Vitamin D Reduces the Need for Opioids in Cancer Patients

Summary: Chronic pain management and treatment in palliative care is quite challenging, like in terminally ill cancer patients. These patients often require high-dose opioids to control pain. Even worse, doctors often need to keep increasing opioid dosage to manage pain. However, high-dose opioids may cause many side effects. Studies show that vitamin D deficiency is pretty common in old adults and terminally ill patients. A new study shows that adding vitamin D to the treatment may help manage pain, reduce opioid dosage, and also help reduce fatigue.

Severe pains, fatigue, and mood disorders are widely prevalent among cancer patients. Chronic pains are a big problem among terminally ill patients. The prevalence of cancer-associated chronic pains is increasing due to increasing cancer incidence.

Chronic pain management in cancer patients is essential to improve their quality of life. It is especially vital, considering that many of them are terminally ill. However, issues with long-term opioid use are well known. Here the concerns are not only about opioid addiction. The even greater concern is that with time many patients become resistant to opioids, thus requiring even higher dosages. Further, opioids may only add to such issues as fatigue.

Vitamin D is amazing in many ways. Just a few decades back, it was mainly associated with bone health. However, new studies have shown that it has many functions. It is needed for hormonal health, metabolic health, and more. Most people living with chronic ailments like cancer have low vitamin D levels in their bodies. Studies show that low vitamin D is associated with worsening mood, fatigue, and many other symptoms.

Vitamin D is now widely used to manage conditions, apart from improving bone health. New studies show that it can even increase bone mass, prevent diabetes, help reduce cancer risk, boost cardiovascular health, help manage depression, reduce symptoms of multiple sclerosis, promote weight loss, and more. Hence, there is a strong scientific basis for exploring its role in chronic pain and palliative care. Also, a proper amount of vitamin D helps in withstanding chemotherapy aches and pains. 

Consequently, researchers from Sweden decided to explore the role of vitamin D in the palliative care of cancer patients. They were especially interested in exploring if vitamin D could improve their quality of life, reduce fatigue, improve mood, and help manage pain. 

Swedish researchers conducted a multicenter randomized, placebo-controlled, double-blind trial in multiple palliative care centers in Sweden. They enrolled 244 patients living with cancer. The intervention group received 4000 IU vitamin D3/Day for 12 weeks, and the control group received a placebo. 

The researchers also focused on multiple aspects like opioid dose and antibiotic use. They found that those on vitamin D have a lower opioid requirement. These groups were less likely to increase the opioid dose when compared to the placebo group. Those who received vitamin D also reported less fatigue. However, antibiotic use among the two groups remained unchanged.

Since vitamin D is a highly safe treatment, these findings are quite interesting. Prescribing vitamin D to patients along with painkillers may help improve treatment outcomes. Such patients are less likely to require a higher dosage of opioids and may also report other benefits like improved mood and reduced fatigue.

Although this study was mainly in palliative cancer patients, these findings may be used to improve the quality of life of those living with chronic pain for various reasons. First, vitamin D supplementation is more likely to help those living with its deficiency. Unfortunately, though, it may not help much in those living with normal vitamin D levels. 

Hence, it is a good idea for those living with symptoms like chronic pain and fatigue to monitor their vitamin D level. Of course, vitamin D would not substitute painkillers, but it can help significantly. Moreover, it can help reduce pain, fatigue, depression, and more. It may even help improve metabolic health. 

By Gurpreet Singh Padda, MD, MBA, MHP