Vitamin D Deficiency and Chronic Fatigue

Following on from previous discussions about chronic fatigue and traumatic brain injury (TBI) this article focuses on research specifically relating to hormone deficiencies. The study was carried out in the Netherlands with a view to trying to identify if hormone deficiencies contribute to post traumatic brain injury fatigue.

According to Naeem (2010) Vitamin D deficiency is a global health problem. With all the medical advances of the century, Vitamin D deficiency is still epidemic. Over a billion people worldwide are vitamin D deficient or insufficient. Vitamin D, also described as “the Sun Vitamin” is a steroid with hormone like activity. It regulates the functions of over 200 genes and is essential for growth and development.

There are two forms of Vitamin D, Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol). Vitamin D status depends on the production of Vitamin D3 in the skin under the influence of ultraviolet radiation from sun and Vitamin D intake through diet or Vitamin D supplements. Usually 50 to 90% of Vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet. Important sources of Vitamin D are egg yolk, fatty fish, fortified dairy products and beef liver.

In addition to its potential role in chronic fatigue Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease. Vitamin D deficiency may even contribute to the development of cancers, especially breast, prostate, and colon cancers as well as it’s role in the immune system, increasing neuromuscular function and improving mood, protecting the brain against toxic chemicals, and potentially reducing pain

The study involved 90 men and women between the ages of 18 – 65 years all suffering from post - traumatic brain injury fatigue. Extensive testing included endocrine tests plus evaluations of sleep, attention, coping styles, daily activity and dependency, physical performance, emotional well-being and quality of life.

The results indicated that 65% of the group were suffering from Vitamin D deficiency with poor sleep and anxiety the next highest indicators. Another interesting result was that sleep problems appeared to strengthen the negative effect of Vitamin D deficiency on fatigue. One theory is that there is some evidence linking melatonin which is involved in regulating circadian rhythms and Vitamin D.

Although it may be easy to say that all TBI clients with fatigue should be treated with Vitamin D it is important to understand the client’s lifestyle. Those with TBI often have significantly less active lives and may have less exposure to sunshine. By encouraging and supporting clients to be more active outside and to ensure they receive a healthy diet then their chronic fatigue may be reduced.

The researchers do advise that further research is needed as one of the main questions is whether Vitamin D levels are a consequence of the client’s altered lifestyle or potentially the actual cause of that lifestyle change due to fatigue.

For full article:

Schneiders J et al (2012)  Factors contributing to chronic fatigue after traumatic brain injury. J Head Trauma Rehabil. Nov-Dec;27(6):404-12