Vitamin D deficiency is more common in patients with schizophrenia. This is due to factors such as social isolation, lack of movement, smoking, spending less time outside, malnutrition, and disruption of vitamin D synthesis by antipsychotic drugs.

The study looked into the relationship between sunlight exposure and positive, negative, and cognitive symptoms. 52 patients were invited to take part and 40 completed the study.

Patients had their serum 25OHD levels measured in order to understand their current vitamin D level in the blood.

The following clinical assessment scales were used pre and post replacement of Vitamin D:

SANS – scale for the assessment of negative symptoms
SAPS – Scale for the Assessment of Positive Symptoms
WCST-CV- Wisconsin Card Sorting Test used to evaluate executive function

Vitamin D deficiency was found in 65.4% of the patients with vitamin D values below the normal limit.

Various levels of oral vitamin D was given once a week for eight weeks to the patients according to their initial levels. Vitamin D levels were measured again eight weeks after the initiation of the treatment. Additionally, patients whose serum vitamin D level could not reach > 30 ng/mL within the eight weeks were given additional doses until the optimal level was reached.

Results showed that the mean SANS score was statistically significantly lower after replacement of vitamin D and the total attention score was also significantly improved. The study therefore concluded that addressing vitamin D deficiency in schizophrenic patients (together with antipsychotic treatment) can improve the total attention span and positive and negative symptoms in schizophrenia.

The abstract can be accessed here.

Neriman A, Hakan Y, Ozge U. The psychotropic effect of vitamin D supplementation on schizophrenia symptoms. BMC psychiatry. 2021 Dec;21(1):1-0.

This paper investigated iron deficiency and schizophrenia. Previous research finding that iron deficiency may alter dopaminergic transmission, this study was conducted to identify whether low blood iron levels could be related to severity of schizophrenia symptoms. This study was conducted on 121 patients during their first episode of schizophrenia disorder. Symptoms were measured using the positive and negative syndrome scale (PANSS), and iron deficiency was defined as a serum ferritin less than 20ng/ml. The study found patients with iron deficiency were significantly more likely to have more prominent negative symptoms, and patients with more negative symptoms had significantly lower serum ferritin (iron) levels than their counterparts. This study highlights a possibility for further investigation as to whether iron supplementation could be used as an intervention.

The abstract can be accessed here

Kim SW, Stewart R, Park WY, Jhon M, Lee JY, Kim SY, Kim JM, Amminger P, Chung YC, Yoon JS. Latent iron deficiency as a marker of negative symptoms in patients with first-episode schizophrenia spectrum disorder. Nutrients. 2018 Nov;10(11):1707

This study investigated omega 3 and schizophrenia. Specifically, the study explored the effect of omega-3 supplementation in symptom severity in schizophrenic patients over a long period of time, as previous studies have had mixed findings when interventions lasted 10-12 weeks.  A randomized placebo-controlled trial was conducted over 26 weeks to study whether omega-3 fatty acids would have an effect on symptom severity in first episode schizophrenic patients. 71 patients were assigned either a placebo of olive oil or 2.2g/day of omega-3 supplement. Severity of symptoms were measured using the positive and negative syndrome scale (PANNSS). A 50% improvement in symptom severity was recorded more frequently in the omega-3 group compared to the placebo group. Significant improvements were found in depressive symptoms, the level of functioning and clinical global impression when patients were supplemented. These findings suggest that a 6-month intervention of omega-3 supplementation may be able to decrease symptom severity in first episode schizophrenia patients.

The abstract can be viewed by clicking here

Pawełczyk T, Grancow-Grabka M, Kotlicka-Antczak M, Trafalska E, Pawełczyk A. A randomized controlled study of the efficacy of six-month supplementation with concentrated fish oil rich in omega-3 polyunsaturated fatty acids in first episode schizophrenia. J Psychiatr Res. 2016 Feb;73:34-44.

This study explored antipsychotics, omega 3 and schizophrenia. The review compiled previous studies surrounding treatment of schizophrenia using omega-3 and looked at what pathways in the brain are impacted by an omega-3 supplementation. After compiling information on omega-3 and anti-psychotic drugs it was found that the drugs used to treat schizophrenia and omega-3 supplementation impact on dopamine and glutamate transmission, oxidative stress, inflammation, myelination, and neurotransmission pathways in a similar way. Through evaluation of multiple clinical studies on omega-3 supplementation it was concluded that omega-3 has been linked to improved symptoms in those experiencing a schizophrenic episode. This research suggests that omega-3 supplementation may be an important consideration in schizophrenia. 

To view the abstract, click here

Shared Biological Pathways between Antipsychotics and Omega-3 Fatty Acids: A Key Feature for Schizophrenia Preventive Treatment? Int J Mol Sci. 2021 Jun 26;22(13):6881

When in balance, stress can be helpful. It keeps us motivated, helps us get out of the bed in the morning, and can serve as a warning sign that we need to make some lifestyle changes. Prolonged stress, on the other hand, can have serious consequences for our wellbeing, not least because of its impact on our eating habits and nutritional needs.

Chronic stress increases the body’s metabolic needs, which may result in increased uptake and excretion of nutrients. Chronic stress can therefore increase nutrient requirements, and also exacerbate deficiencies that already exist. 

Furthermore, during periods of prolonged stress, our food choices may alter, causing increased consumption of sugar and processed foods. One reason for this may be reduced time and energy to prepare meals, leading to increased reliance on processed foods and ready meals. 

Another possible reason is that during periods of stress we actually have an in-built preference for higher fat and sugar foods. Theoretically, this mechanism may have been beneficial to early humans during stressful periods such as food scarcity, since fat provides significant calories and sugar affords a quick release of glucose, and therefore energy. However, in modern times, stress can last for significant periods of time, due to work, relationships, financial pressures and other stressors and so can literally tip the scales in the wrong direction.

Moreover, food availability is more abundant: there is an ever growing array of processed foods, microwave meals, as well as high sugar and fat snacks cheaply and readily available. 

Caffeine, from coffee and energy drinks, is also readily available, and often employed as a coping mechanism for stress and stress-related exhaustion. High consumption of caffeine causes blood glucose levels to fluctuate, through increasing cortisol levels and dysregulating insulinotropic polypeptide and GLP-1, which are both involved in regulating appetite control and insulin levels. 

The impact of prolonged stress, therefore, may be weight gain and blood glucose dysregulation, heightening the risk of the development of chronic diseases related to obesity, such as type II diabetes. 

Using Nutrition to Build Resilience

Nutrition can be used as a means of supporting the body during times of stress, increasing resilience, building strength and re-equipping the body with nutrients that may become depleted during periods of chronic stress. 

Research has indicated that magnesium and vitamin B6 may support individuals experiencing stress. A study by Pouteau et al. (2018) indicated that combined supplementation helped to alleviate stress levels in subjects who were experiencing extreme stress. 

A further study by Jahangard et al. (2019) indicated that individuals who were administered omega-3 fatty acids demonstrated reduced markers of psychological and physiological burnout, including decreased cortisol levels, compared with controls. 

Here are some practical ideas for increasing your consumption of these nutrients: 

• Consume green leafy vegetables, nuts and cacao, which are all rich in magnesium
• Take a bath with Epsom salts to increase magnesium levels transdermally 
• Up your vitamin B6 intake with turkey, chickpeas and salmon. Salmon – along with other oily fish – is also a great source of omega 3 fatty acids. Enjoying turkey and salmon with homemade hummus and a colourful salad would be an excellent way of increasing vitamin B6 and omega-3 fatty acids

We hope you find these tips useful. However, if you’re experiencing frequent panic attacks, chronic anxiety and depression, it may be worth seeking some personalised support with an integrative mental health practitioner that can also advise you on your diet. 

Please head to our ‘Seeking Help’ page for more information on organisations and networks you can reach out to.