Micronutrients and Chronic Pain: A Cross-Sectional Analysis

Abstract:

Objectives: Awareness about the role of micronutrients in the development of chronic pain has drastically increased. We investigated how serum micronutrient levels differ in subjects with chronic pain compared to pain-free subjects.

Methods: A cross-sectional study was conducted with subjects from the All of Us database, divided into cohorts of no, mild/moderate, and severe pain based on numeric rating scale scores. We examined serum levels of vitamins D (25OH-D), C, B12, folate, and magnesium-micronutrients found to be involved in chronic pain (38,006; 656; 62,110; 25,937, and 93,445 subjects, respectively) and defined them as normal, deficient, or borderline deficient based on reference ranges. We examined the variation of these findings based on sex and race/ethnicity.

Results: Subjects with severe pain had lower 25OH-D, B12, and folate levels than those with mild/moderate pain and/or without pain (p < 0.001). We found a higher incidence of 25OH-D, vitamin C (males), and magnesium deficiency in subjects with severe pain (p < 0.05). Black and White subjects with severe pain had lower levels of 25OH-D and folate (p < 0.05 for 25OH-D, NS for folate in Black males, and p < 0.001 for the other groups), but lower vitamin B12 only in Whites (p < 0.001 for females and p < 0.05 for males). Asian and Hispanic females also had lower folate (p < 0.01 and p < 0.001, respectively).

Discussion: We found lower 25OH-D, B12, and folate, and a higher incidence of 25OH-D, vitamin C (males), and magnesium deficiency at subjects with chronic pain, more consistent in Blacks and Whites than in Asians and Hispanics. Micronutrient repletion may influence chronic pain.