MEA comment on new public health advice about Vitamin D supplements | 21 July 2016

The BBC and other media outlets are reporting new official guidance issued by Public Health England today urging everyone to take a vitamin D supplement during the autumn and winter to compensate for all those dreary days without sunshine.

This is music to the ears of ME Association medical adviser Dr Charles Shepherd, who 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). This may also be compounded by 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 – that everyone should consider taking a vitamin D supplement during the autumn and winter months – is therefore very relevant as vitamin D is essential for good muscle and bone health. 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:


www.meassociation.org.uk/2016/06/why-are-we-asking-if-you-have-been-tested-for-vitamin-d-deficiency-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:


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: labtestsonline.org.uk/understanding/analytes/vitamin-d/tab/glance/


Summary of research into vitamin D and ME/CFS from the MEA purple book (2016 edition):


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 less than 25nmol/ml may be associated with symptoms.

NB: Low serum calcium and phosphate and an elevated alkaline phosphatase are consistent with osteomalacia.