Correction of Vitamin D Deficiency Improves PTSD Symptoms in Gulf War Veterans

Gulf War Veterans (GWVs) presenting with irritable bowel syndrome-diarrhea (IBS-D) often exhibit concurrent post-traumatic stress disorder (PTSD) or traumatic brain injury (TBI). All Veterans' Affair physicians are required to assess symptoms of depression, anxiety, and suicide ideation by maintaining yearly training. In a previous study for IBS-D (3), we identified significant vitamin D deficiency (VDD), with an average level of 19 ng/mL. This includes those with and without PTSD, TBI, showing depression and anxiety symptoms. Since VDD is associated with PTSD, and all veterans not on supplementation were found to be VDD (>90%) at our facility, we investigated a possible association between VDD and these neuropsychological conditions. While age and body mass index (BMI), seasons, and demographic locations are known to affect vitamin D levels, we found no correlation between these factors and VDD in the PTSD group and those with IBS-D. In the TBI group, VDD did correlate with BMI. Multiple deployments appeared to have a minor negative effect on vitamin D levels (a 11-13% contribution) in veterans with either PTSD or TBI. Although these veterans showed signs of inflammation with elevated minor C-reactive protein (CRP) levels (4.7 mg/L), there was a negative correlation between CRP and vitamin D to suggest that inflammation is not the primary cause of PTSD or TBI. Following daily vitamin D treatment, vitamin D levels returned to a normal average of 30 ng/mL (less than 30 ng/mL is abnormal). Treatment had no effect on serum calcium levels, but did lead to a resolution of depression, anxiety, TBI, and PTSD symptoms in the majority of patients. These findings suggest that correcting VDD in GWVs visiting GI clinics with co-occurring PTSD and TBI had reduced psychological symptoms. Replacing vitamin D is a simple strategy to implement, rather than increasing neurotrophic medications in some patients.