Shortage of seafood-and-sunshine vitamin revealed as unrecognized source of pain and impaired function
by Craig Weatherby
Researchers at the Mayo Clinic reported today that vitamin D deficiency is more common among patients with chronic pain.
Significantly, they also found that pain patients who were deficient in vitamin D needed more morphine, for longer periods, than their pain-filled peers.
Fish fit the vitamin D bill; Sockeye Salmon stand out
Certain fish rank among the very few substantial food sources of vitamin D.
Among fish, wild sockeye salmon may be the richest source of all, with a single 3.5 ounce serving surpassing the US RDA of 400 IU by about 70 percent:
Vitamin D per 3.5 ounce serving*
Sockeye salmon—687 IU
Albacore tuna—544 IU
Silver salmon—430 IU
King salmon—236 IU
The doctors determined this by testing pain patients’ blood for vitamin D levels, and comparing the vitamin levels to the patients’ reported pain levels, and the amounts and duration of their morphine prescriptions.
The study involved 267 patients with chronic pain of diverse causes admitted to the Mayo Clinic’s pain rehabilitation center from February 2006 through December 2006 (Hooten WM et al 2007).Among the patients, 26 percent had vitamin D inadequacy and needed almost twice the dose of morphine of the patients with adequate vitamin D levels.
The vitamin D-deficient patients used morphine longer: for 71.1 months on average, compared with only 43.8 months for the patients with more vitamin D in their blood.
The group lacking vitamin D also reported lower levels of physical capacity and feeling sicker, when compared to patients with adequate vitamin D levels.
Low levels of vitamin D are already linked to pain and muscle weakness.
To quote an earlier Mayo Clinic study on the subject, “All patients with persistent, nonspecific musculoskeletal pain are at high risk for the consequences of unrecognized and untreated severe hypovitaminosis D [vitamin D deficiency]. This risk extends to those considered at low risk for vitamin D deficiency…” (Plotnikoff GA, Quigley JM 2003).
In a cruel coincidence, pain caused by vitamin D inadequacy responds poorly to opiates and other analgesics.
To ensure adequate levels of vitamin D, spend 30 minutes a day in the sun, eat fatty seafood, and take supplemental vitamin D-3. This is the form found in fish and created by sun exposure, which is more effective than the plant-source vitamin D2 used in most multivitamin supplements.
Experts recommend consuming 1,000 to 2,000 IU of vitamin D3 per day... well above the 400 IU recommended by the US government.
- Hooten WM, Turner MK, Schmidt JE. Prevalence and Clinical Correlates of Vitamin D Inadequancy among Patients with Chronic Pain. Presentation A1380, October 15, 2007.
- American Society of Anesthesiologists 2007 Annual Meeting, San Francisco. Accessed online October 15, 2007 at http://www.asaabstracts.com/strands/asaabstracts/abstract.htm;jsessionid=1F14D8BCCEB3D704490127B111CC44D0?year=2007&index=3&absnum=1501
- Benson J, Wilson A, Stocks N, Moulding N. Muscle pain as an indicator of vitamin D deficiency in an urban Australian Aboriginal population. Med J Aust. 2006 Jul 17;185(2):76-7.
- de Torrente de la Jara G, Pecoud A, Favrat B. Female asylum seekers with musculoskeletal pain: the importance of diagnosis and treatment of hypovitaminosis D. BMC Fam Pract. 2006 Jan 23;7:4.
- Lewis PJ. Vitamin D deficiency may have role in chronic low back pain. BMJ. 2005 Jul 9;331(7508):109.
- Macfarlane GJ, Palmer B, Roy D, Afzal C, Silman AJ, O'Neill T. An excess of widespread pain among South Asians: are low levels of vitamin D implicated? Ann Rheum Dis. 2005 Aug;64(8):1217-9.
- Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003 Dec;78(12):1463-70.