Skip to main content


Log in

Vitamin D deficiency is associated with anxiety and depression in fibromyalgia

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript


Fibromyalgia is a complex problem in which symptoms of anxiety and depression feature prominently. Low levels of vitamin D have been frequently reported in fibromyalgia, but no relationship was demonstrated with anxiety and depression. Seventy-five Caucasian patients who fulfilled the ACR criteria for fibromyalgia had serum vitamin D levels measured and completed the Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression Score (HADS). Deficient levels of vitamin D was found in 13.3% of the patients, while 56.0% had insufficient levels and 30.7% had normal levels. Patients with vitamin D deficiency (<25 nmol/l) had higher HADS [median, IQR, 31.0 (23.8–36.8] than patients with insufficient levels [25–50 nmol/l; HADS 22.5 (17.0–26.0)] or than patients with normal levels [50 nmol/l or greater; HADS 23.5 (19.0–27.5); Kruskal–Wallis ANOVA on ranks p<0.05]. There was no relationship with global measures of disease impact or musculoskeletal symptoms. Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Wolfe F, Ross K, Anderson J, Russell, IJ, Herbert L (1995) The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38:19–28

    Article  PubMed  CAS  Google Scholar 

  2. Al-Allaf AW, Mole PA, Paterson CR, Pullar T (2003) Bone health in patients with fibromyalgia. Rheumatology (Oxford) 42:1202–1206

    Article  CAS  Google Scholar 

  3. Swezey RL, Adams J (1999) Fibromyalgia: a risk factor for osteoporosis. J Rheumatol 26:2642–2644

    PubMed  CAS  Google Scholar 

  4. Jensen B, Wittrup IH, Bliddal H, Danneskiold-Samsoe B, Faber J (2003) Bone mineral density in fibromyalgia patients—correlation to disease activity. Scand J Rheumatol 32:146–150

    Article  PubMed  CAS  Google Scholar 

  5. Macfarlane GJ, Palmer B, Roy D, Afzal C, Silman AJ, O’Neill T (2005) An excess of widespread pain among South Asians: are low levels of vitamin D implicated? Ann Rheum Dis 64:1217–1219

    Article  PubMed  CAS  Google Scholar 

  6. Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multi-center criteria committee. Arthritis Rheum 33:160–172

    Article  PubMed  CAS  Google Scholar 

  7. Burckhardt CS, Clark SR, Bennett RM (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatol 18:728–733

    PubMed  CAS  Google Scholar 

  8. Aylard PR, Gooding JH, McKenna PJ, Snaith RP (1987) A validation study of three anxiety and depression self-assessment scales. J Psychosom Res 31:261–268

    Article  PubMed  CAS  Google Scholar 

  9. Simonelli C, Weiss TW, Morancey J et al (2005) Prevalence of vitamin D inadequacy in a minimal trauma fracture population. Curr Med Res Opin 21:1069–1075

    Article  PubMed  CAS  Google Scholar 

  10. Sewitch MJ, Dobkin PL, Bernatsky S, Baron M, Starr M, Cohen M, Fitzcharles M-A (2004) Medication non-adherence in women with fibromyalgia. Rheumatology (Oxford) 43:648–654

    Article  CAS  Google Scholar 

  11. Dobkin PL, Abrahamowicz M, Fitzcharles MA, Drista M, da Costa D (2005) Maintenance of exercise in women with fibromyalgia. Arthritis Rheum 53:724–731

    Article  PubMed  Google Scholar 

  12. Landsdowne AT, Provost SC (1998) Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl) 135:319–323

    Article  Google Scholar 

  13. Perez-Fernandez R, Alonso M, Segura C, Munoz I, Garcia-Caballero T, Diguez C (1997) Vitamin D receptor gene expression in human pituitary gland. Life Sci 60:35–42

    Article  PubMed  CAS  Google Scholar 

Download references


The authors wish to acknowledge the assistance of Mrs. Norma Parker and Miss Clara Rose Armstrong in the collection and processing of the data.

Author information

Authors and Affiliations


Corresponding author

Correspondence to D. J. Armstrong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Armstrong, D.J., Meenagh, G.K., Bickle, I. et al. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol 26, 551–554 (2007).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: