I rarely use it as an injectable. However, finding methylcobalamin in supplement and food form is recommended. It is available vegan too!
*Methylcobalamin is more stable than adenosylcobalamin in acid and alkaline conditions.
Hydroxocobalamin is a naturally occurring B12, and is found in foods and within our own bodies. Like cyanocobalamin, the body converts it into methylcobalamin and adenosylcobalamin, but hydroxocobalamin does not contain cyanide (it is actually an antidote to cyanide poisoning). It is know as the “long-lasting” form, and is retained by the body longer than any other form, which is why I and many other health professionals choose this form as an injectable. It is also available vegan!
You have options when shopping for B12, just be sure to read the label to know which form you’re buying. I recommend buying a sublingual methylcobalamin or a B Complex capsule.
B Complex is a great way to get B12, B1, B2, B3, B5, B9, and Biotin. I like the Pure Encapsulations brand capsules with methylcobalamin. Usually you can combine a B Complex with B12 acupoint injections (which is what I personally do and recommend to others).
Vitamin D plays a big role in Seasonal Affective Disorder. We have some pretty short days in Seattle at this time of year. On a typical December day, we might technically have 8 hours of daylight, but virtually no sunlight. US climate data shows there are 62 average hours of sunlight during the whole month of December in Seattle! That’s an average of 7 days of sunshine in the whole month! https://www.usclimatedata.com/climate/seattle/washington/united-states/uswa0395.
Studies show 90% of our vitamin D comes from sunlight, and vitamin D makes us feel happier (Hawaii really does equal happiness!). So it’s no surprise that we need to supplement vitamin D from fall through spring in Seattle. Here’s a great study linking the two: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/.
Vitamin D dosage according to Mayo Clinic:
Many older adults don't get regular exposure to sunlight and have trouble absorbing vitamin D, so taking a multivitamin with vitamin D will likely help improve bone health. The recommended daily amount of vitamin D is 400 international units (IU) for children up to age 12 months, 600 IU for ages 1 to 70 years, and 800 IU for people over 70 years.
Personally, I like the D3 capsule by Pure Encapsulations, but there are many quality brands out there to choose from.
Probiotics and gut health are now shown to directly affect emotional health. Studies linking the two are still relatively new and require more research, but I’ll go ahead and list a few articles and potential studies below. Probiotics can be found in refrigerated capsules at your health food store, in kombucha, sauerkraut, most dairy and dairy-free yogurts, kimchi, and other fermented foods.
SAD Lamp Therapy, or as I prefer to refer to it, the “happy lamp.” Mayo Clinic has great guidelines for picking a lamp and directions for use here: https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298.
UW offers lamp therapy and recommends 15-30 minutes a day, preferably in the morning. http://depts.washington.edu/hhpccweb/sadlight/
Acupuncture & Chinese Herbs are absolutely effective against SAD! The focus of my doctoral work was on the treatment of seasonal affective disorder with Chinese medicine. I will make some of the papers and research available on my website. I recommend weekly acupuncture and Chinese herbal medicine, beginning in fall and lasting throughout winter. When treated in fall, it can lessen the onset in winter. When used in combination with vitamin B, vitamin D, probiotics, and a happy lamp, it’s possible to completely prevent SAD. I hope to be publishing on this topic soon!
The countdown is on for a happy winter solstice and longer, brighter days are ahead!
Best in health,
Lacey Smith, DACM, L.Ac./EAMP
Doctor of Acupuncture and Chinese Medicine
Licensed Acupuncturist CA
Licensed East Asian Medicine Practitioner WA