Micronutrients and Chronic Pain: A Cross-Sectional Analysis

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.

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.

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).

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.