Are Your Constant Headaches Due to Low Vitamin D?

When Deficiency Leads to Head Pain

Close-up of hand holding vitamin d pills
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Have you heard your friends talking about their vitamin D level? Did you doctor check your level at your annual checkup?

While vitamin D plays a role in bone health, there is inconsistent data on its role in other medical conditions, such as heart disease, autoimmune diseases, cancer, and pain disorders, like chronic pain and headaches. 

What Is Vitamin D?

Vitamin D is a fat soluble vitamin that exists in two forms:
• cholecalciferol (vitamin D3): derived from ultraviolet light penetrating the skin and present in oily fish, such as salmon and tuna.


• ergocalciferol (vitamin D2): derived from the fungal sterol, ergosterol, and found naturally in sun-dried, shiitake mushrooms.

Both forms of vitamin D are used in the fortification of foods and in vitamin D supplements.

What Is Vitamin D Deficiency?

When individuals are vitamin D deficient, parathyroid hormone levels in the body increase, causing calcium to be leeched from the bones. This leads to bone weakening, causing rickets in children and osteomalacia in adults—patients with osteomalacia have diffuse bone and muscle pain and weakness.

If your doctor decides to check your vitamin D status, he will measure your 25-hydroxyvitamin D level.

What Causes Vitamin D Deficiency?

A number of medical conditions can predispose individuals to vitamin D deficiency including:

  • malnutrition
  • kidney or liver disease
  • gut malabsorption, as in celiac disease

Low sunlight exposure is also a concern for vitamin D deficiency, especially those who reside in nursing homes or who live in geographical regions with little daylight.

Vitamin D and Head Pain

There may be a link between headaches and vitamin D deficiency. In 2009, two researchers in India published a paper in Headache—a study on eight patients with both vitamin D deficiency and chronic tension-type headaches.

All the patients in the study had very low vitamin D levels (25-hydroxyvitamin D levels <10ng/mL), and had little to no relief of their headache with conventional drugs.

The patients were supplemented with daily vitamin D (1000-1500IU) and calcium (1000mg), and obtained headache relief within a few weeks of therapy.

The researchers felt that the vitamin D—not the calcium—was more essential to headache relief due to the timing of the relief. They explained that calcium levels typically return to normal within a week, but the patients did not feel relief of their headache for four to six weeks, which is when their vitamin D levels started returning to normal.

In another study in The Journal of Headache Pain, researchers found that with increasing latitude (moving closer to the North and South Pole and farther away from the equator), the prevalence of headaches, both migraines and tension-type headaches, increased.

As you may already know, the increase in latitude (or the farther you get from the equator) correlates with less intense and a shorter duration of sunlight. With less sunlight, there is less vitamin D absorption, so presumably lower levels overall.

What Is a Sufficient Vitamin D Level?

While there is no consensus on the optimal level of vitamin D, most experts believe that a 25-hydroxyvitamin D level under 20 nanograms per milliliter or ng/mL is deficient. Depending on your other medical problems, your doctor may even prefer a higher vitamin D level—there are simply no definitive guidelines at this time. 

The Bottom Line

Remember that a link or association does not mean that one causes the other. The big picture here is that low vitamin D may contribute to head pain. In other words, headaches may be more common in people who live farther from the equator where there is less sunlight. But this is certainly not a hard and fast rule and more studies—especially large randomized controlled trials—are needed to better articulate this relationship.

Being aware of the potential association between headaches and vitamin D will make you a more informed patient. Consider discussing your physician's opinion on vitamin D or other alternative therapies for your headaches, especially if they are not improving with your current regimen. 

Sources:

Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266-81.

Holick MF et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-30.

Prakash S, Mehta, NC, Dabhi AS, Lakhani O, Khilari M, Shah ND. The prevalence of headache may be related with the latitude: a possible role of Vitamin D insufficiency? The Journal of Headache & Pain. 2010;11(4):301-7

Prakash, S. Shah ND. Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache. 2009;49(8):1214-22.

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