Headaches (chronic tension) 3X more likely to have low vitamin D – also muscle weakness and bone tenderness

Vitamin D Deficiency in Patients With Chronic Tension-Type Headache: A Case-Control Study

Headache: Journal of Head and Face Pain, First published: 3 May 2017, DOI: 10.1111/head.13096

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Sanjay Prakash DM (Neurology), drprakashs@yahoo.co.in, Chaturbhuj Rathore DM (Neurology),

Prayag Makwana DM (Neurology), Ankit Dave DM (Neurology),

Hemant Joshi DM (Neurology),Haresh Parekh DM (Neurology)

Objective: To see the interrelation between chronic tension-type headache (CTTH) and serum vitamin D levels.

Background: Several studies have suggested an association between chronic pain and vitamin D deficiency. Anecdotal evidence suggests that vitamin D deficiency may be associated with tension-type headache and migraine.

Methods: This case-control study was carried out to examine the association between CTTH and serum 25-hydroxy vitamin (25(OH) D) levels. One hundred consecutive adult (>18 years) patients with CTTH and 100 matched healthy controls were enrolled.

Results: The serum 25(OH) D levels were significantly lower in CTTH patients than in the controls ( 14.7 vs 27.4 ng/mL ).

The prevalence of vitamin D deficiency (serum 25 (OH) D < 20 ng/mL) was greater in patients with CTTH (71% vs 25%). [ 2.8 X ]

CTTH patients had a significantly high prevalence of

• musculoskeletal pain (79% vs 57%),

• muscle weakness (29% vs 10%), [ 2.9 X ]

• muscle tenderness score (7.5 vs 1.9), and [ 3.9 X ]

• bone tenderness score (3.0 vs 0.8) in comparison to controls. [ 3.8 X ]

CTTH patients with vitamin D deficient group (<20 ng/mL) had a higher prevalence of

• musculoskeletal pain (58% vs 31%),

• muscle weakness (38% vs 7%), [ 5.4 X ]

• muscle and bone tenderness score,

• associated fatigue (44% vs 17%) and

• more prolonged course (15.5 months vs 11.2 months).

A strong positive correlation was noted between serum vitamin D levels and total muscle tenderness score (R2 = 0. 7365) and total bone tenderness score (R2 = 0. 6293).

Conclusion: Decreased serum 25(OHD) concentration was associated with CTTH. Intervention studies are required to find out if supplementation of vitamin D is effective in patients with CTTH.

Review of Study in Neurology Today - Sept 2017

“Ultimately we're going to need a large-scale vitamin D intervention study to look for outcomes.”