Chronic pain is a widespread health issue affecting millions of people worldwide. While various treatments and interventions exist, emerging research has shed light on the potential connection between vitamin D and chronic pain. In this article, we will explore the role of vitamin D in managing chronic pain and its implications for individuals experiencing long-term pain conditions.
Does it mean that low vitamin d is causing the chronic pain?
No, not really. the most probable explanation is it is that, it’s just a coincidence. in canada we have very low exposure to natural sunlight, and when it’s summer we apply sunscreen, or we prefer to stay in the shade. also the sun rays that come to canada are not the same as those that go to the equator. a person with light skin color needs only 13 minutes of sun exposure around noon, three times a week to make enough vitamin d during the summer months.
people of darker skin color, they have a natural sunscreen called melanin that prevents them from getting sunburned, but also from making vitamin D because melanin blocks the ultraviolet b rays in penetrating the skin.
Vitamin d is a pro-hormone, it’s made in our body when cholesterol is exposed to ultraviolet b sunlight in the skin. then it is transformed to 25 hydroxy vitamin d in the liver, and then it’s transformed to 1,25 di-hydroxy vitamin d or calcitriol, which is the active form of vitamin D.
Calcitriol is important for a variety of functions in our body for example: the absorption of calcium from our guts, then depositing this calcium in our bones, which is important for developing strong bones and preventing osteoporosis. for muscle strength which is important for balance, to reduce falls, and to reduce muscle pain. also for the immune system which is important to fight cancer and infections, and also vitamin d is important for depression, it’s implicated people who have low levels of vitamin d their mood is more depressed.
So you may be asking if people with chronic pain have low vitamin d levels then giving them vitamin D improves the pain?
That would be wonderful but it’s not easy like that. vitamin d is not an analgesic which means it’s not supposed to reduce pain, there are many conflicting studies in this area. some show that if you give vitamin d to people who are deficient or severely deficient in vitamin d, there will be a reduction in pain intensity but there are other studies that did not show any reduction in pain.
However, the consequences of prolonged periods of vitamin d insufficiency or deficiency may cause problems that could lead to chronic pain, for example osteoporosis, fracture, poor balance, muscle weakness, insomnia, recurrent infections, cancer, and depression. so for this reason i recommend all of my patients to take vitamin D.
Where we can get vitamin D?
1. The natural source is the sun. only 10 to 15 minutes a day during the summer would be enough. but who has the time in discipline to do that. it’s interesting that when we make vitamin D in this way we’ll never produce more than what we can handle. it will always be the right amount.
2. Vitamin D is found naturally in some food like fish: salmon, sardines, herring, mackerel, trout, and tuna. also in cod liver and egg yolk.
3. Many foods are fortified with vitamin D. In canada vitamin d fortification is mandated for margarine, infant formula, cow’s milk, and substitutes, egg products, food for use on a variety of low energy diets, meals replacements, and nutritional supplements.
4. Source of vitamin d is from supplements and there are mainly two types of supplements of vitamin d. d2 or ergo calciferol and d3 cholecalciferol. vitamin d2 is made from plants and d3 is made from animals. most fortified foods use vitamin d2 because it’s much cheaper than vitamin d3. however our body uses vitamin d3 better than d2.
What are the recommended daily doses of vitamin d supplementation?
for children from age 4 to 18 years of age it’s 600 international units per day. for adults between 19 and 50 years of age is 400 to 1000 international units per day. and people above 50 years of age is between 800 and 2000 international units per day. when the blood levels are above 250 nanomoles per liter this may indicate that the person is taking too much supplements. the maximum daily dose that is safe is 4,000 international units per day. more than this there is the risk of vitamin d toxicity.
Vitamin D Toxicity
In acute cases hypercalcemia occurs which is too much calcium in the blood. and the symptoms include :
- Muscle weakness
- Nausea, Vomiting
- Bone pain
Chronic: All of the above plus
- Abdominal cramps
- Kidney stones
- Kidney failure
- Cardiac arrhythmias
I’ve seen some research studies where they give high dose of vitamin d at once. like for example 100,000 in a single dose, in a bolus, and although that sounds like a good idea, it’s funny that the majority of the studies that do this they do not show a benefit of vitamin d to improve the immune response, for example to prevent infections or to reduce cancer.
Perhaps a bolus of a high dose of vitamin d is enough to help to put calcium in the bones, but if someone wants to have all the benefits of vitamin d including the immune system, regulated mood, strong muscles, and bones, the best method is to take daily supplements. this resembles more what is like to make natural vitamin d from sunlight exposure.
Please remember that: this article is not intended to offer medical advice. if you think you have problems with vitamin d please consult your pharmacist or physician to get a proper diagnosis and treatment plan for you.