Does vitamin D help with pain relief?
Vitamin D is a fat-soluble vitamin, stored in body cells that may provide pain relief for the following reasons.

Yes, several studies have confirmed that vitamin D may help with pain relief in selected cases.

However, two limitations of these studies include:

  1. Most trials included calcium supplements, so isolating the effects of each nutrient is difficult.
  2. The dosing schedules and population in each study were different.

5 groups of individuals who may derive pain relief with vitamin D supplementation

  1. Those with documented osteoporosis and poor bone health. In this group, low vitamin D levels are linked to increased pain perception and consumption of higher doses of pain-relievers including opioids.
  2. Those with cancer pain and muscular pain but only in individuals who have coexisting low levels of vitamin D.
  3. In overweight or obese and markedly vitamin D–deficient adults, the vitamin D may improve back pain disability.
  4. Those who are diagnosed with chronic fatigue syndrome.
  5. In some cases of chronic nonspecific pain (pain lasting more than three months and not attributable to a specific cause).

How does vitamin D help in pain relief?

The pain-relieving action of vitamin D may be due to the following reasons:

  • Anti-inflammatory action: Vitamin D receptors are present in many cells in the body. Vitamin D acts via these receptors to reduce the release of inflammatory chemicals (prostaglandins and cytokines) in the cells.
  • Role in pain pathways: There are specific cells and receptors in the body via which the pain is perceived. These pathways are controlled by chemicals, such as nerve growth factor, glial-derived neurotrophic factor, and epidermal growth factor receptor. The complex interplay between vitamin D, these chemicals and opioid receptors in the body helps alleviate pain.
  • Muscle fiber repair: Vitamin D is required for the normal development, repair, and growth of muscle fibers. Inadequate vitamin D levels can lead to muscle weakness and pain (myopathy).

What are the recommended amounts of vitamin D?

Though vitamin D can be synthesized in the skin when it is exposed to the sun, the absorption is erratic and depends on factors, such as sunscreen application, melanin content of the skin, and the clothes worn. Hence, food and supplementation remain the best sources to improve your vitamin D levels.

The Recommended Dietary Allowance (RDA) for vitamin D quotes the daily amount needed to maintain bone and muscle health and calcium metabolism in healthy people, assuming minimal sun exposure.

Table 1. RDA for vitamin D according to age
RDA for men, 19 years and older 600 IU daily
RDA for women, 19 years and older 800 IU daily
RDA for children younger than 12 400 IU daily
RDA for children 12 to 24 months 600 IU daily

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Should I take vitamin D2 supplements or vitamin D3?

Both vitamins D2 and D3 are forms of vitamin D that are converted into active forms after sequential activation in the liver and the kidneys.

However, many studies favor vitamin D3 to be more efficacious. If you have documented vitamin D level deficiency, it is better to consume vitamin D3 instead of D2.

The typical dose schedule for both supplements is:

  • 50,000 international units (IU) D2 or D3 orally every week for 6 to 8 weeks, with a maintenance dose of 800 IU daily
  • 1,000 IU of vitamin D3 daily for 6 to 8 weeks

Vitamin D supplementation should be always accompanied by calcium supplementation.

Table 2. Foods that contain vitamin D
Food Vitamin D (IU) per serving
Cod liver oil, 1 tablespoon 1360
Swordfish, cooked, 3 ounces 566
Salmon (sockeye) cooked, 3 ounces 447
Tuna, canned in water, drained, 3 ounces 154
Orange juice fortified with vitamin D, 1 cup 137
Milk, vitamin-fortified, 1 cup 115 and 124
Yogurt, fortified with 20 percent of the daily value of vitamin D, 6 ounces 80
Sardines, canned in oil, drained, 2 sardines 46
Liver, beef, cooked, 3 ounces 42
Egg yolk, 1 large 41
Cereal, fortified with 10 percent of the daily value of vitamin D, 1 cup 40
Cheese, Swiss, 1 ounce 6
Source: Vitamin D. Health Professionals. Dietary Supplement Fact Sheet. National Institutes of Health. Office of Dietary Supplements. August 7, 2019

What are the signs and symptoms of vitamin D deficiency?

In many individuals, vitamin D deficiency may have no symptoms. In others, symptoms, such as bone pain, cramps, joint pains, or frequent muscle aches, may be seen. There may be binge eating tendencies, mood swings, or low moods.

Severe lack of vitamin D in kids presents with rickets, in which the child has muscle weakness, protruding abdomen, and bone deformities.

Severe lack of vitamin D in adults manifests as osteomalacia, and the symptoms are general fatigue, aches, and pains, fractures with minimal exertion, and joint pains.

Can vitamin D be dangerous?

Vitamin D is a fat-soluble vitamin, stored in body cells. The safe upper limit for daily vitamin D supplementation for adults and children aged older than nine years is 4,000 IU. Above these limits, hypervitaminosis D or vitamin D toxicity may be observed.

  • This condition takes several months to develop.
  • The symptoms include nausea and vomiting, weakness, and frequent urination
  • Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones and renal failure.

In a clinical trial, in which women aged 70 years and older took a once-yearly dosage of vitamin D at 500,000 IU for five years, the risk of falls and fractures increased by 15 and 26 percent, respectively, compared to women who received a placebo.

Higher doses of vitamin D suppressed the calcium availability in bones in long run, causing accelerated osteoporosis.

QUESTION

Medically speaking, the term "myalgia" refers to what type of pain? See Answer

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Medically Reviewed on 5/5/2022
References
Image Source: iStock Image

Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci. 2017;18(10):2170. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666851/

Hicks R. Is Vitamin D3 Superior to D2? Medscape. https://www.medscape.com/viewarticle/969165