Vitamin D is best known for helping build strong bones.
But research continues to show this nutrient does far more than support your skeleton.
Vitamin D also appears to influence inflammation, immune function, muscle health, nerve signaling and the way the body experiences pain.
In fact, previous studies have linked low vitamin D to several pain-related conditions in the general population, including musculoskeletal pain and neuropathic pain.
Researchers are still working out exactly how strong that connection is, but the pattern has been hard to ignore: Vitamin D seems to have a modifying effect on pain.
That led researchers at Fayoum University Hospital in Egypt to wonder whether low vitamin D levels before surgery could be linked to more pain afterward — and more need for opioid medication to get through recovery.
And the results were hard to ignore…
Three times as likely to have more pain
The team followed 184 women with breast cancer who were scheduled for unilateral modified radical mastectomy, a surgery to remove one breast and nearby lymph nodes.
Half of the women had vitamin D deficiency, defined as blood levels below 30 nmol/L. The other half had vitamin D levels at or above that mark.
Then researchers tracked their pain levels after surgery and again at 6, 12, 18 and 24 hours.
Women with vitamin D deficiency were more than three times as likely to experience moderate to severe pain during the first 24 hours after surgery compared with women who had adequate vitamin D levels.
And they needed more medication.
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In fact, women with low vitamin D used an average of 112 mg more of the opioid pain medicine tramadol after surgery than women with sufficient vitamin D levels. They also required more fentanyl during surgery.
That matters because opioids can come with side effects like nausea, vomiting, drowsiness, confusion and constipation — and they also carry the risk of dependence and addiction when they’re used longer than needed.
If that weren’t enough, the study showed that women with vitamin D deficiency also experienced significantly higher levels of postoperative nausea. Vomiting was reported only in the vitamin D-deficient group.
Why vitamin D could change how pain feels
The study doesn’t prove that low vitamin D directly caused the extra pain. But it does add to a growing body of research suggesting vitamin D status may affect how the body responds to painful stress.
There are several possible reasons…
First, vitamin D helps regulate inflammation. And inflammation is one of the body’s major pain amplifiers.
Second, vitamin D also plays a role in nerve and muscle function. When levels are low, nerve signaling and muscle recovery may not work as smoothly as they should.
And because vitamin D receptors are found throughout the body, including in tissues involved in immune and nervous system function, researchers believe deficiency may make the body more vulnerable to heightened pain sensitivity.
That could help explain why previous studies have linked low vitamin D to chronic pain, musculoskeletal pain and nerve pain — and why this new study found such a strong connection after surgery.
It may also explain the nausea connection…
The women with low vitamin D needed more opioid medication. And opioids are well known for increasing the risk of postoperative nausea and vomiting.
So while vitamin D may not be the only reason these women had more pain and nausea, it could be one of the easiest factors to check before surgery.
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What to do before surgery
So what does this mean if you or someone you love is preparing for surgery?
First, don’t guess whether your vitamin D levels are in the green zone. The National Endocrine Society suggests that many people need more than the recommended RDA and that testing blood levels is unnecessary in most groups.
But you can ask your doctor about a 25-hydroxyvitamin D blood test, the standard test for checking vitamin D status.
You may be at higher risk for deficiency if you spend little time outdoors, have darker skin, are older or overweight, take certain medications, have digestive problems that affect nutrient absorption or have a poor diet.
Second, if your levels are low, ask your doctor how to boost them before surgery.
For many people, food alone isn’t enough to move the needle. Vitamin D3 supplementation is often needed to raise low levels and to avoid a common mistake that can actually lower them.
Your doctor can help you choose the right dose based on your blood test results, but typically, 3,000 to 5,000 IU daily is considered a safe therapeutic dose. Severe deficiencies may require higher dosing for a period of time, but should only occur under a doctor’s guidance.
Finally, discuss your full pain-control plan with your doctor before surgery.
Ask what medications you’ll receive, what side effects to watch for, how long you should need them and whether non-opioid options may be appropriate.
Pain after surgery is typically expected. But if something as simple as checking and correcting low vitamin D could help reduce pain, nausea and the need for opioids, it’s a conversation worth having before the operating room doors ever open.
Sources:
Scientists discover strange link between vitamin D and pain — ScienceDaily
Association between preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery: a prospective observational study — Regional Anesthesia & Pain Medicine
Vitamin D Deficiency — MedlinePlus
Pain medicines after surgery — Mayo Clinic
FAQ: Vitamin D and Surgery Pain
Research suggests vitamin D may influence pain through its effects on inflammation, nerve signaling, muscle function and immune activity. Studies have linked low vitamin D to several pain-related conditions, and a new study found vitamin D deficiency was associated with more pain after breast cancer surgery.
The study found that women with vitamin D deficiency before breast cancer surgery were more than three times as likely to experience moderate to severe pain in the first 24 hours after surgery. They also needed more opioid pain medication.
In this study, women with sufficient vitamin D levels used less opioid medication after surgery than women who were deficient. More research is needed, but the findings suggest correcting low vitamin D before surgery may help improve recovery.
Ask your doctor about a 25-hydroxyvitamin D blood test. This is the standard test used to check vitamin D status.
If your vitamin D level is low, your doctor may recommend vitamin D3 supplementation before surgery. Don’t take high doses without medical guidance, since too much vitamin D can build up in the body.
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