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  • Letter to the Editor
  • Open Access

Headache may be related to vitamin D deficiency

The Journal of Headache and Pain201011:236

  • Received: 15 June 2010
  • Accepted: 21 June 2010
  • Published:


  • Multiple Sclerosis
  • Schizophrenia
  • Colon Cancer
  • Positive Relation
  • Muscle Pain

Dear Sir,

We appreciate the comments of Zhang and colleagues and agree that our review is not sufficient enough to suggest that vitamin D insufficiency causes headache. The purpose of our review was to delineate a relationship of headache prevalence with the latitude, and we noted a significant relation; the prevalence of headache increased with increasing latitude [1]. The geographical variation of a disease could be due to environmental and genetic factors, and a positive relation with latitude hints towards a role of vitamin D. However, as discussed in the article, a number of confounding factors exist, and a possibility of coincidence exists.

In medical science, a hypothesis is proposed to explain some observable facts. Leedy and Ormrod [2] define hypothesis as “a logical supposition, a reasonable guess, and an educated conjecture”. A hypothesis is a speculative idea that has yet to be explored. It may be important as it guides the research. As far as vitamin D is concerned, a causal association of vitamin D deficiency with various diseases was initially suggested by some epidemiological and ecological observations. Later on, many of these disorders were confirmed by various studies. The association of vitamin D with colon cancer is the best example for it [3]. Even a role of vitamin D in the pathogenesis of multiple sclerosis and schizophrenia was first suggested on epidemiological evidences, including a positive relation with latitude [3, 4].

We agree with the authors that observational studies to find decreased levels of serum vitamin D levels in patients with headache and placebo-controlled studies to observe the therapeutic effects of vitamin D in headache are required to confirm our observations. However, at present, a few case series of vitamin D responsive headaches [5], a few observational studies showing low serum vitamin D levels in patients with headache [6], high prevalence of vitamin D insufficiency in patients with generalized muscle pain syndrome and depression (two most common co-morbid conditions with headache disorders) [5], and a high concentration of vitamin D receptor and vitamin D binding protein in the hypothalamus somewhat suggest that an inter-relation exists between vitamin D and headache [1].


Conflict of interest


Authors’ Affiliations

Department of Neurology, Medical College, SSG Hospital, O-19, Doctor’s Quarters, Jail Road, Baroda, Gujarat, 390001, India


  1. Prakash S, Mehta NC, Dabhi AS, Lakhani O, Khilari M, Shah ND (2010) The prevalence of headache may be related with the latitude: a possible role of vitamin D insufficiency? J Headache Pain (in press)Google Scholar
  2. Leedy PD, Ormrod JE (2001) Practical research: planning and design, 7th edn. Merrill Prentice Hall, Upper Saddle RiverGoogle Scholar
  3. Grant WB (2006) Epidemiology of disease risks in relation to vitamin D insufficiency. Prog Biophys Mol Biol 92(1):65–79, 10.1016/j.pbiomolbio.2006.02.013, 1:CAS:528:DC%2BD28XlsFKrsbk%3D, 16546242View ArticlePubMedGoogle Scholar
  4. McGrath J (2010) Is it time to trial vitamin D supplements for the prevention of schizophrenia? Acta Psychiatr Scand 121(5):321–324, 10.1111/j.1600-0447.2010.01551.x, 20525021View ArticlePubMedGoogle Scholar
  5. Prakash S, Shah ND (2009) Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache 49(8):1214–1222, 10.1111/j.1526-4610.2009.01483.x, 19619241View ArticlePubMedGoogle Scholar
  6. Wheeler SD (2008) Vitamin D deficiency in chronic migraine. Headache 48(S1):S52–S53Google Scholar


© Springer-Verlag 2010


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