2400 Units of Vitamin D a Day for Fibromyalgia

Fibromyalgia, one of the most common joint and muscle diseases, afflicting millions of Americans, is characterized by widespread musculoskeletal pain, often accompanied by other symptoms, such as fatigue. The medical profession used to think it was all in people’s heads, “but today there is irrefutable evidence” that it is indeed a disorder of the body and not just the mind.

Back in 2003, an influential paper was published out of the Mayo Clinic in which a shocking 93 percent of fibromyalgia-type patients were found to be vitamin D deficient, so the researchers concluded that all such patients are at high risk of severe vitamin D deficiency. Wait a second, said the skeptics. There was no control group, and where’s the Mayo Clinic located? Minnesota. Maybe 90 percent of everyone in Minnesota is deficient in vitamin D.

When controlled studies were done, some did indeed find that those suffering from these kinds of pain syndromes were significantly more likely to be D deficient, but other studies did not find this. Even if all the studies did have the same findings, though, that doesn’t mean that low vitamin D levels cause fibromyalgia. Maybe chronic, widespread pain disorders like fibromyalgia cause low vitamin D. After all, it’s the sunshine vitamin, and perhaps fibromyalgia patients aren’t running around outside as much as healthy controls. To know if vitamin D is contributing to the disease, you have to put it to the test. 

Various studies found that the majority of those with pain syndromes and low D levels appeared to benefit from vitamin D supplementation, and clinical improvement was evident in up to 90 percent of patients. But these studies weren’t controlled either. Maybe the subjects would have gotten better on their own without the supplements, or maybe it was the placebo effect. There are many examples in the medical literature of treatments that looked great in uncontrolled trials, like hyperbaric oxygen therapy for multiple sclerosis, but when put to the test in randomized controlled trials, they failed miserably.

And, that’s what seemed to happen in the first randomized controlled trial of vitamin D for a fibromyalgia-type syndrome in 2008. As you can see at 2:55 in my video The Best Supplement for Fibromyalgia, researchers saw no significant difference in pain scores, though the study only lasted three months, and, in that time, the treatment was only able to get the vitamin D blood levels up to about 30. Unfortunately, no controlled study had ever been done pushing levels any higher, until 2014. As you can see at 3:23 in my video, fibromyalgia patients were given up to 2400 units of vitamin D a day for 20 weeks and their D levels rose up to about 50. Then, once they stopped the vitamin D, their levels came back down to match the placebo. That was reflected in their pain scores: a significant drop in pain severity while they were on the D and then back to baseline when they came off of it. The researchers concluded “that this economical [in fact, over-the-counter] therapy with a low side effect profile may well be considered in patients with FMS [fibromyalgia syndrome].”


What changes in our diet may help combat fibromyalgia? See my videos Fibromyalgia vs. Vegetarian and Raw Vegan Diets and Fibromyalgia vs. Mostly Raw & Mostly Vegetarian Diets.

What else can vitamin D supplements do? Check out:

What’s the best way to get vitamin D? See:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Benefits of Slow Breathing

There are all manner of purported hiccup “cures,” which include everything from chewing on a lemon, inhaling pepper, or, our dog’s favorite, eating a spoonful of peanut butter. In my video How to Strengthen the Mind-Body Connection, I talk about the technique I’m excited to try the next time I get hiccups: “supra-supramaximal inspiration,” where you take a very deep breath, hold for ten seconds, then, without exhaling, breathe in even more and hold for another five seconds, and then take one final, tiny breath in and hold for five last seconds to achieve “an immediate and permanent termination to hiccups…”

When I was a kid, I taught myself to control my own hiccups using slow-paced breathing, and, as an adult, was so excited to see there was finally a case report written up on it.

There’s a nerve—the vagus nerve—that goes directly from our brain, to our chest, and to our stomach, connecting our brain back and forth to our heart and our gut, and even to our immune system. The vagus nerve is like the “‘hard-wired’ connection” that allows our brain to turn down inflammation within our body. When you hear about the mind-body connection, that’s what the vagus nerve is and does. “There has been increasing interest in treating a wide range of disorders with implanted pacemaker-like devices for stimulating the vagal afferent [vagus nerve] pathways,” but certain Eastern traditions like Yoga, QiGong, and Zen figured a way to do it without having electrodes implanted into your body.  

“A healthy heart is not a metronome,” as a study titled exactly that explains. “Your heart rate goes up and down with your breathing. When you breathe in, your heart rate tends to go up. When you breathe out, your heart rate tends to go down.” Test this out on yourself right now by feeling your pulse change as you breathe in and out.

Isn’t that remarkable?

That heart-rate variability is a measure of vagal tone—the activity of your vagus nerve. Next time you’re bored, try to make your heart rate speed up and slow down as much as possible within each breath. This can be done because there’s an entirely other oscillating cycle going on at the same time, as you can see at 2:08 in my video, which is the speeding up and then slowing down of your heart rate, based on moment-to-moment changes in your blood pressure. And, as any physics student can tell you, “all oscillating feedback systems with a constant delay have the characteristic of resonance,” meaning you can boost the amplitude if you get the cycles in sync. It’s like pushing your kid on a swing: If you get the timing just right, you can boost them higher and higher. Similarly, if you breathe in and out at just the right frequency, you can force the cycles in sync and boost your heart rate variability, as you can see at 2:36 in my video.

And what’s the benefit again? According to the neurophysiologic model postulation it allows us to affect the function of our autonomic nervous system via vagal afferents to brainstem nuclei like the locus coeruleus, activating hypothalamic vigilance areas.

Huh?

In other words, it’s not just about curing hiccups. Practicing slow breathing a few minutes a day may have lasting beneficial effects on a number of medical and emotional disorders, including asthma, irritable bowel syndrome, fibromyalgia, and depression. In the United States, we’ve also put it to use to improve batting performance in baseball.

To date, most studies have lacked proper controls and have used fancy biofeedback machines to determine each person’s resonant frequency, but, for most people, it comes out to be about five and a half breaths per minute, which is a full breath in and out about every 11 seconds. You can see the graph at 3:34 in my video. When musicians were randomized into slow-breathing groups with or without biofeedback, slow breathing helped regardless. It’s the same with high blood pressure. As you can see at 3:52 in my video, you can use this technique to significantly drop your blood pressure within minutes. The hope is if you practice this a few minutes every day, you can have long-lasting effects the rest of the day breathing normally.

Practice what exactly? Slow breathing—taking five or six breaths per minute, split equally between breathing in and breathing out. So, that’s five seconds in, then five seconds out, all the while breathing “shallowly and naturally.” You don’t want to hyperventilate, so just take natural, shallow breaths, but be sure to simply breathe really slowly. Try it the next time you get hiccups. Works for me every time!


For more tips, watch my video on How to Stop Hiccups.

And, because slowing down our pulse in general may also have beneficial effects, I encourage you to check out:

Every time I’m amazed by ancient wisdom, I have to remind myself of the video I did on toxic heavy metals—Get the Lead Out. So, though traditional healing methods may offer a plethora of insights, they still need to be put to the test.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: