From the Guidelines
Vitamin D supplementation is the primary treatment for pain related to low vitamin D levels, with a recommended dose of 50,000 IU given weekly for 12 weeks and monthly thereafter for severe deficiency. The treatment approach for pain related to low vitamin D levels involves addressing the underlying deficiency. According to the guidelines 1, for individuals with severe vitamin D deficiency, treatment can be given using ergocalciferol, 50,000 IU given weekly for 12 weeks and monthly thereafter. Key considerations for treatment include:
- Determining the severity of the deficiency to guide dosing
- Using ergocalciferol as the safer vitamin D sterol
- Avoiding the use of calcitriol or another 1-hydroxy-lated vitamin D sterol for treating vitamin D deficiency
- Monitoring vitamin D levels regularly to adjust dosing and prevent toxicity Pain relief from vitamin D supplementation typically begins within a few weeks to months of starting treatment, as it helps regulate calcium absorption and bone metabolism, reducing inflammation that contributes to musculoskeletal pain. Regular monitoring of vitamin D levels every few months is crucial to ensure levels reach the optimal range without causing toxicity, with the recommended upper limit of vitamin D being 2,000 IU/day according to the Food and Nutrition Board, National Research Council, National Academy of Sciences 1.
From the Research
Treatment for Pain Related to Low Vitamin D Levels
- The treatment for pain related to low vitamin D levels typically involves vitamin D supplementation, as studies have shown that it can be beneficial in reducing pain in patients with deficient levels of vitamin D 2, 3.
- The optimal level of 25-hydroxyvitamin D (25-OHD) for pain management is not well established, but it is suggested that patients with levels <30 nmol/L are most likely to benefit from supplementation 2.
- Vitamin D supplementation has been shown to have anti-inflammatory effects, which may contribute to its pain-reducing properties 2.
- The dosage of vitamin D supplementation can vary, but studies have used doses ranging from 800-5000 IU/day, with some studies suggesting that a cumulative dose of at least 600,000 IU may be necessary to replenish vitamin D stores 4.
Conditions that May Benefit from Vitamin D Supplementation
- Chronic widespread pain: studies have shown that patients with chronic widespread pain have lower levels of 25-OHD compared to controls 5.
- Muscular pain: vitamin D supplementation has been shown to be beneficial in reducing muscular pain in patients with deficient levels of vitamin D 2, 5.
- Arthritis: studies have shown that patients with arthritis have lower levels of 25-OHD compared to controls, and that vitamin D supplementation may be beneficial in reducing pain and inflammation 5.
Important Considerations
- Vitamin D supplementation should only be considered for patients with documented vitamin D deficiency, as excessive supplementation can be harmful 4, 6.
- The decision to supplement with vitamin D should be made on an individual basis, taking into account the patient's overall health and medical history 4, 6.