Vitamin D Inadequacy May Play Role in Chronic Pain | Arthritis Information

 

In what may be the first study of the prevalence of vitamin D inadequacy in patients seeking treatment for chronic pain, those patients who were on opioids used significantly higher doses and had been taking opioids significantly longer if they had vitamin D inadequacy than if they had normal or adequate vitamin D levels.

Inadequate levels of vitamin D were detected in 26% of 267 patients admitted to a multidisciplinary pain rehabilitation center at a tertiary referral medical center from February through December 2006, according to a report by Dr. W. Michael Hooten given at the annual meeting of the American Society of Anesthesiologists.

Of the 140 patients who were using opioids, 27% had inadequate levels of vitamin D, Dr. Hooten, of the Mayo Clinic, Rochester, Minn., and his associates reported in a poster presentation.

“Vitamin D inadequacy may represent an underrecognized source of nociception and impaired neuromuscular functioning among patients with chronic pain,” he commented.

In other, previous studies, inadequate levels of vitamin D have been found to be associated with both medication-refractory musculoskeletal pain as well as neuromuscular dysfunction.

In the current retrospective study, patients underwent vitamin D testing at admission, were questioned about opioid use, and completed the Short Form-36 Health Status Questionnaire (SF-36).

Serum 25-hydroxyvitamin D levels of 20 ng/mL or higher were considered adequate, and levels below 20 ng/mL were considered inadequate.

Both the patients in the adequate and in the inadequate vitamin D groups were nearly evenly split between opioid users and nonusers.

Among 69 patients with vitamin D inadequacy, 38 were using opioids, and 31 were not.

Among 198 patients with adequate vitamin D, 102 were using opioids and 96 were not.

Patients who were taking opioids used a mean morphine equivalent dose of 134 mg/day in the subgroup who had vitamin D inadequacy and 70 mg/day in the subgroup who had adequate serum vitamin D levels.

Opioid users with inadequate vitamin D had been taking the medications for a mean of 71 months, compared with 44 months for opioid users with sufficient vitamin D.

Opioid users with inadequate vitamin D reported significantly worse health perceptions and physical functioning on the SF-36.

Scores did not differ significantly between the vitamin D groups for bodily pain or “role-emotional.”

In the future, prospective trials of vitamin D therapy are needed in order to more thoroughly assess its effects on pain outcomes and physiological measures of neuromuscular functioning in patients with chronic pain and vitamin D inadequacy, according to Dr. Hooten.

Lynn492008-06-18 09:22:44My Rheumy just told me to start taking Vit D.I know that it helped me with muscular pain..I think we are going to find out so much more about this vitamin in the next many months. Lynn, thanks again for all the work you are doing to get this message out to all of us. You are too kind. I think it's very important to get this info out there. The research being done concerning vitamin D and various illnesses is amazing. I just read this...

Can A Natural Vitamin Help Slow Lung Cancer? Study Looks At Role Vitamin D May Play In Shielding Lungs From Tumors:

You can get Vitamin D from the sunlight on a warm sunny day, from drinking a cool glass of milk or from supplements at the store, but no matter how you get it, a healthy dose of Vitamin D may be doing more good than first thought. In the laboratory, scientists have discovered that high doses of this common vitamin may help slow or prevent the growth of cancer cells.


http://www.medicalnewstoday.com/articles/111733.php

Muscle pain has decreased over the last several months and I think it's due to starting Lyrica and several months later I started Vit. D.  It's a significant reduction in pain/aches.  Thanks for posting, Lynn.  Lindy

Lindy,

I'm glad to read that the Vitamin D is helping with your aches and pains.

Lynn

ps...Don't know if you saw this article from USAToday. I thought this part was very interesting.

Experts, such as Tanya Edwards, head of the integrative medicine department at the Cleveland Clinic, say Americans probably have always been deficient, but increasingly so because of poor sun exposure and diet. Also, there has been more research of vitamin D over the past several years that has raised awareness.

Like Tellem, many adults are not aware they are low on vitamin D, Edwards says.

Older Americans, whose skin cannot synthesize vitamin D as efficiently and whose kidneys are less able to convert vitamin D to its active hormone form, aren't the only adult group at risk, Edwards says.

She began screening all of her patients last year and says 95% have come up deficient. "I'm even seeing it in twenty- and thirtysomethings," she says.

Since genetics play a part, check your D level if a relative is deficient, Edwards says.


http://www.usatoday.com/news/health/2008-06-16-vitamin-d-side_N.htm Lynn492008-06-18 09:23:10Good Morning America had a story on this morning about this. They are discovering a lot of children are Vit D deficient as well. They now say that breast fed babies are not getting enough vit. d and breast feeding mother's sound bulk up on vit. d to pass it on to their children. [QUOTE=Lovie]Good Morning America had a story on this morning about this. They are discovering a lot of children are Vit D deficient as well. They now say that breast fed babies are not getting enough vit. d and breast feeding mother's sound bulk up on vit. d to pass it on to their children. [/QUOTE]

I thought this had been understood about breastfed babies for a long time.   And it is not my understanding that moms could 'bulk up' on it, either.  (Stored in fat, I'd think not passed on in breast milk, right?).  It was standard when I nursed my now 12 yr. old to supplement breastfed babies with vit d drops - Tri-vi-sol, Polyvisol, I think, some have iron, too.  Still told to supplement when my five yr. old was born, too.  They don't get it from breast milk and aren't in the sun, so you have to supplement.  I was told that, actually,  'they don't get it from breast milk'.  
Apparently not a lot of people are that well informed....

Lack of vitamin D rampant in infants, teens:

http://www.usatoday.com/news/health/2008-06-16-vitamin-d-main_N.htm

I'll admit I was getting ready at the time of the broadcast; but I'm certain they were advising nursing mother's to increase their vit. D intake. This has been in the news for the past few weeks.


Vitamin D Deficiency Puts 40% of U.S. Infants and Toddlers At Risk:

TUESDAY, June 3 (HealthDay News) -- At least 40 percent of American infants and toddlers aren't getting enough vitamin D, according to researchers from Children's Hospital in Boston.

Twelve percent of the youngest children in the United States are already deficient in vitamin D, and another 28 percent are at risk for vitamin D deficiency, according to the study, which appears in the June issue of the Archives of Pediatrics and Adolescent Medicine.

Because human breast milk lacks sufficient vitamin D, the number of babies in the research sample being breast-fed were important to the findings.

"These data underscore the fact that breast-fed infants should be supplemented with vitamin D," said study author Dr. Catherine Gordon, director of the bone health program at Children's Hospital in Boston. She added that mothers who are breast-feeding often need vitamin D supplements as well.

Breast-feeding is a known risk factor for low vitamin D levels in infants, which is why many pediatricians routinely recommend vitamin D supplementation for breast-fed infants. Other factors that may contribute to low levels of vitamin D include not drinking enough vitamin D-fortified milk (for toddlers), staying out of the sun or using sunscreen.

Vitamin D, also known as the sunshine vitamin, is produced naturally when the body reacts to sunlight. However, the use of sunscreen and advice to stay out of the sun -- which is important for preventing skin cancer -- may also be reducing levels of vitamin D in people. Few foods naturally contain vitamin D, which is essential for strong bones because it helps the body absorb calcium.

In addition to helping maintain bone health, Gordon said that vitamin D also appears to play a role in maintaining the immune system and that people with low levels of vitamin D may be more susceptible to autoimmune diseases, such as type 1 diabetes and multiple sclerosis, and to certain cancers.

Previously, Gordon and her colleagues studied vitamin D levels in adolescents and found very high levels -- about 42 percent -- of vitamin D deficiency in teens. That finding made them interested in assessing levels in younger children.

http://www.nlm.nih.gov/medlineplus/news/fullstory_65358.htmlI have a question for you moms that have older children. We went for a hike today and as we started out, my daughter and her friend were slathering the 8 children that were with us with sun block. How many of you did this? I never did. I wonder if that ultimately affects vitamin D levels. My kids didn't burn to a crisp. I have to wonder if it is necessary.Lorster,

I think that's a very good question and I've often wondered how much that effects vitamin D levels. I make it a point to get around 15 minutes of sunshine everyday, sans sunscreen.

Lynn
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