Vitamin D Supplementation Reduces Chronic Pain and Symptoms

Associated with Fibromyalgia?

Fibromyalgia is a disease state characterized as a long and difficult battle with

mostly chronic-type muscle pain. Current estimations show that fibromyalgia affects

approximately five to ten million people living within the United States. Although this

condition can be associated with chronic pain its effects range from more than just that

and include fatigue, sleep disturbances, brain fog or cognitive impairment, depression,

and painful tender points throughout the body which can be used in diagnosing the

condition. According to Dr. Amy Meyers (functional medicine practitioner) there are ten

root causes she has outlined as reoccurring in the clinical setting but are not limited to;

gluten intolerance, candida overgrowth, thyroid problems, vitamin deficiencies, Small

Intestine Bacterial Overgrowth (SIBO) and Leaky gut, mycotoxins, mercury toxicity,

adrenal fatigue, MTHFR mutations, and Glutathione deficiency[5]. This research will

focus primarily on vitamin deficient patients but will include individuals with all the

previously mentioned root causes. What our providers seem to know is that a common

correlation between deficient or insufficient levels of magnesium, vitamin D, and B-12 is

common in Fibromyalgia patients [5]. What her team tries to encourage is the use of

vitamin supplementation in clinical use. In the past, some cases have shown a reverse in

symptomatic effects of what Fibromyalgia patients have on a daily basis. The purpose of

this research is to provide information pertaining to what micronutrients fibromyalgia

patients are typically deficient on and what are the effects of clinical supplementation on

the human body over extended periods of time.

The methods section of this research will indicate use of tactics to include up to

date clinical methods of treatment, primary research journal articles, multi-cultural

analyses, and double-blind control trials among others in an assortment of different

countries. Some of the databases incorporated into my search terms include the UNF

library database, Pub-med, google scholar, one Fibromyalgia patient interview, and up-

to date clinical practitioners websites and blogs that promote a multi-faceted analysis to

include the most current health models regarding this disease and supplemental effects.

Some of the keyword search phrases include but are not limited to the following;

Fibromyalgia history and diagnosis, Fibromyalgia vitamin deficiency and

supplementation, root causes of Fibromyalgia, vitamin D supplementation in

Fibromyalgia patients, and references produced by Dr. Amy Meyers on her blog.

Over the course of this research some prevalent things have been brought to

light, more specifically the causes for this disease. One thing in particular pertaining to

this research is that it discusses supplementing specific micronutrients in what only a

fraction of Fibromyalgia patients suffer from. Although there are many root causes

previously mentioned these findings pertain to most of them. This is due to many of the

patients suffering repercussions from multiple causes and not one alone. Over the last

few years documentation of deficiency or insufficiency of Magnesium, Vitamin D, and B-

12 appears to be the more commonly diagnosed. Recently, doctors have also claimed

that Magnesium supplementation has in some cases completely reversed the

symptomatic effects of Fibromyalgia by itself.

In an effort to display prior medical history and associate specific characteristics

with respect to fibromyalgia causes I interviewed a young woman by the name of

Jaqueline Pasquale who has suffered for years with the condition. The purpose of the

interview was to gain an understanding of the multiple causes associated with

diagnosing someone and understanding the multidimensional approach to treatment. In

an effort to pinpoint the assumption that this medical condition results from multiple

things and not often one thing in particular I obtained some of her prior medical history at
her approval. After reviewing and speaking to her for over an hour it was discovered that

one of the main contributors to the chronic pain associated with her case of fibromyalgia

was in fact a calcium deficiency (something that runs in her family) in conjunction with

thyroid issues over the course of puberty for her (between 15-18 years old). At over thirty

years old now the pain associated with her Fibromyalgia is at times unbearable and

prevents much sleep resulting in a spinoff of symptomatic effects including other aspects

of more pain. The most intriguing thing of all the prior history of medical information? Her

chronic pain is managed daily to include multiple daily doses of THC extracted and

consumed in a controlled environment to manage the intensity and does almost not

include pain medications referenced as controlled substances or narcotics.

Much of the research of the last decade indicated a strong correlation between

Vitamin D insufficiencies primarily in women due to them dominating the overall

Fibromyalgia diagnosiss. For that reason alone much of the studies and research

include test results in a class dominated by women. In a prospective cohort study

designed for the description of this medical disorder as it pertains to one-hundred

women who completed the study in its entirety, vitamin D levels were monitored weekly

and supplemented. At the beginning of this research blood levels of 25-hydroxyvitamin D

were estimated at the initial visit and the following 4 weeks until its level exceeded 50

ng/mL [1] The patients that showed a vitamin D deficiency were supplemented with

ergocalciferol 50,000 IU once every week until the blood levels in their body exceeded

50 ng/mL of hydroxyvitamin D [1]. A specific questionnaire assessment was used to

monitor and assess fibromyalgia status before, during, and after vitamin repletion. The

ending results were staggering being that out of the 100 women 61 of them were

recorded as having a vitamin D deficiency and of those 61 women studied the author

describes 42 of them as having a significant improvement in health statuspsot

supplementation [1]. They also go on to conclude that in reference to the management of

fibromyalgia vitamin D supplementation has to be considered.

In a study produced by the international Association for the study of pain based

on Fibromyalgia guidelines consistent with the American College of Rheumatologys

criteria, similar results followed from vitamin D supplementation weekly in thirty women

who fully completed the research. The methods of this analysis completed a randomized

control trial that successfully monitored calcifediol levels and its participants who were all

insufficient at less than 32 ng/mL [2]. The goal of this supplementation was to achieve

calcifediol levels in the range of 32 ng/mL to 48 ng/mL over the course of twenty weeks

in the form of oral supplementation of cholecalciferol [2]. The hypothesis in this research

was to evaluate whether the use of supplementation of vitamin D in patients with already

low levels saw an overall reduction in pain and improved well-being. Ultimately, after a

break of twenty-four weeks after the initial twenty weeks of supplementation results were

analyzed to include health surveys and overall health status post treatment [2]. The

results showed a dramatic decrease in pain perception in reference to Fibromyalgia

status for the majority of participants, no exact number was used only reiterating the

positive benefits of supplementation [2]. It also went on to discuss the benefits of

supplementation as opposed to other therapies due to the lower costs and economic

benefits associated this treatment as opposed to others. Larger studies are needed to

prove its benefits but results go on to outline that in patients that suffer from low vitamin

D levels pain management and improvement can occur from this form of treatment.

A more in-depth research and analysis was conducted by the American Society

for Pain Management Nursing that included forty premenopausal women all with

Fibromyalgia and low vitamin D levels in a controlled study with most patients being

close to age forty. The initial evaluation of these subjects was more intense than the
others and included documentation of body mass index, recording of tender points

associated with Fibromyalgia patients, and measured by a visual analog scale [3]. In a

similar assessment used by previous studies serum vitamin D levels were recorded and

marked as insufficient at levels of less than 37.5 nmol/L [3]. This research was more

focused on correlating the vitamin D levels with pain intensity and included two separate

control groups, one with Fibromyalgia and one without to associate the vitamin D levels

in people with similar chronic pain but ultimately different medical classifications and

diagnosis (all of them premenopausal). Of the forty patients associated with this

research it was then determined that roughly seventy percent of them could be classified

as vitamin D deficient in both control groups [3]. It was determined that Fibromyalgia

patients ultimately had higher scores of pain intensity and an increased amount of tender

points throughout their body. Also, results showed a bigger reduction in chronic pain

levels post supplementation associated with the fibromyalgia patients [3]. Results were

also consistent enough to assume there is no correlation between vitamin D deficiency

and Fibromyalgia patients but rather common generally in premenopausal women in

their later thirties and early forties.

Lastly, a diverse and very similar type of research incorporated monitoring and

supplementing deficient patients diets with oral and placebo vitamin D. All research was

conducted over a period of six months with administering and monitoring serum levels

weekly to conclude the most accurate results. Similar to the prior studies mentioned,

seventy-two Fibromyalgia patients participated and were broken into two control groups;

one group received oral vitamin D and one received placebo. The results accumulated

more information and included a Fibromyalgia Impact Questionnaire, Brief Pain

Inventory, Beck Depression Inventory, Visual analogue scale for pain, and a Survey

Short Form assessment [4]. In conclusion with research guidelines a connection was
made that oral vitamin D administered to patients showed a sixty-nine percent patient

improvement compared to thirty-eight percent of the placebo group [4]. The results also

collectively interpreted optimal reductions in pain for both groups of all participants noted

as being insufficient or deficient at the beginning of research. The visual analog scale for

pain noted a dramatic reduction in pain for the oral group specifically and hints at

practicality of supplementation for future cases.

Of all the research methods analyzed they all conclude with similar results and

reference positive implications for future use of oral supplementation. All support its

multiple benefits with all results fluctuating around six months of participation. Like I

initially stated in the beginning vitamin deficiency in Fibromyalgia patients is a fraction of

what all individuals living with this diagnosis face every day. Its root causes fluctuate with

symptoms typically being a multitude of things and constantly make diagnosis and

treatment very difficult not only for the patients but the doctors as well. Much of the data

used in practical application today includes using a multidimensional approach that

includes patient education, behavioral therapies, exercise regiment intervention, pain

management, and chronic relief. The cost reduction in oral supplementation compared to

other forms of pain management supplements are enormously lower and could

hypothetically save patients a great deal of money in the overall picture. More control

trials are still needed however to ultimately be able to specify recommendations based

on criteria and protocol as it relates to medicine and clinical application. We know the

use of supplementation is effective but relating it to an individual patient basis will require

more time and slightly more consistent results.

 References

1. Matthana M. The relation between vitamin D deficiency and fibromyalgia syndrome in

women. Saudi Medical Journal [serial online]. September 2011;32(9):925-929. Available
from: MEDLINE, Ipswich, MA. Accessed March 7, 2017.
2. Wepner F, Scheuer R, Friedrich M, et al. Effects of vitamin D on patients with
fibromyalgia syndrome: A randomized placebo-controlled trial. Pain [serial online].
February 1, 2014;155:261-268. Available from: ScienceDirect, Ipswich, MA. Accessed
March 9, 2017
3. Okumus M, Koybas M, Borman P, et al. Original Article: Fibromyalgia Syndrome: Is It
Related to Vitamin D Deficiency in Premenopausal Female Patients?. Pain Management
Nursing [serial online]. December 1, 2013;14:e156-e163. Available from: ScienceDirect,
Ipswich, MA. Accessed March 10, 2017.
4. Abou-Raya S, Abou-Raya A, Helmii M. Efficacy of Vitamin D Supplementation in the
Treatment of Fibromyalgia:Randomized Control Trial. Annals Of The Rheumatic
Diseases [serial online]. n.d.;73:295. Available from: Science Citation Index, Ipswich,
MA. Accessed March 11, 2017.
5. Meyers, Dr. Amy. "10 Causes Of Fibromyalgia Your Doctor Doesn't Know About".
mindbodygreen. N.p., 2017. Web. 5 Mar. 2017.
6. Pasquale, Jaqueline. Fibromyalgia Background; Patient Medical History And Diagnosis.
2017. in person.