Iron insufficiency and hypovitaminosis D in adolescents with chronic fatigue and orthostatic intolerance

Ryan M. Antiel, Jonathan S. Caudill, Barbara E.U. Burkhardt, Chad K. Brands, Philip R. Fischer

Research output: Contribution to journalReview articlepeer-review


OBJECTIVES: More than 10% of adolescents suffer from severe fatigue and/or orthostatic intolerance. Adult studies show correlations between iron insufficiency and fatigue as well as between hypovitaminosis D and non-specific pain. We sought to determine whether there were correlations between nutritional factors (iron status, and serum vitamin D levels) and chronic ill health. METHODS: We reviewed records of 188 adolescents with symptoms of fatigue and/or orthostatic intolerance and who underwent autonomic reflex screening. RESULTS: Of the 188 patients, 130 patients (69%) had excessive postural tachycardia (PT) with a heart rate (HR) change of ≥30 bpm. 62 patients (47%, n = 131) had iron insufficiency with low iron stores, and 29 patients (22%, n = 131) were iron deficient. HR change did not correlate to ferritin level (P = 0.15). 21 patients (22%, n = 95) had hypovitaminosis D (25-hydroxyvitamin D ≤20 ng/mL). There was a significant association with hypovitaminosis D and orthostatic intolerance (P = 0.024). CONCLUSION: In patients presenting with chronic fatigue and/or orthostatic intolerance, low ferritin levels and hypovitaminosis D are common, especially in patients with PT.

Original languageEnglish (US)
Pages (from-to)609-611
Number of pages3
JournalSouthern medical journal
Issue number8
StatePublished - Aug 1 2011


  • adolescents
  • hypovitaminosis D
  • low iron storage
  • orthostatic

ASJC Scopus subject areas

  • Medicine(all)


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