Fatigue reduced by Vitamin D (Cancer, muscle, MS, age, etc) - many studies

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Highlighed studies in VitaminDWiki

Cancer

• Less fatigue if more vitamin D (90 percent of palliative cancer were deficient) – Aug 2015
• Palliative care is helped by Vitamin D - many studies
• Fatigued seniors have lower levels of Vitamin D – Oct 2019
• Chemotherapy drugs often reduce Vitamin D levels, restoring levels helps– Aug 2018
• Even after a Cancer diagnosis Vitamin D improves survival – meta-analysis Aug 2022
• Metastatic Cancer probably reduced by vitamin D - many studies
• Cancer and Vitamin D - many studies

Other

• Fibromyalgia pain, fatigue, etc. reduced by 50,000 IU of Vitamin D for 12 weeks – Sept 2023
• Multiple Sclerosis fatigue reduced by weekly Vitamin D (50,000 IU) – June 2023
• Overview Fibromyalgia or Chronic Fatigue and vitamin D
• Muscle fatigue reduced with 10,000 IU of vitamin D – March 2013

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How to reduce cancer-related fatigue? (the spark that ignited this page) - Nov 2023

Did not even mention Vitamin D - Nov 2023
How can we improve our approach to cancer-related fatigue? MD Edge

• "Cancer-related fatigue is said to affect
  • 40% of patients at the time of cancer diagnosis,
  • 65% of patients during active or maintenance treatment,
  • 21%-52% of patients in the 5 years following cancer diagnosis, and even
  • one quarter of patients who are between 5 and 30 years post diagnosis,"
• cancer-related fatigue is “a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.”

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90% of advanced Cancer patients have fatigue and low level of Vitamin D - 2015

Vitamin D deficiency and its association with fatigue and quality of life in advanced cancer patients under palliative care: A cross-sectional study
Palliative Medicine Volume 30, Issue 1 https://doi.org/10.1177/0269216315601954
Montserrat Martínez-Alonso montserrat.martinez at cmb.udl.cat, Adriana Dusso,

Background:
A normal vitamin D status is required for bones and muscles to maintain their function and structure, but it also contributes to the functional integrity of other multiple physiologic systems in the body.

Aim: To assess the relationship of Vitamin D deficiency with health-related quality-of-life issues, fatigue, and physical functioning in advanced cancer patients.

Design: This is a cross-sectional study.

Patients/settings: Adults under palliative care, having a locally advanced or metastatic or inoperable solid cancer.

Results:
Among 30 patients in palliative care with advanced solid cancer, 90% were vitamin D deficient. Serum Vitamin D concentration was positively correlated with patient-reported absence of fatigue (s = 0.49), and physical and functional well-being (s = 0.44 and s = 0.41, respectively, p < 0.01). Fatigue was the symptom with the highest median impact on their lives and was the only one associated with serum vitamin D (p = 0.031), with lower fatigue in patients with vitamin D concentrations in the third tertile. There was no evidence of a direct association between health-related quality of life and vitamin D status.

Conclusion:
The 90% frequency of advanced cancer patients with vitamin D deficiency, together with the positive correlation of vitamin D status with the absence of fatigue and improved physical and functional well-being, points to vitamin D supplementation as a potential therapy to enhance the patient’s quality of life.
 Download the PDF from Sci-Hub via VitaminDWiki

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Less fatigue in Colorectal Cancer Survivors who had higher Vitamin D levels - 2020

Higher Serum Vitamin D Concentrations Are Longitudinally Associated with Better Global Quality of Life and Less Fatigue in Colorectal Cancer Survivors up to 2 Years after Treatment
Cancer Epidemiol Biomarkers Prev (2020) 29 (6): 1135–1144. https://doi.org/10.1158/1055-9965.EPI-19-1522
Janna L. Koole ; Martijn J.L. Bours; Eline H. van Roekel; José J.L. Breedveld-Peters; Fränzel J.B. van Duijnhoven ; Jody van den Ouweland; Stéphanie O. Breukink; Maryska L.G. Janssen-Heijnen; Eric T.P. Keulen ; Matty P. Weijenberg

Background:
Vitamin D status may be an important determinant of health-related quality of life of colorectal cancer survivors. The current study investigated longitudinal associations between serum 25-hydroxyvitamin D3 (25OHD3) concentrations and quality of life in stage I–III colorectal cancer survivors up to 2 years after treatment.

Methods:
Patients with colorectal cancer (n = 261) were included upon diagnosis. Home visits (including blood sampling) were performed at diagnosis and at 6 weeks, 6 months, 1 year, and 2 years after treatment. Serum 25OHD3 concentrations were measured using LC/MS-MS and adjusted for season. Validated questionnaires were used to assess global quality of life and cognitive functioning (EORTC-QLQ-C30), fatigue (EORTC-QLQ-C30 and Checklist Individual Strength, CIS), and depression and anxiety (Hospital Anxiety and Depression Scale). Statistical analyses were performed using linear mixed models and adjusted for sex, age, time since diagnosis, therapy, comorbidities, physical activity, and body mass index.

Results:
At diagnosis, 45% of patients were vitamin D deficient (<50 nmol/L). After treatment, 25OHD3 concentrations increased on average with 3.1 nmol/L every 6 months. In confounder-adjusted models, 20 nmol/L increments in 25OHD3 were longitudinally associated with increased global quality of life [β 2.9; 95% confidence interval (CI), 1.5–4.3] and reduced fatigue (EORTC-QLQ-C30 subscale: β −3.5; 95% CI, −5.3 to −1.8 and CIS: β −2.8; 95% CI, −4.7 to −0.9). Observed associations were present both within and between individuals over time.

Conclusions:
Higher concentrations of 25OHD3 were longitudinally associated with better global quality of life and less fatigue in colorectal cancer survivors.

Impact:
This study suggests that higher 25OHD3 concentrations may be beneficial for colorectal cancer survivors. Future intervention studies are needed to corroborate these findings.
 Download the PDF from VitaminDWiki

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Decrease in Serum Vitamin D Level of Older Patients with Fatigue - Oct 2019

Nutrients Volume 11 Issue 10 10.3390/nu11102531
by Manuela Pennisi 1,Giulia Malaguarnera 1,2ORCID,Giuseppe Di Bartolo 2,Giuseppe Lanza 3,4ORCID,Rita Bella 5ORCID,Eleonora Margherita Chisari 6,Omar Cauli 7ORCID,Enzo Vicari 8 andMichele Malaguarnera 2,7,*ORCID

Fatigue is characterized by reduced energy level, decreased muscle strength, and a variable degree of cognitive impairment. Recent evidences seem to link vitamin D deficiency to fatigue. The aim of this study was to assess and compare vitamin D status in a cohort of older subjects with and without fatigue. We recruited a total of 480 subjects, 240 patients with fatigue and 240 controls without fatigue, from the Cannizzaro Hospital of Catania (Italy). Fatigue severity was measured by the fatigue severity scale, whereas mental and physical fatigue were measured through the Wessely and Powell fatigue scale, respectively. We also measured several blood parameters and 25-OH vitamin D. Subjects with fatigue showed lower levels of vitamin D as compared with those without fatigue. Blood levels of parameters related to fatigue were normal in both groups of subjects, however, platelet, hemoglobin, hematocrit (p < 0.05), mean corpuscular volume, C-reactive protein (CRP), iron, vitamin B12, and folic acid (p < 0.001) were significantly higher in the fatigue group with respect to the control group. Moreover, compared to controls, patients showed higher scores in the physical (p < 0.001), mental (p < 0.001), and severity (p < 0.001) fatigue scales. Finally, vitamin D inversely correlated with fatigue severity (r = −0.428, p < 0.01), whereas creatine kinase and CRP levels did not correlate with vitamin D. In conclusion, our data showed a direct link between vitamin D and fatigue in older subjects, suggesting translational implications in the diagnosis and management of these patients.
 Download the PDF from VitaminDWiki

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Fatigue decreased somewhat after a single 100,000 IU dose of Vitamin D - RCT Dec 2016

__Effect of vitamin D3 on self-perceived fatigue - A double-blind randomized placebo-controlled trial
Medicine (Baltimore). 2016 Dec; 95(52): e5353. doi: 10.1097/MD.0000000000005353__
Albina Nowak, MD,a,∗ Lukas Boesch, MD,a Erik Andres, MD,a Edouard Battegay, PhD,a Thorsten Hornemann, PhD,b Christoph Schmid, PhD,c Heike A. Bischoff-Ferrari, PhD,d Paolo M. Suter, PhD,a and Pierre-Alexandre Krayenbuehl, MDa,e

Background: Vitamin D deficiency is frequent and has been associated with fatigue in uncontrolled trials.

Methods:
This is the first double-blind placebo-controlled clinical trial to investigate the efficacy of per os vitamin D3 (cholecalciferol) in treating fatigue among otherwise healthy persons with low serum 25-hydroxyvitamin D (25(OH)D) levels. We enrolled 120 individuals (mean age 29 ± 6 years, 53% women) presenting with fatigue and vitamin D deficiency (serum 25(OH)D < 20 μg/L). Participants were randomized to a single oral dose of 100,000 units of vitamin D or placebo. The primary endpoint was intra-individual change in the fatigue assessment scale (FAS) at 4 weeks after treatment.

Result:
The mean age of the participants was 29 ± 6 years, 53% were women. Mean FAS decreased significantly more in the vitamin D group (−3.3 ± 5.3; 95% confidence interval [CI] for change −14.1 to 4.1) compared with placebo (−0.8 ± 5.3; 95% CI for change −9.0 to 8.7); (P = 0.01). Amelioration of fatigue was reported more frequently in vitamin D than in placebo group (42 [72%] vs. 31 [50%]; P = 0.01; odds ratio [OR] 2.63, 95% CI for OR 1.23–5.62). Among all participants, improvement in fatigue score correlated with the rise in 25(OH)D level (R = −0.22, P = 0.02).

Conclusion:
Vitamin D treatment significantly improved fatigue in otherwise healthy persons with vitamin D deficiency.
 Download the PDF from VitaminDWiki

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Correction of Low Vitamin D Improves Fatigue: Effect of Correction of Low Vitamin D in Fatigue Study (EViDiF Study)

N Am J Med Sci. 2014 Aug; 6(8): 396–402. doi: 10.4103/1947-2714.139291
Satyajeet Roy, Anthony Sherman, Mary Joan Monari-Sparks, Olga Schweiker, and Krystal Hunter1

Background:
Fatigue is a common presenting complaint of patients in the primary care offices. Low levels of vitamin D have been associated with fatigue in cancer patients. Normalization of vitamin D level improves their fatigue. Whether low vitamin D plays a role in fatigue in medically stable patients is not known.

Aims:
This prospective non-randomized therapeutic study observed the prevalence of low vitamin D in fatigue and the effect of normalization of vitamin D on fatigue.

Material and Methods:
One hundred and seventy four adult patients, who presented in our primary care office with fatigue and stable chronic medical conditions,completed fatigue assessment questionnaires. Patients with low vitamin D levels received ergocalciferol therapy for 5 weeks. Scores of pre- and post-treatment fatigue assessment questionnaires were compared.

Results:
Prevalence of low vitamin D was 77.2% in patients who presented with fatigue. After normalization of vitamin D levels fatigue symptom scores improved significantly (P < 0.001) in all five subscale categories of fatigue assessment questionnaires.

Conclusion:
The prevalence of low vitamin D is high in patients who present with fatigue and stable chronic medical conditions, if any. Normalization of vitamin D levels with ergocalciferol therapy significantly improves the severity of their fatigue symptoms.
 Download the PDF from VitaminDWiki

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A meer 4,000 IU Vitamin D daily reduced opiod for Palliative Cancer - RCT 2021

‘Palliative-D’—Vitamin D Supplementation to Palliative Cancer Patients: A Double Blind, Randomized Placebo-Controlled Multicenter Trial - July 2021
Cancers 2021, 13(15), 3707; https://doi.org/10.3390/cancers13153707
by Maria Helde Frankling 1,2ORCID,Caritha Klasson 1,2,3ORCID,Carina Sandberg 3,Marie Nordström 3,Anna Warnqvist 4,Jenny Bergqvist 5,6,Peter Bergman 7,8ORCID andLinda Björkhem-Bergman 1,2,3,*ORCID

Simple Summary
In this study, the effect of vitamin D supplementation on pain, infections, fatigue and quality of life in patients with advanced cancer with verified vitamin D deficiency was studied. To this end, a randomized controlled trial, ‘Palliative-D’, was conducted, comparing the effect of 4000 IU vitamin D3/day for 12 weeks to placebo in cancer patients admitted to palliative care. Pain was assessed as change in opioid dose and infections measured as days on antibiotics. Vitamin D-supplemented patients increased their opioid doses at a significantly slower rate than patients receiving placebo, i.e., 0.56 µg less fentanyl/h per week with vitamin D treatment. Vitamin D reduced self-assessed fatigue but did not affect antibiotic use or self-assessed Quality of life. The treatment was safe and well-tolerated. In conclusion, correction of vitamin D deficiency may have positive effects on pain and fatigue in palliative cancer patients.

Abstract
The aim of the ‘Palliative-D’ study was to test the hypothesis that correction of vitamin D deficiency reduces opioid use in cancer patients admitted to palliative care. A multicenter randomized, placebo-controlled, double-blind trial in three home-based palliative care facilities in Sweden was performed. Patients with advanced cancer and 25-hydroxyvitamin D < 50 nmol/L were randomized to vitamin D3 4000 IU/day or placebo for 12 weeks. The primary endpoint was the difference of long-acting opioid use (fentanyl ug/h) between the groups during 12 weeks, based on four time points. Secondary outcomes included changes in antibiotic use, fatigue and Quality of Life (QoL). A total of 244 patients were randomized, and 150 patients completed the 12 weeks. The major reason for drop-out was death due to cancer. The vitamin D-group had a significantly smaller increase of opioid doses compared to the placebo-group; beta coefficient −0.56 (p = 0.03), i.e., 0.56 µg less fentanyl/h per week with vitamin D treatment. Vitamin D-reduced fatigue assessed with ESAS was −1.1 points after 12 weeks (p < 0.01). Antibiotic use or QoL did not differ significantly between the groups. The treatment was safe and well-tolerated. In conclusion, correction of vitamin D deficiency may have positive effects on opioid use and fatigue in palliative cancer patients, but only in those with a survival time more than 12 weeks.
 Download the PDF from VitaminDWiki

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The Effect of Vitamin D Supplementation on Treatment-Induced Pain in Cancer Patients: A Systematic Review - Aug 2022

Pain Management Nursing Volume 23, Issue 4, August 2022, Pages 458-466 https://doi.org/10.1016/j.pmn.2022.02.001
Mitra Zarrati PhD ⁎ † 1, Mohammad Hassan Sohouli PhD ‡ 1, Sahar Aleayyub MSc ⁎, Naeemeh Keshavarz PhD §, Elham Razmpoosh PhD ‖, Mihnea-Alexandru Găman MD ¶ #, Somaye Fatahi PhD ⁎, Heshmatolah Heydari PhD †† ‡‡

Objectives
Despite the widespread use of complementary and alternative medicine by patients and physicians alike, there is no accurate evidence regarding the effects of vitamin D supplementation on treatment-induced pain in cancer patients. Thus, the aim of this systematic review of randomized controlled trials (RCTs) was to evaluate the impact of vitamin D administration on therapy-related pain in subjects diagnosed with malignant disorders.

Review analysis methods
We searched the Web of Science, Scopus, PubMed/Medline, Embase, and Google Scholar databases up to October 2020 to identify published RCTs that investigated the use of vitamin D in the management of treatment-induced pain in individuals with cancer.

Results
Nine RCTs were detected. The median duration of the intervention was of 24 weeks (range 12-52 weeks) and dose of vitamin D employed was 2000-50000 IU of vitamin D3 weekly orally each day. Six RCTs reported a significant reduction in pain, whereas three did not detect a notable decrease of this variable. Of the six studies that reported an alleviation of pain, an RCT which recruited 60 participants and lasted for 24 weeks consisted of supplementation with high doses of vitamin D2 weekly for 8 weeks in women receiving anastrozole as adjuvant therapy, then supplementation with vitamin D2 monthly for 4 months, effectively alleviated the aromatase inhibitor-associated musculoskeletal syndrome (AIMSS). The results of the same RCT also suggested a beneficial effect of vitamin D on musculoskeletal pain.

Conclusions
Our results suggest that the supplementation with high doses of vitamin D in cancer patients with low serum levels of vitamin D, can be effective in reducing treatment-related pain.

Section snippets
Search Strategy
This systematic review was executed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria (Moher et al., 2015). Relevant articles were retrieved from the following electronic databases: PubMed/Medline, Clarivate Analytics Web of Science, Scopus, Cochrane, Embase, and Google Scholar. The literature was systematically searched from the inception of these databases until October 2020 using several Medical Subject Headings (MeSH) terms

Results
From the 2,855 articles detected, a total of 9 RCTs were eligible for inclusion in this systematic review (Amir et al., 2010; Beer et al., 2004; Helde-Frankling et al., 2017; Khan et al., 2012; Khan et al., 2010; Niravath et al., 2019; Rastelli et al., 2011; Shapiro et al., 2016; Van Veldhuizen et al., 2000). A number of 2094 studies was excluded for the following reasons: no data on the levels of pain after treatment were reported, some articles did not evaluate treatment-induced pain in . . . .

Discussion
This is the first systematic review of RCTs to examine the effects of vitamin D supplementation on treatment-induced pain in cancer patients. Unfortunately, we were unable to perform a meta-analysis due to the limited number of interventional studies. . . . .

Our systematic review suggests that vitamin D supplementation in patients diagnosed with a malignancy may exhibit a positive impact on treatment-induced pain and may be able to lower pain especially in individuals with low levels of vitamin D. . . . .

Conclusions
Our results suggest that supplementation with high doses of vitamin D in cancer patients with low serum levels of vitamin D, administered after the initiation of AIs therapy, can be effective in reducing treatment-related pain in individuals diagnosed with a malignancy. Based on our findings, the administration of vitamin D in subjects who do not display vitamin D deficiency at baseline does not alleviate pain in cancer patients. . . . . .
References include

• Switching breast cancer patients with progressive bone metastases to third-generation bisphosphonates: measuring impact using the Functional Assessment of Cancer Therapy-Bone Pain (2009)
• Cost issues related to pain management: Report from the cancer pain panel of the agency for health care policy and research (1994)
• Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review

Journal of Clinical Oncology (2006)

• Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis (2017)
• Vitamin D in pain management (2017)

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33+ VitaminDWiki pages have FATIGUE or CFS in the title

This list is automatically updated

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30+ VitaminDWiki Intervention pages with CANCER in title

This list is automatically updated

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VitaminDWiki – Pain - chronic category contains:

167 items in category Chronic pain

See also

• Overview Pain and Vitamin D
• Percentage of people with pain increased 25 percent in 18 years – Jan 2019
• Pain not reduced by 60,000 IU monthly vitamin D (need 50,000 IU weekly) – RCT Aug 2023
• Overview Fibromyalgia or Chronic Fatigue and vitamin D
• Overview Rheumatoid Arthritis and vitamin D
• Shingles and vitamin D
• Shin splints decrease with vitamin D
• Migraine and Vitamin D
• Headache category 82 items
• "musculoskeletal pain" 490 items as of Aug 2023
• "chronic fatigue" 185 items as of Jan 2017
• Category Back Pain 44 items
• 7 pain studies in VitaminDWiki with KNEE in the title as of Aug 2023 (see below)
• Opioid OR Opiate OR Morphine in the title 10 pages as of June 2021

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