Opioid use in palliative cancer patients far less if high level of vitamin D – May 2015

Low Vitamin D Levels Are Associated with Higher Opioid Dose in Palliative Cancer Patients – Results from an Observational Study in Sweden

PLOS ONE May 27, 2015DOI: 10.1371/journal.pone.0128223
Peter Bergman, Susanne Sperneder, Jonas Höijer, Jenny Bergqvist, Linda Björkhem-Bergman

Background
Vitamin D deficiency is common among palliative cancer patients and has been connected to an increased risk for pain, depressions and infections. Therefore we wanted to test the hypothesis that low 25-hydroxyvitamin D (25OHD) levels are associated with higher opioid dose, higher infectious burden and impaired quality of life in palliative cancer patients. The secondary aim was to investigate the association between 25OHD-levels and survival time.

Method
In this prospective, observational study in palliative cancer-patients (n = 100) we performed univariate and multiple linear regression analysis to assess the association of 25OHD levels with opioid dose, infectious burden (antibiotic consumption), quality of life (Edmonton Symptom Assessment Scale, ESAS) and survival time, controlling for potential confounding factors.

Results
The median 25OHD level was 40 nmol/L (range 8-154 nmol/L). There was a significant association between 25OHD levels and opioid dose, beta coefficient -0.67; p=0.02; i.e. a low 25OHD level was associated with a higher opioid dose. This association remained significant after adjustment for stage of the cancer disease in a multivariate analysis, beta coefficient -0.66; p = 0.04. There was no association between 25OHD levels and antibiotic use or quality of life. Univariate cox regression analysis showed a weak correlation between survival time and 25OHD levels (p<0.05). However, decreased albumin levels and increased CRP levels were superior markers to predict survival time; p<0.001 for both analyses.

Conclusion
Low 25OHD-levels are associated with increased opioid consumption in palliative cancer patients. Future interventional studies are needed to investigate if pain can be reduced by vitamin D supplementation in these patients. In addition, this study confirms previous findings that low albumin and increased CRP levels are useful markers for survival time in palliative cancer patients.

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See also VitaminDWiki

• Does vitamin D treat pain – still not absolutely, positively sure – meta-analysis April 2015
• Reduced palliative cancer pain after Vitamin D supplementation – April 2016
• Pain and Vitamin D - Review April 2015
• Off Topic: 4X increase in Americans taking morphine-type drugs in last decade (consider Vitamin D instead) – Aug 2014
• Pain subjectively and objectively lower in people with higher levels of vitamin D – Aug 2014
• Less fatigue if more vitamin D (90 percent of palliative cancer were deficient) – Aug 2015
• Palliative cancer benefit of 4,000 IU of Vitamin D – less opioids, infection, and CRP – Aug 2017

Pain - chronic category has the following

168 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" 240 items have it in title or abstract as of Dec 2024
• 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 14 pages as of Dec 2024

See also Web

• "more Americans now use prescription opioids than smoke cigarettes" Mercola Jan 2017