Vitamin D and Fibromyalgia

Fibromyalgia

Fibromyalgia is a chronic syndrome of body-wide pain. Tender points are the joints, muscles, tendons, and other soft tissues. People with fibromyalgia also have persistent fatigue, memory and mood disorders, and insomnia

Risk factors

The cause of fibromyalgia is unknown. Possible triggers include:

• Physical or emotional trauma
• An abnormal or over-reactive pain response
• An infectious organism, such as a virus

Sunlight exposure and fibromyalgia risk

There is no evidence that risk or symptoms of fibromyalgia are related to sunlight exposure. Some people with fibromyalgia have a vitamin D deficiency. If so, vitamin D from solar ultraviolet-B (UVB) would reduce the symptoms.

Vitamin D and fibromyalgia

Vitamin D levels

Several studies report that people with fibromyalgia have lower vitamin D levels:

• In the United Kingdom, 43% of females with fibromyalgia had very low vitamin D levels compared to 19% without fibromyalgia.
• In Belfast, Northern Ireland, people with fibromyalgia frequently had low vitamin D levels. The study also linked anxiety and depression to low vitamin D levels.

However, other studies have different observations:

• In Israel and Brazil, vitamin D levels did not vary in people with or without fibromyalgia. In the same Brazilian study, there was no connection between vitamin D levels and pain intensity.
• In Turkey, neither vitamin D levels nor bone mineral density varied in people with or without fibromyalgia.

In all of the above studies, vitamin D levels could be the result of disease condition rather than the cause of the disease. Thus, the evidence that vitamin D plays a role in fibromyalgia is weak at best.

How vitamin D works

Some studies have reported that vitamin D may reduce the risk or symptoms of fibromyalgia by lowering inflammation. Vitamin D reduces cytokine production. This protein causes inflammation. However, one study found that fibromyalgia pain was not directly affected by these compounds.

Prevention

There is no evidence that vitamin D reduces the risk of fibromyalgia. However, it may reduce inflammation. Based on studies of other diseases, it might be worthwhile to keep vitamin D blood levels above 30–40 ng/mL (75–100 nmol/L).

Treatment

Vitamin D has been used to treat fibromyalgia in several studies and observations:

• In the United Arab Emirates, people diagnosed with fibromyalgia or muscle pain benefited from vitamin D. However, it was unclear whether those with muscle pain actually had fibromyalgia.
• People in Minnesota with fibromyalgia who initially had low vitamin D levels (10–25 ng/mL [25–63 nmol/L]) participated in a clinical trial. Some people received placebos. Others took 7000 international units (IU)/day of vitamin D3 (cholecalciferol). Vitamin D3 is the type of vitamin D made in the body. After 8 weeks, those receiving placebos showed no improvement. The vitamin D3 group showed significant improvement in fibromyalgia assessment scores. However, they did not show significant improvement in most musculoskeletal symptoms or in activities of daily living. In addition, those with severe vitamin D deficiency had no symptom improvement during the trial nor one year later.
• Diffuse back pain related to vitamin D deficiency is often diagnosed as fibromyalgia. Raising vitamin D blood levels reduces that type of pain.

Vitamin D may reduce fibromyalgia pain. Those with fibromyalgia should consider increasing their vitamin D levels above 30–40 ng/mL (75–100 nmol/L).

Acknowledgements

This evidence summary was written by:

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco,
CA 94164-1603,
USA
www.sunarc.org
[email protected]

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