Vitamin D and knee osteoarthritis

Vitamin D and knee osteoarthritisMarion Hauser, MS, RD

Doctors based out of Victoria University in Australia writing in the September 2017 issue of Archives of osteoporosis are making a connection between knee osteoarthritis, fall risk, and leg muscle strength in osteoarthritic patients.

Here is what they said and what they were looking to confirm:

  • Low vitamin D status in people with knee osteoarthritis is often reported to be associated with increased pain and locomotor dysfunction (reduced ability to walk).
  • However, despite the growing evidence of the  effect of vitamin D on the development and progression of knee osteoarthritis, vitamin D’s role remains conflicting.
  • (Their) study investigated the effect of circulating 25-hydroxyvitamin D (25 (OH) D) on pain, quadriceps strength, lower limb muscle mass and knee power function during balance recovery in people with knee osteoarthritis.”

Here are their results:

  • Twenty-four participants with clinical symptoms of knee osteoarthritis (who were an average age of about 69 years old) participated in the study.
  • Seven patients (29.1%) were classified as vitamin D-insufficient.
    • These patients demonstrated demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.(1)

Vitamin D foods and knee osteoarthritis

Research: Vitamin D Supplementation Improves Quality of Life and Physical Performance in Osteoarthritis Patients

University researchers in Thailand wrote in the July 2017 edition of the international medical publication Nutrients of how much supplementation would offer benefits in patients:

Here are the highlights of this research:

  • One hundred and seventy-five primary knee osteoarthritis patients with low levels of serum 25(OH)D (<30 ng/mL) received 40,000 IU vitamin D₂ (ergocalciferol) per week for six months.
  • Baseline vitamin D status, 58.90% of patients had vitamin D insufficiency, and 41.10% had vitamin D deficiency.
  • After vitamin D₂ supplementation for six months 57.10% of patients had vitamin D sufficiency and 42.90% had vitamin D insufficiency.

Results:

  • Patient quality of life and pain both improved significantly from baseline to the six-month time point.
  • Knee osteoarthritis patients demonstrated significant improvement grip strength and physical performance measurements after vitamin D₂ supplementation.
  • Vitamin D₂ supplementation for six months also reduced oxidative protein damage.(2)

The effects of vitamin D supplementation on pain in individuals with knee osteoarthritis are open to interpretation and warrant further investigation.

In the December 2015 edition of The Clinical journal of pain, a team of researchers lead by Dr. Toni L. Glover of the University of Florida, College of Nursing and investigators from the University of Alabama wrote about vitamin D, knee pain and problems associated with obesity in patients with knee osteoarthritis.

This study is part of a larger ongoing project at the University of Florida and the University of Alabama at Birmingham that aims to enhance the understanding of racial/ethnic differences in pain and limitations among individuals with osteoarthritic disease (Understanding Pain and Limitations in OsteoArthritic Disease; UPLOAD).

Here are the highlight of their study:

  • Low levels of vitamin D, measured by serum 25-hydroxyvitamin D (25(OH)D), in older adults and obese individuals are correlated with several negative health conditions, including chronic pain.
  • The study patients consisted of 256 (63% female) racially diverse (55% black/African Americans) middle-aged and older adults (mean age 56.8 y).
  • Results demonstrated that obesity was associated with lower levels of 25-hydroxyvitamin D.
  • Participants with adequate 25-hydroxyvitamin D levels reported significantly less knee osteoarthritis pain compared with participants with deficient or insufficient levels, regardless of obesity status.
  • Furthermore, there was a significant interaction between obesity and serum 25-hydroxyvitamin D levels for lower extremity functional performance, such that obese individuals with adequate serum 25-hydroxyvitamin D levels demonstrated better performance than those obese participants with deficient or insufficient serum 25-hydroxyvitamin D levels.

So what to make of this research?

  • The researchers suggest that the mechanisms by which adequate serum 25-hydroxyvitamin D levels are associated with pain severity and improved function have not been completely discovered.
  • Because of the strong association between 25-hydroxyvitamin D levels and knee osteoarthritis pain, it is reasonable to postulate that vitamin D supplementation may help reduce pain affiliated with the condition.
  • While some studies suggest that vitamin D does not regrow cartilage  vitamin D supplementation did improve physical function assessed by a timed 20-meter walk and chair-rise test. In another study vitamin D supplementation in veterans was demonstrated to significantly decrease pain level, number of pain sites, use of pain medication, as well as improve sleep and health-related quality of life.
  • The effects of vitamin D supplementation on pain in individuals with knee osteoarthritis are open to interpretation and warrant further investigation.

 

1 Levinger P, Begg R, Sanders KM, Nagano H, Downie C, Petersen A, Hayes A, Cicuttini F. The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study. Archives of Osteoporosis. 2017 Dec 1;12(1):83.

2 Manoy P, Yuktanandana P, Tanavalee A, Anomasiri W, Ngarmukos S, Tanpowpong T, Honsawek S. Vitamin D Supplementation Improves Quality of Life and Physical Performance in Osteoarthritis Patients. Nutrients. 2017 Jul 26;9(8):799.

3 Glover TL, Goodin BR, King CD, Sibille KT, Herbert MS, Sotolongo AS, Cruz-Almeida Y, Bartley EJ, Bulls HW, Horgas AL, Redden DT. A Cross-sectional Examination of Vitamin D, Obesity, and Measures of Pain and Function in Middle-aged and Older Adults With Knee Osteoarthritis. The Clinical journal of pain. 2015 Dec;31(12):1060-7.

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