View Full Version : Vitamin D deficiency is often misdiagnosed as FMS or CFS

03-05-05, 03:51 PM
The Institute of Medicine brought experts together recently to explore the question of whether the RDA or recommended daily allowance, of vitamin D has been set too low. The impetus for the occasion was the mounting evidence for this vitamin's role in preventing common cancers, autoimmune diseases, type 1 diabetes, heart disease, and osteoporosis.

Furthermore, studies have shown that vitamin D deficiency is common in the U.S. Because the typical symptoms are aching bones and muscle discomfort, vitamin D deficiency is often misdiagnosed as fibromyalgia or chronic fatigue syndrome, according to Michael F. Holick, MD, PhD, of the Boston University School of Medicine.

Dr. Holick has conducted a review of all vitamin D studies, which was published in the December 2004 issue of the American Journal of Clinical Nutrition. Vitamin D has become the vitamin of the moment, possibly because researchers in this field want to raise the RDA again. And Dr. Holick's review, which was funded by the U.S. National Institutes of Health, certainly supports the move.

For most Americans, sunlight provides the lion's share of our vitamin D requirements because we eat few foods that naturally contain vitamin D, such as cod liver oil and oily fish (salmon, sardines, and mackerel). But many Americans do not met the minimum requirement of sun exposure. What's more, vitamin D deficiency is more pronounced among people living at higher latitudes, such as the New England States, especially in winter.

Dr. Holick and colleagues conducted a 2002 study at the Boston Medical Center, which found that, by the end of the winter, 32% of students and doctors, aged 18 to 29 years, were vitamin D deficient. Winter isn't the only problem because, year-round, many people spend a lot of time indoors or slather themselves with sunscreen when they do go outside.

So it was not too surprising that another study conducted in Boston found a high degree of D deficiency in white (30%), Hispanic (42%) and black (84%) elderly people at the end of August. Another study found that 38% of nursing home residents were vitamin D deficient.

Much of the sun avoidance and excessive sunscreen use is attributed to public education campaigns by dermatologists warning about skin cancers. It should be noted, however, that the most deadly form of skin cancer, melanoma, is unrelated to sun exposure, as the disease usually occurs in areas of the body not exposed to the sun.

Obesity is yet another cause of vitamin D deficiency, according to Dr. Holick, who found that even when dietary vitamin D intake and sun exposure are adequate, the vitamin becomes unavailable because it becomes stored in the large amount of body fat. Aging skin requires more sun exposure. A 70-year-old exposed to the same amount of sunlight as a 20-year-old will only make 25% of the vitamin D that the young person can make.

Breastfed infants are deficient in vitamin D because human milk is deficient in vitamin D. Dr. Holick offered this explanation for why deficiencies are widely overlooked: During the standard blood work-up, doctors tend to focus on the blood calcium levels, and if they are normal, doctors incorrectly assume their patients are getting enough D.

Why the seemingly sudden interest in vitamin D when intriguing research goes back over a half century? In 1949, a researcher published his observation that people who live at higher latitudes, such as New Hampshire, Vermont, and Massachusetts, had a higher incidence of cancer deaths, compared with people living in southern states, such as Texas, Georgia, and Alabama.

In a telephone interview, Dr. Holick was asked why other researchers didn't pick up on this study and look further. "It was an interesting observation, but people didn't take epidemiology seriously," he answered. "Little attention was paid to it until the 1980s when other researchers reported that colon and breast cancer rates were higher for those living at higher latitudes in the U.S."

Even then, the finding was not taken seriously until researchers understood the mechanism for how the breast, colon, and prostate activate vitamin D and use it to regulate cell growth, which Dr. Holick explained as a process that is, "keeping cell growth in check and possibly preventing the cell from becoming autonomous and developing into an unregulated cancer cell."

After the paper explaining the mechanism was published in the British journal The Lancet, much more research attention began to be paid to vitamin D. And after 1999, many more observational studies were published showing a link between vitamin D deficiency and several chronic diseases. For example, there are higher rates of multiple sclerosis in people who live at higher latitudes; and another study showed vitamin D intake is inversely associated with rheumatoid arthritis.

In a 2001 study published in The Lancet, children treated with 2,000 IU daily of vitamin D from their first birthday onward had an 80% decreased risk of developing type 1 diabetes throughout the next 20 years. And in the last few years, several studies have been published indicating a link between schizophrenia and decreased exposure to sunlight. Dr. Holick's review states that animal studies have successfully shown that type 1 diabetes, rheumatoid arthritis, and multiple sclerosis can be prevented using mice prone to these diseases.

To Dr. Holick, who is an endocrinologist, it is clear from studies like these (and many more that go unmentioned in this article for lack of space) that vitamin D should no longer be thought of only as the nutrient necessary for the prevention of rickets in young children. He said that his work has been instrumental in the vitamin D fortification of several common foods, including milk products, bread, and orange juice.

In the telephone interview, Dr. Holick was asked whether an increase in the RDA for vitamin D was imminent, given the fact that the Institute of Medicine, a division of the National Academy of Science, recently held a meeting on the topic. "No, it usually takes 10 to 15 years to change an RDA," he answered. "A huge bureaucratic system is involved." In the meantime, he and other vitamin D researchers recommend a minimum of 1,000 IU vitamin D daily. This increase, he explained, will maximize the absorption of calcium.

As for the risk of overdose, Dr Holick said, "You'd have to take 10,000 to 20,000 IU daily to approach toxicity." Is the type of vitamin D important? "Multivitamins usually have D2 which comes from yeast, but it's probably only 20-40% as effective as D3," which, he believes is better and longer lasting.

Then there's the question of what constitutes an adequate amount of sunlight: "Five to ten minutes of exposure of the arms and legs or the hands, arms and face two or three times a week," stated Dr. Holick, adding a way of determining the right timing, "25% of the time that it would take to cause a light pinkness to the skin."

12-13-11, 04:54 AM
great post. thanks.

12-20-11, 03:47 PM
Yes! I am a big vit 'd' advocate; I take it for heart health in attempt to stave off the inevitable heart disease that is a genetic condition in my family.

There has been a correlation found between low vit 'd' levels and seasonal affective disorder and depression. There is also a correlation between low vit 'd' levels and onset of MS.

If you are going to supplement, the best absorbed 'd' vitamin is d3 (cholcalciferol) in the form of an oil-based gel-cap, or liquid drops in an oil base. Personally, I take 4000iu/day, and I give my son 1000iu per day. I have my level tested every 6 months or so, and this amount puts me in the mid-range of the recommended level.

If you are interested in learning more about vit 'd', google "vitamin 'd' council" Lots of good links to follow...
ETA: Whoops! I see I'm practicing necromancy here! Anyway, it's still good info!

12-20-11, 04:03 PM
I've been taking vit. D but I am upping the dosage!

mrs. dobbs
12-21-11, 10:16 PM
I've not been diagnosed or even thought of myself as having CFS or FM, but I am extremely fatigued and achy and foggy. I attribute it to depression, but then again I'm so used to feeling tired and in pain that I'm not sure what the deal is. I'm more worried about my vitamin D levels currently.

I've been taking 2000iu of D3 liquid in fractionated coconut oil, on my tongue, daily for several months now, but I am pregnant, have brown skin and live in Scandinavia. I'm going to increase my dosage as well. I have read studies that dark skinned and modestly dressed (i.e. full hijab/abaya-wearing) women living here in the north, not suprisingly, have severe vitamin D deficiencies. What's more is that the vitamin D deficiency among modestly dressed and or dark skinned women living here where there's limited daylight half the year, has been correlated with an increase in autism in our babies born here. I don't dress modestly (no religion/not from an immediate cultural background that does), but I as I said I am brown skinned and have spent very little time in the sun. I am also plus sized and probably vitamin D deficient before I moved here-- though I lived in sunny Southern California. SAD and I suspect vitamin D deficiency are currently making me severely depressed, maybe more depressed than I've ever been (and I have had depression my entire life.) I've talked to a couple of people and they say they've taken the near-toxic dosages to get vitamin D stores in the liver up to a decent level, and say it takes months. I have also read that people often get shots to get their levels up and maintain with vitamin supplements. I'm trying to figure out what dosage I need to take to get out of this depressive pit and make sure my baby doesn't have autism. It's not easy to get elective blood tests through the national health service, but I think I will call and ask my ob-nurse tomorrow.

12-22-11, 10:56 AM
Mrs. Dobbs, in addition, take the vitamin 'd' with a fat source; this will help the absorption. It would be very useful for you to get the blood test, especially given all that you have mentioned. I hesitate, since you are pregnant, to give any sort of recommendation re dosage that you should be taking, but if you google 'Vitamin D Council' you will find some recommendations that you can consider, and also discussion about the possible link between low d levels and fetal developmental issues...

12-22-11, 11:05 AM
Here's a recent study published on medscape that might be helpful:
(sorry, I think you have to register, but it's free)

from the article:
"In our study subjects, a daily dosage of up to 4,000 IU of vitamin D was required to sustain normal metabolism in pregnant women," Dr. Hollis concluded. "Furthermore, following decades of speculation into its safety our research has demonstrated vitamin D supplementation to be both safe and effective."
On the basis of their findings, the investigators suggest that "the current vitamin D EAR and RDA for pregnancy women issued in 2010 by the Institute of Medicine should be raised to 4,000 IU vitamin D per day so that all women regardless of race attain optimal nutritional and hormonal vitamin D status throughout pregnancy."

12-22-11, 11:13 AM
I sometimes feel like I have CFS and I admit a HATRED for sunlight.

Perhaps I should look into supplements.

Good thread. Worth the necromancing.

Kudo's to Mr. Kenny, and Lynne and Beannie

12-22-11, 01:36 PM
It should also be noted that those of us with pale skin (aka white people) are a genetic mutation adapted to northern climates that lacked sun exposure. As a result, people with a more average amount of melanin (everyone *but* whities) who live in northern climates will not be able to absorb as much vitamin D and will require much more supplementation.

I have known a lot of people of colour who live in Le Grand Nord with me who have had trouble with SAD and fatique because nobody ever told them that their skin doesn't absorb the weak sunlight up here, *especially* in the winter.

12-22-11, 01:44 PM
I began taking Vitamin D3 about a year ago because I heard it helps with
SAD (seasonal affective disorder). It didn't help me with those symptoms
at all, but then I read that it can help prevent bone breakage so I
continued to take it. I've had several broken bones in the last 15 years.

When I also read that it can help with Fibromyalgia I realized I hadn't
needed to take a post-lunch nap anywhere near as often as before I
started taking the supplement. It's part of my regular morning routine
now, to take Vitamin D3 along with Omega 3 fish oil, Magnesium and a B-
complex that includes B12.

12-22-11, 04:49 PM
I sometimes feel like I have CFS and I admit a HATRED for sunlight.

Perhaps I should look into supplements.

Good thread. Worth the necromancing.

Kudo's to Mr. Kenny, and Lynne and Beannie
I feel really strongly about vit 'd', and I'm not a person who takes handfuls of supplements. 'D' is a hormone precursor and being deficient in it can have a detrimental effect on both physical and mental states.

And one more to consider is CoQ10, epsecially if your muscles ache all the time. I take it for heart health, but I have found that since I've been taking it I almost never take ibuprofen anymore. I used to take ibuprofen multiple times per week for various 'aches and pains', but I don't seem to have them any more. I know this is anectdotal, but I ran out of CoQ10 for a good month or so, and noticed that I was back to popping the ibuprofens. I started taking it again a few weeks ago and I haven't taken an advil since then.
If you decide to take it, make sure to get oil-based gel-caps, just like the 'd'...

Here is a brief overview from WebMD...

OK, I'll stop now! :p

12-22-11, 07:27 PM
The problem is, I'm lucky enough that I barely pay anything for my meds, but supplements are not covered by health insurance... :(

12-22-11, 08:22 PM
I don't go outside at all. I am very likely vitamin D deficient, but I haven't got that checked out.

12-22-11, 09:48 PM
The problem is, I'm lucky enough that I barely pay anything for my meds, but supplements are not covered by health insurance... :(
'D' is pretty economical. I buy Carlson's liquid d drops (2000iu per drop) for about $12 US on line, and it lasts for about 6 months... (365 drops per bottle , 2 drops per day)

01-05-12, 01:03 AM
I think I talked about this in another thread. The first thing my new Pdoc did was bloodtest. I have been having major muscle tightness joint pain. I had a Vitamin D level WAY below range.

Taking 50000 IU once a week to see if I can boost my levels back up. I think they were like a 11. I think the range is 30-100.

My future brother in law who is a doctor told me to be sure to take Vitamin D with a high fat meal for absorption.

I actually did get my vitamin D fromt he pharmacy and it was covered by insurance as was the Folbic ( B vitamins ) that I was prescribed by another doctor.