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Lower back pain treated by 600,000 IU of Vitamin D – RCT June 2019

Efficiency of vitamin D supplementation in patients with mechanical low back ache

Journal of Clinical Orthopaedics and Trauma, https://doi.org/10.1016/j.jcot.2019.06.018

VitaminDWiki

10 days of 60,000 IU each day (defined a pulse-d), for a total of 600,000 IU
Second trial was with 60,000 IUs daily for just 5 days. for a total of 300,000 IU
They found that obese need more vitamin D
   other studies have documented about 2-3X more is needed
They used 3 types of Vitamin D
All three were associated with reduced back pain.in 3 weeks
But they did not try Vitamin D against a placebo, and it is known that acute back pain reduces in 6-8 weeks
The highest and longest response was with a nano syrup = lipophilic - which is probably a nano emulsion
Here are some of the Vitamin D Emulsions being tried at VitaminDWiki in 2019
Bio Emulsion Forte, Micro D3, PreventiX, Hi-Pro Emulsi-D3, Bio-Emulsion-D3, and Liquid Vitamin D3
All emulsions were purchased at Amazon. Typically $20 for 2,000,000 IU
VitaminDWiki agrees with the study on this page, emulsions appear to be very good
The study on this page used a total of 600,000 IU which is ~$6
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Back Pain category in VitaminDWiki starts with

Items in both categories Back Pain and Vitamin D Receptor are listed here:

VitaminDWiki obeservation

This is the 4th successful use of high-dose Vitamin D for back pain
   Many studies and a book on loading doses
There are no sucessful back pain trials using daily dosing
High-dose appears to be essential to make a large gradient to get past the Vitamin D Receptor
Magnesium appears synergistic with Vitamin D for back pain as well as many other health problems
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If I needed to treat my own back pain (cured years ago) I would

  1. Start with topical Magnesium Chloride on my back daily for a week before the Vitamin D
    • Probably also take Magnesium Citrate orally for a week before
    • Continue with topical and oral Magnesium for a month
  2. Use 50,000 IU of vitamin D daily for 7 to 10 days(their actual nano dose size was 71,000)
    • Micro D3 form seems good, -alternately Bio-Tech 50,000 capsules
    • Continue with a maintenance dose of 50,000 IU twice a month - forever
    • If I were obese, I would double each Vitamin D dose size
  • Would also do physical therapy for my back as I have done in the past
  • Would not expect the treatment to be a cure - probably need to repeat (with lower dosing) ~ annual? as needed

 Download the PDF from Sci-Hub via VitaminDWiki
 Download the Back pain Questionnaire PDF from VitaminDWiki

3 forms of Vitamin D

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Higher BMI ==> less response (Need more D in the future)

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300,000 IU and 600,000 IU portions of the trial

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Actual IU always >60,000 IU (stated IU = 60,000)

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Background: Preliminary evidence suggests an association of hypovitaminosis D (hypo.D) with mechanical Low back ache (mLBA).

Aim
This study was designed to 1. Explore the relationship of hypovitaminosis D with mLBA in the absence of other confounding factors 2. Formulate and validate an appropriate treatment protocol and 3. Explore the differences in outcomes with various oral formulations of vitamin D available in Indian market.

Materials & methods
Three randomised groups of patients with mLBA and hypo.D between 18 and 45 years of age without any co morbid conditions were studied for the effectiveness of adjunctive vit.D supplementation of 6,00,000 IUs (60,000 IUs/day for ten consecutive days) in the form of granule or nano syrup or soft gel capsule for the treatment of mLBA. Review evaluation of pain, functional disability and vit.D was done at three weeks and an additional evaluation of vit.D was done at nine months. Evaluation with 3,00,000 IUs of vit.D (60,000 IUs/day for five consecutive days) was done with nano syrup in a different cohort.

Results
High prevalence of hypo.D (96%) was noted in patients with mLBA. Significant improvement was noted after supplementation of vit.D. The subjects of nano syrup group have shown significantly better improvement compared to others (P < 0.000). Non obese and chronic patients have shown significantly better results than their peers. Though there was significant difference in vit.D before treatment, the difference of improvement between the genders, deficiency and insufficiency, in-door and out-door, smokers and non smoker subgroups was not significant. Seasonal variation in vit.D before and after the treatment was significant.

Conclusion
Hypovitaminosis D can be a potential causative factor for mLBA in addition to the other known causes. Proper evaluation and adjunctive vit.D supplementation can effectively break the vicious cycle of low back ache with significant improvement in serum vit.D level, effective relief of pain and significant functional improvement without any adverse effects. Improvement in vit.D was not significantly related to its initial status and obese individuals have shown significantly lesser improvement. The results with nano syrup formulation were significantly better compared to others. Formulation based dosage adjustments assume significance in view of these results.


Created by admin. Last Modification: Saturday January 4, 2020 10:39:40 GMT-0000 by admin. (Version 25)

Attached files

ID Name Comment Uploaded Size Downloads
12213 Actual Vit D content.jpg admin 28 Jun, 2019 26.39 Kb 1032
12212 Response vs BMI.jpg admin 28 Jun, 2019 67.72 Kb 1149
12211 3 forms.jpg admin 28 Jun, 2019 30.54 Kb 1092
12210 300 and 600.jpg admin 28 Jun, 2019 19.26 Kb 1103
12208 back-pain-questionnaire.pdf admin 27 Jun, 2019 23.07 Kb 1337
12207 Lower Back Pain Sci-Hub Netherlands.pdf admin 27 Jun, 2019 1.26 Mb 1141