Fibromyalgia treated with Vitamin D (50,000 IU weekly for 3 months) – 2016, 2017, 2018, 2019

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Nov 2016

Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency
Int J Rheum Dis. 2016 Nov 11. doi: 10.1111/1756-185X.12960. [Epub ahead of print]
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Yilmaz R1, Salli A2, Cingoz HT3, Kucuksen S2, Ugurlu H2.
1Department of Physical Medicine and Rehabilitation, Yoncali Physical Medicine and Rehabilitation Hospital, Kutahya, Turkey.
2Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
3Department of Physical Medicine and Rehabilitation, Seydisehir State Hospital, Konya, Turkey.

AIM:
The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency.

METHOD:
Patients with nonspecific CWP and vitamin D deficiency (25-OH D3 < 25 ng/mL) were included into the study. Replacement treatments of 50 000 IU/week oral vitamin D3 for 3 months were given to the patients. Patients were assessed pre- and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction.

RESULTS:
Fifty-eight patients with a mean age of 36.9 ± 9.2 years were included into the study. 25-OH D3 levels of patients elevated from 10.6 ± 5.1 ng/mL to 46.5 ± 24.0 ng/mL after replacement treatment (P < 0.001).
Marked decrease in

• VAS-pain,
• VAS-asthenia,
• severity of waking unrefreshed, TPC, and BDI

and an evident increase in

• subgroups of SF-36

were established in patients after treatment (P < 0.001).
The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P = 0.013); 85% of patients stated satisfaction with the treatment.

CONCLUSIONS:
Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.

PMID: 27860257 DOI: 10.1111/1756-185X.12960

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June 2017

Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia
Most of the Quality of life parameters were statistically improved by weekly 50,000 IU of vitamin D

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June 2018

Vitamin D Supplementation Seems to Improve Fibromyalgia Symptoms: Preliminary Results
Isr Med Assoc J. 2018 Jun;20(6):379-381.
de Carvalho JF, da Rocha Araújo FAG, da Mota LMA, Aires RB, de Araujo RP.
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BACKGROUND:
Vitamin D deficiency and insufficiency have been reported in fibromyalgia. However, to the best of our knowledge, only one study has evaluated the role of 25-hydroxyvitamin D [25(OH)D] supplementation on fibromyalgia symptoms.

OBJECTIVES: To analyze the effects of 3 months of 25(OH)D supplementation on symptoms of fibromyalgia.

METHODS: This study included 11 female patient. Demographic and clinical data, tender points, visual analog scale results, and pre- and post-serum levels of 25(OH)D supplementation were analyzed. The levels of 25(OH)D were measured by a radioimmunologic test.

RESULTS:
Patients with fibromyalgia diagnosis and 25(OH)D values ≤ 30 ng/ml were recruited to receive 50,000 IU of oral vitamin D once every week for 3 months. The disease was diagnosed based on the American College of Rheumatology criteria. The median age of all patients was 48.5 (28-67) years and 63.4% were Caucasian. Disease duration varied from 1-10 years. The 25(OH)D levels increased significantly after 3 months, 18.4 (15.5-25.8) ng/ml vs. 33.8 (28-58) ng/ml, P = 0.01. Interestingly, an improvement of visual analog scale scores was observed at 3 months, 90 (0-100) vs. 30 (0-80), P = 0.002. Eight patients (72.2%) responded that they experienced a very significant improvement in symptoms. In addition, a trend for reduction of the number of tender points was observed after 3 months, 17 (11-18) vs. 10 (0-18), P = 0.07.

CONCLUSIONS: The 25(OH)D levels and disease symptoms in patients with fibromyalgia and vitamin D deficiency/insufficiency seem to improve with vitamin D supplementation.

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Oct 2019

The effect of Vitamin D replacement on spinal inhibitory pathways in women with chronic widespread pain
Ozge Kenis-Coskun, Esra Giray, Osman Hakan Gunduz, Gulseren Akyuz
To appear in: Journal of Steroid Biochemistry and Molecular Biology. DOI: https://doi.org/10.1016/j.jsbmb.2019.105488
8 weeks of 50,000 IU to women who had Chronic Pain and had <10 ng level of vitamin D

Vitamin D replacement helps in pain reduction in patients with chronic widespread pain (CWP). But the current literature lack studies that investigate its mechanism. Cutaneous silent period (CSP) is the electrophysiologic analog of the spinal inhibitory pathways and an objective method to document their involvement. This study aims to show if vitamin D replacement has an effect on the spinal inhibitory pathways through CSP parameters. Female patients who have CWP with vitamin D deficiency were included. Patients received an 8-week replacement therapy of vitamin D. Patients' pain were evaluated using the visual analog scale (VAS) and Leeds assessment of neuropathic symptoms and signs pain scale (LANSS). Quality of life with Nottingham Health Profile (NHP) and CSP parameters were also recorded before and after treatment. A total of 51 patients were included in the final analyses. The mean age of the patients was 44.3 ± 12.7 (minimum 18-maximum 65). Mean symptom duration was 13.1 ± 6.7 (minimum3-maximum 24) months. Patients' mean BMI was 21.6 ± 3.9 (minimum 18.0 maximum 29.1). Patients' median VAS and LANSS scores decreased significantly (p < 0.01) and NHP scores improved significantly in all subsets (p<0.01). Vitamin D replacement did not significantly change CSP latency and duration (p=0.06 and p=0.12).Vitamin D replacement does not seem to work via modifying the spinal inhibitory pathways that are involved in the formation of the cutaneous silent period. This is the first study to objectively investigate the effect of vitamin D replacement on central sensitization mechanisms.

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2020 studies - not interventions

Association Between Low Vitamin D Levels and the Greater Impact of Fibromyalgia - July 2020
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Is vitamin D an effective treatment for pain in patients with fibromyalgia?- June 2020
Behind a paywall doi: 10.1097/EBP.0000000000000954

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