Doctor’s Tip: Vitamin D and fybromyalgia
Fibromyalgia affects 3% to 10% of Americans, and is most prevalent in women age 20 to 50. Symptoms include aching and stiffness, often involving the whole body, but primarily the neck, shoulders, low back and hips. Other symptoms include fatigue, sleep disorders, numbness, headaches and irritable bowel symptoms.
Fibromyalgia is closely related to chronic fatigue syndrome, although in the former musculoskeletal symptoms predominate and lassitude in the latter. The cause of chronic fibromyalgia is unknown, but abnormal perception of painful stimuli, sleep disorders, depression and viral infections have been suggested. If a patient presents with symptoms of fibromyalgia, it’s important to rule out conditions such as rheumatoid arthritis, lupus, polymyositis, polymyalgia rheumatica, low thyroid and sleep apnea.
The only findings on exam that suggest fibromyalgia are pain with pressure over certain trigger points on the body, such as the trapezius muscles in the shoulders, the inner knees and the outside of the elbows. There are no lab tests that are positive in fibromyalgia. This illness is therefore frustrating for both physicians and patients, and it’s easy for both providers and patients to start thinking the disease psychological. However, there is good science that supports this being a physical and not a mental illness.
Also frustrating is the lack of effective treatment. Opioids and anti-inflammatories such as ibuprofen and naproxen don’t help. Corticosteroids such as cortisone don’t help. Acupuncture doesn’t help. Certain antidepressants help some patients somewhat, as do anti-seizure medications such as gabapentin. Exercise programs, cognitive behavioral therapy, and mindful meditation can offer some relief.
According to a recent blog on Dr. Greger’s website nutritionfacts.org, there is something that has been shown recently to help symptoms of fibromyalgia: 2,400 units of vitamin D3 a day. Over the years, there have been many uncontrolled studies looking at treating fibromyalgia with low doses of vitamin D, and results have been mixed. However, in 2014 a well-controlled study using 2,400 units a day showed clear reduction in pain scores, and especially given that this treatment is inexpensive and free of side effects, it is definitely worth trying.
Why would large daily doses of vitamin D3 help the symptoms of fibromyalgia? The answer isn’t known, but we do know this about vitamin D: According to Dr. Joel Fuhrman, author of several books including “Eat to Live,” it regulates several genes and cellular processes. Almost all cells, organs and tissues in our body have vitamin D receptors, including our nervous system and muscles. Vitamin D helps build strong bones and enhances the immune system. It fights inflammation, including inflammatory diseases such as asthma, ulcerative colitis and Crohn’s disease.
Greg Feinsinger, M.D., is a retired family physician with a special interest in heart disease and diabetes prevention and reversal, ideally though lifestyle changes. He’s available for free, one-hour consultations — call 379-5718.
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