100,000 IU of vitamin D monthly decreases use of NASIDs by 13 percent if low vitamin D – RCT

Created May 2018

Monthly vitamin D supplementation, pain, and pattern of analgesic prescription: secondary analysis from the randomized, double-blind, placebo-controlled Vitamin D Assessment study

PAIN: June 2018 - Volume 159 - Issue 6 - p 1074–1082, doi: 10.1097/j.pain.0000000000001189

Wu, Zhenqianga; Camargo, Carlos, A., Jrb; Malihi, Zarintaja; Bartley, Jimc; Waayer, Debbiea; Lawes, Carlene, M.M.a; Toop, Lesd; Khaw, Kay-Teee; Scragg, Roberta,*

Their definition of low vitamin D is < 20 ngMost likely would have better results with bi-weekly dosing* Fibromyalgia pain with trazodone reduced by 50 percent with weekly 50,000 IU of vitamin D – RCT Nov 2014* Fibromyalgia treated with Vitamin D (50,000 IU weekly for 3 months) – 2016, 2017, 2018, 2019* Note: Same average amount of vitamin D, but given every 2, not every 4 weeks* Widespread pain, arthritis pain and muscle pain are associated with low vitamin D – meta-analysis March 2018Pain - chronic category has the following{include}

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Observational studies suggest that vitamin D deficiency is associated with higher risk of pain. However, evidence on the effect of vitamin D supplementation on pain is limited and contradictory. The aim of this study was to compare the effect of monthly high-dose vitamin D supplementation on a pain impact questionnaire (PIQ-6) score and prescription of analgesics in the general population.

We performed a randomized, double-blind, placebo-controlled trial of 5108 community-dwelling participants, aged 50 to 84 years, who were randomly assigned to receive monthly 100,000-IU capsules of vitamin D3 (n = 2558) or placebo (n = 2550) for a median of 3.3 years. The PIQ-6 was administered at baseline, year 1, and final follow-up. Analgesic prescription data were collected from Ministry of Health.

There was no difference in mean PIQ-6 score at the end of follow-up (adjusted mean difference: 0.06; P = 0.82) between the vitamin D (n = 2041) and placebo (n = 2014) participants.

The proportion of participants dispensed one or more opioids was similar in the vitamin D group (n = 559, 21.9%) compared with placebo (n = 593, 23.3%); the relative risk (RR) adjusted for age, sex, and ethnicity was 0.94 (P = 0.24).

Similar results were observed for dispensing of nonsteroidal anti-inflammatory drugs (RR = 0.94; P = 0.24) and other nonopioids (RR = 0.98; P = 0.34).

Focusing on vitamin D deficient participants (<50 nmol/L, 24.9%), there was a lower risk of dispensing nonsteroidal anti-inflammatory drugs in the vitamin D group compared with placebo (RR = 0.87; P = 0.009 ); all other subgroup analyses were not significant. Long-term monthly high-dose vitamin D supplementation did not improve mean PIQ-6 score or reduce analgesic dispensing in the general population.

Tags: Chronic Pain Intervention Intervention - non daily