Aug 22, 2012

The importance of proper Vitamin D levels in POTS patients

A new case report has been published regarding a 37 year old woman whose POTS symptoms were greatly improved after calcitriol supplementation.  Calcitriol is the hormonally active form of Vitamin D.  Vitamin D is normally converted into calcitriol in the kidney, but in some persons with a 1-α hydroxylation defect, this would not occur.  Here is the link to the article:

Low Vitamin D levels are very common in North America and northern Europe, but it seems to be a universal problem amongst almost every POTS patient I have spoken with that has had their Vitamin D levels tested.  I wonder if the autonomic experts at Mayo and Vanderbilt and elsewhere have tested large groups of POTS patients for the 1-α hydroxylation defect, or looked at the portion of our genes associated with this process.

If you have POTS and you haven't already done so, ask your doctor to test your Vitamin D levels during your next visit.  In the meanwhile, make sure you eat plenty of healthy foods that have Vitamin D and that you get at least 10-20 minutes of sunshine on your skin everyday (sunscreen and clothing blocks Vitamin D production).

I have been on 1000 I.U. of a Vitamin D3 supplement, twice daily, for over a year, because my Vitamin D levels were very low when my doctor tested them.  I also make sure to get plenty of sunshine on my skin, since your body can produce it's own Vitamin D when your skin is exposed to natural sunlight.  Despite a healthy diet, supplementation and adequate sunlight, my Vitamin D levels still hover around the low end of the normal range.  I am going to bring up this case report to my doctor at my next visit and see what she thinks.

There is extensive medical literature on the role of Vitamin D in autoimmunity and overall immune system health - so much that I should probably dedicate an entire blog post to that topic.  Stay tuned...


  1. Wait, are you telling us to go outside with no clothes on to get our Vitamin D? I'm shocked!

    Okay, I'm kidding.

    Vitamin B12 and D deficiencies are what caused my neuropathy, and my neuropathy let to POTS. I am on 5,000 IU of D a day, but rarely get outside since I am stuck in bed most of the time. My levels are in the normal range (or were several months ago when I was tested), but I am not sure if they are on the high end or low end. Next time I have lab work done, I'm going to ask to have my B12, D, and electrolytes checked (apparently they need checked because of the Florinef). :)

  2. It does seem such a common problem doesn't it. Like you I've been on Vit D for years but still struggle to keep my levels up. I'd add that for many of us with muscle pain and weakness, Vit D can make a huge difference. For me it definitely takes the edge off it and I really notice when I don't take it. There's a huge problem with Vit D here in Australia as well. We had a Slip Slop Slap campaign (Slip on a shirt, Slop of the sunscreen, Slap on a hat)in the 80s/90s to try and reduce skin cancer rates and it was really successful and people never exposed themselves to the sun. Now Vit D levels are at critical levels.

    Oh and I'd add for the ladies reading that lack of Vit D also leads to an increase in facial hair. It's one of the main factors why so many elderly women in nursing homes have so much facial hair, simply no sun exposure!

  3. Interesting; thanks! My vitamin D levels were low as well, and I was given a regimen to bring it up. Before I was diagnosed with POTS I made a point to get some sun every day to help bring the D levels up -- but the heat intolerance of POTS has kept me in most of the time this summer. Hopefully I'll be out more as it gets cooler. Thanks for your helpful site!