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. doi: 10.3109/02813432.2010.505407.


Objective: To investigate vitamin D levels in patients with non-specific musculoskeletal pain, headache, and fatigue.

Design: A cross-sectional descriptive study.

Setting: A health center in Oslo, Norway, with a multi-ethnic population.

Subjects: A total of 572 patients referred by a general practitioner (GP) for an examination of hypovitaminosis D who reported musculoskeletal pain, headache, or fatigue. The patients' native countries were: Norway (n = 249), Europe, America, and South-East Asia (n = 83), and the Middle East, Africa, and South Asia (n = 240). Both genders and all ages were included.

Main outcome measures: Vitamin D levels (25-hydroxyvitamin D) in nmol/L.

Results: Hypovitaminosis D (25-hydroxyvitamin D < 50 nmol/L) was found in 58% of patients. One-third of ethnic Norwegians had hypovitaminosis D, while 83% of patients from the Middle East, Africa, and South Asia had hypovitaminosis D with minimal seasonal variation of levels. One in two women from these countries had a vitamin D level below 25 nmol/L. Mean vitamin D level was lower in patients with headaches compared with patients with other symptoms. Some 15% of patients with low (< 50 nmol/L) vitamin D levels reported headaches, compared with 5% of those with normal vitamin D levels.

Conclusion: Our study shows a high prevalence of hypovitaminosis D in patients with non-specific musculoskeletal pain, headache, or fatigue for whom the GP had suspected a low vitamin D level. Hypovitaminosis D was not restricted to immigrant patients. These results indicate that GPs should maintain awareness of hypovitaminosis D and refer patients who report headaches, fatigue, and musculoskeletal pain with minimal sun exposure and a low dietary vitamin D intake for assessment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Fatigue / blood*
  • Fatigue / etiology
  • Female
  • Headache / blood*
  • Headache / etiology
  • Humans
  • Male
  • Musculoskeletal Diseases / blood*
  • Musculoskeletal Diseases / etiology
  • Norway / epidemiology
  • Norway / ethnology
  • Pain / blood*
  • Pain / etiology
  • Sunlight
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / ethnology


  • Vitamin D
  • 25-hydroxyvitamin D