Back in November one of my blogs focused on the phenomenon of generalised body pain and vitamin D deficiency. The blog was based on my experience in practice of usually female patients, but it was also triggered by a chance conversation I had had very recently with a general practitioner here in the UK who claimed to be getting good results in his patients with generalised pain through treatment with vitamin D.
This week saw the publication of a study which lends some support to the concept that generalised pain can be rooted in a problem with low vitamin D levels. This British research, published on-line in the Annals of Rheumatic Disease, assessed the relationship between pain and vitamin D levels in almost 7000 men and women.
The researchers found that, overall, women with lower vitamin D (25-hydroxy-cholecalciferol) levels were more likely to suffer from chronic widespread pain compared to women with higher vitamin D status. After adjusting for so-called confounding factors, this research revealed that women with a vitamin D level of less than 75 nmol/L had a 57 per cent increased risk of suffering from chronic widespread pain compared to women with vitamin D levels of between 75 and 99 nmol/L.
This, this research showed a significant association between vitamin D levels and chronic widespread pain in women. However, no significant association was found in men. The reason for this gender difference is not known. However, my experience in practice has been that individuals with generalised pain in whom vitamin D insufficiency appears to be the triggering factor are usually female.
In my blog in November, I wrote that I view a 25-hydroxy-cholecalciferol level of 50 nmol/L or less as evidence of deficiency. I may need to revise that value now, because this latest research suggests that as far as pain is concerned, vitamin D levels of less than 75 nmol/L may be suboptimal.
References:
Atherton K, et al. Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey. Ann Rheum Dis [Epub ahead of print 2 August 2008].
Perhaps the pain experinced in women is related not only to deficiency of vitamin D, but some other “combined” deficiency.
For example lack of iron or magnesium due to monthley blood loss?
That is very interesting. Just to corroborate… My mother-in-law is Italian and insists she is allergic to England! When she is in Italy and living the outdoors life in the sun, her virtually crippling pain that she experiences in England is eased. This may be just an excuse to live in Italy of course … but she has be diagnosed with fibromyalgia.
Hello John – Do you recommend a particular brand/make of Vitamin D which you know is effective. I could go to a local chemist and pick one up off the shelf. However, I am particular about what supplements I take.
Thanks
Nina
Taking Natalija’s comment further, what about undiagnosed hypothyroidism as a ‘combined’ deficiency, of which Vitamin D might be just one aspect? Aches and pains are a common symptom of hypothyroidism (I can personally vouch for that), and some believe that there are millions of undiagnosed hypothyroids out there due to general ignorance amongst GPs of how common it is plus thyroid blood test reference ranges which miss many cases of hypothyroidism that would benefit from treatment.
And Lisa mentions fibromyalgia, which with CFS or ME, is thought by doctors such as Dr John Lowe and Dr Sarah Myhill to be undiagnosed hypothyroidism …
Am I making connections where there aren’t any?
Jackie
The best food sources of vitamin D are cod liver oil and lard from pasture-raised pigs.
Reference the question from Nina, i take Bio D Emulsion from Nutri Link and find it has the most positive effect on my health. i had a painful hip and started taking Bio d Emulsion, together with Eskimo 3 from Nutri and 1000mg of vitamin C twice daily. the effects were, i was ‘pain free’ overnight, and have continued to be so. i’m certain if i had not taken these supplements i would now be thinking of hip replacement surgery. i think everyone would benefit from extra Vitamin D in this wet and grey summer we are having in the UK.
Re Nina’s query. It’s important to remember that to achieve the optimal levels of 25(OH)D one should supplement ONLY with cholocalciferol, Vit D3 — not any other form of D3, especially not Calcitriol.
The maximum pill size available in the UK is mainly 400IU, which is ridiculous, since in the winter months, or if you’re not sunbathing, most adults need around 5,000-10,000IU daily to achieve and then maintain optimum levels — that’s a lot of 400IU pills!
Really comprehensive info on VitD is available on John Cannell’s brilliant website http://www.vitamindcouncil.com. Do have a look, if you haven’t already.
Thanks to Dr. Briffa for consistently bringing us information most docs don’t know or care about. It is very important to know that all Statin drugs rob the body of Vitamin D3, it took a long period of debilitating pain to discover that I was woefully Vitamin D deficient. Dr. Beatrice Golomb, Principal Researcher for the Statin Effects Study at Univ. of Calif., San Diego found that use of Statins makes Vitamin D levels plummet. After coronary artery by-pass surgery, I could barely walk 20 feet, was totally exhausted and had plenty of pain. Over and over again I was told it was “normal”, but once I began supplementing with VitD3 and Cod Liver Oil, the exhaustion, pain and weakness in my legs stopped entirely (I quit the Statin drugs). Perhaps, Dr. Briffa will let others know how statins are preventing heart patients from having full and pain-free recoveries. This is information the manufacturers of statins do not want us to know, because world-wide, it is currently the most profitable pharmaceutical on the market. Good for them and the kiss of death for us. Thanks again Dr. Briffa!
Thank you Cynthia and Dominic.
My daughter and I both suffer from ‘bone pain’. This is hard to understand if you have never experienced it. We both have the sickle cell positive trait which I think is linked to our bone pain. My GP says this is not possible as we would need to be suffering sickle cell anaemia to experience the symptoms (bone pain being one such symptom). I’m certainly going to try a vitamin D supplement as my daughter has been referred to a rheumatology specialist (who didn’t quite understand that her pain was in her bones and not in her joints).
I was electrocuted Jan 2005 my pain seemed to get unbearable over the next year. I was diagnosed with fibromyagia by one doctor. Over the next year I saw 15 doctors. None of them could figure out what was wrong only that my pain was real and they thought it was connected to my accident. I finally saw a physical medicine doctor at Scott & White who said there wasn’t a name for what I had and I would always have it.
My Father and my Aunt both have the same pain. My Aunt was recently tested for a vitamin D levels. Which were very low. I am starting to have hope that one day I will wake up without pain and not have to take five differnt medication a day. Thank you for making people aware of the studies.
I agree with Lisa’s mother in law when in Italy: as soon as I am in a hot country I am totally pain free. Two weeks after returning to UK I have aches and pains again. Obviously, I shall have to leave the country!!
I have been suffering with increasingly dibilitating fibromyagia, chronic fatique, and now artritis.
A friend encouraged me to have my Vit D level checked. It was 19, and they have started me on 50,000 iu once a week for 8 weeks, with follow up monitoring.
Any other suggestions, for improving my heath. I live in Minnesota, and dream of moving to to the SouthWest.
Thanks for your consideration and willingness to share.
Respectfully Submitted, Joy
I have been in pain for 10 years, been diagnosed w/fibromyalgia. And finally, was tested to check D levels which are in the 30’s. I have been taking vit. D supplements for 6 months 2000 mg daily. Doctor today gave me 5000 mg to take daily. What is the anticipated outlook for the bone pain to decrease?
The consequences that cause the disease can lead to death, and so this disease is painful and people suffering from it suffers greatly by the constant pain caused by taking medications that are opioid narcotics such as Lortab, Vicodin, hydrocodone, which are very effective in suppressing the pain that causes the disease, we hope that people care and know findrxonline adequately informed as well as notes on your site.
Please, please take this under advisement.
Like many of you posted above, I too have the same health complaints, along w/ a low vit. d level. What almost every single doctor misses is that this is usually associated with elevated calcium (meaning A N Y W H E R E in the 10 level) . . . and trust me, that’s not the range your calcium should be–if it’s 10, then you’re sick. This (high calcium), in conjunction with elevated PTH levels and a DEXA scan are probably all you need to obtain a diagnosis of a parathyroid tumor. You will NEVER resolve your vit. d/calcium/bone loss, bone/joint pain until this is rectified. It is never appropriate to diagnose a patient with fibromyalgia, and possibly not even depression, when they display these symptoms.
Almost all PCP’s cannot properly diagnose parathyroid tumors
and, incredibly enough, most Endos. & radiologists cannot find them even when Sestamibi scans are performed.
Please research this as a very probable underlying cause of your symptoms!
With reference to above letter, I have had a parathyroid removal surgery (2 years ago) and still have calcium levels ranging between l0.4 and l0.9 depending on how much Vit.D3 I take. If I stop supplement, the calcium goes down but then so does my Vit.D level (to 22) My endo. does not seem to know what to do. Having severe body pain and lethargy. Any suggestions??
I have a VERY strong suspicion that the reason vitamin D levels are low, not necessarily as a cause of chronic pain, but that low levels of vitamin D are a result of chronic pain.
It seems weather a pt. takes vitamin D or not, vitamin D levels are lowered when pain levels are lowered. Weather that is a reflection on the reagents used & methods of testing for vitamin D (I think it is agreed 25-hydroxy-cholecalciferol is the best test available, yet the best for what result?)
Is it possible that 25-hydroxy-cholecalciferol tests could measure pain with some specific causes, pain in general, or a marker of a cause of pain that has yet to be discovered? (perhaps having to do with cortisol levels, thyroid (possibly a thyroid hormone we have yet to have found a test for? or other hormones?), specific IL levels?
It is far more research needs to be done before we blame vitamin D as the direct cause of pain. It doesn’t fit as a direct cause, yet I think we may be onto something far bigger. My money is on interleukins or perhaps even certain CYP-450 antagonists, thus the reason certain CYP-450 inhibitors work so well on pain.
Let the research continue. I’m quite certain that we haven’t reached the bottom of this yet, although the correlation between the low 25-hydroxy-cholecalciferol levels and pain are undeniable, it seems clear that there is not a direct link between the two.
I have had Coeliac condition since 1991 and was diagnosed with underactive thyriod in 2001 when the body pain improved i and my GP diagnosed fibromyalgia which seemed to fit the desciption of my symptoms. But I have had a vitamin D deficiency at level 10 and trying to take the supplements and i do feel a bit better but it is still difficulty with the aches and pains and at 58 im fed up with feeling tired and etc and etc