Assessment of vitamin D deficiency prevalence in adults with chronic fatigue syndrome: a cross-sectional study, 2025, Jawale

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Senior Member (Voting Rights)

ISSN 2250-1150
doi: 10.48047/ijprt/15.02.327

ASSESSMENT OF VITAMIN D DEFICIENCY PREVALENCE IN ADULTS WITH CHRONIC FATIGUE SYNDROME: A CROSS-SECTIONAL STUDY

Dr. Rahul Vasudeo Jawale 1, Dr. Ankur Anil Jhavar2, Dr. Ashish Sanjay Sarode 3,
Dr. Dilip Onkar Patil4, Dr. Dinesh Eknath Nehete5, Dr. Chetan Bhagwat Chaudhari6

1,2,3Assistant Professor, Department of General Medicine, Dr Ulhas Patil Medical College &
Hospital, Jalgaon, Maharashtra, India.
4,5,6Professor, Department of General Medicine, Dr Ulhas Patil Medical College & Hospital,
Jalgaon, Maharashtra, India.
Received Date: 02/07/2025 Accepted: 12/08/2025

Corresponding Author: Dr. Ashish Sanjay Sarode, Assistant Professor, Department of General
Medicine, Dr Ulhas Patil Medical College & Hospital, Jalgaon, Maharashtra, India.
Email: s.sarode22@gmail.com
ABSTRACT

Background:

Chronic Fatigue Syndrome (CFS) is a complex disorder characterized by extreme
fatigue that does not improve with rest and may worsen with physical or mental activity. Recent
studies suggest a potential link between Vitamin D deficiency and the severity of symptoms
experienced by CFS patients.

Objective:

This study aimed to assess the prevalence of Vitamin D deficiency in adults diagnosed with Chronic Fatigue Syndrome and to explore the relationship between Vitamin D levels and fatigue severity. Methods: In this cross-sectional study, we evaluated 350 adults diagnosed with CFS at a tertiary care clinic. We measured serum Vitamin D levels and collected data on fatigue severity through standardized questionnaires. Vitamin D deficiency was defined as a serum level of less than 20 ng/mL.

Results:

The prevalence of Vitamin D deficiency among the study participants was found to be 67.7%. The mean Vitamin D level was 19.4 ng/mL (SD ± 6.3). A statistically significant negative correlation was observed between Vitamin D levels and fatigue severity (r = -0.28, p < 0.001). Comparisons with a healthy control group matched for age and sex revealed significantly lower Vitamin D levels in the CFS group (p < 0.001).

Conclusion:

A high prevalence of Vitamin D deficiency was observed in the
CFS patient population, with deficiency significantly associated with greater fatigue severity.
These findings suggest that screening for and managing Vitamin D deficiency may be crucial in
the clinical management of CFS.

Keywords: Chronic Fatigue Syndrome, Vitamin D Deficiency, Fatigue Severity
 
This strangely has the exact same title as this paper which was also from India but on a quick inspection they looked to be different
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Thread 'Assessment of Vitamin D Deficiency Prevalence in Adults with Chronic Fatigue Syndrome: A Cross-Sectional Study, 2025, Saranya'

https://healthcare-bulletin.co.uk/a...atigue-syndrome-a-cross-sectional-study-3312/

Research Article | Volume 15 Issue 5 (May, 2025) | Pages 120 - 124
Assessment of Vitamin D Deficiency Prevalence in Adults with Chronic Fatigue Syndrome: A Cross-Sectional Study
Pon. Saranya1
Vikrannth Vasanthakumar2
N. Deepthi3

1
Assistant Professor, Department of General Medicine, Govt Thiruvannamalai Medical College and Hospital, India

2
Associate Professor, Department of General Medicine, Saveetha Medical college and...
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The study selected on the basis of the Fukuda criteria using data collected retrospectively from medical records. The sample was 42% male which is a bit high and might suggest there some bias arising clinic’s referral patterns. I am struggling to see from the paper how they measured fatigue levels but that could just be me.

It is interesting to see the study reported a high level of Vitamin D deficiency (67.7%) in their CFS population and found a moderate association between level of fatigue and the size of the deficiency in contrast to healthy controls. However I am also struggling to see what criteria were used to select/match the healthy controls.

There is as always the problem that the Vitamin D deficiency may result from non specific factors of being unwell such as poor diet or less exposure to sunlight, so ideally the control groups would include sedentary non ill individuals or people with a different but equally disabling condition. So at present it is not clear what this might be telling us about ME/CFS over their patients just being unwell. However seeking to reverse any deficiency once identified would seem to make sense.

Also though there is a putative association between the severity of their CFS patients and the degree of vitamin deficiency this does not tell us any thing about any potential causal relationship, given it, as above, could just reflect the level of the impact of the disability on diet and access to sunlight. Further with the overlap between the symptoms of the deficiency and the general symptoms expected in the target clinical grouping it is hard to know what aspects relate to which condition, is the deficiency a coincidental cooccurrence or does it reflect some underlying physiological relationship.

My anecdotal experience of B12 deficiency is that redressing the deficiency produces a fixed amount of improvement in my apparent ME/CFS, but only to the point that the deficiency is eliminated. Then continued dosing has no further impact on my ME/CFS unless I stop maintenance dosing and return to deficit. My inference is that B12 dosing only impacts my deficiency not my underlying ME/CFS.

Though, I think this study supports the needs for regular monitoring of vitamin levels in ME/CFS, confirming previous suggestions that levels of deficiencies are higher that would be expected compared to a normal population, further research is require before we can comment on the relationship between any observed deficiencies and ME/CFS.

I would love to see a prospective study of more tightly defined ME/CFS patient group looking at a range of vitamins, focusing also on PEM and including well matched controls and relevant sedentary controls, that further looked at the implications of redressing the deficiencies in a wider range of vitamins, with a follow up of at least a year or even longer, to establish if any supplementation did anything beyond redressing identified deficits.

As it stands I worry this study might encourage indiscriminate D supplementation in every one with ME/CFS without any clear understanding of how much it can be generalised from this loser CFS cohort, and not clarifying who and for how long they might benefit. Also it may inappropriately encourage higher than required dosages aimed at treating the underlying ME/CFS without currently any real justification, as we have previously seem in relation to B12 even at times encouraged by some less scrupulous doctors.
 
Peter T said:
There is as always the problem that the Vitamin D deficiency may result from non specific factors of being unwell such as poor diet or less exposure to sunlight, so ideally the control groups would include sedentary non ill individuals or people with a different but equally disabling condition. So at present it is not clear what this might be telling us about ME/CFS over just being ill, though seeking to reverse any deficiency once identified would seem to make sense.
Click to expand...

I think it is a fair assumption that low vitamin D in ME/CFS will be entirely or almost entirely due to being housebound. I doubt it tells us anything else about ME/CFS.

Also, this is probably in India. Asians with a modern lifestyle in the UK have a very high rate of low vitamin D levels for dietary and pigmentation reasons. That might not apply in India but I don't think the figures here are going to be any use for other populations.

I have suggested in my draft factsheet for professionals that vitamin D status needs reviewing in everyone with ME/CFS anyway and I think it should come to mind to any physician. This is another problem with the rehab OT/physio approach to ME/CFS. Basic medical issues are likely to be forgotten.
 
Jonathan Edwards said:
I think it is a fair assumption that low vitamin D in ME/CFS will be entirely or almost entirely due to being housebound. I doubt it tells us anything else about ME/CFS.

Also, this is probably in India. Asians with a modern lifestyle in the UK have a very high rate of low vitamin D levels for dietary and pigmentation reasons. That might not apply in India but I don't think the figures here are going to be any use for other populations.

I have suggested in my draft factsheet for professionals that vitamin D status needs reviewing in everyone with ME/CFS anyway and I think it should come to mind to any physician. This is another problem with the rehab OT/physio approach to ME/CFS. Basic medical issues are likely to be forgotten.
Click to expand...

I very much agree but see a benefit from better research being done to counter the over enthusiastic practitioners and the downright quacks. I suspect a large number of people with ME/CFS have when going through the ‘trying anything and everything’ phase will have over supplemented.

For a spell in the 1990s under a nutrionalist I was spending £80 a month on supplements, perhaps the equivalent of over £200 now. This was at a time when, had I known it, I should have been saving for immenant ill health retirement.
 
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