07 Aug Vitamin D and Muscle Pain
Vitamin D and Muscle Pain
· The concept of Vitamin D sufficiency, insufficiency and deficiency is marked by calcium hemostasis and skeletal metabolism, which can be distinguished from the biological effects of Vitamin D – osteomalacia in Vitamin D deficiency to no effect on calcium metabolism in Vitamin D sufficiency. (Peacock M, 1985)
· The increased secretion in PTH in vitamin D insufficiency is well documented, and contributes to bone fragility, and probably to bone fractures, in the elderly through increased bone turnover and decreased bone density (Benhamou CL, 1995;). Serum 25OHD level below 30 nmol/l (12 ng/ml) are associated with secondary hyperparathyroidism, increased bone turnover and decreased bone mineral density (BMD) at the hip. As described in previously done studies the muscle function was found to be severely impaired in individuals with Vitamin D levels less than 20 nmol/l, which was confirmed by another study which showed that lower muscle function is impaired in men and women with Vitamin D kevels less than 30 nmol/l (Glerup H, 2000) (Bischoff HA, 1999)
· The symptoms of osteomalacic myopathy that occurs in deficiency of Vitamin D range from muscular weakness and hypotonic in children with rickets, proximal myopathy in older children, diffuse skeletal pain, muscular pain in absence of any specific pattern ,difficulties in rising from a chair, inability to ascend stairs (Gloth FM, 1991). A case report revealed that vitamin D deficiency results in poor muscle function, weakness and myalgia that are reversible upon achieving a vitamin D replete state (Gunton J E, 2018). In patients of fibromyalgia, which is characterized by chronic muscular pain Vitamin D supplementation of 50,000 IU/week for 20 weeks, showed statistical significant improvement in pain and quality of life (Wepner, et al., 2014). Low vitamin D levels have been linked to an increased risk for statin induced myalgia in several observational studies.
· Vitamin D has an important role in the regulation of Ca2+ transport and protein synthesis in the muscle cell. Vitamin D increases the calcium pool, which is essential for muscle contraction. The suppression of inflammation in general and of PGE2 especially exhibits credible mechanistic explanations for the effect of vitamin D in pain. Though the evidence of vitamin D supplementation in pain treatment still awaits evaluation by further concrete scientific studies, it is clear that Vitamin D supplementation in Vitamin D deficient patient can be offered as an independent therapy in patients with chronic pain of non-specific musculoskeletal origin.
Please always ensure to check with your Doctor / Healthcare / GP before starting with any new medication or therapy.
– Benhamou CL, T. D. (1995;). Calciotropic hormones in elderly people with and without hip fracture . Osteoporos I, 5:1,103–7.
– Bischoff HA, S. H. (1999). Muscle strength inthe elderly: its relation to vitamin D metabolites. . Arch Phys Med Rehab , 80: 54-8.
– Glerup H, M. K. (2000). Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int , 66:419–24.
– Gloth FM, L. J. (1991). Can vitamin D deficiency produce an unusual pain syndrome ? Arch Inter Med, 151:1662–4.
– Gunton J E, G. C. (2018). Vitamin D and Muscle . Bone Reports , 163-167.
– Peacock M, S. P. (1985). Vitamin D deficiency, insufficiency, sufficiency and intoxication.What do they mean ? Sixth workshop on vitamin D. Berlin: de, 569–70.
– Wepner, F., Scheuer, R., Schuetz-Wieser, B., Machacek, P., Pieler-Bruha, E., Cross, H., Friedrich, M. (2014). Effects of vitamin D on patients with fibromyalgia syndrome: A randomized placebo-controlled trial. Pain , 155, 261–268.