How Long Does It Take To Improve From Vitamin D Deficiency
Asked by Lisa Emrich
How Long Does It Take To Improve From Vitamin D Deficiency?
Last week my internist checked my Vitamin D levels in addition to TSH levels. My vitamin D level came in at 7.8 ng/mL, rather low to non-existent . TSH was 5.1. Symptoms associated with both of these results include fatigue, malaise, brain fog, numbness, muscle pain, and depression.
Physical symptoms of vitamin D deficiency include the following in muscles – mild/moderate weakness , pain/achiness, spasticity/cramps, and wasting. Numbness/tingling is also common. Sounds a lot like my recent MS symptoms.
My question is: For those who have been vitamin D deficient and started supplemental therapy, how long was it before some of these symptoms improved or resolved?
Any advice or encouragement welcome. I am one sad, tired, achy, numb, spastic, weak, brain dead person these days.
Being Sick Or Getting Infections Often
One of vitamin Ds most important roles is keeping your immune system strong so youre able to fight viruses and bacteria that cause illness.
It directly interacts with the cells that are responsible for fighting infection .
If you often become sick, especially with colds or the flu, low levels of vitamin D may be a contributing factor.
Several large observational studies have shown a link between a deficiency and respiratory tract infections such as colds, bronchitis, and pneumonia .
A number of studies have found that taking vitamin D supplements at a dosage of up to 4,000 IU daily may reduce your risk of developing a respiratory tract infection .
Summary
Vitamin D plays important roles in immune function. One of the most common symptoms of a deficiency is an increased risk of illness or infections.
Vitamin D Deficiency And Parkinsons Disease
Numerous studies have begun to see a connection with vitamin D deficiency, tremors and diseases such as Parkinson’s. A 2007 publication in “Movement Disorders” stated the hypothesis that vitamin D may play a role in Parkinson’s disease, and that dietary and supplemental changes may aid in the prevention and therapy of Parkinson’s. A 2010 study published in “Neuropsychobiology” showed a connection between vitamin D deficiency and neurological functions such as tremors. The researchers concluded that correcting vitamin D deficiency may reduce the number of neurological disorders such as Parkinson’s disease and neuromuscular disorders that are diagnosed.
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Vitamin E And Idiopathic Neuropathy
There has been a lot of research done on Vitamin E as one of the causes of peripheral neuropathy. It has been particularly well studied for its preventative role in Toxic Neuropathy from cancer treatments. If vitamin E was used during these harsh drug treatments, then study participants were protected from ever getting this toxic neuropathy. This was shown in many studies unfortunately it is still not being used in clinical practice at cancer centers.
There have also been many instances of neuropathy from Vitamin E deficiency and it certainly deserves a critical look as one of the possible causes in EVERYONE with idiopathic neuropathy. There have been many families studied with ‘familial’ neuropathy who actually have an inborn error of Vitamin E metabolism that can be easily corrected with supplementation.
Despite scientists being aware of this genetic ‘quirk’ that is one of the causes of peripheral neuropathy, doctors do not test for this genetic problem, nor do they check a simple vitamin E blood level- which is nearly always low in those with this Vitamin E processing problem. In other studies, the low vitamin E levels began BEFORE the nerve damage, so it’s clearly NOT the genetic quirk that causes the neuropathy, but the low vitamin E levels.
Ethics Approval And Consent To Participate
The study was approved by the Institutional Ethics Committee of the Faculty of Medicine, Zagazig University . Written informed consent was obtained from all study participants after explaining the details and benefits as well as risks to them. Surrogate consent from the patients legal guardian or designated health proxy was permitted in cases where the patient did not have decision-making capacity.
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When To See A Doctor
Most people do not realize that theyre vitamin D deficient, as symptoms are generally subtle. You may not recognize them easily, even if theyre significantly affecting your quality of life.
As a rule of thumb, you may consider asking your doctor to check for vitamin D deficiency if you notice any possible symptoms and have any risk factors. They can check your vitamin D levels with a blood test.
Your doctor may also help rule out other causes behind some of the symptoms youre experiencing.
General And Biochemical Characteristics Of Type 2 Dm Participants
The mean age±SD was 56.51±9.03 years the mean BMI±SD was 31.01±4.42 the median duration of type 2 DM was 6 years the median FBG was 8.55 mmol/L the median HbA1c was 7.75 the mean SBP±SD was 137.94±16.81 mm Hg the mean DBP±SD was 82.97±10.23 mm Hg the median 25-hydroxyvitamin D was 14.77 ng/mL and the percentage of current smoking was 18% . Characteristics of participants according to their gender are presented in .
Association between vitamin D status and taking neuropathic pain medications among participants with type 2 DM
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Numerous Factors Are Involved
Sari and colleagues attributed the improvement in balance scores primarily to axonal regeneration. In a follow-up letter to the editor, Celikbilek noted that although the neurotrophic effects of vitamin D on nerve function could be the primary reason for improvements in patients with DPN who receive supplementation, other cellular factors may also play a role by regulating the amount of activated vitamin D delivered to the muscle and pancreatic beta cells. He notes that vitamin D may might also elevate the pain threshold through a nociceptor repair function.
As research continues, studies show that vitamin D seems to influence a broad range of metabolic systems by complex signaling pathways. In a recent meta-analysis, Yammine and colleagues examined four studies including 364 patients with type 2 diabetes and DPN to assess whether vitamin D supplementation would improve pain.² Results of the individual studies showed increases in serum vitamin D levels along with improvements in McGill Pain Questionnaire scores, although there was a lack of correlation between pain scores and changes in vitamin D serum levels.
Dosage Of Vitamin D For Peripheral Neuropathy
The dose of vitamin D for peripheral neuropathy will depend on your serum vitamin D or calcidiol levels. A dose of 50000 IU cholecalciferol once weekly is proven to reduce diabetic neuropathy symptoms in 8 weeks.
A dose of 1000-2000 IU per day works for most individuals but in case of severe deficiency, your health practitioner may suggest higher weekly dosages.The dose could differ based on your serum calcifediol/ calcidiol or serum vitamin D levels.
Opt for vitamin D3 and not D2 supplements.
Sun exposure is a simple way of getting necessary vitamin D, but the high incidence of skin cancer and rising global warming makes it difficult to give specific advice on the duration of sun exposure.
For example, an individual residing in Northern Australia can produce 1000 IU vitamin D in 6-7 minutes and 9-12 minutes , if exposed to the sun between 10, am to 2 pm. But if that individual is in Tasmania, he may need 7-9 minutes and 40-47 minutes for equivalent levels.
Please consider working with a health practitioner to identify the dose that would suit your health.
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How Much Vitamin D Is Enough
Instead of identifying how much vitamin D a person should take to reduce the risk of developing neuropathy and the pain associated with it, it would be wiser to identify protective serum vitamin D levels. The reality is no one dose is suitable for everyone. Around the nation, everyones baseline serum vitamin D levels will likely look very different. A person from Florida who spends regular time in the sun and eats an abundance of fresh seafood is likely to have higher baseline vitamin D levels than, say, a person from the Upper Peninsula of Michigan who eats a vegan diet. Its expected that those two individuals would need different amounts of supplemental vitamin D in their diet to reach optimal serum levels. So, what serum levels are best to reduce risk and decrease the severity of DPN?
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Exercise + Vitamin D Helpes Diabetic Neuropathy In Many Ways
The Comparison between Effects of 12 weeks Combined Training and Vitamin D Supplement on Improvement of Sensory-motor Neuropathy in type 2 Diabetic Women.Adv Biomed Res. 2017 May 2 6:55. doi: 10.4103/2277-9175.205528. eCollection 2017.Nadi M1, Marandi SM1, Esfarjani F1, Saleki M2, Mohammadi M3.
BACKGROUND:Peripheral neuropathy is a common complaint of diabetes. This study aimed to determine the effects of 12 weeks combined training with Vitamin D supplement on improvement of sensory-motor neuropathy in women with diabetic neuropathy.
MATERIALS AND METHODS:This clinical trial study conducted on 90 patients were selected and randomly divided into two groups. Finally, 81 adult females with diabetes type II were interred in this study. The control group had no training, but received Vitamin D. The experimental group received Vitamin D and 12 weeks training program including aerobic exercises, strength, and flexibility. Aerobic exercise intensity was set at 60-70% maximum heart rate and resistance training intensity was determined by 10 R.M. Michigan neuropathy questionnaire, reflex hammer and tuning fork 128 Hz used to screening tense of neuropathy that were used for pretest and posttest.
RESULTS:Following 3 months combined training and supplementation with Vitamin D, had observed a significant reduction in
PMID: 28553628 PMCID: PMC5434674 DOI: 10.4103/2277-9175.205528
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Risk Of Bias Assessment
Through the literature searches, the included reports were mainly cross-sectional and case-control studies, with no cohort studies. Two cross-sectional studies explained any patients excluded from the analyses, and one summarised the patient response rates. The cross-sectional studies were subject to further follow-up and more case-control studies were expected to be included. The DPN diagnostic standards of the included studies differed due to varying pathophysiologies resulting from the clinical manifestations and differences in mechanisms.
Vitamin D Deficiency Affects Neuropathic Pain And Balance
In a randomized, placebo-controlled study of patients with DPN and low vitamin D levels, Sari and colleagues examined the effects of vitamin D replacement therapy on neuropathic pain and balance. They based their study on research that showed vitamin D-associated improvements in axon regeneration and myelination following nerve injury,as well as increases in synthesis and prevention of neuronal degeneration.
Other studies have looked at the reduction of neuropathic pain following vitamin D supplementation, but this was the first investigation of the effect of vitamin D on balance disturbances in patients with DPN, possibly through a beneficial effect on the central nervous system and muscle tissue.
In their study, Sari and colleagues administered a one-time injection of 300,000 IU vitamin D in a liquid formulation to patients with low levels of circulating 25-hydroxyvitamin D -D) who had polyneuropathy that was confirmed with electromyography. Neuropathic pain was assessed at baseline and after 12 weeks using the Douleur Neuropathique in 4 questions , a patient questionnaire, and balance was assessed using the Berg Balance Scale, a functional balance test.
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Correcting Vitamin D Deficiency May Help In Immune
Systemic autoimmune conditions can affect both central and peripheral nervous system and in case of an attack on the peripheral nervous system peripheral neuropathy is the most common complication.
Antibodies refer to proteins produced in the body to attack foreign infections and eliminate them while autoantibodies are proteins that attack the bodyâs tissue in autoimmune conditions.
In autoimmune mediated neuropathies, these autoantibodies attack the nerve tissue such as myelin sheath and other proteins that influence brain and nerve health.
Individuals with autoimmune conditions like rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease and Sjögrenâs syndrome may also experience peripheral neuropathies.
Patients with immune-mediated peripheral neuropathies may also be diagnosed with Vitamin D deficiency.
Researchers hypothesise that immune cells respond to the sunshine vitaminâs therapeutic action and hence rectifying this deficiency can help relieve symptoms of peripheral neuropathy in autoimmune conditions.
5 to 10% of the patients with Sjögrenâs syndrome present with complications that involve the peripheral nervous system.
Sjögrenâs syndrome patients are found to have low vitamin D levels, and this deficiency is associated with the development of peripheral neuropathy and lymphoma. Itâs supplementation may benefit in such conditions further research in human studies is warranted.
Vitamin E Deficiency May Cause Peripheral Neuropathy
Since vitamin E is a fat-soluble vitamin, its deficiency is observed in conditions with reduced fat absorption. Also, mutations in genes linked to tocopherol metabolism can impair its utilisation.
In 1986, Mueller et al. carried out a range of studies in various animal and human models to understand the link between Vitamin E levels and normal neurological functions. He focused mainly on diseases related to fat malabsorption, such as abetalipoproteinaemia, the corresponding serum Vitamin E concentrations and the related neuropathological reactions.
Through his extensive research, it was concluded that optimal serum Vitamin E levels are key to healthy nerve functioning.
This was shortly followed by experimental confirmation that low tocopherol concentrations or vitamin E deficiency could lead to nerve injury and is associated with symptoms of peripheral neuropathy.
Scientists began looking into a possible reversal of Vitamin E deficiency-induced neuropathy.
Through a study carried out on a patient with chronic neuropathy and hepatobiliary disease , they observed that water-soluble Vitamin E supplementation for nine months nerve pain and function in individuals with vitamin E deficiency-induced neuropathy.
High dose Vitamin E therapy for two years or more has been shown to aid muscle coordination and prevent myelin sheath degeneration associated with Vitamin E deficiency-induced peripheral neuropathy.
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Ethics Statement & Conflict Of Interest
IRB/Ethics committee Requirements: NAHuman subjects: NAAnimal subjects: NAConflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors have declared no financial support was received from any organization for the submitted work.Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work.Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
Assessment Of Neuropathy Status
Neuropathy status was determined using the well-validated PainDETECT questionnaire that uses a scale from 0 to 38 to define neuropathy. Participants with a neuropathy score from 0 to 12 were considered as nociceptive , participants with a neuropathy score from 13 to 18 were considered as having unclear neuropathy status and participants with a neuropathy score from 19 to 38 were considered as having neuropathic pain.
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New Study Investigates The Effect Of High
Type 2 diabetes affects more than 30 million individuals, and the youth account for 20% to 50% of new onset diabetes cases.
Previous research has demonstrated that low levels of vitamin D are associated with an increased risk of type 2 diabetes. Vitamin D has been shown to play a role in reducing inflammation and inhibiting -cell destruction.
According to a new study 2 weeks ago in Nutrients, researchers investigated the effect ofhigh-dosevitamin D supplementation on microcirculation, inflammatory markers, and peripheral neuropathy symptoms in patients with type 2 diabetes.
This study included 67 patients with type 2 diabetes and peripheral neuropathy. The research team investigated the effect of different doses of vitamin D supplementation on microcirculation, neuropathy symptoms, and inflammatory markers in patients with type 2 diabetes. Each patient was given either 5,000 IU or 40,000 IU once a week for a 24-week period. Neuropathy assessment included neuropathic symptomatic score, neuropathic disability score, and visual analogue scale. Cutaneous microcirculation was assessed by laser Doppler flowmetry. Laboratory assessment included total cholesterol, C-reactive protein, HA1c, vitamin D 25-hydroxy, parathyroid hormone, interleukin -1, IL-6, IL-10, and tumor necrosis factor-. These were assessed at baseline and after treatment.
Can A Lack Of Vitamin D Cause Numbness In The Extremities
Vitamin D, also sometimes called the “sunshine vitamin,” is essential for healthy bone production and growth, since it helps your body absorb more dietary calcium. Not having enough vitamin D in your system means you will absorb almost 50 percent less dietary calcium than you would otherwise. A lack of vitamin D in your system is indicated by a blood test measuring vitamin D levels, and if left untreated, a deficiency can lead to poor bone health and some diseases. Muscle problems, which can be experienced as numbness in your extremities, along with other symptoms, are an indication of having too much vitamin D in your system.
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Precautions With Vitamin D Use
High levels of vitamin D may cause toxicity. It can increase calcium absorption, and high calcium levels contribute to the toxicity.
Toxicity symptoms include nausea, vomiting, diarrhoea, anorexia, constipation at early stages etc. Other symptoms include kidney stones, bone pain, frequent urination, drowsiness, headaches irregular heartbeat, weakness, nervousness, itching etc.
Therefore, it is necessary to work with a health practitioner to identify a dose of vitamin D that would suit you and to decide the duration of therapy as well.
Certain medications that affect calcium levels in the body may have drug interactions with the sunshine vitamin. These include corticosteroids, phenobarbital, phenytoin. Also, drugs that interfere with fat metabolism such as orlistat and cholestyramine can reduce the vitamin absorption.
Magnesium levels need to be taken care of when taking Vit D supplements. Magnesium is involved in Vitamin D metabolism, and it may be linked to sunshine vitaminâs deficiency.
Please consult a health practitioner before taking Vitamin D supplements.
Association Between Vitamin D Deficiency And Diabetic Neuropathy
Maitree Patel, Faisal Sheriff
Cite as:
Highlights
Prior knowledge about this subject
- Some studies have shown that low serum vitamin D levels are an independent predictor of diabetic polyneuropathy, the evidence on the role of vitamin D replacements in improving symptoms of neuropathy are limited.
Findings of this study
- Patients suffering from vitamin D deficiency for any reason, develop insulin resistance which in turn leads to worsening symptoms related to nerve damage.
- Vitamin D-associated improvements in axon regeneration and myelination following nerve injury, as well as increases in nerve growth factor synthesis and prevention of neuronal degeneration.
- Furthermore, another potential positive effect of Vitamin D is that it may favorably alter coronary calcification, which is a precursor of vascular events and a common finding in Type 2 diabetes.
Impact of this study in clinical practice
- Vitamin D supplementation to not only prevent the progression of diabetic neuropathy but also reduce the severe pain associated with damage to the microvasculature.
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