Calcium and vitamin D supplementation do not influence menopause-related symptoms: Results of the Women's Health Initiative Trial

LeBlanc, Erin S.; Hedlin, Haley; Qin, Feifei; Desai, Manisha; Wactawski‐Wende, Jean; Perrin, Nancy; Manson, JoAnn E.; Johnson, Karen C.; Tylavsky, Frances A.; Stefanick, Marcia L.

doi:10.1016/j.maturitas.2015.04.007

Cited by 15 publications

(8 citation statements)

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“…To the best of our knowledge, only four vitamin D RCTs have been conducted with self-perceived fatigue as one of the main outcomes in general population samples or individuals with idiopathic fatigue. Our results are in line with the RCTs showing little evidence of improvement in fatigue after eight weeks of vitamin D supplementation in primary care patients with low 25OHD levels (N = 90; SMD = −0.13, 95% CI: −0.55, 0.28) 32 , after six months of vitamin D supplementation in patients with chronic fatigue syndrome (N = 45; SMD = 0.12, 95% CI: −0.47, 0.71) 21 , or over an average of five years of combined calcium and vitamin D supplementation in middle-aged and older women (N = 34,157; p = 0.764) 33 .…”

Section: Discussionmentioning

confidence: 99%

“…Two other RCTs showed little evidence of an effect of vitamin D supplementation on fatigue symptoms in primary care patients with low 25OHD levels (intervention n = 48, placebo n = 42, SMD = −0.13, 95% CI: −0.55, 0.28) 32 or in individuals with CFS/ME (intervention n = 21, placebo n = 24, SMD = 0.12, 95% CI: −0.47, 0.71) 21 . A large RCT of combined calcium and vitamin D supplementation in middle-aged and older women found no strong evidence of a difference in fatigue between the intervention (N = 17,101) and placebo (N = 17,056) groups (p-value = 0.764, no change score was reported) 33 . We performed a random effects meta-analysis of the three smaller RCTs reporting fatigue change scores and find that the effect of vitamin D supplementation on fatigue is inconclusive and heterogeneous (SMD: 0.29, 95% CI: −0.83, 0.24, I-squared: 77.3%, p-value for heterogeneity: 0.012).…”

Section: Introductionmentioning

confidence: 99%

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Investigating causality in the association between vitamin D status and self-reported tiredness

Havdahl

Mitchell

Paternoster

et al. 2019

Sci Rep

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Self-reported tiredness or low energy, often referred to as fatigue, has been linked to low levels of circulating 25-hydroxyvitamin D (25OHD), a biomarker of vitamin D status. Although it is uncertain if the association is causal, fatigue is a common indication for testing, and correcting, low 25OHD-levels. We used two-sample Mendelian randomization to test for genetic evidence of a causal association between low 25OHD-levels and fatigue. Genetic-25OHD associations were estimated from the largest genome-wide association study of vitamin D to date, and genetic-fatigue associations were estimated in 327,478 individuals of European descent in UK Biobank, of whom 19,526 (5.96%) reported fatigue (tiredness or low energy nearly every day over the past two weeks). Using seven genome-wide significant 25OHD-reducing genetic variants, there was little evidence for a causal effect of 25OHD on fatigue (odds ratio for fatigue was 1.05 with 95% confidence interval of 0.87–1.27 per 1-SD decrease in log-transformed 25OHD). There was also little evidence of association between any individual 25OHD-reducing variant and fatigue. Our results suggest that a clinically relevant protective effect of 25OHD-levels on fatigue is unlikely. Therefore, vitamin D supplementation of the general population to raise 25OHD-levels is not likely to be useful in preventing fatigue.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Investigating causality in the association between vitamin D status and self-reported tiredness

Havdahl

Mitchell

Paternoster

et al. 2019

Sci Rep

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“…Testing and correction of 25(OH)D levels are commonly studied in cases of fatigue [7,[89][90][91][92][93], but more studies are needed to prove the effectiveness of vitamin D supplementation in reducing or preventing of the CRF. The VICTORIA study aims to confirm this association through a randomized controlled trial [94].…”

Section: Discussionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy

et al. 2022

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Background The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. Methods This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. Results At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (β = -2.279, p = 0.045) and muscle/joint aches (β = -0.779, p = 0.013) were significant with CRF only at baseline. Conclusions This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy.

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“…Overall, the included trials fall into two main groups: vitamin D alone and vitamin D plus calcium. See Table 2 for excluded studies [7,15,22,29,30] and their reason.…”

Section: Description Of Studiesmentioning

confidence: 99%

Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review

et al. 2019

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Menopause is associated with the onset of climacteric symptoms due to low estradiol levels, which may cause insufficient maturation of the vaginal mucosa. Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels, thereby restoring vaginal health. The objective of this systematic review, the first on this subject, was to investigate the effect of vitamin D on the vaginal health of menopausal women. PubMed, Embase, Scopus, Web of Science, and Google Scholar databases and reference lists of hand-searched articles were searched for published studies from February 2000 to November 2018. The selection criteria were as follows: randomized or quasi-randomized trials that compared the effects of vitamin D or related compounds, alone or with calcium, on vaginal health (growth and differentiation of epithelial cells, dryness, acidity [pH]) outcomes in menopausal women. The methodological quality of these studies was examined using the Cochrane tool checklist by two independent investigators, following which the data were extracted. Of six examined studies, two showed that vitamin D administration improved the growth and differentiation of vaginal epithelial cells, improved vaginal pH, and decreased vaginal dryness in menopausal women. Although the level of evidence for the effects of vitamin D on vaginal health is low in our study, we concluded that vitamin D may improve the vaginal health of women, especially during menopause.

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Calcium and vitamin D supplementation do not influence menopause-related symptoms: Results of the Women's Health Initiative Trial

Cited by 15 publications

References 49 publications

Investigating causality in the association between vitamin D status and self-reported tiredness

Investigating causality in the association between vitamin D status and self-reported tiredness

Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy

Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review

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