title: Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway.
abstract: OBJECTIVE
  To investigate vitamin D levels in patients with non-specific musculoskeletal pain, headache, and fatigue.
  
  
  METHODS
  A cross-sectional descriptive study.
  
  
  METHODS
  A health center in Oslo, Norway, with a multi-ethnic population.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Practice and Community Medicine, Institute of Health and Society, University of Oslo, Norway. k.i.v.knutsen@medisin.uio.no
authors.forename: Kirsten Valebjørg
authors.initials: KV
authors.lastname: Knutsen
authors.forename: Mette
authors.initials: M
authors.lastname: Brekke
authors.forename: Svein
authors.initials: S
authors.lastname: Gjelstad
authors.forename: Per
authors.initials: P
authors.lastname: Lagerløv
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000097:blood* / Q000209:etiology; D005260:Female; D006261:Headache / Q000097:blood* / Q000209:etiology; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000097:blood* / Q000209:etiology; D009664:Norway / Q000453:epidemiology / Q000208:ethnology; D010146:Pain / Q000097:blood* / Q000209:etiology; D013472:Sunlight; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology / Q000208:ethnology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D