Vitamin D Deficiencies in Pain Patients
by Mark L. Gostine, MD and Fred N. Davis, MD
 Vitamin D’s role in calcium metabolism is well known. In the
last ten years, since the vitamin D receptor (VDR) was cloned and recognized, researchers
realized the compound is more accurately categorized as a hormone with many activities
unrelated to calcium physiology. Vitamin D modulates the immune system, is an important
antiproliferative, and may help treat cancer.1-3 Vitamin D receptors are
present in blood forming elements, pancreatic islet cells, the nervous system, and muscle
tissues.
Vitamin D technically refers to both vitamin D2 and vitamin D3. Vitamin D2 is the
provitamin ergosterol found in plants, while vitamin D3, or cholecalciferol is found in
animals. Either form can prevent osteomalacia and rickets, although vitamin D3 is more
active.
Vitamin D deficiencies were once very common but were generally eliminated with the
advent of vitamin D fortified foods. Unfortunately, the prevalence once again seems to be
widespread in diverse populations. Dark skinned individuals, the obese, the elderly, and
those in northern latitudes seem to be more at risk.4-6
The recurrence of hypovitaminosis D is related to a variety of factors in the modern
lifestyle. These include the explosion of non dairy beverage consumption, a lifetime spent
predominantly indoors, fear of sun exposure, and the widespread adoption of sun screens.
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— Jul/Aug 2006
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