Fibromyalgia VITAMIN D

[Ted Hutchinson]

Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16850115&query_hl=23&itool=pubmed_docsum)

Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed.........and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16259310&query_hl=23&itool=pubmed_docsum)

Many patients with systemic lupus erythematosus (SLE) and fibromyalgia (FM) may spend less time exposed to the sun than healthy individuals and thus might have low vitamin D levels. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=11708429&query_hl=23&itool=pubmed_docsum)

Is fibromyalgia just a vitamin D deficiency from Bill Sardi's ... (http://www.knowledgeofhealth.com/report.asp?story=Is%20fibromyalgia%20just%20a%20vi tamin%20D%20deficiency&catagory=Vitamin%20D,%20Fibromyalgia)

Vitamin D3 supplements have been shown to help people whose fibromyalgia is affected by lack of sun.
"In a Mayo Clinic study of 100 FMS patients, all 100 had sub-clinical levels of Vitamin D3," Sorem said.
"With D3 supplementation, the majority had good to great results within 72 hours," he added. (http://159.54.227.3/apps/pbcs.dll/article?AID=/20060925/LIVING/609250324/1004)
You will need to use the links provided at The Vitamin D council (http://www.vitamindcouncil.com/) to find the best source of high strength CHOLECACIFEROL Vitamin D3.

[GJZH]

I just saw a RA doc today and told me to add Vitamin D supplements to my diet...He told me to add 400 mgs per day...and not to worry that he would do a blood test at three months to make certain I am not taking too much Vitamin D...

[Ted Hutchinson]

I just saw a RA doc today and told me to add Vitamin D supplements to my diet...He told me to add 400 mgs per day...and not to worry that he would do a blood test at three months to make certain I am not taking too much Vitamin D...
For others
5 micrograms/day =200 iu/day
50micrograms=2000iu ..this is currently regarded as the Toxic Upper Limit however recent research suggest that this limit needs raising to 10,000iu/d see Critique of the Considerations for Establishing Tolerable Upper Intake Levels for Vitamin D (http://www.direct-ms.org/pdf/VitDVieth/Vieth%20Critique%20UL%20Vit%20D.pdf)
8 x 50= 400
8 x 2,000= 16,000iu/d while this may seem a lot bear in mind that on a sunny day if you lie naked in the sun your skin will make around 12,000iu in 15 minutes or so and while the efficiency of the system means surplus to capacity is disregarded it is reasonable to suppose that 20,000iu is the kind of amount prolonged exposure would create.
The case against ergocalciferol (vitamin D2) as a vitamin supplement (http://www.ajcn.org/cgi/content/full/84/4/694) sets out the reasons why it is far better to use Cholecalciferol, vitamin d3 than Ergocalciferol vitamin d2. They are not one and the same although both are sold as "vitamin d" in the UK. You must ask, particularly if you find Vit d stated in multivitamin/mineral tablets or Calcium/vitamin d mixes. Older people particularly absorb only around 70% of the vitamin d from Ergocalciferol so it's really not cost effective.
Follow the links on The Vitamin D council Website for the best/cheapest source of vitamin d3 Cholecalciferol I know (http://www.vitamindcouncil.com/) You will see they also supply 50,000iu capsules which makes the amount your doc suggests seem trivial.
One useful thing about vitamin d3 is it has a half-life of around 3 weeks. This means if you wanted to take 16,000iu daily this would be the same as 48,000iu every 3 days. So one 50,000iu capsule every 3 or 4 days would work out equivalent.
You will see from Dr. Joe’s Vitamin D Regimen
50,000 IU daily until 80-120 nmol/L Vitamin D levels are reached in the blood
1,000 to 7,000 IU daily for well being
Monitored by a periodic Vitamin D / 25 OH blood test (http://www.endocrinemetabolic.com/resources/enews/2006/vitdnews10272006.pdf)
is one suggestion for raising vitamin d status quickly.

[Ted Hutchinson]

What other type of vitamins does everyone take for there Fibro? I used to take quite a few different ones-I can't even remember all their names! I don't know if I'm totally sure they worked or not. So, what types do you take and did your doctor tell you to take them?

AggieI started this thread to talk about the relationship of FMS to vitamin d3 and/or whether it's possible, as many of the symptoms of vitamin d deficiency/insufficiency are identical to the symptoms of FMS, some people may find that by correcting their vitamin d3 insufficiency/deficiency they may also improve their FMS symptoms.

I think if people want to talk about other supplements that may be helpful to deal with the symptoms of FMS, that discussion would be better in a separate vitamins/fms thread, so this thread can be left to consider only the Vitamin D3 /Fms connection.

[Bluey]

I do feel better in the summer. Maybe there's something to this Vit D3 being needed.
Thanks.

[Ted Hutchinson]

I do feel better in the summer. Maybe there's something to this Vit D3 being needed.
Thanks.Supplementing with Vitamin D3 Cholecalciferol is cheap and easy. Follow the links here The Vitamin D council (http://www.vitamindcouncil.com/) to the Best cheapest source of vitamin d3 cholecalciferol.

The 5000iu capsules they supply cost around £17 to the UK but will be much cheaper in dollars and local postage in USA. This will provide 250 capsules.
To raise vitamin d status I'd take 10 capsules when I unpacked them and then one a day. If after a week I hadn't noticed any improvement I'd take another 10 followed by one capsule daily.

When you take cholecalciferol it takes probably 3 days for it to be absorbed and converted to whatever and be flowing round your blood stream so having a large amount then waiting to see the impact is a reasonable way to go about raising your levels. By 2 months you should be able to wind down to just one a day and if you are feeling as well as you do in the summer then you could safely go to a maintainance dose of 5 or6 capsules a week.
When the Winter and early Spring are over and you are getting out into the sunshine then you can drop down to just one or two capsules a week.

The Toxic Upper Level for Vitamin d3 should be 10,000iu/d over a period of 2 yrs or so. So don't worry about taking 50,000iu once a week for a couple of months. All this is doing is making up for deficiency status. It's about the same as you'd make if you lay stark naked in the sun on and off during a sunny summer day. Just 15 mins sunshine will produce 12,000iu so you can see this is the kind of amount your body is geared up to deal with.

The Half Life of vitamin d3 when in the blood stream is about 3 weeks so the intitial high dose will be depleting as the winter progresses. So keep on a fairly high dose for the intitial couple of months before you start to drop the dose.
If you go for the 50,000iu capsules then one of these each week for 2 months and then one a fortnight after should do until April when you could drop down to one a month.

[BrokenBladder]

Great thread Ted.......my Rheumy did a test on me for Vitamin D and I don't know the results yet. My problem is that I also have a bladder condition called interstitial cystitis(bleeding ulcers on my bladder wall)which prevents me from taking vitamins. I have attempted to take them in the past and it puts my bladder in a flare. Yikes!! Any other suggestions?

[Ted Hutchinson]

Great thread Ted.......my Rheumy did a test on me for Vitamin D and I don't know the results yet. My problem is that I also have a bladder condition called interstitial cystitis(bleeding ulcers on my bladder wall)which prevents me from taking vitamins. I have attempted to take them in the past and it puts my bladder in a flare. Yikes!! Any other suggestions?Sunlight Robbery - Health Research Forum (http://www.healthresearchforum.org.uk/sunlight.html) details how you can sunbathe safely and improve your vitamin d3 status.
Vitamin D calculator (http://zardoz.nilu.no/~olaeng/fastrt/VitD-ez.html) enables you to enter your latitude, longitude, altitude to work out if there is sufficient power in the sun at your location to synthesise Vitamin d from sunlight.
Erythemal UV Index — Forecast and Archive (http://www.temis.nl/uvradiation/UVindex.html) enables you to see if there is a high/low risk of getting sunburnt.
Remember it is SUNBURN that is associated with skin cancers. Your skin will make sufficient vitamin d3 to keep you topped up in a quarter of the time it takes for your skin to start going pink so there is no excuse for not getting at 10-15mins sun exposure daily. In fact the prognosis for those who have been treated for melanoma is far better if they continue to get regular sun exposure.

You can of course improve your resistance to burning by increasing the omega 3 content of your diet, change to drinking green tea instead of brown tea or coffee, improve your diet so you eat more foods containing vitamin c, e, more advice on healthy eating to improve your skin's natural sunscreen potential here (http://www.whfoods.com/genpage.php?tname=george&dbid=144#answer)

The vitamin D council (http://www.vitamindcouncil.com/) has links to a place which sells UVB specific sunlamps which would be an alternative if you live further from the Equator than latitude 40 and need some Winter sunshine. Ordinary suntan lamps may provide UVB if the tubes are new. After about 500-800hrs use the UVB element tends to reduce. So it's difficult to be sure a commercial suntan palour is providing a reasonable ratio of UVB<>UVA
You could of course buy your own solaria and monitor the time the tubes have been used.

[uvamomb]

When mine was checked, I had NO detectable Vitamin D in my blood at all. My endo put me on 50,000 units per week for I believe six weeks, and then rechecked. It was back in the normal range. I am still in bad pain daily, but I don't have just fibro, so who knows? I encouraged my Chronic Pain Support Group to have their levels checked. One did, the one with RA. Hers was same as mine - no detectable Vitamin D. She felt much less achy after her course of the 50,000 units per week. There must be something to this!

[Emily1]

What about myers cocktail iv vitamins? Not sure how that would end up on your bladder but the iv vitamins kick some major butt and may be something you can take?

or you could move to arizona for some vitamind d -goodness where I come from we dont get nearly enough of it! ;)

My natural doc recommended recently I get checked for vitamin d, I keep forgetting to mention to my doctor. The post above shocks me and I will certainly remember to do this. I do however, take a very good general vitamin course from enzymatic therapy. Its helped a lot.

[Sydney]

Ted,
I read all your posts on Vitamin D. I have Fibro. and RSD - very severe chronic widespread body pain. Have taken over 30 meds incuding oycontone, methadone and all the other heavy hitters with no pain relief.
My one naturopathic Dr. claims that if I get my D level up to about 80 I will have some pain relief. My last D level was 18. I cannot go out in the sun as I have sun allergies and also severe allodynia which makes sun bathing painful.
I was taking about 4,000 D3 a day for months when I realized it also has Vit A in it. I know Vit A can be toxic at 10,000. However, someone on ths forum said that was the synthetic form. They said acne patients receive 30,000 A per day ( I think that was it). Anyway - your sugggestion for the 50,000 D makes me question how much Vit A I would be getting and would I be overdosing on the A. I also take Cod Liver Oil which has another 3,000 a day. Thanks for all the info. Sydney

[Ted Hutchinson]

Ted,
I read all your posts on Vitamin D. I have Fibro. and RSD - very severe chronic widespread body pain. Have taken over 30 meds incuding oycontone, methadone and all the other heavy hitters with no pain relief.
My one naturopathic Dr. claims that if I get my D level up to about 80 I will have some pain relief. My last D level was 18. I cannot go out in the sun as I have sun allergies and also severe allodynia which makes sun bathing painful.
I was taking about 4,000 D3 a day for months when I realized it also has Vit A in it. I know Vit A can be toxic at 10,000. However, someone on ths forum said that was the synthetic form. They said acne patients receive 30,000 A per day ( I think that was it). Anyway - your sugggestion for the 50,000 D makes me question how much Vit A I would be getting and would I be overdosing on the A. I also take Cod Liver Oil which has another 3,000 a day. Thanks for all the info. SydneyI personally would be unhappy about taking too much vitamin A. I haven't spent enough time researching it (Vit A)to make any further comment. I'm happy with the information from The Vitamin D council (http://www.vitamindcouncil.com/) about the amount of Vitamin d3 Cholecalciferol that is sensible and safe to take. The best sources from the links at that site are cheap and of appropriate strength and don't have any Vitamin A content so there is no problem with that. Taking 50,000iu cholecalciferol weekly should get your Vitamin D status up in a couple of months so it would probably be the quickest safest way for you to manage it. It may not be the whole story for your fibro, but a low vitamin d level such as you had would produce fatigue and pain so until you sort the vitamin d you won't know what's what.

[Bluey]

Is there a link between Vit D3 and Magnesium for energy production?
Thank you :)

[Sydney]

Ted,
I had posted earlier re: my concern about overdosing on Vit A when taking the D. I learned now that the D3 which is in the capsule with the A is from fish liver oil , The D3 that is in a capsule without the Vit A is from lanolin. Thus I can take as many of those as I want and won't have to worry about the Vit A overdose. However, my nutritionist thinks the fish liver oil is better than the lanolin. Thus, I will take a "base" of the D3 with Vit A (fish liver oil) and the remainder of just the D3. He also likes using D3 rather than D2.
Now ---Question. You mentioned you could take 50,000 D3 a week. I think you said you saw it on the Vit D Council. I can't find anything there that says you can take that much. Can you help me with locating that research? I really need to get up to about 80 to hopefully help with this FM pain.
I thought about taking 4,000 a day since I read somewhere that was the max. This is confusing.
In Holick's book, the UV Advavantage he puts people on 50,000 D2 a week for 8 weeks - so maybe you can do 50,000 D3 a week. I was concernced since one was D2 and one was D3. I know someone who followed that protocal and her D level went from 8 - 70 in a few months. Most of the D is Vit D2 -not D3 that increased.
Oh - now the soles of my feet are tingling and aching from being on my feet too long. Also, I now have pain in knees and ankles - never had this before.
Any thoughts?
Thanks for your help.
Sydney

[Ted Hutchinson]

Ted,
I had posted earlier re: my concern about overdosing on Vit A when taking the D. I learned now that the D3 which is in the capsule with the A is from fish liver oil , The D3 that is in a capsule without the Vit A is from lanolin. Thus I can take as many of those as I want and won't have to worry about the Vit A overdose. However, my nutritionist thinks the fish liver oil is better than the lanolin. Thus, I will take a "base" of the D3 with Vit A (fish liver oil) and the remainder of just the D3. He also likes using D3 rather than D2.
Now ---Question. You mentioned you could take 50,000 D3 a week. I think you said you saw it on the Vit D Council. I can't find anything there that says you can take that much. Can you help me with locating that research? I really need to get up to about 80 to hopefully help with this FM pain.
I thought about taking 4,000 a day since I read somewhere that was the max. This is confusing.
In Holick's book, the UV Advavantage he puts people on 50,000 D2 a week for 8 weeks - so maybe you can do 50,000 D3 a week. I was concernced since one was D2 and one was D3. I know someone who followed that protocal and her D level went from 8 - 70 in a few months. Most of the D is Vit D2 -not D3 that increased.
Oh - now the soles of my feet are tingling and aching from being on my feet too long. Also, I now have pain in knees and ankles - never had this before.
Any thoughts?
Thanks for your help.
SydneyI live in the UK around latitude 53N so people living above latitude 45N will mostly (apart from those with sunbeds or who have been holidaying nearer the Equator) will have had well over 100 days of using Vitamin d from their reserves at around 4000iu/d and those reserves will also be degrading at the rate of 50% every 21 days as that is the natural halflife of vitamin d once in the system. It is therefore a case of using the calculator to work out roughly how much in total you need to take to recover the vitamin d status you had at the start of the Winter.
This Sets out the reasons for using d3 (http://www.ajcn.org/cgi/content/abstract/84/4/694) As you say Horlick is the source of my suggestion that ONE 50,000iu capsule a week for around 8 weeks should be sufficient to make up the lost reserves. Without a test one cannot be certain but once the 8 weeks is up if you then drop the dose to one a fortnight that will average around 3,500/d. This is around the figure Heaney has show is needed (http://www.ajcn.org/cgi/content/full/77/1/204) and well under the amount Vieth has shown is toxic (http://www.direct-ms.org/pdf/VitDVieth/Vieth%20Critique%20UL%20Vit%20D.pdf)
This recommends 50,000 daily units for 30 days. (http://www.endocrinemetabolic.com/resources/enews/2006/vitdnews10272006.pdf) and is coming from Redwood City which I would have thought was far enough south for reguar sunshine exposure. I still think my suggestion should be adequate for those without access to a Vit D status test.

You will see that Cannell says I take 5,000 units a day in the winter but I know what my vitamin D level is because I get it checked several times a year. If I had cancer, heart disease, Alzheimers disease, multiple sclerosis, or a hundred other common diseases, I might take more than 5,000 units a day — but I would check my calcium and vitamin D levels even more often. I would also follow my doctor's advice about standard medical treatment. (http://www.vitamindcouncil.com/newsletter/2006-jan.shtml) so he himself takes 35000iu a week which isn't far from the 50,000iu a week I am suggesting for the first 8 weeks of raising status.

But of course it depends where you live and how often the sun shines and whether or not it is in practice possible to get extra vitamin d from sun exposure. But be aware that Cannell lives/works in Atascadero, lat 35N which is an awful lot nearer the Equator than I do.

The fish oil is very good for DHA which is good for depression and brain health so I'm all for people getting as much of that as possible but am similarly concerned about not pushing the Vitamin A too high.

[Sydney]

Ted,
Thanks for your expertise, insights and articles. Re: the 50,000 D a week - in Holick's book UV Advantage he recommendeds Vit D (but does not say 2 or 3. However, he does say it must be gotten through a presecription from a Dr. Therefore, would you assume that it is Vit D 2 --because you can get Vit D3 - 50,000 capsules in the place you showed me on the last post.
I think I definitely need the 50,000 a week plan for 8 weeks. Perhaps even longer because I cannot go into the sun and I have also recently (past 2 years) gained a lot of weight from meds for Fibro. and RSD. Thus I need more than the normal Vit D. Would you go with the D3?
Another question? What about the calcium issue? Should I be taking calcium as well with the Vit D? Are there any other things I need with the Vit D for better absorption other than taking it with food. Also, is it best to take it throughout the day or just all at once? By the way, I live at the 40th latitude. It doesn't make much difference because my medical condition does not allow me to go into the sun. I get a bad rash and my body burns /stings like crazy. (This just started last summer)
Are you aware of any other vitamins/minerals that might be helpful for FM. -that have not already been mentioned in the forums. I thought you may be a vitamin specialist or a pharmacist. Perhaps you have a specific interest in just Vitamin D. I joined the Vit D council and subscribd to the newsletter but did not receive it yet. My one Dr. swears D is the answer to my pain. However, my neur. says it is neuropathic pain and questions that this is the answer.
I' appreciate your answers to my questions . You are extremely helpful and I enjoy reading the articles. Sydney

[Ted Hutchinson]

the 50,000 D a week - in Holick's book UV Advantage he recommends Vit D (but does not say 2 or 3The case against ergocalciferol (vitamin D2) as a vitamin ... (http://www.ajcn.org/cgi/content/abstract/84/4/694) This sets out the reasons why you should only use Cholecalciferol. There was a time when it wasn't possible to get 50,000iu vit d so the only source was a prescription for d2 from a doctor. Now the preferred form is readily available and VERY VERY CHEAP there is NO REASON not to use it But be aware that this strength does have the potential to cause problems if taken DAILY for MONTHS. Taken for a short period (stoss therapy) or weekly to raise status or fortnightly to maintain status it will average out at less than the amount that is known to cause problems.

about the calcium issue? Should I be taking calcium as well with the Vit D? World'd Healthiest Foods Calcium Foodsources (http://www.whfoods.com/genpage.php?tname=nutrient&dbid=45#foodsources) you do need to ensure an adequate supply of calcium but having looked at the amounts in a normal healthy diet I find it difficult to see how anyone can be short. But maybe that's because I make my own yogurt every week so I have a continual supply, I also have KEFIR grains and they produce a continuous stream of Kefir that needs using up in smoothies, sauces etc, I would hate to be deprived of cheese, I also have a spinach patch which I can pick almost every week through the year along with Swiss Chard. We also so a nut/seed sprinkle which gets added to the yogurt to cheer that up and sesame seed is brilliant for calcium . So I think adding calcium supplements would be a waste of money for me. I don't know what you eat but the fact is increase your vitamin d and your calcium status will increase.
Vit D for better absorption other than taking it with food. While I have read somewhere that as cholecalciferol is fat soluble it's best eaten with a food contain fats I've not see any evidence that supports this.

Also, is it best to take it throughout the day or just all at once? the capsules are really tiny so definitely don't try to spread them out. The half life once in your body is 3 weeks so really it's how you find it best suited. You can either buy the 50,000iu and take one a week 8 weeks then 1 a fortnight or if you really don't go outside at all on every 12 or 13 days. That will average 4000iu/d. But as I've pointed out the Heaney research puts to ideal in the RANGE of 3 -5 thousand iu/daily so you could use the 5000iu daily capsules or just take a 50,000 every 10 days. I prefer the sunshine route but I get plenty of OMEGA 3, (acts a natural sunscreen) Vitamin d (acts as a UVB photoprotection) I only drink green tea (improves photoprotection of skin) I eat linseed daily (improves skin tone) and I have a diet high in antioxidants. You can improve the natural sunscreen ability of your skin so you don't need to slather sunscreen and noxious chemicals over it to enable you to go outside (http://www.whfoods.com/genpage.php?tname=george&dbid=144#answer) but I don't live at latitude 40 but 53 and it may be a tad warmer in the Summer where you are and covering up after your 20 mins is probably a good idea.

Are you aware of any other vitamins/minerals that might be helpful for FM. Have a look at this Magnesium and Fibromyalgia information (http://www.mgwater.com/listc.shtml#fm)

I thought you may be a vitamin specialist or a pharmacist. Perhaps you have a specific interest in just Vitamin D.The basis of my condition Post Polio Syndrome is I believe something to do with the autoimmune response and since I've been taking the Direct-ms org supplements (http://www.direct-ms.org/supplements.html) I've been much better. I had got to the point where I was about to buy a wheelchair but I've managed to avoid that and can now stand to prepare a meal and providing I manage my energy levels can do nearly everything I want to do. So as far as I'm concerned keeping my immune status as high as possible and my natural anti inflammatory as high as possible helps my condition. It makes common sense to ensure your vitamin d, omega 3, calcium and magnesium are all present and correct as with the basic vitamins. There are so many different enzyme reactions and body tissues that need these that it's no wonder a shortage of any one can produce so many different reactions in different people. When you look how something as basic as cola can Deplete you body of calcium, magnesium and zinc (http://healthbolt.net/2006/12/08/what-happens-to-your-body-if-you-drink-a-coke-right-now/) in about an hour it's not surprising that we have increasing incidence of Osteoporosis. Forgot to say I have no financial or professional interest in Vitamin d, omega 3, magnesium or anything else for that matter. Just feel there are so many unnecessary deaths and illness arising from neglect of the fact we evolved in the open air, eating fish and organically grown fresh fruit and vegetables and if we were lucky enough occasionally would catch an animal or find some eggs. While I'm not suggesting we go back to prehistoric living conditions I think current fast food meals and commercially produced food puts profit before health and we would all be healthier if we ate seasonal, locally produced, non intensively reared, foods in as natural unrefined state as is possible. Rant over.

Worth adding a link to a new review paper on the Risk assessment for vitamin D (http://www.ajcn.org/cgi/content/full/85/1/6) This details all the research that has been done on the safety of Vitamin d3 so reading the tables and comparing those amounts with the quantities I've suggested should enable the most sceptical reader that there will be no-observed-adverse-effects at these levels.

[Ted Hutchinson]

Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16850115&query_hl=4&itool=pubmed_docsum)Fibromyalgia is a complex problem in which symptoms of anxiety and depression feature prominently. Low levels of vitamin D have been frequently reported in fibromyalgia, but no relationship was demonstrated with anxiety and depression. Seventy-five Caucasian patients who fulfilled the ACR criteria for fibromyalgia had serum vitamin D levels measured and completed the Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression Score (HADS). Deficient levels of vitamin D was found in 13.3% of the patients, while 56.0% had insufficient levels and 30.7% had normal levels. Patients with vitamin D deficiency (<25 nmol/l) had higher HADS [median, IQR, 31.0 (23.8-36.8] than patients with insufficient levels [25-50 nmol/l; HADS 22.5 (17.0-26.0)] or than patients with normal levels [50 nmol/l or greater; HADS 23.5 (19.0-27.5); Kruskal-Wallis ANOVA on ranks p<0.05]. There was no relationship with global measures of disease impact or musculoskeletal symptoms. Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health.

Do remember when reading this that Healthy men seem to use 3000–5000 IU cholecalciferol/d (http://www.ajcn.org/cgi/content/full/77/1/204)
and For adults, vitamin D intake of 100 mcg (4000 IU)/day is physiologic and safe ......wellbeing score improved more for the 100-mcg/(4000 IU)/day group than for the lower-dosed group (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15260882)

[Ted Hutchinson]

The epidemic of vitamin D deficiency.
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17396471)A 37-year-old woman was referred to our endocrine clinic for management of her long-standing hypothyroidism. Her main complaints were muscle aches and pains that started about a year ago. The symptoms progressed to generalized muscle weakness. She described difficulty in getting out of her chair and in climbing stairs. She had an extensive work-up done by her neurologist and rheumatologist, including nerve-conduction studies and a muscle biopsy. The evaluation was normal, and she was diagnosed with fibromyalgia. She had gastric bypass surgery in 1998 and lost 150 pounds since the operation. She also has had lactose intolerance and a compression fracture without trauma. Her weight was 314 pounds. She had proximal muscle weakness. The rest of her physical examination was normal. Serum laboratory values are listed in Table 1. Based on the laboratory values, she was diagnosed as having severe vitamin D deficiency. She was started on 50,000 IU of vitamin D2 (Ergocalciferol) once a week for 6 months. Now her 25 hydroxyvitamin D level is 40 ng/mL, and her muscle strength has improved.

While it may not be the case that everyone with FMS is also vitamin d deficient/insufficient, this is another example where someone with Vitamin d deficiency gets a Fibromyalgia diagnosis.
It would have been better if they had used Cholecalciferol Vitamin D3 as that is more effective, cheaper and safer.
It would also be better if they had raised vitamin d status to optimal 50ng/mL 125nmol/L.

[Aubrae]

Ted and others - thanks for all the valuable information. I was also recently diagnosed with a severe vitamin D deficiency.

It's important that the issue of possible malabsorption be emphasized. Some intestinal systems are not absorbing the vitamin D - and thereby eliminating it before it has any positive effect. Malabsorption can be due to several issues -including celiac disease (often manifests as an allergy to gluten).

Your doctor, through periodic tests, can determine if your body is indeed capable of absorption. For those having mild malabsorption issues, my doctor told me it would make sense that the most effective method would be smaller and more frequent daily doses of of Vitamin D3. Anyone have thoughts on this?

Does anyone else have problems with absorption of Vitamin D, and if so, how was it resolved?

[Ted Hutchinson]

I get my 5000iu Vitamin D3 Cholecalciferol capsules from the Best source listed on The Vitamin D Council Website. As I haven't had a Vitamin D blood test I'm not able to say if it's absorbed or not. But I do feel much better than I have for years so I'm confident it is being absorbed.

It is fat soluble and I've experimented with sliding open a capsule and dropping the contents into a tablespoon of fish/flaxseed oil and found it dissolved easily and I suspect may be absorbed better (but have no evidence to support this contention but I think it plausible)

I've also tried, out if interest, dissolving a cholecalciferol capsule in a tablespoon of olive oil and then massaging that into the skin. This also appears to work, in that both the powder and the oil appear to be be massaged into the skin. It may be that this more closely replicates the way we are supposed, by Vit D synthesis in the skin, to acquire and deal with this vitamin.

To actually prove massaging Vitamin d enhanced oil into the skin was an effective way of absorbing it one would have to measure Vit d status before, then apply it this way for a month or so, then remeasure Vit d status.

Dr. Davis (http://heartscanblog.blogspot.com/2007/03/vitamin-d-must-be-oil-based.html) is insistent that the Vit d must be oil based so maybe it's worth either trying his suggestions or try my suggestions for dissolving in omega 3 oils and consuming or into a massage oil and applying directly onto your skin.

[Aubrae]

Ted - that's a great idea about the oil and absorption through the skin. I also posted on your other vitamin D-related thread. Thanks for keeping this thread going. I too am convinced that there is indeed some connection to my aches and pains and the Vitamin D - in a short time I have felt a real difference.

[Ted Hutchinson]

Cytokine patterns in fibromyalgia and their correlation with clinical manifestations. (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17543146)
OBJECTIVE: To examine the possible role of the soluble factor in fibromyalgia (FM) by studying the correlation of cytokine levels with the patients' clinical and psychiatric profile. METHODS: Eighty FM patients underwent clinical and psychiatric evaluations, and plasma levels of cytokines (IL-1, IL-6, IL-8, IL-10, TNF-alpha), aspecific markers of inflammation, rheumatoid factor (RF), anti-extractable nuclear antigen (ENA) antibodies, and anti-nuclear factor (FAN) were measured. RESULTS: Higher levels of IL-10, IL-8 and TNF-alpha were found in FM patients than in controls. Significant correlations between the biochemical parameters and clinical data were found. CONCLUSION: The higher levels of cytokines found in FM patients suggest the presence of an inflammatory response system (IRS) and highlight a parallel between the clinical symptoms and biochemical data. They support the hypothesis that cytokines may play a role in the clinical features of fibromyalgia. In addition, the similar cytokine patterns found in FM patients with different psychiatric profiles suggests that IRS impairment may play a specific role in the disease.

High-dose vitamin D supplements act as anti-inflammatory (http://www.nutraingredients.com/news-by-product/news.asp?id=66953&idCat=92&k=vitamin-D-inflammation-CHF)

[Ted Hutchinson]

you could move to arizona for some vitamind d -goodness where I come from we dont get nearly enough of it! ;)The problem with sun exposure is that most people don't understand that you need very short exposures and then time for the vitamin D to be absorbed. You skin makes vitamin d very quickly particularly those areas previously least exposed to sunshine, as soon at there is the hint of a tan the ability to make D3 decreases. The older you get (35 is old in this respect) the less able you skin is to make D3, it's the cholesterol in your skin that the UVB converts to D3 so people on statins .... you can guess I'm sure. By the time you are 65 then your Vit d making capacity is down 60% so you need much longer. But you still must not fry that newly made D3 or it will be processed on into substances you body cannot use.

Also folks like to shower/rubdown after getting all glowing in the sun and being fat soluble what happens to the D3 on your skin in contact with soap. Sure although a good proportion of the D3 will be safely under the surface of the skin anything that is on the surface will be washed or rubbed away.

I don't think I've put a link to Vitamin D3 Chronic Pain pages (http://pain-topics.org/clinical_concepts/vitamind.php) There is lots of evidence based information about the use of vitamin d to reduce pain here. Anyone with a vitamin d status below 60ng 150nmol/l may be suffering more pain than they need.

My natural doc recommended recently I get checked for vitamin d, I keep forgetting to mention to my doctor. The post above shocks me and I will certainly remember to do this. There is absolutely no need to go to the docs for a 25(OH)D test Grassrootshealth D Action (http://www.grassrootshealth.org/daction/index.php) do them for $30 in return for a few answers to some very simple questions.

Everyone with FMS should have a 25(OH)D status above 60ng 150nmol/l
Generally speaking this will require D3 supplements around 5000iu/daily
if you are NOT average sized (bigger or smaller) work it out by weight 100iu/d for each 3lbs + 1000iu for each 30lbs.

[Naominjw]

Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16850115&query_hl=23&itool=pubmed_docsum)

Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed.........and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16259310&query_hl=23&itool=pubmed_docsum)


These are such important studies. My child actually met the criteria for both chronic fatigue and fibromyalgia, but since she also was diagnosed with depression and later, a very early onset schizophrenia, they said her pain was part of her "mental illness (http://www.itsnotmental.com)." (Her pain preceded the depression).

She had the low vitamin D AND the hypothyroidism, AND several other things (including intestinal malabsorption so also had osteoporosis). But like what you put above, treating the underlying causes got rid of the muscle pain and the rest of the symptoms (her bone density was near normal after 4 years).

She still has excessive fatigue after vigorous exercise (like working out at the gym, hiking, etc), though, and needs extra hours of sleep after the strenuous activities.... we don't know why.

[Ted Hutchinson]

Dr. Cannell:
For almost 20 years, I have been suffering from muscle pains with brain fog and GI problems and falls and that is only the start. The symptoms have only gotten worse year after year. I have been to a new specialist every year trying to figure out what was wrong with me. I was always depressed. Then the word fibromyalgia and chronic fatigue syndrome came up. My blood tests have always been normal, but I felt like I was dying. I could not even get down to the ground and play with my daughter and was unable to get back up again. It affected all that I do on a daily basis and was extremely painful.Last year, in a last ditch effort, I went to a rheumatologist and explained my long list of problems and all the years I have been suffering with them. He drew a Vitamin D level and it was only 13 ng/mL. With a mega dose of Vitamin D under my doctor's supervision, I started to feel better. By 2 weeks most of my symptoms had disappeared. All those problems of over 20 years went away in two months. I am a registered nurse with a graduate degree and have researched over the 20 years to find what was wrong with me. It wasn't until I started taking the Vitamin D that I was able to think clearer, not have daily GI problems, walk without falling, be pain free and my depression went away. Before, I thought I was going to die. Thank you for all you do, I wish I could send a contribution. You may save millions of lives in the long run.
Maria,
Seattle
You're welcome. You have a good endocrinologist. However, many patients with fibromyalgia report they cannot take vitamin D. For those people, I recommend sun tanning parlors or one of our in-home UV units. If you keep your level above 50 ng/mL, you should be able to live a normal life now.As far as dying, remember, everyone who takes Vitamin D will die. It's simply a question of when. What we hope, even expect, is vitamin D will square off the mortality curve. Now, people start dying from the diseases of civilization in their forties, struck down by heart disease, cancer, etc. Premature deaths accelerates in the 50s and are in full swing by the 60s. That is, the mortality curve slops downward, beginning in the late 40s, people succumbing to the diseases of civilization. Perhaps vitamin D will allow people to live normal lives until they reach their 90s–100s, when we will all suddenly drop dead of old age!When the famous Dr. Denis Burkitt noted that "diseases of civilization" were rare in Africa—although many patients died of malaria or gastrointestinal diseases—he was working in Uganda, right on the equator. What Dr. Burkitt failed to notice, when he hypothesized it was fiber in the diet that prevented the diseases of civilization, was his patients frequently wore little clothing and were under an equatorial sun 365 days a year. Dr. Burkitt thought it was fiber, but it was the vitamin D.

From Dr Cannell's newsletter The Vitamin D Council (http://www.vitamindcouncil.org/newsletter/2009-march.shtml)

[Ted Hutchinson]

These are such important studies. My child actually met the criteria for both chronic fatigue and fibromyalgia, but since she also was diagnosed with depression and later, a very early onset schizophrenia, they said her pain was part of her "mental illness (http://www.itsnotmental.com)." (Her pain preceded the depression).

She had the low vitamin D AND the hypothyroidism, AND several other things (including intestinal malabsorption so also had osteoporosis). But like what you put above, treating the underlying causes got rid of the muscle pain and the rest of the symptoms (her bone density was near normal after 4 years).

She still has excessive fatigue after vigorous exercise (like working out at the gym, hiking, etc), though, and needs extra hours of sleep after the strenuous activities.... we don't know why.You do not say to what extent her vitamin D status has been corrected or how.
If you are relying on prescription D2 then perhaps that is the reason.
Many people, particularly older women (but not exclusively) simply cannot handle D2. The problem is not that they do not absorb it or indeed circulate it but they cannot convert it to D3 or the active VD3 metabolite calcitriol.


ARE YOU A TREE? (http://heartscanblog.blogspot.com/2009/03/are-you-tree.html)

I'll post some links to the connection between Vitamin d and depression later today but there is plenty of evidence that low vitamin d status leads to depression and using effective amounts of an effective form, not D2 the prescribed form sorts the problems.

[Naominjw]

She is using OTC Vitamin D3. Her last vitamin D level was done by Quest so, we don't know what it really is. But, it was low normal, and the doc said for her to increase the amount she is taking from 2000 to 3000. Seems like 2000-3000 is "maintenance" for her. I do not know why she needs so much just to have a normal level. Maybe the intestinal malabsorption? She is on a gf/cf/ef/sf diet but may have issues with other foods as well.

Summer at last is approaching. What I am thinking is that each winter, perhaps she needs to increase the amount she takes.

[Ted Hutchinson]

She is using OTC Vitamin D3. Her last vitamin D level was done by Quest so, we don't know what it really is. But, it was low normal, and the doc said for her to increase the amount she is taking from 2000 to 3000. Seems like 2000-3000 is "maintenance" for her. I do not know why she needs so much just to have a normal level. Maybe the intestinal malabsorption? She is on a gf/cf/ef/sf diet but may have issues with other foods as well.

Summer at last is approaching. What I am thinking is that each winter, perhaps she needs to increase the amount she takes.Have you calculated her intake by weight?
1000iu for each 30lbs
100iu/d for each 3 lbs.

2500iu/d = enough for someone 75lbs. 5st 7lbs but chronic illness does put extra demands on the system and some people seem to burn it up. I hope you are using either an oil based gel (http://www.iherb.com/ProductDetails.aspx?pid=10421&at=0) capsule ($5 code WAB666) or a dry powder filled (https://secure.bio-tech-pharm.com/detail.aspx?product_id=18&cat_id=2&subcat_id=0) capsule. I suspect the hard tablets form may pass through.

Vitamin d council (http://www.vitamindcouncil.org/) are now suggesting UV lights may be a good idea for those with absorption problems.
See the letter in his newsletter from a person with Chron's. (http://www.vitamindcouncil.org/newsletter/2009-march.shtml)

I've also considered taking the dry powder form and dissolving that in an edible massage oil and applying that to the skin. I think that bypassing the digestive system my be a good idea for some people. I've no research on this to prove it works. But as cholecalciferol is biologically identical the form your skin makes it seems logical that the skin would absorb it if you massaged it in.

There is some evidence that Vitamin D enriched skin cream affects 25(OH)D status.

[Naominjw]

It is dry powder filled. According to the formula above she is not taking enough (and neither am I)

THANK YOU FOR THE WEALTH OF INFORMATION.

BTW - I actually have UV lights at home due to a bird who needs it! Still, compared to outdoor light, it is pitiful. I really noticed yesterday when it finally got briefly warm enough to put the bird in a cage outside.

[ScarlettOne]

I just order 250 capsules of Vit D
Here's to better health.
I went to the Vit D council website and ordered what they recommended.

[smokingun35]

Ted - that's a great idea about the oil and absorption through the skin. I also posted on your other vitamin D-related thread. Thanks for keeping this thread going. I too am convinced that there is indeed some connection to my aches and pains and the Vitamin D - in a short time I have felt a real difference.

How long did it take for you to recognize a change in how you felt? I am taking 2000iu daily as that's the most our pharmacy would sell without a prescription, for about 1 week now.

[Ted Hutchinson]

How long did it take for you to recognize a change in how you felt? I am taking 2000iu daily as that's the most our pharmacy would sell without a prescription, for about 1 week now.50,000iu cholecalciferol (https://secure.bio-tech-pharm.com/detail.aspx?product_id=20&cat_id=2&subcat_id=0) You need these to start with

2000iu/daily will not and cannot raise most people to the level that the hormone system needs to produce and distribute CALCTRIOL at Vmax.
Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers (http://www.ajcn.org/cgi/content/abstract/89/5/1321) This paper shows that 3320iu/daily only just got those taking it above the minimum threshold and still left them 40nmol/l below the optimum for Calcicitriol production.

Ideally you should take 3 of those 2000iu/daily to have any impact and it will take 3 months before your status will be around 50ng 125nmol/l

If you want to speed the process up get the 50,000iu suggested above and take ONE DAILY for one WEEK then ONE EACH WEEK you will have a quick loading session and then average 7000iu/daily and that should be sufficient for most people with FMS.
You may like to use the formula 1000iu/daily for each 30lbs you weigh + 100iu/daily for each extra 3lbs weight.
example 150lbs = 5 x 30 = 5 x 1000 =5000iu/daily.

It is safer to be higher rather than lower with your D3 supplement intake.

The Risk of Additional Vitamin D. (http://www.ncbi.nlm.nih.gov/pubmed/19364661) This paper shows that taking up to 10,000iu/daily poses NO RISK WHATSOEVER, even when the people taking that amount daily are also exposed to lots of regular sunshine or as they say "rather high physiologic background level of vitamin D."

After 3 months of using an EFFECTIVE amount of D3, have a 25(OH)D level $40 postal test (http://www.grassrootshealth.net/) and either reduce the daily interval to raise, or increase the daily interval to reduce your 25(OH)D level to raise or lower your average daily intake from the 50,000iu capsules so you stay around 60ng 150nmol/l.

[Nana4&cntn]

Ted,

I have been taking 50,000iu VitD weekly for nearly a year and have raised my blood concentration from 8 to 59, I will have it checked again next week and am hoping to go to 5000 per week.

I have not noticed a change in how I feel physically, I have however noticed a change in the quality of my sleep. Go figure:confused:

Kathy

[Ted Hutchinson]

Ted,

I have been taking 50,000iu VitD weekly for nearly a year and have raised my blood concentration from 8 to 59, I will have it checked again next week and am hoping to go to 5000 per week.

I have not noticed a change in how I feel physically, I have however noticed a change in the quality of my sleep. Go figure:confused:

KathyYou do not say if you were using prescribed vitamin d or OTC.

It is possible to have used D2 Ergocalciferol and have a raised total 25(OH)D score but still not be benefiting fully from Vitamin D. Swapping to 50,000iu D3. (https://secure.bio-tech-pharm.com/detail.aspx?product_id=20&cat_id=2&subcat_id=0) may make a significant difference to the way you feel physically.

I can see no justification whatsoever in staying with prescription D2 Ergocalciferol.

[Jonesy4]

What about myers cocktail iv vitamins? Not sure how that would end up on your bladder but the iv vitamins kick some major butt and may be something you can take? (http://bamboo-fiber-clothing.com)

[Ted Hutchinson]

What about myers cocktail iv vitamins? Not sure how that would end up on your bladder but the iv vitamins kick some major butt and may be something you can take? (http://bamboo-fiber-clothing.com) myers cocktail
Magnesium chloride hexahydrate 20% 2-5 mL Magnesium
Calcium gluconate 10% 1-3 mL Calcium
Hydroxocobalamin 1,000 mcg/mL 1 mL Vitamin B12
Pyridoxine hydrochloride 100 mg/mL 1 mL Vitamin B6
Dexpanthenol 250 mg/mL 1 mL Vitamin B5
B complex 100 1 mL Vitamin B complex
Vitamin C 222 mg/mL 4-20 mL Vitamin C

No vitamin D in Myer's cocktail so no relevance really to this thread which is about Vitamin D and it's relation to Fibromyalgia.
.
Sure the magnesium content and the B vitamin complex may be helpful but you can buy better B group vitamins I'd make sure I was using one containing Methylcobalamin (http://www.iherb.com/Vitamin-B12-Methylcobalamin) and effective forms of Magnesium are readily available.

[Nana4&cntn]

I order 50,000iuD3 from Bio-Tech and am prescribed calcitrol (pinkish/brownish gels)

[Ted Hutchinson]

I order 50,000iuD3 from Bio-Tech and am prescribed calcitrol (pinkish/brownish gels)Excellent,
50,000iu a week = 7000iu/d It isn't surprising therefore that with an underlying chronic condition it has taken so long to attain a level around 60ng.
Do keep trying to get as much sun as possible if you do drop down to 5000iu over the summer and go back up to 50,000iu/weekly from Oct through the Feb next winter. It does take time as you have an awful lot of cells in your body and each single cell has a use for vitamin d and so it's a while before they all get rebuild with the correct amount of vitamim d as required.

[Ted Hutchinson]

I just came across this today and it fits in with the experience above. We have to remember that the number of cells in the body is numbered in the trillions and just about all of them have a use not only for Vitamin D but also omega 3.

Robert Andrew Brown
Author Omega Six The Devils Fat
www.omegasixthedevilsfat

It takes about 600 days to change 50% of adipose tissue, and change will still be going on at year 5.

The relationship is inversely exponential.

The rate of change varies between fat depots.

Breast fat will see significant change in months. (https://www.blogger.com/comment.g?blogID=1629175743855013102&postID=2548987600628836228)

the relevance here is that Vitamin D3 is fat soluble. If it takes 2~5 yrs to rebuild the omega 3<> omega 6 ratio in cells it will take a similar length of time to rebuild cells with their ideal component of vitamin D3. While I do feel many people feel much better almost immediately when taking their initial vitamin D in my case it was over a year before I realised that I was not feeling the same level of pain as previously. I think there is sufficient reason to continue with a Vitamin D supplement program that keeps 25(OH)D around 55ng 175nmol/l (http://www.imminst.org/forum/index.php?act=attach&type=post&id=6065) irrespective of the impact on FMS so if after 2yrs you still haven't felt the benefit for your FMS symptoms then at least you've reduced your cancer heart disease risk.