Vitamin D Supplements Associated With Lower Opioid Dependence Among Patients With Palliative Cancer, Vitamin D Deficiency

Previous studies have demonstrated an association between low levels of vitamin D in the blood and pain, sensitivity to infection, fatigue, depression, and lower self-rated quality of life.

Patients with palliative cancer and vitamin D deficiency who receive vitamin D supplements may have a reduced need for opioid pain relief and lower levels of fatigue during treatment, according to a study published in Cancers. Previous studies have demonstrated an association between low levels of vitamin D in the blood and pain, sensitivity to infection, fatigue, depression, and lower self-rated quality of life.

The randomized, placebo-controlled study enrolled 244 patients with palliative cancer between 2017 and 2020, all of whom had a vitamin D deficiency at the start of the study. These patients received either 12 weeks of treatment with a relatively high dose of vitamin D (4000 IE/day) or a placebo. At the beginning of the study, as well as 4, 8, and 12 weeks from the start of the study, the investigators measured changes in opioid doses as a measure of pain.

“The results showed that vitamin D treatment was well tolerated and that the vitamin D-treated patients had a significantly slower increase in opioid doses than the placebo group during the study period,” said Linda Björkhem-Bergman, MD, senior physician at Stockholms Sjukhem, in a press release. “In addition, they experienced less cancer-related fatigue compared to the placebo group.”

Despite these improvements in pain management and fatigue, there was no observed difference in antibiotic use or self-rated quality of life between the supplement arm and the placebo arm, according to the investigators.

“The effects were quite small, but statistically significant and may have clinical significance for patients with vitamin D deficiency who have cancer in the palliative phase,” said Maria Helde Frankling, senior physician at ASIH, in the release. “This is the first time it has been shown that vitamin D treatment for palliative cancer patients can have an effect on both opioid-sensitive pain and fatigue.”

The investigators said a potential weakness of their study was the large drop-out rate. Of the 244 patients enrolled, only 150 were able to complete the full 12-week study, as many patients died from their cancer during the study.

REFERENCE

Vitamin D reduces the need for opioids in palliative cancer [news release]. EurekAlert; August 5, 2021. Accessed August 6, 2021. https://www.eurekalert.org/news-releases/924548