Efficacy of Vitamin D Replacement Therapy on 28 Cases of [ME/CFS] After COVID-19 Vaccination, 2025, Kodama et al

Efficacy of Vitamin D Replacement Therapy on 28 Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After COVID-19 Vaccination

Shinichiro Kodama, Nafuko Konishi, Yuriko Hirai, Akinori Fujisawa, Mitsuko Nakata, Satoshi Teramukai, Masanori Fukushima

Background
Prolonged symptoms have been reported following both COVID-19 infection and vaccination, with some cases leading to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Of 80 patients presenting to our hospital with post-vaccination syndrome, 28 met the diagnostic criteria for ME/CFS. We conducted a retrospective study on these 28 patients.

Methods
We measured serum 25-hydroxyvitamin D levels in 28 patients who developed ME/CFS after COVID-19 vaccination between August 2022 and February 2024. Vitamin D replacement therapy included dietary counseling, sun exposure recommendations, and oral vitamin D supplementation. We evaluated changes in blood vitamin D levels and symptom improvement.

Results
At initial visit, 27 of 28 patients diagnosed with ME/CFS had insufficient or deficient serum 25-hydroxyvitamin D levels (16 ± 4ng/mL, mean ± SD). Following vitamin D replacement therapy, we observed an increase in blood vitamin D levels (28 ± 5ng/mL) associated with a decrease in ME/CFS diagnostic symptoms (from 10.3 ± 2.1 to 3.3 ± 2.0). Notably, 23 of 28 patients (82%) no longer met ME/CFS diagnostic criteria after the therapy. Among the symptoms, sleep problems showed the most improvement (71%), followed by autonomic symptoms (68%).

Conclusions
For patients developing ME/CFS after COVID-19 vaccination with insufficient or deficient vitamin D levels, appropriate vitamin D replacement therapy under medical guidance may lead to symptomatic relief. We are preparing a randomized controlled trial to evaluate the efficacy of vitamin D replacement therapy in individuals with ME/CFS who have developed vitamin D deficiency following COVID-19 infection or vaccination.

Link | PDF (Nutrition) [Open Access]

 

Method

• Canada criteria

Dietary counseling

• Instructed to eat foods high vit. D, but encouraged to figure the specific diet out on their own

Sunbathing instruction

• Encouraged to get at least 15-30 minutes of sun exposure daily, if possible.

Oral vitamin D supplementation

• Those unable to sunbathe were given 1.000 IU of vitamin D daily
• Had to buy supplements themselves
• More than half took supplements

Symptomatic treatment

• Symptomatic treatment was provided, which included exercise therapy, drug therapy, and nutritional counseling.
• Protein intake after exercise was also recommended to build muscle strength and aid in recovery from muscle fatigue.
  
• If unable to exercise, do as much daily activity as possible
• Told to stop all medical treatments they did not find beneficial, unless they were for underlying issues

 

Symptoms persisted for a minimum of 4 months and a maximum of 2 years and 4 months, with a median of 1 year and 3 months between the onset of symptoms and presentation to our hospital. All patients presented with long-term distress, uncertainty about their future, and mistrust of their healthcare. They were burdened physically, mentally, and financially.

(…)

All patients believed their symptoms were caused by the COVID-19 vaccination. However, the doctors they had previously seen did not agree with this belief or did not provide clear evidence that the COVID-19 vaccination was not the cause of their symptoms. For the first time, patients received empathy for their opinions from their doctors after visiting our hospital. Before coming to our hospital, many patients felt psychologically driven away by their doctors.

(…)

In our study, we measured serum 25(OH) vitamin D levels in patients with ME/CFS and found a significantly high prevalence of vitamin D insufficiency or deficiency. Improvement in these levels through vitamin D replacement therapy was associated with significant improvement in ME/CFS symptoms. Based on this result, vitamin D levels may serve as another possible biomarker for ME/CFS.

 

There is so much wrong with this paper, I don’t know where to start. The entire discussion is particularly concerning, there’s so much speculation!

 

"Based on this result, vitamin D levels may serve as another possible biomarker for ME/CFS".

If ME/CFS was associated with vitamin D levels we would have known about this decades ago.

 

I remember the first time I started supplementing vitamin D3 after getting a rather low result on testing. My result wasn't drastically low, it was just a bit low. After a few weeks of supplementing 1000 iU per day I tested again and my vitamin D3 had actually dropped!

 

I also had low vit D levels. Even though supplementation improved my levels, it didn't make any difference in my symptoms.

Vitamin D happens to be one of the many metabolites that is generated from cholesterol by NAD(P)H dependent enzymes--steroid hormones and bile acids have also been shown to be reduced in ME/CFS. I think it is much more likely that reduced vitamin D levels in some pwME are another sign of a problem upstream, rather than the direct cause.

 

Same here, I started taking 2,000 IU of vitamin D a day, thinking it might help my energy, and it didn't.

 

I was on 6000 IU for six months after covid because I was low prior to infection, it did not stop me from getting severe ME/CFS.

 

I have been taking a 25µg vitamin D tablet daily for several years, I also take a vitamin B complex tablet, vitamin C and generic multivitamin with iron.

My motivation was partly because I am liable to vitamin B deficiency and could not arrange for the six monthly vitamin B injections to be given to me at home. I also read that vitamin D plays a role vitamin B metabolism so added that in.

I have not noticed that the vitamins result any improvement in my functioning, but my intention was to attempt to avoid going into deficit. Previously I noticed an improvement following the vitamin B injections if given when I was deficient, but when having them regularly I noticed no improvement but they did stop me going back into deficit.

(Note the multivitamin is to stop me worrying so much about the variable quality of my diet and the vitamin C is supposed to be preventative for gout. Certainly I have had no gout attacks since taking two 500mg tablets daily.)

 

Same experience here. I don't remember the exact dose now but I took vitamin D for quite a while in my early days of ME/CFS after mono/glandular fever, thinking it might be helpful. It did nothing, so I stopped.