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Vitamin D is a vital nutrient for healing and repair. Learn more about Vitamins D’s effect on pain, recovery, and bone health in today’s post…
Symptoms of Vitamin D deficiency
Deficiency in vitamin D can cause a range of muscle and joint symptoms such as:
- Bone ache/ pain (most commonly in the lower back, pelvis or legs)
- Muscle pain (especially thighs and buttocks)
- Chronic widespread pain
- Muscle stiffness (especially in the mornings)
Deficiency can also cause other symptoms such as fatigue and low mood. Patients with symptoms of low vitamin D are often misdiagnosed with depression, fibromyalgia, chronic fatigue syndrome and growing pains.
Am I deficient?
Rates of insufficiency/ deficiency in the UK are extremely high. One study showed that prevalence of vitamin D insufficiency in British adults was as high as 87% in the winter months [Hyppönen, 2007]! In another study, 93% of patients with persistent muscle and joint pain were found to be vitamin D deficient [Plotnikoff, 2003]
People with dark skin and people with limited sun exposure are particularly at risk of vitamin D deficiency because they will make less from sunlight. Older adults and the obese are also more likely to be deficient.
Your vitamin D levels can be checked quickly and easily with a vitamin D home test.
Vitamin D and pain
Vitamin D and widespread pain
Multiple studies have highlighted the connection between widespread pain and vitamin D deficiency.
In one study, 58 patients with chronic widespread pain (including patients diagnosed with fibromyalgia) and vitamin D deficiency were given 50, 000 IU/ week of oral vitamin D for 3 months. By the end of the study the average reduction in pain was 47% [Yilmaz 2016]. Improvements in depression and quality of life were also seen. Interestingly, 10 patients who were classified as having fibromyalgia pre-treatment were no longer classified as having fibromyalgia after 3 months.
Vitamin D and chronic low back pain
In one study, sixty-eight patients with chronic low back pain and vitamin D deficiency were given 60,000IU of vitamin D every week for 6 weeks. After 6 months their pain average pain levels decreased by 55% despite only 66% of patients achieving normal vitamin D levels [Ghai, 2017].
Vitamin D and migraine
In a 2021 metanalysis it was concluded that “Vitamin D treatment is effective to alleviate migraine.” The analysis showed that vitamin D treatment is associated with substantially reduced number of headache days, frequency of headache attacks, headache severity and Migraine Disability Assessment score [Zhang, 2021].
Vitamin D and Osteoporosis
Vitamin D helps your body absorb and use calcium, which gives your bones their strength.
Vitamin D deficiency is a major factor in osteoporotic fractures, falls and loss of muscles power. It is recommended that Vitamin D deficiency should be aggressively treated in osteoporotic patients with the aim of achieving serum levels above or equal to 75 nmol/L [Brincar, 2015].
Vitamin D for pain relief and injury recovery
Given the high prevalence of vitamin D deficiency (particularly during winter months) is it worth having your levels checked especially if you suffer with any of the signs of deficiency.
Knowing your exact vitamin D level also allows for specific supplement dosing.
Getting Vitamin D
You can get Vitamin D from food or make it from sunlight. However, food only contains very small amounts, so it’s almost impossible to get all your body needs with just food alone. Supplementation is therefore required for most people in the UK, at least during the non-summer months (October-March).
Best food sources of vitamin D
- Fatty fish
- Egg yolks
It is best to modify your vitamin D dose based on your test results.
If you suffer with osteoporosis look for a supplement that also contain vitamin K2.
If you are overweight or obese your dose will need to be increased [Ekwaru, 2014]. Overweight patients should increase their dose by 1.5x, obese patients by 2-3x.
Who shouldn’t take Vitamin D?
Most people can take vitamin D supplements with no problems. However, some people should not take vitamin D, or only do so under the supervision of a doctor. For example, people certain medications e.g: Digoxin (for an irregular heartbeat) or Thiazide diuretics (commonly used to treat high blood pressure). Or people with medical conditions including:
- Primary hyperparathyroidism
- Hodgkin’s or non-Hodgkin’s lymphoma
- Granulomatous disease
- Kidney disease
- High blood calcium levels –
- Billington, E. O., Burt, L. A., Rose, M. S., Davison, E. M., Gaudet, S., Kan, M., … & Hanley, D. A. (2020). Safety of high-dose vitamin D supplementation: Secondary analysis of a randomized controlled trial. The Journal of Clinical Endocrinology & Metabolism, 105(4), 1261-1273.
- Brincat, M., Gambin, J., Brincat, M., & Calleja-Agius, J. (2015). The role of vitamin D in osteoporosis. Maturitas, 80(3), 329-332.
- Chen, N., Wan, Z., Han, S. F., Li, B. Y., Zhang, Z. L., & Qin, L. Q. (2014). Effect of vitamin D supplementation on the level of circulating high-sensitivity C-reactive protein: a meta-analysis of randomized controlled trials. Nutrients, 6(6), 2206-2216.
- Ekwaru, J. P., Zwicker, J. D., Holick, M. F., Giovannucci, E., & Veugelers, P. J. (2014). The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. PLoS One, 9(11), e111265.
- Franca Gois, P. H., Wolley, M., Ranganathan, D., & Seguro, A. C. (2018). Vitamin D deficiency in chronic kidney disease: Recent evidence and controversies. International journal of environmental research and public health, 15(8), 1773. Ghai, B., Bansal, D., Kanukula, R., Gudala, K., Sachdeva, N., Dhatt, S. S., & Kumar, V. (2017). Vitamin D supplementation in patients with chronic low back pain: an open label, single arm clinical trial. Pain physician, 20(1), E99-E105.
- Ghai, B., Bansal, D., Kanukula, R., Gudala, K., Sachdeva, N., Dhatt, S. S., & Kumar, V. (2017). Vitamin D supplementation in patients with chronic low back pain: an open label, single arm clinical trial. Pain physician, 20(1), E99-E105.
- Ghorbani, Z., Togha, M., Rafiee, P., Ahmadi, Z. S., Magham, R. R., Djalali, M., … & Mahmoudi, M. (2020). Vitamin D3 might improve headache characteristics and protect against inflammation in migraine: a randomized clinical trial. Neurological Sciences, 41(5), 1183-1192. Hyppönen, E., & Power, C. (2007). Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. The American journal of clinical nutrition, 85(3), 860-868.
- Le Goaziou, M. F., Kellou, N., Flori, M., Perdrix, C., Dupraz, C., Bodier, E., & Souweine, G. (2014). Vitamin D supplementation for diffuse musculoskeletal pain: Results of a before-and-after study. The European journal of general practice, 20(1), 3-9.
- Plotnikoff, G. A., & Quigley, J. M. (2003, December). Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. In Mayo clinic proceedings (Vol. 78, No. 12, pp. 1463-1470). Elsevier.
- Tague, S. E., Clarke, G. L., Winter, M. K., McCarson, K. E., Wright, D. E., & Smith, P. G. (2011). Vitamin D deficiency promotes skeletal muscle hypersensitivity and sensory hyperinnervation. Journal of Neuroscience, 31(39), 13728-13738.
- Vieth, R. (1999). Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. The American journal of clinical nutrition, 69(5), 842-856.
- Von Känel, R., Müller-Hartmannsgruber, V., Kokinogenis, G., & Egloff, N. (2014). Vitamin D and central hypersensitivity in patients with chronic pain. Pain medicine, 15(9), 1609-1618
- Yilmaz, R., Salli, A., Cingoz, H. T., Kucuksen, S., & Ugurlu, H. (2016). Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency. International journal of rheumatic diseases, 19(12), 1255-1262.
- Zhang, Y. F., Xu, Z. Q., Zhou, H. J., Liu, Y. Z., & Jiang, X. J. (2021). The Efficacy of Vitamin D Supplementation for Migraine: A Meta-Analysis of Randomized Controlled Studies. Clinical Neuropharmacology, 44(1), 5-8.
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey CI. For more information about Steffen click here.