Interesting abstract, because here are a couple of abstracts from a doctor who believes in prescribing vit D for patients with musculoskeletal pain.
Mayo Clin Proc. 2003 Dec;78(12):1463-70.
Comment in:
Mayo Clin Proc. 2003 Dec;78(12):1457-9.
Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain.
Plotnikoff GA, Quigley JM.
Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, Minn, USA. [email protected]
OBJECTIVE: To determine the prevalence of hypovitaminosis D in primary care outpatients with persistent, nonspecific musculoskeletal pain syndromes refractory to standard therapies.
PATIENTS AND METHODS: In this cross-sectional study, 150 patients presented consecutively between February 2000 and June 2002 with persistent, nonspecific musculoskeletal pain to the Community University Health Care Center, a university-affiliated inner city primary care clinic in Minneapolis, Minn (45 degrees north). Immigrant (n = 83) and nonimmigrant (n = 67) persons of both sexes, aged 10 to 65 years, from 6 broad ethnic groups were screened for vitamin D status. Serum 25-hydroxyvitamin D levels were determined by radioimmunoassay.
RESULTS: Of the African American, East African, Hispanic, and American Indian patients, 100% had deficient levels of vitamin D (< or = 20 ng/mL). Of all patients, 93% (140/ 150) had deficient levels of vitamin D (mean, 12.08 ng/mL; 95% confidence interval, 11.18-12.99 ng/mL). Nonimmigrants had vitamin D levels as deficient as immigrants (P = .48). Levels of vitamin D in men were as deficient as in women (P = .42). Of all patients, 28% (42/150) had severely deficient vitamin D levels (< or = 8 ng/mL), including 55% of whom were younger than 30 years. Five patients, 4 of whom were aged 35 years or younger, had vitamin D serum levels below the level of detection. The severity of deficiency was disproportionate by age for young women (P < .001), by sex for East African patients (P < .001), and by race for African American patients (P = .006). Season was not a significant factor in determining vitamin D serum levels (P = .06).
CONCLUSION: All patients with persistent, nonspecific musculoskeletal pain are at high risk for the consequences of unrecognized and untreated severe hypovitaminosis D. This risk extends to those considered at low risk for vitamin D deficiency: nonelderly, nonhousebound, or nonimmigrant persons of either sex. Nonimmigrant women of childbearing age with such pain appear to be at greatest risk for misdiagnosis or delayed diagnosis. Because osteomalacia is a known cause of persistent, nonspecific musculoskeletal pain, screening all outpatients with such pain for hypovitaminosis D should be standard practice in clinical care.
PMID: 14661675 [PubMed - indexed for MEDLINE]
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Minn Med. 2003 Jan;86(1):43-5.
Vitamin D--the steroid hormone prescription for every patient.
Plotnikoff GA.
University of Minnesota, USA.
Physicians in the United States rarely screen for hypovitaminosis D and rarely prescribe vitamin D, even when medically indicated. This is of particular concern in Minnesota. The sun's intensity at Minnesota's latitudes limits vitamin D production, at best, to March through October. A variety of lifestyle situations, including long work hours, may preclude adequate sun exposure. Additionally, people of Northern European background may avoid sun exposure to reduce risk of skin cancer and premature aging. And people of Asian and African heritage may not have sufficient vitamin D production due to increased skin pigmentation. This brief article summarizes key points regarding the importance of vitamin D, including its action as a steroid hormone and its role in cancer, hypertension, and autoimmune disease as well as in perinatal and prenatal health. The potential benefit of hypovitaminosis D screening and vitamin D supplementation is discussed, as are the populations most likely to need screening and supplementation.
PMID: 12585559 [PubMed - indexed for MEDLINE]
Now, one consideration might be the following, and I'll admit that I haven't taken time to look into it. Supposedly, there are different forms of vitamin D and its precursors. So, maybe the body isn't metabolizing it correctly. Also, it could be that these researchers are measuring it in a different way or are measuring a different form of it, since there's supposedly an active form and an inactive form of Vit D (I think).
PS - Since you didn't give the link to the previous topic on sunlight, I'll add it here, for benefit of folks who might have trouble finding it later.
http://flash.lymenet.org/ubb/Forum1/HTML/024684.html
[This message has been edited by TX Lyme Mom (edited 23 April 2004).]