SUMMARY
Objectives: The steroid hormone, vitamin D and the pep-tide hormone, parathormone are reported to influence not only bone metabolism, but also other metabolic and nervous, cardiovascular and immune functions, and mood. Regular actions of these hormones depend highly on intracellular magnesium content. Although symptoms are recognized, they usually are not correlated to these hormones. Foregoing case studies have revealed that vitamin D and/or parathormone disorders are common causes of CFS-fibromyalgia like symptoms.
Methods: Four patients with chronic fatigue-like symptoms and vitamin D (250HD3) and parathormone (PTH intact) disorders are illustrated to demonstrate conflicting laboratory results. Patients were treated with 5,000 to 10,000 IU cholecalciferol, plus multiminerals and trace elements. Clinical outcome was assessed and treatment difficulties are reported.
Results: Diagnostic pitfalls are shown. Vitamin D and parathormone disorders are not completely detectable by calcium and phosphate screening. In 2 of this 4 demonstrated cases treatable diagnosis would have been missed without endocrinological screening. In the case of undetected long-standing disorder of these hormones, intracellular mineral derangement follows, thus inducing vitamin D resistance and parathormone ineffectiveness which makes therapy difficult. Combining vitamin D therapy with multiminerals possibly may overcome these obstacles.
Conclusions: Vitamin D and parathormone disturbance should not be overlooked in chronic fatigue. Appropriate therapy is easy, inexpen-sive and harmless. Early diagnosis and treatment might be essential to avoid chronic fatigue syndrome. The complexity of diagnosis, therapy and scientific background may lead to a new understanding of “psycho-somatic” disease. The relation between intracellular minerals, trace ele-ments, cellular energy supply and responsible hormones should become clearer.
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A. D. Höck
A. D. Höck is in Practice of Internal Medicine and Psychotherapy, Hohenstaufen-ring 53, 50674 Koln, Germany, Europe.