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Aches? Pains? An Extra Dose Of Vitamin D May Provide Relief

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Newsmaker
We have had a number of inquiries from patient who have been "recommended" to take a list of different vitamins and supplements by other patients. It is very important to only follow the recommendations made by your doctor. In one case a patient who had distal gastric bypass (a procedure that we do not perform) was making recommendation to Duodenal Switch (which we perform) of us. Physiologically, the way these two operations work is not in any way similar. The requirements after one operation may not be needed after the other one. I do not discount the value of sharing information. As physician we continuously strive to learn the most updated and new information pertinent to the care of our patients.
Ara Keshishian, MD, FACS

 

Aches? Pains? An Extra Dose Of Vitamin D May Provide Relief
Pain is the most common complaint leading patients to seek medical care and much of it is chronic, lasting 3 months or longer. According to an extensive review of clinical research in a new report from Pain Treatment Topics, inadequate vitamin D intake has been linked to a long list of chronic painful maladies, including bone and joint pain of various types, muscle pain, fibromyalgia syndrome, rheumatic disorders, osteoarthritis, and other complaints. Lack of vitamin D also has been implicated in the mood disturbances of chronic fatigue syndrome and seasonal affective disorder.

According to Stewart B. Leavitt, MA, PhD, editor of Pain Treatment Topics and author of the report, "our examination of the research, including 22 clinical investigations of patients with various chronic pain and fatigue syndromes, found that these persons almost always had inadequate levels of vitamin D. When sufficient vitamin D supplementation was provided, the aches, pains, weakness, and related problems in most of them either vanished or were at least helped to a significant extent."

The report, "Vitamin D A Neglected 'Analgesic' for Chronic Musculoskeletal Pain," was peer-reviewed by a panel of 8 experts and includes the following important points:

• Vitamin D is a complex nutrient that functions as a hormone to benefit numerous body tissues and organs, including bones, muscles, and nerves.
• A surprising majority of persons in many parts of the world, including the United States, do not get adequate vitamin D from sun exposure or foods. Why such deficiencies are associated with pain in some persons but not others is not always known.
• The currently recommended adequate intake of vitamin D up to 600 IU per day is outdated and too low. According to the research, most children and adults need at least 1000 IU per day, and persons with chronic musculoskeletal pain would benefit from 2000 IU or more per day of supplemental vitamin D3 (also called cholecalciferol).
• Vitamin D supplements have a highly favorable safety profile. They interact with very few drugs or other agents, and are usually not harmful unless extremely high doses such as, 50,000 IU or more are taken daily for an extended period of time.
• Vitamin D supplements are easy for patients to selfadminister, are well tolerated, and typically cost as little as 7 to 10 cents per day.

In conclusion, Leavitt stresses that vitamin D should not be viewed as a cure for all pain conditions and in all patients. It also is not necessarily a
replacement for other pain treatments. "While further research would be helpful," he says, "current best evidence indicates that recommending supplemental vitamin D for patients with chronic musculoskeletal pain and fatigue disorders would do no harm and could do much good at little cost. It should be considered by healthcare providers for their patients early in the course of pain management."

Pain Treatment Topics and the associated Pain-Topics.org website provide open and free access to noncommercial, evidence-based clinical news,
information, research, and education on the causes and effective treatment of the many types of pain conditions. It is independently produced and currently supported by an unrestricted educational grant from Covidien/Mallinckrodt Inc., St. Louis, MO, a leading manufacturer of generic opioid analgesic products.
Pain Treatment Topics 202 Shermer Rd. Glenview, IL 60025 http://Pain-Topics.org

Calcium Alone Does Not Reduce Hip Fracture Risk
People, especially the elderly, may reach for calcium supplements in hopes of protecting themselves against bone fractures in case of a fall. But a recent analysis of several studies found no reduction in risk of hip fracture with calcium supplementation.

The analysis was supported in part by the Agricultural Research Service (ARS). It comes on the heels of another ARS-funded study suggesting that today's current recommended amount of dietary calcium for American adults may be greater than actually needed. ARS is a scientific research agency of the U.S. Department of Agriculture.

Bess Dawson-Hughes and colleagues in academia and medicine researched calcium intake studies that had been published between January 1960 and December 2006. They also systematically searched information from biomedical databases, reference lists and abstracts for the study review. Dawson-Hughes is director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Mass.

The analysis was published in the American Journal of Clinical Nutrition.

Among the studies that met the researchers' screening criteria, seven included a total of 170,991 women with nearly 3,000 hip fractures. Five of the studies included a total of 68,606 men with 214 hip fractures. Pooled results from those studies suggest that calcium intake is not appreciably
associated with hip fracture risk in women or men. That means the researchers did not find that a higher calcium intake reduced the incidence of hip fractures. Hip fractures are the most frequent and severe fractures among the elderly, and experts estimate the average cost of care at $29,000 per patient. Increased calcium intake is still commonly recommended as a single fracture prevention strategy, although considerable uncertainty exists regarding optimal intakes of calcium, the authors wrote. For example, for adults over age 50, the recommended calcium intake is 700 milligrams (mg) daily in the United Kingdom, but 1,200 mg daily in the United States.

The authors concluded that the findings do not support an overall benefit from greater-than-average calcium intake. Future studies of fracture prevention should focus on the best combination of calcium plus vitamin D, rather than on calcium supplementation alone, according to authors.

Adapted from materials provided by USDA/ Agricultural
Research Service

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