Beyond Bone Health: The Role of Vitamin D in the Treatment of Chronic Pain

When you think of vitamin D, there's a good chance that you think of the effects it has on bone strength. Maybe you also think of the effects it has on energy levels.

But did you know that vitamin D supplementation plays an important role in the treatment of chronic pain?

Over the last 20 years, more and more research has been done to explore the impact of vitamin D and pain relief. And the results have been significant. 

We now know that many people with chronic pain conditions have vitamin D deficiency. And when they start taking enough vitamin D to bring their levels up, many people notice significant improvements in their pain.¹

If you have a condition such as fibromyalgia and you're finding that your pain is still uncontrolled, you need to consider having your vitamin D levels checked. You may have vitamin D deficiency that's worsening your pain and quality of life.

Many of my patients have chronic pain and vitamin D deficiency, and I've seen firsthand how much treating their low vitamin D levels has helped with pain. So this blog is going to go over the ins and outs of vitamin D and how it helps with the treatment of chronic, painful conditions.

What is Vitamin D?

Vitamin D is a nutrient that helps to control the amount of calcium in the body. This is why you'll often see calcium supplements combined with vitamin D. 

Vitamin D is best known for the impact it has on keeping bones healthy and strong. But it also plays a vital role in regulating our nervous systems, our immune systems, inflammation, and pain perception throughout the body.²

The main way that our bodies get vitamin D is through the sun. When sunlight touches our skin, an inactive compound called 7-Dehydrocholesterol is converted into cholecalciferol, which is better known as Vitamin D3. This is then processed in the liver and kidneys, and it's eventually distributed throughout the body. 

Vitamin D and Bone Health³

The other way we get vitamin D is from food and supplements. When you get vitamin D this way, it goes straight to the liver to be processed with the other vitamin D made from the sun. 

Foods that contain vitamin D include:⁴

  • Fish

  • Beef liver

  • Egg yolk

  • Mushrooms⁵

  • Fortified cereals and milks

As you can see, there aren't many foods that naturally contain vitamin D. This is why getting enough sunlight and taking a vitamin D supplement is so important.

Causes of Low Levels of Vitamin D

While the causes of vitamin D deficiency may vary, it all comes down to problems absorbing or producing vitamin D in the body. 

Causes of vitamin D deficiency include:⁶

  • Not getting enough sunlight

  • Darker skin pigment, as this makes it harder for vitamin D to be produced

  • Liver or kidney disease, as this makes it difficult for the body to process vitamin D

  • Medications that affect liver function

  • Certain cancers, such as lymphoma

  • Certain gastrointestinal disorders that cause decreased absorption of vitamin D

  • Vitamin D receptor (VDR) genetic expression

  • Chronic infectious disease

In my practice, I suspect that many of my patients who have a harder time maintaining Vitamin D levels after supplementation have potential issues with VDR gene expression. 

I also treat lots of patients with chronic underlying infections, and we know that there’s a strong correlation between infections and vitamin D deficiency.⁷ Some of these chronic infections include: 

  • Myalgic encephalomyelitis (ME)

  • Chronic fatigue syndrome (CFS

  • Epstein Barr viral illness

  • Lyme disease

Symptoms of Vitamin D Deficiency

Many people have low levels of vitamin D without realizing it. And if they do have symptoms, they're often vague and can be attributed to other medical conditions.

The symptoms of vitamin D deficiency include:⁸

  • Muscle and bone pain

  • Fatigue

  • Increased sensitivity to pain

  • Tingling in your hands or feet

  • Muscle weakness

  • Muscle tremors or spasms

How is Vitamin D Deficiency Diagnosed?

Because the symptoms of vitamin D deficiency are vague, it's important to have your vitamin D levels checked routinely to make sure your levels are where they need to be. 

Vitamin D levels can be checked on bloodwork, and it's something that I check on every one of my patients. Levels of vitamin D less than 50 ng/mL are considered low and should be treated with supplementation.⁹

I've actually found that about 98% of my patients, upon initial testing, have vitamin D levels less than 50 ng/mL. People are usually surprised to find that their levels are this low, but it often explains some of the unpleasant symptoms they're having.

How Vitamin D Helps With Pain Relief

Now that we know what vitamin D is, how exactly does it help with chronic pain? 

When it comes to the nervous system, vitamin D is neuroprotective. This means that it's protective to our nervous systems.

Many chronic pain conditions, such as fibromyalgia, are a result of increased sensitivity to the nervous system, and vitamin D has been shown to help with this.¹⁰  When our bodies have enough vitamin D, we're less sensitive to nerve, bone, and muscle pain. The most common cause of musculoskeletal pain is from arthritis. 

Vitamin D also has anti-inflammatory effects in the body. By limiting the amount of inflammatory cells called pro-inflammatory cytokines that are released in the body, vitamin D helps to decrease inflammation - which improves pain for many people.¹⁰

And conversely, when there's not enough vitamin D in the body to regulate these cytokines, inflammation increases. And for many people, this results in pain.

It’s important to mention that many people with chronic pain have been found to have low levels of vitamin D.¹¹ This is why their relationship has been explored and continues to be studied. 

At this point, we’re not sure if vitamin D causes chronic pain or if it’s simply associated with it. But we do know that pain is a result of inflammation, and many people with chronic pain have higher levels of inflammation throughout their bodies.¹² So because of this, their bodies likely use a lot more vitamin D to try to control and regulate this inflammation. Without proper supplementation, this causes their vitamin D levels to be lower. 

And in attempts to reduce inflammation in the body, people with chronic pain conditions are commonly treated with steroids - which have been found to decrease levels of vitamin D.¹¹

This is why it’s so important to make sure your vitamin D levels are where they need to be, especially for people with chronic pain.

What is the Dose of Vitamin D For People With Chronic Pain?

At a minimum, vitamin D levels need to be at 50 ng/mL. But for my patients, especially patients with chronic pain, I recommend levels between 70 and 90 ng/mL.¹³

Getting your vitamin D levels this high may take some time. And for many of my patients who have very low levels, it requires a combination of oral supplements and injections. The dose that you need depends on many factors, including how low your vitamin D levels are to begin with.

But at a minimum, you need to take 5,000iu daily just to maintain your current vitamin D levels. This is especially important for patients with chronic pain.

Many studies have shown that after taking proper vitamin D supplementation for three to six months, patients with fibromyalgia noted significant improvements in their pain, mood, and overall quality of life.¹⁰

Please remember that you shouldn’t begin taking vitamin D supplements without first seeing your doctor to have your levels checked. You may not need it and if you do it can give you a better idea of how deficient you are and how much you may need to supplement.

How Much Sunlight Do You Need?

Even if you take a vitamin D supplement, it's important to still try to get sunlight exposure too. To prevent vitamin D deficiency, you should get 20 minutes of sunshine every day. It's important to note that you should have at least 40% of your skin exposed during those 20 minutes.⁷

This can be especially difficult to do in the winter months when it's colder outside and the sun isn't out. 

Should You Get Your Vitamin D Levels Checked?

In short, yes! Vitamin D is an essential vitamin that your body needs to maintain strong bones, control inflammation, have a healthy immune system, and regulate how you feel pain. 

Many of my patients have chronic pain conditions, and I've seen how correcting low vitamin D levels has improved their pain. This is why I always check vitamin D levels for all of my patients. 

If you haven't had your vitamin D levels checked in the last six months, make sure to schedule an appointment with your functional medicine provider to get this checked. If you're a patient with Wisdom Way Medicine, you can schedule an appointment with me at the link below.

In the meantime, do your best to get outside and into the sunlight!