It's been common knowledge for quite some time that vitamin D helps to build strong bones. But, research in recent years has shown that low levels of vitamin D is associated with fibromyalgia pain, musculoskeletal and bone pain, and other chronic pain conditions. Studies also suggest that the "sunshine vitamin" may relieve other autoimmune conditions such as rheumatoid arthritis.

Last November research from the Mayo Clinic identified a link between inadequate vitamin D levels and the amount of narcotic medication patients take to control chronic pain. In most cases people with chronic pain, including fibromyalgia pain, take narcotic-type drugs such as morphine, fentanyl or oxycodone. The role vitamin D plays in the pain-causing conditions suggests a possible natural or alternative treatment to relieve fibromyalgia.

In the study, which was published in the journal Pain Medicine, researchers found that patients who required narcotic pain medication, and who also had inadequate levels of vitamin D, were taking nearly twice as much of the pain medication as those who had adequate levels of vitamin D. These patients also reported they had worse physical functioning and viewed their overall health as worse than patients with adequate levels of the nutrient.

"This is an important finding as we continue to investigate the causes of chronic pain," says Michael Turner, M.D., a physical medicine and rehabilitation physician at Mayo Clinic and lead author of the study. "Vitamin D is known to promote both bone and muscle strength. Conversely, deficiency is an under-recognized source of diffuse pain and impaired neuromuscular functioning. By recognizing it, physicians can significantly improve their patients' pain, function and quality of life."

Also, there was a connection between increasing body mass index (or BMI, a measure of obesity) and decreasing levels of vitamin D. Studies have found that people who are obese are more likely to experience worse pain, or pain in multiple locations.

"Physicians who care for patients with chronic, diffuse pain that seems musculoskeletal - and involves many areas of tenderness to palpation - should strongly consider checking a vitamin D level," he says. "For example, many patients who have been labeled with fibromyalgia are, in fact, suffering from symptomatic vitamin D inadequacy. Vigilance is especially required when risk factors are present such as obesity, darker pigmented skin or limited exposure to sunlight."

While the study is positive news as the health community and patients struggle to find more effective treatments and a cure for fibromyalgia, it doesn't suggest that vitamin D deficiency is the main cause of fibromyalgia - it's just one contributing cause among others that the U.S. Department of Health and Human Services have identified, including genetics, an infection, or repetitive injuries to the body.

Dr. Turner recommends that if you suffer from chronic pain (such as fibromyalgia pain) that requires narcotic medication, you should have a simple, and inexpensive blood test done to check your levels of vitamin D, especially if you're overweight, housebound, or have darker pigmentation.

How Much Vitamin D Do You Need to Control Fibromyalgia Pain

To help relieve fibromyalgia, try to spend 15 minutes in the sun before noon or after 2 p.m. (if you're darker you may want to spend up to 30 minutes). Plus you can get vitamin D from food sources such as cod liver oil, salmon, mackerel, and fortified milk and cereals.

The Office of Dietary Supplements (ODS) advises that adequate intake levels of vitamin D for adults are between 200 and 600 IU (international units) per day. However, the tolerable upper level intake is 2000 IU daily. Although some research suggests that most people could take as much as 10,000 IU daily with little harm, the ODS states that there is not enough evidence to support this.

Taking long-term high doses of vitamin D for fibromyalgia could lead to vitamin D toxicity and symptoms such as nausea, vomiting, constipation and weakness. You could also develop kidney stones or calcium buildup in your blood, which could cause a heart arrhythmia and mental problems.

Also, vitamin D supplements can interact with certain medications such as some epileptic medications, weight loss drugs such as Orlistat®, and steroids.

Sources: Mayo Clinic press release; Department of Health and Human Services website; National Institute of Health; Office of Dietary Supplements


Journal: Pain Medicine, 9(8):979-84

Date: November 2008

Study: Prevalence and clinical correlates of vitamin D inadequacy among patients with chronic pain.


Authors:    Turner MK, Hooten WM, Schmidt JE, Kerkvliet JL, Townsend CO, Bruce BK.