Clarification: article “More potential dangers of the UK NICE Guideline on “CFS/ME” for people with ME/CFS?”

Ed:  Any statement or response by Dr Sarah Myhill will also be posted on ME agenda.

Clarification about the article
More potential dangers of the UK NICE Guideline on “CFS/ME” for people with ME/CFS?
Issued by Margaret Williams

10th January 2008

Margaret Williams notes the post dated 10th January 2008 on LocalME on behalf of Dr Sarah Myhill (“Dr Myhill does not prescribe toxic Vit D”) and notes Dr Myhill’s statement that the article above had got it wrong because: “I do not use calcitriol but cholecalciferol. There is a world of difference!”

For the avoidance of doubt, the article was careful to state that Dr Myhill “apparently prescribes” 0.5 micrograms of calcitriol.

Margaret Williams accepts that Dr Myhill may not routinely prescribe 0.5 micrograms of calcitriol for her own patients with low levels of 25 (OH)D. However on one occasion Dr Myhill suggested this for a person with low 25 (OH)D levels. This specific recommendation was made by Dr Myhill to Professor Malcolm Hooper, who had contacted Dr Myhill on behalf of the person concerned.

The person for whom it was intended was not a patient of Dr Myhill but asked to become one and, in view of Dr Myhill’s recommendation, wished to purchase the 0.5 micrograms of calcitriol from Dr Myhill. Dr Myhill’s receptionist (Helen) confirmed that they did possess the 0.5 micrograms of calcitriol and that the person could indeed buy it from Dr Myhill but that their stocks were running low. However, having spoken to Dr Myhill while the person remained on the telephone, the receptionist returned to say that both requests had been refused by Dr Myhill. For that reason, Dr Myhill’s receptionist willingly provided the person with the name of their supplier (Phoenix Healthcare: telephone number 01675 – 436505). On contacting Phoenix Healthcare, the person was informed that they were merely distributors of calcitriol and that the manufacturer was Teva Ltd in Leeds (telephone number 0113 – 238 – 0099). As stated in the article, the composition of the calcitriol was unhesitatingly provided by the Medical Information department of Teva Ltd and is as set out in the article. The only additional piece of information is that the Medical Information department at Teva Ltd subsequently contacted the person and confirmed that the source of the cholecalciferol used by Teva Ltd in the production of their calcitriol is wholly synthetic.

Had the information regarding the source of the calcitriol recommended by Dr Myhill to Professor Hooper not been provided by Dr Myhill’s receptionist, the person would have had no means of knowing the source of the calcitriol apparently used by Dr Myhill.

For the record, cholecalciferol is the naturally occurring form of vitamin D; it is metabolised by the liver to form calcidiol (25(OH)D or 25-hydroxyvitamin D), which in turn is converted by the kidney to the active form calcitriol (1,25(OH)2D) or 1,25-dihydroxyvitamin D). Calcitriol is the most potent steroid hormone derived from cholecalcilferol and according to the Vitamin Council is the most potent steroid hormone in the human body
( http://www.vitamindcouncil.com/vitaminDPharmacology.shtml  ).

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