Vitamin D
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Vitamin D is sometimes viewed as a non-issue for CFIDS except when following a protocol like that at marshallprotocol.com. It is my opinion that Vitamin D is an important adjunct for recovery from CFIDS (regardless of protocol). Boron may be an assistant to Vitamin D.

I believe that Dr. Mercola, MD recommended optimal levels for Vitamin D is correct.

  • 45-50 ng/ml or 115-128 nmol/l [source]

The following table indicates how much supplementation is needed (over a 6 month period) to reach these levels.

Daily IUs of D 50 ng/ml 128 nmol/l
11281 5 13
10028 10 26
8774 15 38
7521 20 51
6267 25 64
5014 30 77
3760 35 90
2507 40 102
1253 45 115
0 50 128
   
Based on  14 nmol/l = 1371 IU

I would recommend keeping at 4000 IU/day (FDA deems that to be completely safe) instead of going to higher level -- and take a longer time to get there.

One International Unit (IU) of vitamin D is defined as the activity of 0.025 μg of cholecalciferol.
  • 1 μg vitamin D = 40 units vitamin D
  • 1unit vitamin D = 0.025 μg vitamin D.
Vitamin D is a generic term used to describe all substances that exhibit the biological activity of cholecalciferol. These include:
  • vitamin D1 (calciferol)
  • vitamin D2 (ergocalciferol)
  • vitamin D3 (cholecalciferol) <--BEST
  • 1 (OH)D3 (1 Hydroxycholecalciferol; alfacalcidol)
  • 25(OH)D3 (25 Hydroxycholecalciferol; calcifediol)
  • 1,25(OH)2D3 (1,25, Dihydroxycholecalciferol; calcitriol)
  • 24,25(OH)2D3 (24,25, Dihydroxycholecalciferol)
  • dihydrotachysterol.

Vitamin D2 is the form most commonly added to foods and dietary supplements (estimated to be 20% as effective as D3).

 Long term low vitamin 1,25D levels have significant health risks.

  • 1,25(OH)2D3 treatment reduces blood pressure, plasma renin activity, and Ang II levels in hyperparathyroidism patients (the poor man's Benicar)

There are some studies suggesting that Vitamin D supplements may help CFS/FM patients especially since it reduces inflammation  and "1,25(OH)2D3 with anticoagulant activity may serve as adjunctive antithrombotic agents". For a detail summary and recommendations, click here

For the most recent research, read "Vitamin D status, 1,25-dihydroxyvitamin D3, and the immune system."
From the full text article:

  • "The active form of vitamin D, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], has been shown to inhibit the development of autoimmune diseases"
  • "An additional factor that determines the effect of vitamin D status on immune function is dietary calcium."
  • "vitamin D deficiency in particular have been shown to occur among patients with inflammatory bowel disease (IBD)"
  • "the ability of 1,25(OH)2D3 to suppress the development of various autoimmune diseases and to prolong allograft survival, 1,25(OH)2D3 has been called an immunosuppressive hormone"
  • "dietary calcium dependent and -independent effects of 1,25(OH)2D3 on autoimmune responses. Both dietary calcium and 1,25(OH)2D3 are important regulators of autoimmune responses in the gastrointestinal tract and central nervous system."

A recent article (Jan, 2005) in the Times (UK) is also worth reading. [quoted].

A survey article on Vitamin D

Vitamin D is a major controller of the entire immune system. Depressing vitamin D will turn down (or off) the immune system so you immune-response symptoms may disappear -- however, it also means that the infections that you have will no longer be fought and will rapidly reproduce. The reports of a strong herx reaction from 1 mg of minocycline after reducing vitamin D (when 200mg produced no herx before) appears to because of this rapid unhindered growth of the infections. This turning off of the immune system does not apply to just bacteria sensitive to minocycline, but across the board to other infections: cancer virii, viral etc. Suppress vitamin D levels have cause diabetes to appear in test animals while their match sibling with adequate vitamin D never developed diabetes.

The chart below shows the actual distribution of types of Vitamin D in one group of women

From "Vitamin D status: effects on parathyroid hormone and 1,25-dihydroxyvitamin D in postmenopausal women"  Am J Clin Nutr 2000;71:157781.

A measure called "D-Ratio" has been proposed but never validated against real data. The chart below shows the ratio on this typical population. Originally a ratio of 4.0 was deemed significant it is now down to 2.25, or a large percentage of any population. Charting the normal range on the sarcoidosis patients, you see that only about 1/3 of the patients are outside of the normal band and may benefit from reduction of Vitamin 1,25D.

Distribution for a normal healthy population.

From:

REINHOLD VIETH, YASMIN LADAK, AND PAUL G. WALFISH

Age-Related Changes in the 25-Hydroxyvitamin D Versus
Parathyroid Hormone Relationship Suggest a Different
Reason Why Older Adults Require More Vitamin D
J Clin Endocrinol Metab, January 2003, 88(1):185191
 

   

CFS/FM Literature on Vitamin D

  • Low levels are seen with fibromyalgia
  • Dr. Teitelbaum in Townsend Letter, "Vitamin D deficiency has also been implicated in CFS "
  • Suggested as benefiting CFS patients

Symptoms of Vitamin D Deficiency

  • Weak Muscles
  • Pains in legs and muscles
  • Hearing Loss
  • Muscle spasms caused by a low calcium level
  • Weight gain / Obesity (may be acting thru reduction of Calcium levels)
  • Aggravation of the symptoms of inflammatory bowel disease

Health Risk of low Vitamin D (especially 1,25D)

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