Is vitamin D deficiency a confounder in alcoholic skeletal muscle myopathy?

Excessive intake of alcohol is often associated with low or subnormal levels of vitamin D even in the absence of active liver disease. As vitamin D deficiency is a well-recognized cause of myopathy, alcoholic myopathy might be related to vitamin D deficiency. Chronic alcoholic myopathy affects approximately half of chronic alcoholics and is characterized by the insidious development of muscular weakness and wasting. Although alcohol or its metabolites may have a direct toxic effect on muscles, the relationship between alcoholic myopathy and vitamin D deficiency has not been examined extensively.

We reviewed the literature on alcoholic myopathy and hypovitaminosis D myopathy and compared the pathophysiological findings to designate possible mechanisms of vitamin D action in alcohol-related myopathy.

Given the strong interdependency of suboptimal levels of vitamin D, phosphate, and magnesium in chronic alcohol abuse, we hypothesize that combined deficiencies interfere with membrane and intracellular metabolic processes in chronic alcohol-related myopathy; however, it is not yet possible to define exact mechanisms of interaction.