Myotonic Dystrophy Patients Show Vitamin D Deficiencies

A recent Italian study of myotonic dystrophy patients concluded that many patients up to 88% may show deficiencies of Vitamin D. Over 40% of patients showed severe Vitamin D deficiencies. Patients with DM may need to consider a multivitamin of Vitamin D supplement to insure adequate nutrition. Many DM patients have less social and ambulatory abilities which may limit their outdoor activities in sunny weather. The sun  which is a source of vitamin D.

Here is some basic information on Vitamin D

What is vitamin D and what does it do?

Vitamin D is a nutrient found in some foods that is needed for health and to maintain strong bones. It does so by helping the body absorb calcium (one of bone’s main building blocks) from food and supplements. People who get too little vitamin D may develop soft, thin, and brittle bones, a condition known as rickets in children and osteomalacia in adults.

Vitamin D is important to the body in many other ways as well. Muscles need it to move, for example, nerves need it to carry messages between the brain and every body part, and the immune system needs vitamin D to fight off invading bacteria and viruses. Together with calcium, vitamin D also helps protect older adults from osteoporosis. Vitamin D is found in cells throughout the body.

How much vitamin D do I need?

The amount of vitamin D you need each day depends on your age. Average daily recommended amounts from the Food and Nutrition Board (a national group of experts) for different ages are listed below in International Units (IU):

Life Stage Recommended Amount
Birth to 12 months 400 IU
Children 1–13 years 600 IU
Teens 14–18 years 600 IU
Adults 19–70 years 600 IU
Adults 71 years and older 800 IU
Pregnant and breastfeeding women 600 IU

What foods provide vitamin D?

Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets.

  • Fatty fish such as salmon, tuna, and mackerel are among the best sources.
  • Beef liver, cheese, and egg yolks provide small amounts.
  • Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores, the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
  • Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
  • Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages; check the labels.

Can I get vitamin D from the sun?

The body makes vitamin D when skin is directly exposed to the sun, and most people meet at least some of their vitamin D needs this way. Skin exposed to sunshine indoors through a window will not produce vitamin D. Cloudy days, shade, and having dark-colored skin also cut down on the amount of vitamin D the skin makes.

However, despite the importance of the sun to vitamin D synthesis, it is prudent to limit exposure of skin to sunlight in order to lower the risk for skin cancer. When out in the sun for more than a few minutes, wear protective clothing and apply sunscreen with an SPF (sun protection factor) of 8 or more. Tanning beds also cause the skin to make vitamin D, but pose similar risks for skin cancer.

People who avoid the sun or who cover their bodies with sunscreen or clothing should include good sources of vitamin D in their diets or take a supplement. Recommended intakes of vitamin D are set on the assumption of little sun exposure.

Vitamin D, parathyroid hormone and muscle impairment in myotonic dystrophies.

J Neurol Sci. 2013 Jun 25. pii: S0022-510X(13)00268-2. doi: 10.1016/j.jns.2013.06.008.

Source

Endocrinology and Diabetology Unit, Dept. of Biomedical Sciences for Health, University of Milan, Milan, Italy. Electronic address: elenapasseri83@libero.it.

Abstract

Parathyroid function in Myotonic Dystrophy (DM) patients has been poorly investigated. Parathyroid and muscle parameters were assessed in 31 male DM1 (44±2years), 13 male DM2 (56±2years) and 32 healthy controls. Hyperparathyroidism was diagnosed in 18% of patients without differences between DM types. In all DM patients, hyperparathyroidism was associated with normocalcemia but one with hypercalcemia. DM patients presented significantly higher PTH and lower vitamin D (25OHD) compared with controls, also considering seasonality. Severe vitamin D deficiency (25OHD<10ng/ml) was diagnosed in 40% and hypovitaminosis D (25OHD<30ng/ml) occurred in 88% of DM patients. About one-third of DM1 presented hypophosphatemia associated with elevated PTH levels. Serum 25OHD levels negatively correlated with PTH and with body fat mass. Considering DM1 patients, serum PTH levels positively correlated with CTG triplet repeats. Furthermore, PTH levels negatively correlated with total modified Medical Research Council (MRC) and positively with Muscular Impairment Rating Scale (MIRS). By contrast, in DM2 patients muscle assessment did not show any correlation with parathyroid function. In conclusion, we arrived at the following: 1) severe vitamin D deficiency is common in DM patients and it is associated with secondary hyperparathyroidism; 2) primary hyperparathyroidism, though rare, may occur; 3) increased adiposity in DM may be a risk factor for hypovitaminosis D; and 4) high serum PTH levels may indicate a muscle impairment, at least in DM1.

Copyright © 2013 Elsevier B.V. All rights reserved.

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1 thought on “Myotonic Dystrophy Patients Show Vitamin D Deficiencies

  1. Good evening…my aunt is suffering from this sindrome and I am an Italian Dietitian. She asked me to follow her by a nutritional point of view in order to lose weight. So is it important only the supplementation of vitamin D? I was thinking about Omega3 and Omega6 and Iron ’cause she doesn’t eat fish enough (only once a week). She is 43 years old and overweight (BMI 28,8).

    Please, let me know it. My e-mail address is maretta250990@gmail.com

    Thank you.

    Mara Cazzola

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