Vitamin D Levels in Patients Presenting with Non-Specific Neuromuscular Pain and Fatigue in Ethiopia

Ethiop J Health Sci. 2020 May;30(3):337-346. doi: 10.4314/ejhs.v30i3.4.


Background: Vitamin D is an important micronutrient impacting multiple physiologic functions including calcium, phosphorus and bone metabolism. Various studies demonstrate low vitamin D levels in non-specific neuromuscular pain disorders and chronic-fatigue-syndromes. This observation was supported by significant improvement of these disorders following Vitamin D supplementation. Several studies demonstrate low serum vitamin D levels in healthy adult Ethiopians despite availability of abundant sunlight.

Method: Retrospective medical records review of 62 patients presented to Yehuleshet Specialty Clinic between March 2014-August 2015 with non-specific neuromuscular pain and fatigue. Serum vitamin D levels were obtained at initial clinic visit.

Results: The mean (±SD) age was 51.5 ±15.5 years. Two-third (69.4%) of the participants were female. The majority (56.5%) presented with mixed symptoms, including generalized body ache, paresthesia, neck and back pain, while 45.2% reported fatigue. Fifteen (24.2%) participants were on antiepileptic drugs. All patients had initial serum vitamin D levels < 30 ng/ml, among these 62.9% demonstrated severe deficiency (< 12 ng/ml). Thirty (48.4%) participants reported symptomatic improvement after treatment with standard doses of vitamin D and calcium. Age > 50 years, being housewife, use of antiepileptic medications (AEDs), and higher serum parathyroid hormone are associated with severe vitamin D deficiency.

Conclusion: This study demonstrated high prevalence of vitamin D deficiency among patients with non-specific neuromuscular pain and fatigue. Vitamin D replacement resulted in significant clinical improvement. It is important to screen vitamin D in individuals with limited sunlight exposure and patients on AEDs when presenting with neuromuscular pain and fatigue.

Keywords: Neuromuscular pain; fatigue; vitamin D deficiency.

MeSH terms

  • Adult
  • Calcium / blood
  • Calcium / therapeutic use
  • Dietary Supplements
  • Ethiopia / epidemiology
  • Fatigue / blood*
  • Fatigue / etiology
  • Fatigue / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / blood*
  • Pain / etiology
  • Prevalence
  • Retrospective Studies
  • Vitamin D / blood*
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / therapy


  • Vitamin D
  • Calcium