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Child development

September 2011

Research

Fibromyalgia

Should we be testing and treating for vitamin D deficiency?

Volume 40, No.9, September 2011 Pages 712-716

FibromyalgiaDeepa Daniel MBBS, FRACGP, DCH, was an academic registrar, Department of General Practice, University of Melbourne, Victoria.

Marie Pirotta MBBS, FRACGP, PhD, NHMRC Career Development Fellow, General Practice and Primary Health Care Academic Centre, University of Melbourne, and General Practitioner, Victoria.

Aim

This review aims to synthesise the evidence regarding any association between vitamin D deficiency and fibromyalgia, addressing whether general practitioners should be testing and treating these patients for vitamin D deficiency.

Methods

A systematic literature review was performed, using MEDLINE as the primary database, to find and critically appraise all relevant research fulfilling inclusion criteria from January 1990 until September 2010.

Results

There were conflicting results in the cross sectional studies obtained, with no association in studies using control groups and mixed results in larger population based studies. One adequately powered randomised controlled trial suggests fibromyalgia pain is not improved by vitamin D supplementation.

Discussion

The evidence for an association between fibromyalgia and vitamin D deficiency is inconclusive, with no improvement in pain on supplementation. However, patients with concurrent risk factors for deficiency should be tested and treated for vitamin D deficiency to minimise osteoporosis risk and maximise muscular strength.

Internationally, interest in vitamin D is high, due to increased detection of vitamin D insufficiency, combined with better knowledge of the role of vitamin D in health outcomes.1 With the explosion of ordering of vitamin D assays in recent years (Table 1), and questions about the appropriateness of screening, general practitioners should target vitamin D testing and supplementation to specific populations with evidence of health benefit.

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Correspondence afp@racgp.org.au

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