Vitamin D status in chronic fatigue syndrome/myalgic encephalomyelitis: a cohort study from the UK

[Murph]

https://www.ncbi.nlm.nih.gov/pubmed/29118054

BMJ Open. 2017 Nov 8;7(11):e015296. doi: 10.1136/bmjopen-2016-015296.
Vitamin D status in chronic fatigue syndrome/myalgic encephalomyelitis: a cohort study from the North-West of England.
Earl KE1, Sakellariou GK1,2, Sinclair M1, Fenech M1,3, Croden F4, Owens DJ5, Tang J6, Miller A3, Lawton C4, Dye L4, Close GL5, Fraser WD6, McArdle A1, Beadsworth MBJ1,3.
Author information
Abstract
OBJECTIVE:
Severe vitamin D deficiency is a recognised cause of skeletal muscle fatigue and myopathy. The aim of this study was to examine whether chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with altered circulating vitamin D metabolites.

DESIGN:
Cohort study.

SETTING:
UK university hospital, recruiting from April 2014 to April 2015.

PARTICIPANTS:
Ninety-two patients with CFS/ME and 94 age-matched healthy controls (HCs).

MAIN OUTCOME MEASURES:
The presence of a significant association between CFS/ME, fatigue and vitamin D measures.

RESULTS:
No evidence of a deficiency in serum total 25(OH) vitamin D (25(OH)D2 and 25(OH)D3 metabolites) was evident in individuals with CFS/ME. Liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis revealed that total 25(OH)D was significantly higher (p=0.001) in serum of patients with CFS/ME compared with HCs (60.2 and 47.3 nmol/L, respectively). Analysis of food/supplement diaries with WinDiets revealed that the higher total 25(OH) vitamin D concentrations observed in the CFS/ME group were associated with increased vitamin D intake through use of supplements compared with the control group. Analysis of Chalder Fatigue Questionnaire data revealed no association between perceived fatigue and vitamin D levels.

CONCLUSIONS:
Low serum concentrations of total 25(OH)D do not appear to be a contributing factor to the level of fatigue of CFS/ME.

 

[Jesse2233]

Good to have this negative result documented

 

[JaimeS]

@Jesse2233 --

1) Dxed with NICE guidelines. There's worse, but there's also better.
2) They included people who were taking vitamin D supplements! Goodness gracious.

That's probably all that needs to be said, but:

• If the person were deficient in Vitamin D, there's a good chance that's why they were taking it. It's a common supplement so it's possible they were taking it 'just because', but there's a good chance they had it tested and that's why they're supplementing. So now their Vitamin D is back to normal, and they count as having normal Vit D in the study.
• If the person weren't deficient, they were probably not taking it.
• Even in a study where they ask you to stop taking your supplements, Vit D will leave the system slowly, so even if they asked the participants to stop taking Vit D their levels would still be elevated.

So now everyone looks fine... This is pretty junky.

Perhaps their point is that hypovitaminosis D is not causing their patients' chronic fatigue in which case yes, they proved that's the case.

Here is other research, also UK, done better; all of these have noted marked depression of Vit D levels in patients:

https://www.ncbi.nlm.nih.gov/pubmed/25455721
https://www.ncbi.nlm.nih.gov/pubmed/20209476

Interestingly a study on "chronic fatigue" (the symptom) showed a correlated between low Vit D and orthostatic intolerance, which many studies have noted has a high incidence in ME/CFS:

https://www.ncbi.nlm.nih.gov/pubmed/21886073

 

[Jesse2233]

Thanks @JaimeS good points

 

[anni66]

In UK most GPs correlate vitD with bone health. It' s input in genome function and immune system are not well known here.I suspect that if vitD was checked when first diagnosed then it would be a more relevant study.
Why include those who supplement at all?

When i first looked into this as daughter tested very low pre ME diagnosis but post glandular fever, i found a graph that correlated various illnesses with global location ( indication of vit D availability). There was a strong correlation for MS, some forms of cancer.

Correlation is not causation but definitely worthy of exploration.

 

[sb4]

Interesting but I agree with a lot of what Jamie said and I would also add that this by no means rules out increasing vitamin D levels curing or improving your symptoms.

Perhaps our immune systems are under greater stress compared to controls and so we would benefit and need more vit D in comparison.

 

[JaimeS]

In UK most GPs correlate vitD with bone health.

So I've heard! Interesting. It's considered to be associated with many other things as well, across the pond. I made the statement that "Vitamin D is one of the first things your doctor should check in instances of fatigue" and UK folk were: ... "not here".

Perhaps our immune systems are under greater stress compared to controls and so we would benefit and need more vit D in comparison.

Mine started off very, very low and I find I do best when it's on the higher end of normal. I'd agree that it seems like I need more resources in general. I start to feel pretty bad if my B12 goes lower than high-normal as well.

 

[Martin aka paused||M.E.]

@JaimeS @Murph
I have been to a doctor who worked with Carmen Scheibenbogen from Charité Clinic in Germany. He said Vitamin D plays a tremendous role in chronic fatigue and other immunological symptoms. In fact my levels were too low!