FM and Vitamins B12 & D Deficiency

Date: October 6, 2009
Expert: Archana J. McEligot, PhD
Associate Professor, Department of Health Science, California State University, Fullerton

Q: Is there any correlation between fibromyalgia and deficiency in vitamins B12 & D?

A: Investigational studies on dietary intakes and fibromyalgia are very active currently, however studies show mixed results. A direct evidence linking vitamin B12 and fibromyalgia is limited, but because fibromyalgia symptoms are a milieu of overlapping conditions, the role of vitamin B12 in modulating fibromyalgia symptoms is plausible. The primary symptom that vitamin B12 could potentially alleviate is chronic fatigue. An earlier study showed that fibromyalgia patients with chronic fatigue showed higher levels of homocysteine (a marker of heart disease) in the cerebrospinal fluid. Many research studies demonstrate that high homocysteine blood levels is related to lower vitamin B12 and folate concentrations, suggesting that increasing foods rich in folate and vitamin B12 could reduce homocysteine levels and potentially alleviate chronic fatigue in fibromyalgia symptoms.

 
The direct biological effects of vitamin B12 deficiency include damaged nerve sheaths, creeping paralysis and general malfunctioning of nerves and muscles, all of this can result in anemia and chronic fatigue. As adults age, because stomach acid concentrations change and/or are reduced, many people lose the ability to efficiently absorb vitamin B12 and therefore physicians recommend B12 shots. Dietary folate, vitamin B12 and B6 function in-concert together in several pathways and should be consumed at the recommended levels throughout the day.

 
The dietary recommendation for vitamin B12 is 2.4 μg/day (Note: 1.0 μg = 0.001 mg; therefore, 2.4 μg/day = 0.0024 mg/day).  Foods high in vitamin B12 are chicken liver (3 oz = 14.0 μg), sirloin steak (3 oz = 2.0 μg), cottage cheese (1 cup = 2.0 μg) and tuna (3.0 oz = 3.0 μg).  Consuming the recommended allowance should alleviate chronic fatigue symptoms, and because no known toxicities are associated with vitamin B12, consuming tolerable higher amounts may potentially relieve severe symptoms.

 
Several studies suggest a role of vitamin D with fibromyalgia, specifically with chronic pain and muscle weakness.  Vitamin D is involved in several autoimmune diseases including arthritis, lupus and fibromyalgia, as well as chronic diseases such as cancer and heart disease.  Deficiencies in vitamin D have been associated with multiple sclerosis and reduced bone growth and muscle function. Therefore, consuming the recommended levels of vitamin D may contribute to alleviating fibromyalgia symptoms.

 
The dietary recommendation for vitamin D is 10 μg/day for ages 51-70. Our bodies can synthesize vitamin D via sun exposure and therefore it isn’t necessary to obtain it through the diet. Sun exposure for about 15 minutes is sufficient, for most, to obtain vitamin D.  Dietary sources include salmon (3 oz = 4.3 μg), shrimp (3 oz = 3.0 μg) and fortified milk (1 cup = 2.5 μg).

 
Importantly, there are toxicities associated with overconsumption of vitamin D and therefore only the recommended amounts should be consumed.

Prior to beginning dietary changes, it’s important to discuss these issues with your healthcare provider.