Why are we asking this question?
Firstly, because many people with ME/CFS believe that minerals, vitamins and supplements can be a helpful part of their management programme – despite the fact that there is no sound research evidence of deficiencies being present (with the exception of vitamin D) and no evidence from clinical trials to support their use. And in some cases this involves a considerable amount of expenditure as these products are not usually prescribed by doctors on the NHS.
Lack of any research evidence to support the use of these products is confirmed in a new review of the literature on this subject, which was published in PLOSone on April 28. See abstract below.
Secondly, because the MEA has asked Sue Luscombe, our professional adviser on diet and nutrition, along with research dietitian Michelle Dobrota-Gibbs, to prepare a new MEA booklet covering all aspects of diet, nutrition and supplement intake in ME/CFS. The booklet will summarise all the current research evidence on diet, nutrition and supplements and answer all the common questions that we receive on these topics. So if you have any points or questions that you feel are important in relation to any aspect of diet or nutrition in ME/CFS please let us have them within the next few weeks – so we can make sure that this new information booklet contains everything that people want to know on this very important aspect of management.
Dr Charles Shepherd
Hon Medical Adviser, ME Association
ABSTRACT TAKEN FROM PLOSone, 28 April 2017
Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis
Monica L. Joustra(1) , Isidor Minovic(2), Karin A. M. Janssens(1), Stephan J. L. Bakker(2), Judith G. M. Rosmalen(1)
1) Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
2) Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, Top Institute Food and Nutrition, Wageningen, the Netherlands
Many chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) patients (35–68%) use nutritional supplements, while it is unclear whether deficiencies in vitamins and minerals contribute to symptoms in these patients. Objectives were (1) to determine vitamin and mineral status in CFS and FMS patients as compared to healthy controls; (2) to investigate the association between vitamin and mineral status and clinical parameters, including symptom severity and quality of life; and (3) to determine the effect of supplementation on clinical parameters.
The databases PubMed, EMBASE, Web of Knowledge, and PsycINFO were searched for eligible studies. Articles published from January 1st 1994 for CFS patients and 1990 for FMS patients till March 1st 2017 were included. Articles were included if the status of one or more vitamins or minerals were reported, or an intervention concerning vitamins or minerals was performed. Two reviewers independently extracted data and assessed the risk of bias.
A total of 5 RCTs and 40 observational studies were included in the qualitative synthesis, of which 27 studies were included in the meta-analyses. Circulating concentrations of vitamin E were lower in patients compared to controls (pooled standardized mean difference (SMD): -1.57, 95%CI: -3.09, -0.05; p = .042). However, this difference was not present when restricting the analyses to the subgroup of studies with high quality scores. Poor study quality and a substantial heterogeneity in most studies was found. No vitamins or minerals have been repeatedly or consistently linked to clinical parameters. In addition, RCTs testing supplements containing these vitamins and/or minerals did not result in clinical improvements.
Little evidence was found to support the hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of CFS and FMS, and that the use of supplements is effective in these patients.