Vitamin D is a hormone which is synthesized in presence of sunlight by the skin. It is also produced through the consumption of certain foods and plays an important role in the functioning and different processes in the body. Vitamin D, which is important not only for a healthy immune system but also for a healthy skeleton, also has anti-inflammatory effects in the body by suppressing T-cell responses and reducing the release of pro-inflammatory cytokines. While health and fitness enthusiasts would usually take supplements like optimum nutrition whey, the importance of vitamin D supplements, which are just as important, are often underestimated and forgotten, as they are ignorant of how common Vitamin D deficiency is. According to the Institute of Medicine in the US, serum levels of Vitamin D below 50 nmol/L is insufficient for a healthy body.
According to the International Association for the Study of Pain, the definition of pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Chronic Pain is pain experienced on a majority of days beyond the normal tissue healing time of 3 months.
A wide range of conditions like migraines, back pain and osteoarthritis all fall under this broad category. Chronic pain includes long-standing diffuse musculo-skeletal pain along with other symptoms, including fatigue, psychological distress and poor concentration.
The causes of chronic pain are highly complex and diverse. Its treatment usually requires both a non-pharmacological and pharmacological approach, which is largely focused on the use of anti-inflammatory and analgesic drugs which not only have limited effectiveness but can lead to serious long-term addiction and abuse. Being highly prevalent in countries like the USA in over 40% of the adult population, it has high societal costs and is a leading cause of disability.
The link between Vitamin D deficiency and chronic pain
Doctors associate low Vitamin D levels commonly with a number of multitude of health conditions, including hypertension/blood pressure, cardiovascular disease, cancer, type-II diabetes, autoimmune diseases, mood disorders/depression, inflammation, Alzheimer’s and cognitive function.
However, conclusions from researches and studies are not always supported by randomized controlled trials and are largely inconsistent. Several recent studies examined the relationship between vitamin D deficiency and pain.
Observational studies have associated low vitamin D levels with higher opioid doses and increased pain and interventional studies have shown positive repercussions of vitamin D supplementation on muscular pain and cancer pain – but only in patients with insufficient levels of vitamin D at the beginning of the intervention.
According to a March 2009 study published by the Mayo Clinic, “patients who required narcotic pain medication, and who also had inadequate levels of vitamin D, were taking much higher doses of pain medication — nearly twice as much — as those who had adequate levels”. Possible mechanisms for Vitamin D probably helps in pain management due to its anti-inflammatory effects added to reduced prostaglandin and cytokine release and effects on T-cell responses.
While there is no hard evidence from randomized, controlled trials that replenishing vitamin D levels will cure chronic pain, Greg Plotnikoff, MD, senior consultant with the Allina Center for Health Care Innovations in Minnesota says that it doesn’t hurt to try. In 2003, Plotnikoff published a study on 150 people who came to a community health clinic in Minneapolis complaining of chronic pain out of which, 93% had extremely low vitamin D levels. While there is lack of conclusive proof that boosting your vitamin D level will erase your pain, if vitamin D does work for chronic pain, it would offer a simple and inexpensive treatment with probably limited and known adverse effects.
Hence, vitamin D may constitute a simple, safe and potentially beneficial way to reduce chronic pain among Vitamin – D deficient patients, but before we draw any firm conclusions, we require more placebo-controlled and randomised studies.
So in case of chronic pain, it could be good practice to ask your doctor to check your vitamin D levels as a standard of care for everyone with nonspecific chronic musculo-skeletal pain.
It has been evaluated that the desirable level of vitamin D is 75–110 nmol/L. Sun exposure covers most of the vitamin D in the summertime. 50% of the skin is exposed for 12 minutes at noontime at mid-latitudes is equivalent to a daily oral dose of 3.000 IU of vitamin D.
While some foods like salmon are rich in Vitamin D, most fruits and vegetables lack in Vitamin D. The normal diet alone is unable to provide a sufficient amount of vitamin D in absence of sun exposure. Supplements are very important. Multivitamin tablets usually contain 200–400 IU or 5–10 μg of vitamin D. The dosage of vitamin D supplementation required for a particular patient varies with the current vitamin D level and degree of deficiency of the patient.
Doctors consider Vitamin D supplementation up to 50 μg (2.000 IU) daily a reasonable amount for patients with chronic pain. Not only is the treatment relatively safe and cheap, but vitamin D supplementation has positive effects on health in general. Hence, the supplement may not be a complete cure for the pain, but for a chronic pain patient, even a small relief would be like gifting a full chocolate box to a child.
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