Vitamin D deficiency associated with chronic fatigue in brain injured patients

New evidences presented at the European Congress of Endocrinology has shown that vitamin D deficiency is closely associated with the chronic fatigue that often follows post traumatic brain injury (TBI).

TBI is a major cause of death and disability worldwide. In the European Union the annual incidence of TBI hospitalizations and fatalities is estimated at 235 per 100,000 people. This means that on average a large European state such as the UK, France or Germany, will have around 140,000 new traumatic brain injuries every year (national figures vary). Around two-thirds of post TBI patients go on to suffer chronic fatigue. Now a group of researchers in the Netherlands have linked vitamin D deficiency to chronic fatigue in post-TBI sufferers.

The group, led by Dr Jessica Schnieders from Rijnstate Hospital in Arnham, The Netherlands, looked at vitamin D and hormone levels in 90 fatigued and non-fatigued subjects. They also systematically evaluated pituitary hormones and factors such as sleep, attention, emotional well-being, quality of life, coping style, and daily activity. They found that 51% of TBI patients were severely fatigued 10 years after the trauma. Vitamin D deficiency was present in 65% of post TBI patients and significantly related with fatigue (P<0.05),>

--Lead researcher, Dr Jessica Schnieders said:
“In the Netherlands we have 30,000 people every year who suffer a traumatic brain injury and many of these go on to suffer from chronic fatigue. This is early work, so we need to confirm that vitamin D is the cause of this fatigue, and if so to see if taking vitamin D, perhaps coupled with improved sleep patterns, can alleviate some of the symptoms.

“We looked at patients around 10 years after their trauma. Fatigued post traumatic brain injury patients are less active, and generally experience a reduced quality of life. They have difficulties in maintaining relationships and keeping jobs, and are less independent than people who have not had to cope with such trauma.”

Erectile dysfunction and increased dangers of cardiovascular disease

Research presented at the European Congress of Endocrinology shows for the first time that men with erectile dysfunction and low testosterone have a higher than normal risk of dying from cardiovascular disease. Further work from the same research group shows that obesity is also associated with an impairment of blood flow to the penis, which in turn is also associated with cardiovascular disease in men with erectile dysfunction.
A group led by Dr Giovanni Corona (University of Florence) carried out two separate studies on a group of men attending a clinic for erectile dysfunction. The first study* looked at testosterone levels in patients with erectile dysfunction. They investigated testosterone levels of 1687 patients attending the andrology clinic for erectile dysfunction, and followed them up for an average of 4.3 years. In the follow-up period, 137 of the patients had a major cardiac event, with 15 fatalities. Low testosterone itself was not associated with major cardiac events, but those patients with the lowest testosterone who had a major cardiac event were significantly more likely to die than those with higher levels of testosterone (P<0.001;>

--Researcher Dr Giovanni Corona said:
“Our work shows that screening for testosterone deficiency in men with erectile dysfunction may help clinicians identify those at higher risk from cardiovascular events. However, at the moment we can’t say whether low testosterone levels are the cause or the consequence of this higher risk.
“This work needs to be confirmed by larger studies. However, this is the first time that low testosterone is associated with higher death rates from heart disease in men with erectile dysfunction. Our work indicates that if you have erectile dysfunction, and if you have a very low testosterone level, then you are up to 7 times more likely to die from a major cardiac event than if you have erectile dysfunction and normal testosterone levels. It may be worth screening the testosterone levels of men who come to clinics with erectile dysfunction, as this may be a way of identifying those who are most at risk from heart disease. At the same time, we need large-scale studies to look at whether testosterone replacement therapy in at-risk men can prevent unnecessary deaths from heart disease.”
In a second study** (but using the same group of patients as above), the group showed that the degree of obesity, along with erectile dysfunction, were significantly and independently associated with cardiac events. When a separate analysis was performed for classes of obesity, reduced blood flow to the penis was shown to be significantly related with incident of major cardiac events in obese men (i.e. those with a BMI greater than 30 kg/m2; P<0.05).>