June 29, 2016



Director's Letter
Carole Baggerly
Director, GrassrootsHealth

I have been taking vitamin D daily now for almost 10 years. I take 10,000 IU D3/day and my current serum level is about 70 ng/ml. (You may note the 10,000 IU level and think that's high.  I have a friend who takes 5000 IU/day and achieves the same 70 ng/ml level.  So, a key message here is that unless you test, you don't know what vitamin D is doing for you.)

A key thing that I know is that I don't take any anti-inflammatory medicines and, given my age (over 70), it is notable that I am quite free of arthritic pain. I know I am just one data-point in this information, but it's nice to be part of the group!

When new people start the project, the very first thing they report is 'ohmygoodness--I have considerably less pain', or 'this is the first time in years that my pain has gone away'.  The effect seems to happen quickly if you are deficient to start with. 
 
This week we are summarizing what we have learned from your data on pain and a paper where a VA medical center changed their standard of care to include vitamin D testing for patients who present with two or more areas of chronic pain. I applaud their efforts! They initiated a quality improvement initiative based on research - moving research into practice.  Vitamin D DOES matter with pain.

Onwards!

Carole

Carole Baggerly 
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice NOW!
 
Your Data Your Answers: Vitamin D and Pain

Each D*action participant fills out a comprehensive health questionnaire. This data allows us to analyze and report how vitamin D affects general health. 

With respect to pain the questionnaire asks 'In the last 6 months have you had pain anywhere?' If 'yes' they can report up to 3 body parts with pain and an associated pain rating. 

Pain rating by vitamin D status

Data from our cohort, 8000 strong, indicates a 16% lower pain rating associated with an increase of vitamin D serum levels (from < 15 ng/ml to  75 ng/ml). 

 

The average pain rating for this chart was calculated from the highest pain rating reported by each participant (at least 18 years of age) or a pain rating of zero if they had no pain. 

Body parts with pain

What are the most common body parts with pain? The back is the overall winner, but you can see the distribution below.



Pain by gender

Women were more likely than men to report having experience pain. One thing to note is that D*action continues to be predominantly women (2/3).

 

Pain by age

In general, as age increased more people experienced pain.




By continuing to test with D*action, every 6 months, and completing the health questionnaire, you are able to keep on top of changes in your vitamin D level, and we can publish data such as this to get more traction for vitamin D in the mainstream medical community.
 
Paper of the Week



Improvement of Pain, Sleep, and Quality of Life in Chronic Pain Patients with Vitamin D Supplementation
The Clinical Journal of Pain
April 2013
Wei Huang, et al.


This paper summarizes the results of 28 veterans who presented with two or more areas of chronic pain with a low serum level of vitamin D (< 30 ng/ml). If a patient was insufficient (20-29 ng/ml) they were given 1200 IU D3/day. If they were deficient (< 20 ng/ml) they were given 50,000 IU D2/week. Measurements were taken one week before supplementation and again after three months of supplementation. Standard care, including pain medication, was continued during supplementation.

Measurements were taken in several categories including pain location and levels, quality of life measurements as defined by the VR-36 standard and sleep quality from the PSQI standard. 

All measurements improved significantly except role-functioning emotional. Vitamin D levels increased from an average of 19 ng/ml to 26 ng/ml; the 10-point pain score (see sidebar) decreased from 7.10 to 5.68; sleep duration increased from an average of 4.6 hours to 5.3 hours; and physical functioning increased from 33 to 45 (100 point scale). 

The conclusion:

"Standardized vitamin D supplementation in veterans with multiple areas of chronic pain can be effective in alleviating their pain and improving sleep, and various aspects of quality of life."

A "quality improvement initiative"

This paper used a retrospective analysis after the first phase of a new quality improvement initiative at a major VA medical center in southeast US was complete (May 2009 - November 2010). The new standard was to test serum 25(OH)D in patients with two or more areas of chronic pain and supplement based on the results of that test.

This VA medical center is indeed moving research into practice!

Read Paper
Editor's Letter
Susan Siljander
Marketing Director, GrassrootsHealth

I have been lucky and have not experienced chronic pain in my life (unless it was due to a sports injury - but I don't count that since it is self-inflicted). It was interesting researching pain this week. My big take-away was that chronic pain can have a big impact on other parts of your life. When looking for images I found this one that sums it up:


I commend the VA center for changing their standard of care to try and stop this cycle - to improve quality of life for their veterans.

I hope we hear about more and more of these initiatives around the globe, as we know:
  • vitamin D improves many processes in the body
  • vitamin D is inexpensive (or free!)
  • vitamin D is easy to take
  • vitamin D can change lives
Have a great week!
 
Susan Siljander
Marketing Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research Into Practice NOW!
Order Now
Your participation in this project provides information for your answers to D questions and helps fund the GrassrootsHealth projects.


GrassrootsHealth Launches Vitamin D Project Aimed at Improving Birth Outcomes in Missoula, Montana.

Improvements to birth outcomes have the potential to save the state $35MM in health care costs a year through vitamin D testing, monitoring, and supplementation.


Scientists' Call to D*action 
48 international vitamin D researchers join in promoting immediate public health action on vitamin D through achieving serum levels of 40-60 ng/ml.
Updated 8/11/2015

 
Disease Incidence Prevention Chart
A chart showing the required vitamin D serum levels for prevention of many diseases including cancers, falls, heart attacks and diabetes and several others. 
Updated 8/24/2012

 
Moving Research into Practice
A summary booklet of key Vitamin D research findings by GrassrootsHealth

Pain Score

0 - no pain

1 - minimal discomfort that is easily forgotten and no medication is considered

2 - minor aches, but pain medications is not needed as long as you are concentrating or busy with something else

3 - pain interferes with activity, but over-the-counter pain relievers relieve it completely for 3 to 4 hours

4 - over-the-counter pain relievers help enough to allow you to forget the pain as long as you are concentrating or busy with something else

5 - even with over-the-counter medications, pain is noticed and it impedes your activity

6 - activities cannot be performed because over-the-counter analgesics are not controlling pain. Prescription pain relievers are needed to allow activity to continue without thinking about the pain

7 - with prescription pain relievers and some effort, you can still perform activities, but pain is affecting your concentration

8 - activity is severely limited even with prescription pain relievers, and it is difficult to even read or carry on a conversation

9 - medications are not helping the pain, and physical activity is impossible

10 - pain is incapacitating despite narcotics and other prescription medications, and you are unable to do anything but cry or moan uncontrollably.

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