Background Fibromyalgia (FM) is a chronic hypersensitivity pain syndrome with altered central pain processing. Whether vitamin D deficiency contributes to this pain syndrome has not been clearly defined.
Objectives From among all new patients referred over a three-year period to our clinics by G.P.s, our aims were to identify the new patients diagnosed with FM and to analyse their vitamin D levels.
Methods At first visit to our clinics, we record patients’ demographics, their musculoskeletal diagnosis and pre-determined clinical data in a database which is continually updated at follow-up visits. We performed a retrospective database review of all new patients seen between 1/1/2009 – 31/12/2011 to identify patients diagnosed anew with FM. Using ACR 1990 FM criteria, the diagnosis was confirmed by chart review and their vitamin D levels were recorded. Vitamin D deficiency was defined as a 25 hydroxy-vitamin D level of <75 nmol/L (<30ng/mL); severe deficiency as <25 nmol/L.
Results Between 1/1/2009 – 31/12/2011, 696 new patients were seen: 62 (9%) had FM of which 60 (97%) were female, 2 were male. The average age was 43 years (range 18 - 72). Race: 60 Caucasian (97%), one African (1.5%), one Asian (1.5%). In 54 of the FM patients, FM was the only musculoskeletal diagnosis. Eight patients had FM and another musculoskeletal condition at presentation (5 osteoarthritis, 1 gout and osteoarthritis, 1 psoriatic arthritis, 1 shoulder capsulitis). Vitamin D levels were available for 55 of these FM patients (89%) with results as follows: <75 nmol/L in 42 (76%), <25 nmol/L in 12 (22%) and ≥75 nmol/L in 13 (24%) patients.
Conclusions Three-quarters of newly diagnosed FM patients had hypovitaminosis D and more than 1 in 5 had severe deficiency. This could reflect background vitamin D deficiency which is prevalent in Ireland. Another postulate is that some non-specific pain syndromes are caused by subclinical osteomalacia misdiagnosed as FM. Should vitamin D deficiency be corrected before we label patients as having FM? More research is needed in this area.
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Disclosure of Interest None Declared