Measuring the levels of deficiency of vitamin D and iron in a cohort of patients diagnosed with endometriosis.
Author: D. Shepperson Mills
The Endometriosis and Fertility Clinic, London, United Kingdom.
Objective
The aetiology of endometriosis is unknown, although several studies have implicated immunological abnormalities in endometriosis pathogenesis. Endometriosis affects women of reproductive age, and research suggests that they have a higher prevalence of autoimmunity. Both vitamin D insufficiency and iron deficiency have been implicated in autoimmunity.
Design
The aim of this retrospective pilot study is to evaluate the nutrient deficiencies in those women diagnosed with active endometriosis by laparoscopy. We specifically looked at vitamin D and iron levels in a cohort of self-selecting women with endometriosis to see if there were any commonalities.
Materials and methods
Blood samples were taken by the patient's GP surgery and tested for iron and vitamin D levels. Fifty women who attended The EFC over two years were chosen at random. All the women attended three or more consultations, completed MYMOP medical audits each session, (Measure Yourself Medical Outcome Profile, MRC).
Results
Analysis showed that two-thirds of our women reporting pain, IBS and fatigue, were found to have low or border-line levels of vitamin D and/or iron. Patients reported poor nutrition and low exercise due to pain. The level of pain and fatigue was categorized 5-6 severe (range 0-6 MYMOP). Many of the cohort have full-time careers preventing them being outdoors. Vitamin D deficiency is often seen in women of reproductive age. Research into deficiencies in patients hospitalized with inflammatory bowel disease showed low serum vitamin D(25-OH) in 25-65%, with iron deficiency at 40%. Two-thirds of our women reported digestive problems, and may be malabsorbing nutrients due to their use of NSAIDs for pain. Phytic acid in wheat and soya chelate iron thus preventing absorption.
Conclusion
The results of this preliminary study show that for some women with endometriosis, their levels of vitamin D and iron are below normal levels. A larger cohort of women diagnosed with endometriosis is warranted to confirm our findings.
Key Words
Iron, Vitamin D, Endometriosis