Vitamin D status in patients with musculoskeletal pain, fatigue and headache: A cross-sectional descriptive study in a multi-ethnic general practice in Norway.
Scand J Prim Health Care. 2010 Jul 20.
Knutsen KV, Brekke M, Gjelstad S, Lagerløv P.
Department of General Practice and Community Medicine, Institute of Health and Society, University of Oslo, Norway.
Objective. To investigate vitamin D levels in patients with non-specific musculoskeletal pain, headache, and fatigue.
Design. A cross-sectional descriptive study. Setting. A health center in Oslo, Norway, with a multi-ethnic population.
Subjects. A total of 572 patients referred by a general practitioner (GP) for an examination of hypovitaminosis D who reported musculoskeletal pain, headache, or fatigue. The patients' native countries were: Norway (n = 249), Europe, America, and South-East Asia (n = 83), and the Middle East, Africa, and South Asia (n = 240). Both genders and all ages were included. Main outcome measures. Vitamin D levels (25-hydroxyvitamin D) in nmol/L.
Results. Hypovitaminosis D (25-hydroxyvitamin D < 50 nmol/L) was found in 58% of patients.
One-third of ethnic Norwegians had hypovitaminosis D, while 83% of patients from the Middle East, Africa, and South Asia had hypovitaminosis D with minimal seasonal variation of levels.
One in two women from these countries had a vitamin D level below 25 nmol/L.
Mean vitamin D level was lower in patients with headaches compared with patients with other symptoms.
Some 15% of patients with low (< 50 nmol/L) vitamin D levels reported headaches, compared with 5% of those with normal vitamin D levels.
Conclusion. Our study shows a high prevalence of hypovitaminosis D in patients with non-specific musculoskeletal pain, headache, or fatigue for whom the GP had suspected a low vitamin D level. Hypovitaminosis D was not restricted to immigrant patients. These results indicate that GPs should maintain awareness of hypovitaminosis D and refer patients who report headaches, fatigue, and musculoskeletal pain with minimal sun exposure and a low dietary vitamin D intake for assessment. PMID: 20642395
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