Basic information from the MEA on vitamin D (deficiency, symptoms, testing, prevention and treatment) and ME/CFS:
Vitamin D and ME/CFS
Link to recent BBC news item:
http://www.bbc.co.uk/news/health-36846894 >>>>
Everyone should consider taking vitamin D supplements in autumn and winter, public health advice in England and Wales says.
It comes as a government commissioned report sets the recommended levels at 10 micrograms of the vitamin a day.
But officials are concerned this may not be achievable through diet alone, particularly when sunlight, which helps in vitamin D production, is scarce.
Low vitamin D levels can lead to brittle bones and rickets in children.
Dr Charles Shepherd comments:
We often flag up the fact that people with ME/CFS, especially those who are partially or totally housebound, are at increased risk of developing vitamin D deficiency - mainly due to the lack of exposure to sunlight (which helps with vitamin D production) but this may also be compounded due to lack of foods that are good sources of vitamin D in their diet (i.e. oily fish, eggs, fortified breakfast cereals).
This new advice from Public Health England, which recommends that everyone should consider taking a vitamin D supplement during the autumn and winter months, is therefore very relevant - because vitamin D is essential for good muscle and bone health. So any deficiency of vitamin D in ME/CFS could add to the problems of muscle weakness that is already occurring.
On a personal basis, I will now be following this advice and taking a vitamin D supplement during the autumn and winter months.
Link to the most recent MEA statement on vitamin D and ME/CFS and our June 2016 MEA website poll on the subject:
http://www.meassociation.org.uk/201...-in-this-months-mea-website-poll-1-june-2016/
All aspects of vitamin D, and vitamin D deficiency, are covered in the MEA information leaflet on vitamin D:
http://www.meassociation.org.uk/shop/management-leaflets/vitamin-d/
Summary of key points relating to the vitamin D (25-hydroxyvitamin D) blood test:
The National Osteoporosis society (NOS) guidelines (UK, 2013) and the Institute of Medicine (US) classify vitamin D results as follows:
- 25-hydroxyvitamin D of less than 30 nmol/L is deficient
- 25-hydroxyvitamin D of 30-50 nmol/L may be inadequate in some people
- 25-hydroxyvitamin D of greater than 50 nmol/L is sufficient for almost the whole population.
Low blood levels of 25-hydroxyvitamin D may mean that you are not getting enough exposure to sunlight or enough vitamin D in your food to meet your body's demand or that there is a problem with its absorption from the intestines.
Occasionally, drugs used to treat seizures, particularly phenytoin (epanutin), can interfere with the liver's production of 25-hydroxyvitamin D.
High levels of 25- hydroxyvitamin D usually reflect excess supplementation from vitamin pills or other nutritional supplements.
More info on the vitamin D blood test:
http://labtestsonline.org.uk/understanding/analytes/vitamin-d/tab/glance/
Summary of research into vitamin D and ME/CFS from the MEA purple book:
Consider vitamin D deficiency in adults with restrictive diets and lack of access to sunlight.
A retrospective study of serum 25-OH (hydroxy) vitamin D levels in 221 ME/CFS patients found moderate to severe suboptimal levels, with a mean level of 44.4nmol/l (Berkovitz
et al 2009).
Vitamin D deficiency often goes unrecognised and can cause bone or muscle pain and muscle weakness. It can co-exist with ME/CFS.
Levels < 25nmol/ml may be associated with symptoms.
NB: Low serum calcium and phosphate and an elevated alkaline phosphatase are consistent with osteomalacia.
Dr Charles Shepherd
Hon Medical Adviser, MEA
