Saturday, May 6, 2017

Don't Pin Your Hopes on Vitamin D Supplements

When it comes to knee pain, certain beliefs are vampire-like in their resistance to debunking. You find yourself trying to drive a stake into the heart of these beliefs, but in vain.

Basically, even when evidence-based medicine shows certain treatments and supplements don’t work, some people will continue to cling to them.

Glucosamine is one of these. It’s been extensively, thoroughly debunked as a cartilage regrower, as a pain reliever, as a function improver, but you throw a rock at a Bad Knees Convention, and you’ll hit about twenty people who swear by it. Some will say they can’t leave the house before taking their glucosamine tablet. (My standard disclaimer applies here: if glucosamine helps you, and you’re fine coughing up the money for it, go right ahead. But of course, I also believe if taping a piece of pink construction paper to your nose helps with your knee pain, that’s fine too.)

Another belief that is less widespread regards vitamin D supplements, and their beneficial effect on knee pain. When I wrote this post, I was taking vitamin D myself (not related to knee pain, which I no longer have, but rather for general health reasons). Nowadays the vitamin D fad is kind of burning out, and taking high doses has been shown to cause problems.

Yet I’m willing to bet there are still holdouts when it comes to using vitamin D to treat knee pain. So in their honor, I bring you this study, which is about a year old. The lead of this summary about it:
Vitamin D, which can reduce bone turnover and cartilage degradation, did not slow progression of knee osteoarthritis (OA) or reduce knee OA pain when tested in a randomized placebo-controlled trial.
The study included 413 patients who were considered vitamin D deficient. So, if anyone would see an improvement from taking the vitamin, presumably they would. For two years they took vitamin D (or didn’t if they were in the placebo group). Then MRIs were done and pain scores taken.

The authors concluded:
Results showed that even among study participants with low 25-hydroxyvitamin D, supplementation did not slow cartilage loss or improve WOMAC-assessed pain. These data suggest a lack of evidence to support vitamin D supplementation for slowing disease progression or structural change in knee osteoarthritis.
Fun bit of trivia: The lead researcher on this study was Changhai Ding, who also did the very first study I came across that really buoyed my hopes when I had knee problems. I mention that study in the book: it showed cartilage defects were found to improve about as often as they got worse over a two-year period. Fascinating, amazing, uplifting!

6 comments:

  1. I had a bad experience. Initially I went round several orthopedic consultations with no one diagm=nosing it as chondromalacia patella. I was asked to do blood tests which showed low levels of vitamin D about 4.3. I was told it as a reason for my bilateral knee pain and the diagnosis was delayed by 6 months solely due to this. And when I had appropriate diagnosis, my bilateral knee pain had worsened.

    Regards,
    Healing time

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  2. I was on vitamin D(5000ui daily)/2 years when i was stricken by the knee problem

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  3. And here it is folks. Sanity finally prevails. The British Medical Association recommends against arthroscopic surgery for osteoarthritis of the knee and meniscus tears:

    http://www.bmj.com/content/357/bmj.j1982

    Going to be some knee surgeons making a lot less coin!

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  4. Hello

    On a different subject, have you seen this study that correlates Patellofemoral Pain with anxiety:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876957/

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    Replies
    1. Yes, that makes sense. I think generally the intensity of perceived pain correlates well with anxiety.

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  5. I believe that vitamin D3 1000 IU taken on most days and natural vitamin E (d alpha) 200 IU taken most days was possibly helpful to me in recovering 100% from a severe weight bearing bone bruise with small osteochondral lesion. That, along with strictly avoiding nsaids, ice and PT (since Pt aggravated bb and the nsaids killed my stomach and seemed to have other negative effects) and just doing natural activities (long walks with tons of stairs with light stretching) seemed to cause rapid healing. This along with avoiding reading about knee injuries or focusing on them totally recovered my knee and back after many months of being almost completely incapacitated - I would improve a little and then setback almost to zero - looking at possible invasive knee procedures and spinal fusion as options down the road.

    After a couple of months of the above, I went from unable to walk much and unable to descend stairs in both knees 6 months after bruise and unable to sit more than 2 minutes due to severe back and pelvis pain - as the initial knee injury hurt my other knee and back through compensation - to being able to walk at an aggressive pace for many miles on various terrain and walk or run up and downstairs without handrails or any kind of cautious stepping etc and not even thinking about my knees or back. Anyway, just thought I would share my experience.

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