If you don't like the weather, just wait 5 minutes. Most of you have probably visited some part of the country, if not the world, that is known for its rapidly changing & highly variable climate. I think of the science of medicine along these same lines. Just yesterday, I wrote about the possible dangers of very high dose vitamin D, at least with regards to bone turnover markers. Well, turn about is fair play. So today, I thought I'd mention a research letter published in this week's Archives of Internal Medicine in which the authors randomized 40 young women 18-40yo who suffered from severe dysmenorrhea w/vitamin D <45ng/mL to a single 300,000IU dose of vitamin D vs placebo 5 days prior to their next menstrual cycle and then monitored for 2 months.
Interestingly enough, those randomized to high dose vitamin D reported tremendous 41% reduction from baseline in menstrual cramps compared to those who received placebo and reported no change in pain from baseline. This was corroborated by no use of non-steroidal anti-inflammatories by those women randomized to vitamin D compared to continued use by those who received placebo.
Knowing what we now know from yesterday's study, we should be concerned about the possible issues associated with long term repeated administration of high dose vitamin D. We also don't know if these same results can be replicated in women with higher levels of vitamin D (although it's most likely that this will be a smaller group).
And while I've been preaching over & over again that observational studies are good for developing hypotheses while randomized controlled studies demonstrate cause & effect, I'm afraid the small number of participants and short period of follow up prevent us from making changes to our vitamin D & dysmenorrhea guidelines. In other words, we'll have to wait for a vitamin D study involving greater numbers of women suffering from dysmenorrhea prior to making a blanket recommendation.
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What would be the final recommendation?
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