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F. Michael Gloth III, MD; Jennifer M. Lindsay, PA-C; Lorrie B. Zelesnick, PA-C; William B. Greenough III, MD

Arch Intern Med. 1991;151(8):1662-1664.

Abstract
An unusual pain occurred in five patients in the presence of compromised vitamin D status and resolved 5 to 7 days after supplementation with vitamin D in the form of ergocalciferol. The pain had a hyperesthetic quality and did not respond to the use of analgesics, including opiate derivatives. Treatment with therapeutic levels of a tricyclic antidepressant did not bring relief of symptoms. In one case, months after treatment and subsequent improvement of vitamin D status and pain, the vitamin D status again declined and the pain recurred. The pain again resolved with vitamin D replacement and improvement of levels. There may be a pain syndrome associated with vitamin D depletion that appears as hyperesthesia worsened by light, superficial pressure or even small increments of movement. This pain restricts mobility and function and may lead to further complications, such as pressure sores.

(Arch Intern Med. 1991;151:1662-1664)

Author Affiliations
From the Division of Geriatric Medicine and Gerontology, Department of Medicine, The Johns Hopkins University School of Medicine (Drs Gloth and Greenough) and The Francis Scott Key Medical Center (Drs Gloth and Greenough and Mss Lindsay and Zelesnick), Baltimore, Md.

Footnotes
Accepted for publication November 21, 1990.

Reprint requests to Gerontology Research Center/Applied Physiology Section, 4940 Eastern Ave, Baltimore, MD 21224 (Dr Gloth).

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