Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndr

[Kati]

Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis

Monica L. Joustra (1), Isidor Minovic (2 , Karin A. M. Janssens (1), Stephan J. L. Bakker (2), Judith G. M. Rosmalen (1)

(1)Affiliation Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
(2) Affiliations Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, Top Institute Food and Nutrition, Wageningen, the Netherlands

Received: October 10, 2016; Accepted: April 13, 2017; Published: April 28, 2017


Abstract


Background
Many chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) patients (35–68%) use nutritional supplements, while it is unclear whether deficiencies in vitamins and minerals contribute to symptoms in these patients. Objectives were (1) to determine vitamin and mineral status in CFS and FMS patients as compared to healthy controls; (2) to investigate the association between vitamin and mineral status and clinical parameters, including symptom severity and quality of life; and (3) to determine the effect of supplementation on clinical parameters.

Methods
The databases PubMed, EMBASE, Web of Knowledge, and PsycINFO were searched for eligible studies. Articles published from January 1st 1994 for CFS patients and 1990 for FMS patients till March 1st 2017 were included. Articles were included if the status of one or more vitamins or minerals were reported, or an intervention concerning vitamins or minerals was performed. Two reviewers independently extracted data and assessed the risk of bias.

Results
A total of 5 RCTs and 40 observational studies were included in the qualitative synthesis, of which 27 studies were included in the meta-analyses. Circulating concentrations of vitamin E were lower in patients compared to controls (pooled standardized mean difference (SMD): -1.57, 95%CI: -3.09, -0.05; p = .042). However, this difference was not present when restricting the analyses to the subgroup of studies with high quality scores. Poor study quality and a substantial heterogeneity in most studies was found. No vitamins or minerals have been repeatedly or consistently linked to clinical parameters. In addition, RCTs testing supplements containing these vitamins and/or minerals did not result in clinical improvements.

Discussion
Little evidence was found to support the hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of CFS and FMS, and that the use of supplements is effective in these patients.


Link to paper

 

[Research 1st]

The paper isn't reliable because the litmus test was never performed, namely:

1) Select PWCFS with organic disease signs (O.I, Seizures, Hypothyroid, POTS, MCS, PCOS, Cancer) instead of excluding them from research. In other words, not using 'Fatigue' as the sign up criteria. If you do that, then I'd agree i bet most of them aren't deficient in much at all, other than Vitamin D if they live in the Northern Hemisphere or they're housebound and don't get any sunlight.

2) As this is not allowed (due to Fukuda CFS), then do the researchers check the CFS patients aren't taking supplements when having blood draws for a fair period of time before the blood draws begin? Stopping a few weeks isn't accurate, you'd have to stop for months for levels to lower to natural (pre supplement levels). This information is never given.

So until we do this, it's not accurate either way for any review to say PWCFS don't suffer from deficiencies.
Practically everyone I've spoken to does, and those that don't, take supplements!

Without low in supplements I'm deficient in 8 things, and I doubt I'm unique.

 

[alicec]

Deficiency isn't the only reason that supplements may sometimes be helpful to at least some people.

With a number of inborn errors of metabolism, including mitochondrial diseases, the strategy of supplying large amounts of co-factors and other reactants to stimulate a defective enzyme is often successful, at least to some extent.

Naviaux's research suggests that metabolic disturbances are widespread in ME/CFS and a number of pathways are functioning poorly - a core few that seem to be common and a larger number that vary with the individual.

Maybe some of us sometimes hit on a combination of co-factors that boost the function of one or more enzymes that have become sluggish, not necessarily because of genetic factors, but because of the mechanism of the disease.

Using deficiency as the criterion is just setting up a straw person that is easy to knock down.

 

[Kati]

3 of the 5 authors belong to the Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. It raises a flag to me. Why is it that only psychs do systematic reviews and meta-analysis?

Here is a passage that is worrisome to me:

Although both interventions lead to significantly higher vitamin A, C, and E serum levels, the FMS symptoms did not improve in both groups. Furthermore, the most recent RCT investigated the effect of vitamin D, on symptoms in CFS patients, over a period of 6 months [75]. Despite a statistically significant increase in vitamin D, they found no evidence of improvement in symptoms of fatigue or depression. Lastly, in the fifth RCT, cholecalciferol was administered for 20 weeks in FMS patients, with the dosage depending on patients calcifediol levels [74]. A significant treatment effect on intensity of pain was found in the treatment group versus placebo. No changes in somatization, depression and anxiety, physical and mental health, and FMS symptom severity were observed in both the treatment and placebo group

(Bolding mine)

 

[NelliePledge]

Would have though they'd be looking for reduction in pain from vit D as it is linked to bone pain rather tan impact on depression

 

[Effi]

3 of the 5 authors belong to the Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. It raises a flag to me.

Judith Rosmalen is one of the most hardcore BPS people of the Netherlands. She is also a member of the dutch health council that is supposed to make new treatment guidelines for PWME. If anyone hasn't signed the dutch health council petition yet (demanding to change the health council members into NON psych), please do! https://meisgeensolk.petities.nl/?locale=en

 

[TiredSam]

No changes in somatization ... were observed

To be fair, that would be impossible.

Although I can't help wondering what tools they have available to observe a change in somatization, just on the offchance that a measurable one does occur?

 

[Hip]

Using deficiency as the criterion is just setting up a straw person that is easy to knock down.

I agree. Higher doses of vitamins and minerals can have physiological effects beyond just meeting the nutritional requirements to prevent deficiency.

For example, magnesium is believed to be a NMDA receptor blocker, which can thereby help prevent glutamate from over-activating this receptor. But these NMDA receptor-blocking effects of magnesium only make a noticeable impact when you take higher doses of magnesium (eg by injection or transdermally) that are beyond the normal daily nutritional requirements.

I used high dose transdermal magnesium sulfate myself for several years as a treatment for my generalized anxiety disorder (which I postulate is caused by high brain glutamate), and it had a noticeable effect. But that effect I am pretty sure came from NMDA receptor-blocking, rather than just meeting the daily nutritional requirements for magnesium.

Magnesium is also known to calm horses, probably through the same NMDA receptor mechanism.

 

[ljimbo423]

Although not a vitamin or a mineral, glutathione, the body's "master" anti-oxidant is very often low in CFS. This study found that 83% of people with CFS were low in glutathione. Gltutathione is extremely important to maintain good health and reduce oxidative stress, among other things.


LINK

1. First of all, do we find that fibromyalgia and chronic fatigue patients do, indeed, have abnormal methylation chemistry? YES

The initial methylation testing showed that:

• Every single patient had abnormal results.

• The average starting value of glutathione in our patients was 3.2 mmol/L (normal being 3.9-5.5 mmol/L)), and the average starting value for SAM (S-Adenosyl methionine, aka SAM-e, the major methylator) was 218 mmol/L (normal being 221-256 mmol/L).

• 83% started with low glutathione levels.

 

[Kati]

Although not a vitamin or a mineral, glutathione, the body's "master" anti-oxidant is very often low in CFS. This study found that 83% of people with CFS were low in glutathione. Gltutathione is extremely important to maintain good health and reduce oxidative stress, among other things.


LINK

Where is the link to the peer-reviewed scientific article? A Pro-Health article is not going to cut it for me. A published book won't either.

 

[ljimbo423]

Where is the link to the peer-reviewed scientific article? A Pro-Health article is not going to cut it for me. A published book won't either.

I sounds like you are looking for good solid science, and that makes sense to me. Unfortunately, it usually takes years to get it. That's usually my first avenue of research. However, I have chosen not to wait for the research and I am very happy I didn't.

At one point I was 80-90% bedridden and now I am functioning at a solid levels 5 and continue to improve, almost week to week.

Most of the interventions I have made to improve my health, were not based on peer reviewed science, because there is so little available that have a high degree of success in improving cfs.

Could I have improved with the right doctor and peer reviewed science? Probably, I just went a different way.

 

[Kati]

I sounds like you are looking for good solid science, and that makes sense to me. Unfortunately, it usually takes years to get it. That's usually my first avenue of research. However, I have chosen not to wait for the research and I am very happy I didn't.

At one point I was 80-90% bedridden and now I am functioning at a solid levels 5 and continue to improve, almost week to week.

Most of the interventions I have made to improve my health, were not based on peer reviewed science, because there is so little available that have a high degree of success in improving cfs.

Could I have improved with the right doctor and peer reviewed science? Probably, I just went a different way.

This thread is about the meta-analysis and systematic review. You may want to start a new thread, because this forum is about published and peer-reviewed science. There is lots to talk about the initial topic amd it would be best not branch put onto something else from another ball park, if you know what I mean.

 

[flitza]

I agree. Higher doses of vitamins and minerals can have physiological effects beyond just meeting the nutritional requirements to prevent deficiency.

For example, magnesium is believed to be a NMDA receptor blocker, which can thereby help prevent glutamate from over-activating this receptor. But these NMDA receptor-blocking effects of magnesium only make a noticeable impact when you take higher doses of magnesium (eg by injection or transdermally) that are beyond the normal daily nutritional requirements.

I used high dose transdermal magnesium sulfate myself for several years as a treatment for my generalized anxiety disorder (which I postulate is caused by high brain glutamate), and it had a noticeable effect. But that effect I am pretty sure came from NMDA receptor-blocking, rather than just meeting the daily nutritional requirements for magnesium.

Magnesium is also known to calm horses, probably through the same NMDA receptor mechanism.

You said you used high dose for several years: How high? The implication is that you are no longer doing so. If so, why?

 

[Hip]

You said you used high dose for several years: How high? The implication is that you are no longer doing so. If so, why?

Hard to determine the exact dose I administered, because it depends on the process of transdermal absorption.

But I would guess that when I apply saturated Epsom salts solution transdermally from head to toe as I do, I might be getting in the order of a 1 to 2 gram dose of elemental magnesium. The actual amount of magnesium that I apply to my skin from head to toe is around 4 grams of elemental magnesium, but not all of this is absorbed. I would guesstimate that around 1 to 2 grams is absorbed. I would usually apply this twice a day, so that's a total of 2 to 4 grams of elemental magnesium each day, via this transdermal route.

The highest oral dose of magnesium I can take is around 500 mg, because for me higher amounts cause bowel flushing. When I took this 500 mg magnesium dose orally, it created no noticeable reduction in my anxiety symptoms. Whereas the transdermal Epsom salts did noticeably reduce anxiety levels. Thus I can only assume from this that the transdermal dose is significantly higher than 500 mg. Hence my 2 to 4 grams a day estimate.

I still use transdermal magnesium sometimes, but because I found much better ways of controlling my generalized anxiety disorder (such as N-acetyl-glucosamine), I no longer use transdermal magnesium much.