Low Vitamin D States Observed in U.S. Marines and Navy Sailors with Early Multi-Symptom Illness : Maloney, July 2020

[Sly Saint]

Abstract: Research has implicated immune system inflammation as an underlying etiology of
multi-symptom illnesses, and vitamin D has been shown to have a significant role in immune system function. In this retrospective review performed on the medical charts of service members who presented with signs and symptoms of multi-symptom illnesses, we focused on serum 25(OH)D3 levels and looked for associations of vitamin D status (deficient, insucient, and normal) with age (20–31 years versus 31–56 years) and deployment status (war zones versus other).
Two groups (U.S. Marines and Navy Sailors) were sampled and both showed high incidences of below normal vitamin D levels. However, with the Marines, age-related dierences in serum levels (p = 0.009) were found only among those who deployed to Iraq/Afghanistan in comparison to those in non-combat locations. The comparison within the Navy sample showed that mobilized sailors had lower 25(OH)D3 levels than the group that did not deploy (p = 0.04). In addition, 100% of the sailors who deployed had below normal levels versus only 33% in the cadre group. The data suggest that personnel returning from a war zone with signs of early multi-symptom illness should be checked for low vitamin D status

Introduction
Many U.S. service members returning from the wars involving Iraq and Afghanistan since
1990–1991 have returned with chronic multi-symptom illnesses [1] (often disabling) for which the pathophysiology or etiology is unknown. Recent research includes the finding that some multi-symptom illnesses such as Gulf War illness (GWI) and myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) are associated with pre-lytic herpes virus partial reactivation [2–5].
This partial reactivation involves the synthesis of herpetic virus dUTPase protein antigens with
resulting stimulation of inflammatory intermediates. There has been independent documentation of increased inflammatory cytokines in veterans with GWI [6–8]. There have also been clinical studies which suggest an atypical or partial reactivation of herpetic viruses as an etiology of chronic multi-symptom illnesses including ME/CFS and in those with neuropathic chronic pain syndromes.
Non routine, experimental, antiviral therapy has been used with moderate success to treat patients with these chronic multi-symptom illnesses [9–12].
The active form of vitamin D, 1,25(OH)2 D3 is a hormone that can be produced outside the
kidneys in immune system cells, and this hormone uses vitamin D receptors on activated lymphocytes,macrophages, and dendritic cells [13–16]. Persistent low serum levels of active vitamin D precursor, 25(OH)D3 may chronically impair the immune system in individuals with multi-symptom illnesses...

https://www.mdpi.com/2218-273X/10/7/1032

 

[Arnie Pye]

The comparison within the Navy sample showed that mobilized sailors had lower 25(OH)D3 levels than the group that did not deploy (p = 0.04). In addition, 100% of the sailors who deployed had below normal levels versus only 33% in the cadre group. The data suggest that personnel returning from a war zone with signs of early multi-symptom illness should be checked for low vitamin D status

If 100% of people who have been deployed in war zones come back with below normal levels of vitamin D, it seems blindingly obvious to me that there must be a connection between losing vitamin D and high levels of stress hormones - but cortisol and adrenaline/epinephrine don't get single mention.

The last sentence of the Conclusions says :

These findings suggest that serum 25(OH)D3 levels should be checked and treated in symptomatic U.S. Marines and Navy Sailors deploying to and returning from areas of conflict.

It occurs to me that some service personnel stay in war zones for many, many months at a time. It makes far more sense to supply vitamin D supplements while they are on active service rather than allowing them to suffer from the effects of vitamin D getting lower and lower over time. Surely the powers-that-be have a duty to help their staff to stay as well as possible under the circumstances?

 

[Kitty]

I wonder if clothing and kit whilst on active duty might also be a factor? If a soldier goes outdoors in a conflict zone, his/her skin tends to be covered up pretty comprehensively; they may also avoid going out at all except when necessary. Only thinking aloud, though, I don't really know anyone who's served in the forces.

 

[Trish]

I haven't read the paper, but I would not assume that the factor leading to depletion of Vitamin D when deployed to war zones was necessarily stress related. There are plenty of other factors that could explain it. For example change in diet, reduced sun exposure through wearing more protective kit, or preventive medications given during deployment.