Data pooled from 27 studies of vitamin and mineral deficiencies in fibromyalgia and chronic fatigue syndrome (CFS) patients showed no evidence for a link to these diseases, a recent study reports.
The article “Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis,” was recently published in the journal Plos One.
The causes of CFS and fibromyalgia syndrome (FMS) are not known. CFS is characterized by profound disabling fatigue, while FMS is characterized by chronic widespread pain. Chronic pain and fatigue are common in both patient groups, and can occur simultaneously. Up to 80% of CFS patients have a history of FMS.
Because many CFS and FMS patients (35-68%) use nutritional supplements, at times with negative impacts on their health, the team set out to find whether deficiencies in vitamins and minerals contribute to symptoms in these patients by pooling the data from several studies.
The researchers also investigated the effect of supplements on clinical parameters, such as intensity of pain, somatization (expressing psychological symptoms and seeking medical help for them), depression and anxiety, physical and mental health, and symptom severity in FMS, and fatigue or depression in CFS, in five randomized control trials.
Average blood levels of vitamins C, D, and E and the minerals calcium and magnesium, were not found to differ in patients with CFS or FMS from healthy controls. Vitamin D deficiency was in general not observed.
The authors note that few studies of the effect of vitamin and mineral supplements in CFS and FMS have actually been done. Of note, they found that amitriptyline and magnesium supplementation was more effective on all measured outcomes than amitriptyline alone in FMS patients.
Also, cholecalciferol administered for 20 weeks in FMS patients led to a positive effect on pain intensity compared to controls.
No changes in somatization, depression and anxiety, physical and mental health, and FMS symptom severity were observed in both the treatment and control groups.
The authors, however, stress that these are single studies, and that the results have not been shown repeatedly.
In three other randomized control trials, vitamins (including A, B, C, D, E), minerals (including calcium, magnesium) and (co)enzymes, showed no beneficial effect in CFS patients, neither did vitamin C and E treatment combined with exercise versus exercise only in FMS patients over a period of 12 weeks.
Vitamin D supplementation showed no beneficial effect in CFS patients.
The authors found that studies on vitamin and mineral deficiencies often gave contradictory results, making it difficult to reach a conclusion about vitamin status in CFS and FMS patients. Researchers said higher quality studies are needed.
“We conclude that there is little evidence to support the hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of both CFS and FMS.” the authors wrote.
“Furthermore, the current literature on vitamins and minerals in CFS and FMS is of poor quality and stresses the need for well-performed intervention research, and large population-based and age-matched prospective studies … to gain more insight in the role of vitamins and minerals in the pathophysiology of CFS and FMS. According to our results, potential vitamins and minerals that should be further examined include vitamin A and vitamin E,” the authors said.