The following article come from NutritionFacts.org, Dr. Michael Greger. Sign up on the website to receive the latest in nutritional news and research updates delivered directly to your inbox.
Fibromyalgia is one of the most common joint and muscle diseases, affecting millions of Americans, characterized by widespread musculoskeletal pain, and often accompanied by other symptoms, such as fatigue. The medical profession used to think it was all in people’s heads, “but today there is irrefutable evidence” that it is, indeed, a disorder of the body and not just the mind.
Back in 2003, an influential paper was published out of the Mayo Clinic, in which a shocking 93% of fibromyalgia-type patients were found to be vitamin D deficient; and so, they concluded that all such patients are at high risk of severe vitamin D deficiency. But wait a second, said the skeptics, there was no control group. Where’s the Mayo Clinic located? Minnesota. Maybe 90% of everyone in Minnesota is D deficient.
When controlled studies were done, some did, indeed, find that those suffering from these kinds of pain syndromes were significantly more likely to be D deficient, but other studies did not. Even if all the studies did, though, that doesn’t mean that low vitamin D levels cause fibromyalgia. Maybe, chronic widespread pain disorders, like fibromyalgia, cause low vitamin D. It’s the sunshine vitamin, after all, and fibromyalgia patients may not be running around outside as much as healthy controls. To know if vitamin D is contributing to the disease, you have to put it to the test.
Studies like this found that the majority of those with pain syndromes and low D levels appeared to benefit from vitamin D supplementation. Clinical improvement in up to 90% of patients. (You can imagine how rife vitamin D deficiency is among Arab women in the Middle East.) But these studies weren’t controlled either. Maybe they would have gotten better on their own without the supplements, or maybe it was the placebo effect? There are many examples in the medical literature of treatments that looked great in uncontrolled trials, like hyperbaric oxygen therapy for multiple sclerosis, but when put to the test in randomized controlled trials, they failed miserably.
And, that’s what seemed to happen in the first randomized controlled trial of vitamin D for a fibromyalgia-type syndrome in 2008. No significant difference in pain scores, though the study only lasted three months, and in that time, the treatment was only able to get the vitamin D blood levels up to about 30. Unfortunately, no controlled study had ever been done pushing levels any higher, until 2014. Fibromyalgia patients were given up to 2400 units of D a day for 20 weeks; and their D levels rose up to about 50 and then, once they stopped the vitamin D, levels came back down to match the placebo. That was reflected in their pain scores, a significant drop in pain severity while they were on the D and then, back to baseline when they came off of it. The researchers concluded “that this economical—[in fact, over-the-counter]—therapy with a low side effect profile may well be considered in patients with [fibromyalgia syndrome.]”
- Wepner F, Scheuer R, Schuetz-Wieser B, Machacek P, Pieler-Bruha E, Cross HS, Hahne J, Friedrich M. Effects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial. Pain. 2014 Feb;155(2):261-8.
- Matthana MH. The relation between vitamin D deficiency and fibromyalgia syndrome in women. Saudi Med J. 2011 Sep;32(9):925-9.
- Tandeter H, Grynbaum M, Zuili I, Shany S, Shvartzman P. Serum 25-OH vitamin D levels in patients with fibromyalgia. Isr Med Assoc J. 2009 Jun;11(6):339-42.
- McBeth J, Pye SR, O’Neill TW, Macfarlane GJ, Tajar A, Bartfai G, Boonen S, Bouillon R, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Pendleton N, Punab M, Silman AJ, Vanderschueren D, Wu FC; EMAS Group. Musculoskeletal pain is associated with very low levels of vitamin D in men: results from the European Male Ageing Study. Ann Rheum Dis. 2010 Aug;69(8):1448-52.
- Heidari B, Shirvani JS, Firouzjahi A, Heidari P, Hajian-Tilaki KO. Association between nonspecific skeletal pain and vitamin D deficiency. Int J Rheum Dis. 2010 Oct;13(4):340-6.
- Badsha H, Daher M, Ooi Kong K. Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. Clin Rheumatol. 2009 Aug;28(8):971-3.
- Block SR. Vitamin D deficiency is not associated with nonspecific musculoskeletal pain syndromes including fibromyalgia. Mayo Clin Proc. 2004 Dec;79(12):1585-6; author reply 1586-7.
- Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003 Dec;78(12):1463-70.
- Warner AE, Arnspiger SA. Diffuse musculoskeletal pain is not associated with low vitamin D levels or improved by treatment with vitamin D. J Clin Rheumatol. 2008 Feb;14(1):12-6.
- Clauw DJ. Fibromyalgia and related conditions. Mayo Clin Proc. 2015 May;90(5):680-92.
- Bennett M, Heard R. Hyperbaric oxygen therapy for multiple sclerosis. CNS Neurosci Ther. 2010 Apr;16(2):115-24.