Vitamin D supplementation reduces pain in Fibromyalgia

by Bruce Sylvester – Fibromyalgia syndrome (FMS) patients with low vitamin D can reduce pain by taking supplements, and possibly lower the costs of other drug and non-drug interventions, researchers reported on Jan. 17, 2014 in the journal of PAIN.

As background, the authors noted that calcifediol is produced in the liver by the enzyme cholecalciferol (vitamin D3). Calcifediol converts to calcitriol, which is the active form of vitamin D. Serum calcifediol is widely used as an indicator of vitamin D status.

“Low blood levels of calcifediol are especially common in patients with severe pain and fibromyalgia. But although the role of calcifediol in the perception of chronic pain is a widely discussed subject, we lack clear evidence of the role of vitamin D supplementation in fibromyalgia patients,” said lead investigator Florian Wepner, MD, Department of Orthopaedic Pain Management, Spine Unit, Orthopaedic Hospital, Speising, Vienna, Austria. “We therefore set out to determine whether raising the calcifediol levels in these patients would alleviate pain and cause a general improvement in concomitant disorders.”

The researchers randomized 30 women with fibromyalgia with low serum calcifediol levels (below 32ng/ml) to treatment with oral cholecalciferol supplements, or to a placebo control group.

The goal for active treatment was serum calcifediol levels between 32 and 48ng/ml for 20 weeks.

The researchers evaluated serum calcifediol levels at weeks 5 and 13; dosing was adjusted based on the results. Calcifediol levels were measured again at 25 weeks, and treatment was discontinued.

Calcifediol levels were measured again after another 24 weeks without cholecalciferol supplementation.

During the first 25 weeks of supplementation, the treatment group achieved significant improvements on a scale of physical role functioning; the placebo group was unchanged.

Twenty-four weeks after supplementation had ended, the researchers found a significant reduction in the level of perceived pain in the treatment group.

“We believe that the data presented in the present study are promising. FMS is a very extensive symptom complex that cannot be explained by a vitamin D deficiency alone. However, vitamin D supplementation may be regarded as a relatively safe and economical treatment for FMS patients and an extremely cost-effective alternative or adjunct to expensive pharmacological treatment as well as physical, behavioral, and multimodal therapies,” said Wepner.