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: 3 July 2010

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


  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


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