Role of Vitamin D in Fibromyalgia
Fibromyalgia (FM) is a disorder that includes widespread musculo-skeletal pain accompanied by fatigue, sleep, memory and mood issues. Sometimes, symptoms begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms slowly accumulate with time with no single triggering event. Fibromyalgia is a chronic syndrome with an increasing prevalence, characterized by widespread musculo-skeletal pain in combination with a variety of cognitive symptoms and fatigue.
Many scientific evidences have resulted in a significant improvement of the understanding of the pathophysiology of the disease. However, current therapeutic approaches in patients with FM remains a multidimensional approach including patient education, behavioral therapy, exercise, pain management and relief of chronic symptoms rather than using drug therapies, based on the mechanisms of disease development. Vitamin D, a fat-soluble vitamin derived mainly from skin synthesis through ultraviolet radiation, has been recognized to manifest a plethora of extra-skeletal actions, a part from its fundamental role in skeletal and calcium homeostasis, including modulation of cell growth, neuro muscular actions and potential anti-inflammatory properties.
Recent findings indicated that hypovitaminosis D is common in FM patients. Supplementation studies are limited so far, indicating potential beneficial effects on pain and severity of the disease, but specific recommendations were lacking. This review aimed to summarize and critically appraise the data regarding the pathophysiological interplay between vitamin D and FM, available results from observational and supplementation studies so far with a clinical discourse on current knowledge gaps and future research agenda.