Vitamin D in Pain Management

• Published in: International journal of molecular sciences Vol. 18; no. 10; p. 2170
• Main Authors: Helde-Frankling, Maria, Björkhem-Bergman, Linda
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18.10.2017; MDPI
• Subjects: 25-Hydroxyvitamin D; Animals; Cancer; Cancer Pain - drug therapy; Chronic Pain - drug therapy; Hormones; Humans; infections; Inflammation; Lymphocytes T; Medicin och hälsovetenskap; Musculoskeletal Pain - drug therapy; myopathy; opioid; Opioids; Pain; Pain management; Pain Management - methods; Pain perception; Patients; Prostaglandin E2; quality of life; Review; Skin; statins; Vitamin D; Vitamin D - administration & dosage; Vitamin D - metabolism; Vitamin D - therapeutic use; Vitamin deficiency; Vitamins - administration & dosage; Vitamins - metabolism; Vitamins - therapeutic use; pain; myopathy; statins; vitamin D; opioid; infections; cancer; quality of life
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms18102170

Vitamin D is a hormone synthesized in the skin in the presence of sunlight. Like other hormones, vitamin D plays a role in a wide range of processes in the body. Here we review the possible role of vitamin D in nociceptive and inflammatory pain. In observational studies, low vitamin D levels have been associated with increased pain and higher opioid doses. Recent interventional studies have shown promising effects of vitamin D supplementation on cancer pain and muscular pain-but only in patients with insufficient levels of vitamin D when starting intervention. Possible mechanisms for vitamin D in pain management are the anti-inflammatory effects mediated by reduced cytokine and prostaglandin release and effects on T-cell responses. The recent finding of vitamin D-mediated inhibition of Prostaglandin E2 (PGE2) is especially interesting and exhibits a credible mechanistic explanation. Having reviewed current literature, we suggest that patients with deficient levels defined as 25-hydroxyvitamin D (25-OHD) levels <30 nmol/L are most likely to benefit from supplementation, while individuals with 25-OHD >50 nmol/L probably have little benefit from supplementation. Our conclusion is that vitamin D may constitute a safe, simple and potentially beneficial way to reduce pain among patients with vitamin D deficiency, but that more randomized and placebo-controlled studies are needed before any firm conclusions can be drawn.