Vitamin D Deficiency: A Hidden Threat to Women Uncovered

Women with vitamin D deficiency tolerate breast removal surgery significantly worse: they are three times more likely to suffer from moderate postoperative pain and require noticeably larger amounts of painkillers. This was demonstrated by an international study, the results of which were published in the journal Regional Anesthesia (RA).

Vitamin D, as the study authors explain, can influence pain perception — it is involved in immune system function and possesses anti-inflammatory properties. Meanwhile, its deficiency is a widespread problem among patients with breast cancer.

The study was conducted at Fayoum University Hospital in Egypt from September 2024 to April 2025. Researchers observed 184 women who were scheduled for radical mastectomy — complete removal of the breast. In half of the participants, vitamin D levels were below the critical threshold of 30 nmol/L, while in the rest they were above it. The average age of the patients was 42–44 years.

The pain management protocol was the same for all: fentanyl was administered during surgery, followed by intravenous paracetamol afterward. In addition, each patient could self-administer tramadol through a special patient-controlled analgesia system.

The results were telling. Women with vitamin D deficiency were approximately three times more likely to experience moderate or significant pain during the first 24 hours after the procedure. At the same time, severe pain — at the level of 7 points or higher on a ten-point scale — was not recorded in either group. The differences pertained specifically to the moderate pain range.

The need for painkillers also differed dramatically. During surgery, patients with low vitamin D levels required on average 8 mcg more fentanyl. However, the most notable gap emerged after the surgical procedure: tramadol consumption in this group was approximately 112 mg higher compared to women without the deficiency.

Another notable finding was that patients with vitamin D deficiency more frequently complained of postoperative nausea. Vomiting was observed exclusively in this group, although no statistically significant difference for this parameter was identified.

The authors emphasize an important caveat: the study was observational in nature and does not prove a direct causal relationship. The analysis did not account for the stage of the oncological disease, anxiety levels, sleep quality, prior therapy, and a number of other factors that could influence pain syndrome.

Nevertheless, the researchers believe that correcting vitamin D deficiency before surgery — in patients with levels below 30 nmol/L — could potentially reduce the severity of postoperative pain and decrease the need for opioid medications.