Dr. Cataldie's Corner

Mary Get’s a “D” for Nutrition

Mary presented to treatment several months ago. She gave an all too increasingly familiar story of her journey into opiate addiction. It all started out after she was injured in a motor vehicle accident three years before her admission. She was given Lortab and liked the feeling. On admission she was up to 180 mg of Roxicodon per day just to function and the chronic pain in her back was worse than ever. She also had generalized muscle, bone, and joint pain. Physical examination revealed pain to touch on her lower legs and her sternum. She was also noted to have a very poor appetite which is not uncommon in opiate addiction. Blood tests showed a very low Vitamin D level. She was detoxed and started on high doses of Vitamin D (which should be done only under MD supervision). Over a period of several weeks, her muscle and joint pain essentially disappeared or as she puts it; “I don’t even think about it anymore. Maybe it was all in my head.” She’s right it was in her head and in her muscles. Muscle cells have vitamin D receptors on them for a reason.  Low Vitamin D makes a person more sensitive to pain and people with low Vitamin D often do not get relief from pain medications. There is also the fact that opiates can actually increase pain. It’s called hyperalgia. Low vitamin D can also cause headaches and fatigue. Long term opiate use and resultant low vitamin D can actually cause your body to reabsorb your own bones in order to get calcium for necessary functions. Vitamin D helps your body absorb dietary calcium though your intestine so you don’t have to dissolve your own skeletal system to get it.  No vitamin D means no dietary calcium is absorbed, so the body raids its own calcium stores from bones. This in turn causes bones to become fragile and break easily (osteoporosis). Mary’s vitamin D levels became normal and she was placed on a maintenance dose of vitamin D.  Interestingly enough, low vitamin D is also associated with depression in some people. Again, vitamin therapy especially with A,D,E,K should be done with medical supervision. Mary is currently involved in aftercare, has a sponsor, has a home group, has returned to work, and is working a 12 step recovery program – one day at a time.


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