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Vitamin D may be an effective treatment for chronic tension headaches

Posted on: April 15, 2011   by  John Cannell, MD

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Question: True or False?

Vitamin D is the best treatment for chronic tension headaches.

 

Answer: Maybe.

Standard treatments are pretty bad. I predict vitamin D will become a standard treatment option in the future. Sometimes one scientist gets hold of a subject and keeps writing about it and sometimes I will write about such a scientist. Dr. Prakash, of the Medical College in Gujarat, India, is such a man.

First, Dr. Prakash treated 8 patients with chronic tension headaches with vitamin D. All eight had failed conventional treatment but all eight responded to vitamin D. Although a small open study, many great discoveries first see daylight in exactly this manner.

Prakash S, Shah ND. Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache. 2009 Sep;49(8):1214-22.

Then Dr. Prakush asked himself the usual questions:

  • Are headaches less common close to the equator?
  • Are they less common in the summer?
  • Are they less common at high altitude?

He searched the literature and found evidence that scientists answered two of his three questions years ago. Yes, headaches are less common close to the equator and in the summer. Apparently, no one knows if high altitude helps headaches but confounders may preclude it from being answered.

Prakash S, Mehta NC, Dabhi AS, Lakhani O, Khilari M, Shah ND. The prevalence of headache may be related with the latitude: a possible role of Vitamin D insufficiency? J Headache Pain. 2010 Aug;11(4):301-7. Epub 2010 May 13. Review.

By the way, the same association with low vitamin D and headache was found more recently by researchers at the University of Oslo in Norway. In a lovely and well-written paper Dr. Kirsten Knutsen and her colleagues found that of all the three groups they studied, patients with (1) headaches, (2) local musculoskeletal pain, and (3) fatigue with generalized musculoskeletal pain, the patients with headaches had the lowest 25(OH)D levels, 14 ng/ml.

In this, her first vitamin D paper (actually I believe her first peer-reviewed journal paper of any kind), Dr. Knutsen ends by advising physicians to be on the lookout for patients with these pain symptoms and vitamin D deficiency.

I agree and add that in my experience, vitamin D is the single best treatment for chronic tension headaches but sometime levels in the high normal ranges are needed, 70-90 ng/ml.

Knutsen KV, Brekke M, Gjelstad S, Lagerløv P. Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scand J Prim Health Care. 2010 Sep;28(3):166-71.

 

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