Vitamin D

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Vitamin D is a fat-soluble steroid hormone responsible for the intestinal absorption of calcium, iron, magnesium, phosphate and zinc. In humans, dietary Vitamin D is negligible; most comes from exposure of skin to sunlight or from supplementation.

Immune function[edit]

Vitamin D improves regulatory T cell function in healthy adults[1] and in patients with relapsing remitting multiple sclerosis,[2] suggesting that it may play a role in both preventing and ameliorating autoimmune disease.

Infectious disease[edit]

Vitamin D deficiency increases the risk of viral infections.[3]

Epstein-Barr virus[edit]

An Epstein-Barr virus protein EBNA-3 has an affinity for the Vitamin D receptor and may actually block the activation of VDR-dependent genes by Vitamin D.[4]


Optimal levels[edit]

The recommended blood level of Vitamin D varies considerably by government body and health society.

The US Institute of Medicine suggests levels between 20 ng/ml and 50ng/ml.[5]

The Vitamin D Council suggests a level of 50 ng/ml or 125 nmol/l as "ideal."[6][7]

In the United States, 41.6% have serum levels below 20 ng/ml, the threshold for deficiency or 82.1% of African-Americans and 69.2% of Hispanics.[8]


Vitamin D toxicity as a result of supplementation is rare and requires extremely high doses.[5]

Chronic Fatigue Syndrome[edit]

A retrospective study found patients with CFS have lower levels of Vitamin D than the general population. However, it was uncertain whether this is correlated with the amount of time CFS patients spend indoors or with some other factor.[9]

Raising Vitamin D levels has reportedly resulted in remission for some CFS patients.[10]

Recent research has found no toxicity at 10,000 IU per day and levels as high as 15,000 IU/day are probably tolerated.[11]. At this dosage it will take 75-90 before symptom improvement is expected to be seen. Some people have seen some symptoms improved within days, but those are likely a small minority.[12]

In 2015, Witham, et al, found that high-dose oral vitamin D3 did not improve markers of vascular health or fatigue in patients with chronic fatigue syndrome. The study consisted of patients with chronic fatigue syndrome according to the Fukuda (1994) and Canadian (2003) criteria who were either given 100,000 units oral vitamin D3 or a matching placebo every 2 months for 6 months.[13]


A cohort of Saudi women with fibromyalgia was found to be Vitamin D deficient. Vitamin D status was inversely correlated with pain. High dose Vitamin D supplementation resulted in improvement or resolution of symptoms.[14] A second study also found improvement of symptoms with Vitamin D supplementation.[15]

Autoimmune disease[edit]

Low Vitamin D is a possible risk factor for asthma,[16] SLE,[17] multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease[18] and autoimmune thyroid disease.[19] Active Crohn's disease was associated with lower Vitamin D levels.[20]

Multiple sclerosis[edit]

Among people with early stage MS, those with higher Vitamin D levels had better outcomes five years after follow up.[21]

It is theorized that there may be a link between low Vitamin D, Epstein-Barr virus and MS.[22]

2011 UK and Canadian scientists, comparing DNA changes found against existing databases, identified the mutated gene, CYP27B1, in 35 parents of children with MS and, in every case, the child inherited this gene. Researchers say this adds weight to suggestions of a link between vitamin D deficiency and MS. When people inherit two copies of this gene they develop a genetic form of rickets - a disease caused by vitamin D deficiency which is the major cause of infantile rickets. Just one copy of the mutated CYP27B1 gene affects a key enzyme which leads people with this gene to have lower levels of vitamin D.There are high levels of both vitamin D deficiency and MS among Scotland's 10,500 MS sufferers, the highest incidence of MS anywhere in the world. This is copied and pasted - find original paper and edit --JenB (talk) 23:54, 28 March 2016 (PDT)

Notable studies relating to ME/CFS[edit]

  • 2015, Effect of intermittent vitamin D3 on vascular function and symptoms in chronic fatigue syndrome – A randomised controlled trial
    Abstract: "Low 25-hydroxyvitamin D levels are common in patients with chronic fatigue syndrome; such patients also manifest impaired vascular health. We tested whether high-dose intermittent oral vitamin D therapy improved markers of vascular health and fatigue in patients with chronic fatigue syndrome. METHODS AND RESULTS: Parallel-group, double-blind, randomised placebo-controlled trial. Patients with chronic fatigue syndrome according to the Fukuda (1994) and Canadian (2003) criteria were randomised to receive 100,000 units oral vitamin D3 or matching placebo every 2 months for 6 months. The primary outcome was arterial stiffness measured using carotid-femoral pulse wave velocity at 6 months. Secondary outcomes included flow-mediated dilatation of the brachial artery, blood pressure, cholesterol, insulin resistance, markers of inflammation and oxidative stress, and the Piper Fatigue scale. As many as 50 participants were randomised; mean age 49 (SD 13) years, mean baseline pulse wave velocity 7.8 m/s (SD 2.3), mean baseline office blood pressure 128/78 (18/12) mmHg and mean baseline 25-hydroxyvitamin D level 46 (18) nmol/L. 25-hydroxyvitamin D levels increased by 22 nmol/L at 6 months in the treatment group relative to placebo. There was no effect of treatment on pulse wave velocity at 6 months (adjusted treatment effect 0.0 m/s; 95% CI -0.6 to 0.6; p = 0.93). No improvement was seen in other vascular and metabolic outcomes, or in the Piper Fatigue scale at 6 months (adjusted treatment effect 0.2 points; 95% CI -0.8 to 1.2; p = 0.73). CONCLUSION: High-dose oral vitamin D3 did not improve markers of vascular health or fatigue in patients with chronic fatigue syndrome.[23]
  • 2014, Association between vitamin D status and markers of vascular health in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)
    Abstract: "Low circulating 25 hydroxyvitamin D (25OHD) levels have been associated with increased blood pressure, impaired vascular health and an increased risk of cardiovascular events. We have previously shown that patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have vascular dysfunction, which is related to increased levels of low grade inflammation and oxidative stress. Vitamin D may affect the cardiovascular system through multiple pathways — via influence on the inflammatory process and oxidative stress, by effects on cardiac myocyte hypertrophy, vascular stiffness and calcification, and by direct effects on endothelial function."[24]

Learn more[edit]

See also[edit]


  1. Bock, Gerlies; Prietl, Barbara; Mader, Julia K.; Höller, Evelyne; Wolf, Michael; Pilz, Stefan; Graninger, Winfried B.; Obermayer-Pietsch, Barbara M.; Pieber, Thomas R. (November 2011), "The effect of vitamin D supplementation on peripheral regulatory T cells and β cell function in healthy humans: a randomized controlled trial", Diabetes/Metabolism Research and Reviews, 27 (8): 942–945, ISSN 1520-7560, PMID 22069289, doi:10.1002/dmrr.1276 
  2. Smolders, Joost; Thewissen, Mariëlle; Peelen, Evelyn; Menheere, Paul; Tervaert, Jan Willem Cohen; Damoiseaux, Jan; Hupperts, Raymond (2009-08-13), "Vitamin D Status Is Positively Correlated with Regulatory T Cell Function in Patients with Multiple Sclerosis", PLOS ONE, 4 (8): –6635, ISSN 1932-6203, doi:10.1371/journal.pone.0006635, retrieved 2016-11-10 
  3. Reference needed
  4. Yenamandra, Surya Pavan; Hellman, Ulf; Kempkes, Bettina; Darekar, Suhas Deoram; Petermann, Sabine; Sculley, Tom; Klein, George; Kashuba, Elena (December 2010), "Epstein-Barr virus encoded EBNA-3 binds to vitamin D receptor and blocks activation of its target genes", Cellular and molecular life sciences: CMLS, 67 (24): 4249–4256, ISSN 1420-9071, PMID 20593215, doi:10.1007/s00018-010-0441-4 
  5. 5.0 5.1 Theimer, Sharon (2015-03-15), "Vitamin D Toxicity Rare in People Who Take Supplements, Mayo Clinic Study Finds", Mayo Clinic News Network, retrieved 2016-11-10 
  6. Vitamin D Council - Testing for vitamin D
  7. Vitamin D Council - Why should you keep your vitamin D level around 50 ng/ml?
  8. Forrest, Kimberly Y. Z.; Stuhldreher, Wendy L. (January 2011), "Prevalence and correlates of vitamin D deficiency in US adults", Nutrition Research (New York, N.Y.), 31 (1): 48–54, ISSN 1879-0739, PMID 21310306, doi:10.1016/j.nutres.2010.12.001 
  9. Berkovitz, Saul; Ambler, Gareth; Jenkins, Michael; Thurgood, Sue (2009-07-01), "Serum 25-hydroxy Vitamin D Levels in Chronic Fatigue Syndrome: a Retrospective Survey", International Journal for Vitamin and Nutrition Research, 79 (4): 250–254, ISSN 0300-9831, doi:10.1024/0300-9831.79.4.250, retrieved 2016-11-10 
  10. IACFS/ME - Vitamin D deficiency results in chronic fatigue and multi-system symptoms, Anna Dorothea Hoeck. (pdf)
  11. CFS Remission - Vitamin D Toxicity Myth
  12. Reference needed
  13. Witham, M.D. et al. Effect of intermittent vitamin D3 on vascular function and symptoms in chronic fatigue syndrome – A randomised controlled trial. (2015) Nutrition, Metabolism and Cardiovascular Diseases, Volume 25 , Issue 3 , 287 - 294. Doi: 10.1016/j.numecd.2014.10.007
  14. Abokrysha, Noha T. (March 2012), "Vitamin D deficiency in women with fibromyalgia in Saudi Arabia", Pain Medicine (Malden, Mass.), 13 (3): 452–458, ISSN 1526-4637, PMID 22221390, doi:10.1111/j.1526-4637.2011.01304.x 
  15. Matthana, Mona H. (September 2011), "The relation between vitamin D deficiency and fibromyalgia syndrome in women", Saudi Medical Journal, 32 (9): 925–929, ISSN 0379-5284, PMID 21894355 
  16. Reference needed
  17. Kamen, Diane L.; Cooper, Glinda S.; Bouali, Henda; Shaftman, Stephanie R.; Hollis, Bruce W.; Gilkeson, Gary S. (February 2006), "Vitamin D deficiency in systemic lupus erythematosus", Autoimmunity Reviews, Special Issue on CIS Spring School of Autoimmune Diseases, 5 (2): 114–117, ISSN 1568-9972, doi:10.1016/j.autrev.2005.05.009, retrieved 2016-11-10 
  18. Cantorna, Margherita T.; Mahon, Brett D. (2004-12-01), "Mounting Evidence for Vitamin D as an Environmental Factor Affecting Autoimmune Disease Prevalence", Experimental Biology and Medicine, 229 (11): 1136–1142, ISSN 1535-3702, PMID 15564440, retrieved 2016-11-10 
  19. Bizzaro, Giorgia; Shoenfeld, Yehuda (February 2015), "Vitamin D and autoimmune thyroid diseases: facts and unresolved questions", Immunologic Research, 61 (1-2): 46–52, ISSN 1559-0755, PMID 25407646, doi:10.1007/s12026-014-8579-z 
  20. Jørgensen, Søren Peter; Hvas, Christian Lodberg; Agnholt, Jørgen; Christensen, Lisbet Ambrosius; Heickendorff, Lene; Dahlerup, Jens Frederik (November 2013), "Active Crohn's disease is associated with low vitamin D levels", Journal of Crohn's & Colitis, 7 (10): 407–413, ISSN 1876-4479, PMID 23403039, doi:10.1016/j.crohns.2013.01.012 
  21. Torgan, Carol (2014-02-03), "Vitamin D Levels Predict Multiple Sclerosis Progression", NIH Research Matters, retrieved 2016-11-10 
  22. Holmøy, Trygve (2008), "Vitamin D status modulates the immune response to Epstein Barr virus: Synergistic effect of risk factors in multiple sclerosis", Medical Hypotheses, 70 (1): 66–69, ISSN 0306-9877, doi:10.1016/j.mehy.2007.04.030, retrieved 2016-11-10 
  23. Witham, MD; Adams, F; McSwiggan, S; Kennedy, G; Kabir, G; Belch, JJ; Khan, F (2015), "Effect of intermittent vitamin D3 on vascular function and symptoms in chronic fatigue syndrome – A randomised controlled trial", Nutrition, Metabolism and Cardiovascular Diseases, 25 (3): 287-294, doi:10.1016/j.numecd.2014.10.007 
  24. Witham, Miles; Kennedy, Gwen; Belch, Jill; Hill, Alexander; Khan, Faisel (2014), "Association between vitamin D status and markers of vascular health in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)", International Journal of Cardiology, 174 (1): 139 - 140, doi:10.1016/j.ijcard.2014.03.145 

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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history