BMJ Support Palliat Care doi:10.1136/bmjspcare-2015-000921
Linda Björkhem-Bergman1,2 and Peter Bergman2
1Department of Palliative Home Care and Hospice Ward, ASIH Stockholm Södra, Älvsjö, Sweden
2Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
Correspondence to: Dr Linda Björkhem-Bergman, Department of Palliative Medicine and Advanced Medical Home Care, ASIH Långbro Park, Bergtallsvägen 12, Älvsjö 12559, Sweden; linda.bjorkhem-bergman at ki.se
- Pain reduced when enough vitamin D was given – review March 2015
- Does vitamin D treat pain – still not absolutely, positively sure – meta-analysis April 2015
- Overview Pain and Vitamin D
- Palliative cancer benefit of 4,000 IU of Vitamin D – less opioids, infection, and CRP – Aug 2017
- Opioid use in palliative cancer patients far less if high level of vitamin D – May 2015
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Vitamin D is a hormone that is synthesised in the skin in the presence of sunlight. Sufficient vitamin D levels are important—not only for a healthy skeleton—but also for a healthy immune system. Many patients with cancer have insufficient vitamin D levels, and low vitamin D levels are associated with increased ‘all-cause mortality’ and especially mortality due to cancer. Low vitamin D levels have also been associated with increased risk of infections, increased pain, depressive disorders and impaired quality of life. We review the role of vitamin D in the immune system, in relation to cancer disease, pain and depression. We have recently performed an observational study in 100 patients with palliative cancer in Sweden.
The main result was that low vitamin D levels were associated with higher opioid dose, that is, more pain.
We also describe a case report where vitamin D supplementation resulted in radically decreased opioid dose, less pain and better well-being.
Vitamin D supplementation is not connected with any adverse side effects and is easy to administrate. Thus, we hypothesise that vitamin D-supplementation to patients with palliative cancer might be beneficial and could improve their well-being, decrease pain and reduce susceptibility to infections. However, more clinical studies in this field are needed before firm conclusions can be drawn.