Vitamin D deficiency and treatment in Iraqi patients with primary fibromyalgia syndrome

Abstract

To establish the frequency of vitamin D deficiency in patients with primary fibromyalgia syndrome (FMS) in Basrah, Iraq, and to evaluate the effectiveness of vitamin D supplements in managing disease symptoms. 160 FMS patients and 160 matched healthy controls were studied. Serum vitamin D levels were measured. Patients were randomly assigned to one of three treatment groups: Group 1 receiving antidepressant (amitriptyline 10 mg/day); group 2 treated with vitamin D (cholecalciferol 50,000 IU/week) and group 3 received both. All treatments were followed-up for 3 months. The frequency of vitamin D deficiency was high (95%). The mean age of patients was 34.3 ± 9.5 years and 92.5% were females. The widespread pain index (WPI) scores significantly improved after 12 weeks in groups 2 and 1 (5.3 ± 3.4 and 7.9 ± 3.4 respectively) compared to baseline (11.9 ± 2.8 and 13.4 ± 2.6 respectively; p = 0.003). The WPI scores of the patients in group 3 improved early into week 4 (3.3 ± 2.7) and continued to improve at weeks 8 and 12 (2.7 ± 2.6 and 1.96 ± 1.6). There were clinically significant improvement in the patients in all treatment groups, most notably in the symptoms severity score (SSS) of fatigue, waking unrefreshed and cognitive impairment. Effects were greatest in the group treated with vitamin D and antidepressants. Vitamin D deficiency is common in FMS patients and it is associated with worsening of symptoms. Vitamin D supplementation in deficient FMS patients is associated with significant improvement. Screening of FMS patients for hypovitaminosis D is recommended.