Vitamin D metabolites are known to be involved in hundreds, possibly thousands of gene transcriptions in the genes themselves. This makes it not really a true vitamin. The website www.vitamindcouncil.org has regular updates comparing the relationship of vitamin D levels to many pathophysiologies, but seldom mentions them in relation to musculoskeletal pain. We do know from a 2003 study by Plotnikoff and Quigley that D hypovitaminosis is common with non-specific musculoskeletal pain.

I have lifted the following article written by Dr John Cannell MD from the website in its entirety because of the description of an astounding drop in the bodies vitamin D levels after elective surgery as reported below.

Reid D, Toole BJ, Knox S, Talwar D, Harten J, O’Reilly DS, Blackwell S, Kinsella J, McMillan DC, Wallace AM. The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty. Am J Clin Nutr. 2011 May;93(5):1006-11. Epub 2011 Mar 16.

“Dr. Reid and colleagues of the University of Glasgow found 25(OH)D fell dramatically after a knee replacement. “

“They measured 25(OH)D before and after a knee replacement on 33 subjects and found 25(OH)D reduced by 40% from before to 2 days after the surgery. Even at three months, 25(OH)D was still 20% lower than preoperative levels indicating, perhaps, the healing knee was “using up” or metabolically clearing the vitamin D. Again, since we don’t know what the 25(OH)D levels were before the MIs in Dr. Barth’s paper, we don’t know if acute MI’s metabolically clear any vitamin D. I suspect they do, although nothing like a knee replacement, which involves major damage to a large joint.”

“While we only definitively know about the effects of knee replacement surgery on 25(OH)D, I think in the meantime it’s important to be sufficient in vitamin D for lots of reasons when going to the hospital. The take home message is that if you are going into the hospital for any reason, especially surgery, make sure you have plenty of vitamin D reserves by having your 25(OH)D at around 50 ng/ml before admission.”

The three best ways to get your vitamin D dosage optimized are in order; get out in the sun for at least part of the day, go to a tanning bed if the sun don’t shine, and thirdly take a vitamin D supplement. I can’t tell you how much to take because I’m not a doctor. Dr Cannell can, and does, on his website.

Let the sun shine in…

Stew