The Surprising Link Between Vitamin D & Pain

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The 10almonds Team

Most people, or at least most women of a certain age, know that vitamin D is especially important to us as we get older (women of a certain age, because: increased osteoporosis risk especially for women and especially with untreated menopause, because estrogen and progesterone are also essential for healthy bone turnover*)

*Unless you’re a man with typical manly hormones, in which case, testosterone has you covered! But for the rest of us, estrogen and progesterone are what’s needed to avoid the increased risk, and for all of us, vitamin D is necessary to for health bone rebuilding.

However! While vitamin D is well-known amongst our demographic to be important for bone health (and quite well-known for being relevant to immune health*, too), its effects on some other systems are not so widely understood, and that’s what we’ll talk about today.

*See for example: Does Vitamin D Help Against COVID? ← short answer: vitamin D does so many things for your immune system, and/but no, protecting you from COVID is not one of them. However, it may reduce the risk of long COVID, at least.

First though, a quick vitamin D primer for anyone catching up:

So, what’s this about vitamin D and pain?

It’s about how the body responds

Researchers (Dr. Mahdy Abdelhady et al.) investigated this matter and found that women with vitamin D deficiency who underwent surgery were about 3x more likely to experience moderate to severe postoperative pain and used substantially more opioid medication afterwards.

In numbers:

  • It was an observational study with 184 women undergoing surgery between September 2024 and April 2025, with half of the participants deficient in vitamin D and half having higher levels.
  • Patients with vitamin D levels below 30nmol/L were classified as deficient, while those above that threshold formed the comparison group (we could call it a control group, but since it was an observational study rather than a RCT, we don’t say that).
  • Patients with low vitamin D required more fentanyl during* surgery and, on average, used 112 mg more tramadol after surgery through patient-controlled pain pumps.
  • None of the patients reported extremely severe pain, but the vitamin D deficient group had many more cases of moderate pain scores between 4 and 6 on a 10-point scale.
  • Nausea after surgery was more common in the vitamin D deficient group, and vomiting occurred only in that group, although the vomiting difference wasn’t statistically significant.

*Yes, pain relief is needed even while unconscious during general anesthesia, for reasons explained here: How Does Anesthesia Work?

As for why this happened the way it did: it’s an observational study so we can’t say for 100% sure, but the researchers believe it is likely mostly because of how vitamin D influences pain processing through its effects on inflammation and the immune system, which in turn also affect how the body responds to injury.

You can read this paper in full here: Association between preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery: a prospective observational study

Want to learn more?

We’ve written quite a bit about pain management, including:

Take care!

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  • GLP-1 Drugs As Mood-Brighteners?

    The 10almonds Team

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We first wrote about GLP-1 receptor agonists (i.e. semaglutide drugs like Ozempic and Wegovy) a couple of years ago when popularity was just beginning to take off:

    Semaglutide for Weight Loss?

    However, as we at that time had room only to touch briefly on the side effects and what happens when you stop taking it, you might also want to check out:

    What happens when I stop taking a drug like Ozempic or Mounjaro?

    …and:

    Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

    Body & brain

    A lot of mental health disorders, and/or the medications for them, can affect body weight (in most cases: increasing it, the eating disorders usually do the opposite, unhealthily).

    In the case of antidepressants, we talked about this here: How Much Weight Gain Do Antidepressants Cause?

    …but there are other contenders that are less common (but still very common in the grand scheme of things), such many antipsychotics and mood stabilizers; in both of those cases the most widely-prescribed drugs have weight gain as a side effect.

    So, a large (n=25,677) research review was conducted by Dr. Sigrid Breit & Dr. Daniela Hubl, looking into the safety and efficacy of GLP-1 RAs in patients with (and without) those conditions and/or medications.

    In nutshell: they found that as well as being safe and effective for weight loss, they had mood-improving effects too.

    Some take-aways from their research (if, for brevity, we skip over the metabolic benefits, weight loss, etc, which are all well-established):

    • Five different studies showed mental health improvements in people with schizophrenia, bipolar disorder, or major depression.
    • No increased risk of suicidal ideation or behavior was found with GLP-1 RAs in people with or without mental illness*.

    *in contrast, see: How Serious Are Antidepressant Side Effects?, in which we discuss the potential for (uncommon, but it happens sometimes) paradoxical increase in suicidality upon taking antidepressants

    You may be thinking: “That’s all great, but I don’t have a mental illness”

    If so, then… Congratulations! And also: there are benefits regardless: GLP-1 RAs also improved mood and emotional well-being in people without mental illness, while outperforming insulin and other diabetic drugs.

    As to how it works for mental health, there’s a lot that’s not yet known, but:

    ❝GLP-1 RAs may have antidepressant and anti-anxiety effects, potentially due to their anti-inflammatory and anti-oxidative properties, which can also help reduce neuroinflammation.❞

    ~ Dr. Sigrid Breit

    See also: The Inflamed Mind: A Radical New Approach To Depression – by Dr. Edward Bullmore, for how that works

    As for the research we’ve been writing about today, you can read the paper in full, here:

    The effect of GLP-1RAs on mental health and psychotropics-induced metabolic disorders: A systematic review

    Want a natural method instead?

    For general GLP-1RA effects:

    It is possible to get many of the effects of GLP-1 RAs without taking GLP-1 RAs, by enjoying foods that increase incretin, a hormone group (the most well-known of which is GLP-1) that slows down stomach emptying, which means a gentler blood sugar curve and feeling fuller for longer. It also acts on the hypothalamus, controlling appetite via the brain too (signalling fullness and reducing hunger).

    For what foods to focus on, see: 5 Ways To Naturally Boost The “Ozempic Effect” ← this is from Dr. Jason Fung, who is perhaps most well-known for his work in functional medicine for reversing diabetes, and he’s once again giving us sound advice about metabolic hormone-hacking with dietary tweaks!

    However! If you (correctly) think that there’s a lot we don’t know about how GLP-1 RAs affect (or indeed, effect) weight loss and satiety, it’s nothing compared to what we don’t know about how GLP-1 RAs improve mood, which is, well, as you saw, researchers are guessing, so far. Which is how science should be! Because those guesses can be formulated into hypotheses that can be tested and then either furthered (if the results supported the hypothesis) or changed (if the results didn’t support the hypothesis). But guesses aren’t always where we want to be at when it comes to our personal health, so here are some more evidence-based approaches:

    Take care!

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  • Berberine For Metabolic Health

    The 10almonds Team

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    Is Berberine Nature’s Ozempic/Wegovy?

    Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.

    It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).

    Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:

    • Reduced fasting blood sugar levels
    • Improved insulin sensitivity
    • Reduced LDL and triglycerides
    • Increased HDL levels

    So, what does the science say?

    It’s (mostly!) not nature’s Wegovy/Ozempic

    It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.

    Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.

    Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.

    In less arcane words: it boosts some enzymes and inhibits others.

    Each of these boosts/inhibitions has a positive effect on metabolic health.

    However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.

    See: Effects of Berberine on the Gastrointestinal Microbiota

    Does it work for weight loss?

    Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.

    ❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.

    However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)

    Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞

    (click through to read in full)

    Is it safe?

    It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.

    Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.

    Where can I get it?

    As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.

    Enjoy!

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  • Another Benefit To Coffee: Insulin Sensitivity!

    The 10almonds Team

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We have written before about the health benefits (and risks) of coffee; for most people, the benefits far outweigh the risks, but individual cases may vary:

    The Bitter Truth About Coffee (or is it?) ← this is a mythbusting edition

    Speaking of bitterness; coffee has abundant polyphenols, which means an abundance of benefits that we discuss in the links above and below this line 😉

    See also: Why Bitter Is Better: Enjoy Bitter Foods For Your Heart & Brain ← while it says foods in the title, this does cover coffee too.

    For mythbusting on caffeine specifically, enjoy: Caffeine: Cognitive Enhancer Or Brain-Wrecker?

    There are also gut health benefits from drinking coffee, and what’s good for our gut is invariably good for our heart and brain:

    Coffee & Your Gut ← gut bacteria do not, by the way, have a preference about how you make your coffee or whether it is caffeinated or not

    Aaaaaand, we recently shared new research on how coffee appears to be protective against frailty in older age. We say “appears to be”, because it was a longitudinal study and so technically we cannot say categorically that the link was causal, but the association is very strong, to the point that it’d take quite some explaining if it’s anything other than the coffee consumption that caused it.

    You can read about that here: Coffee vs Frailty!

    Now, the latest: Coffee & Insulin Sensitivity (and how to do it right)

    A large (n=7,453) study of people aged 19–64 examined coffee-drinking habits and insulin sensitivity, looking at markers including the homeostasis model assessment of insulin resistance (HOMA-IR).

    For the women in the study:

    • One cup of black coffee daily reduced HOMA-IR and fasting insulin by 26% and 21%, respectively.
    • Two cups of black coffee daily were linked to a 23% lower risk of elevated fasting insulin or HOMA-IR.
    • Two or more cups of black coffee yielded a 27% and 36% reduction in HOMA-IR and fasting insulin, respectively.

    For the men in the study:

    • In men, no significant associations with glucose metabolism markers were observed. Sorry.

    For those enjoying cream/sugar in their coffee:

    • In those consuming coffee with sugar and/or cream, no significant associations with glucose metabolism markers were observed.

    You can read the paper itself here:

    Association Between Coffee Consumption and Glucose Metabolism Markers in Korean Adults

    Want to learn more?

    French biochemist Jessie Inchauspé, the “Glucose Goddess”, had this to say about the topic of coffee and blood sugars (an adjacent topic to coffee and insulin sensitivity):

    Coffee, From A Blood Sugar Management Perspective

    Lastly… Want to stock up on coffee?

    Here’s a store for Lavazza Coffee that offers discounts if that’s something you like 😎

    Enjoy!

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  • Self-Compassion – by Dr. Kristin Neff

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The 10almonds Team

    A lot of people struggle with self-esteem, and depending on one’s surrounding culture, it can even seem socially obligatory to be constantly valuing oneself highly (or else, who else will if we do not?). But, as Dr. Neff points out, there’s an inherent problem with reinforcing for oneself even a positive message like “I am smart, strong, and capable!” because sometimes all of us have moments of being stupid, weak, and incapable (occasionally all three at once!), which places us in a position of having to choose between self-deceit and self-deprecation, neither of which are good.

    Instead, Dr. Neff advocates for self-compassion, for treating oneself as one (hopefully) would a loved one—seeing their/our mistakes, weaknesses, failures, and loving them/ourself anyway.

    She does not, however, argue that we should accept just anything from ourselves uncritically, but rather, we identify our mistakes, learn, grow, and progress. So not “I should have known better!”, nor even “How was I supposed to know?!”, but rather, “Now I have learned a thing”.

    The style of the book is quite personal, as though having a heart-to-heart over a hot drink perhaps, but the format is organized and progresses naturally from one idea to the next, taking the reader to where we need to be.

    Bottom line: if you have trouble with self-esteem (as most people do), then that’s a trap that there is a way out of, and it doesn’t require being perfect or lowering one’s standards, just being kinder to oneself along the way—and this book can help inculcate that.

    Click here to check out Self-Compassion, and indeed be kind to yourself!

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  • Apples vs Oranges – Which is Healthier?

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    The 10almonds Team

    Our Verdict

    When comparing apples to oranges, we picked the oranges.

    Why?

    In terms of macros, the two fruits are approximately equal (and indeed, on average, precisely equal in the most important metric, which is fiber). So, a tie here.

    In the category of vitamins, apples are higher in vitamin K, while oranges are higher in vitamins A, B1, B2, B3, B5, B6, B7, B9, C, and choline. An easy win for oranges this time.

    When it comes to minerals, apples have more iron and manganese, while oranges have more calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc. Another easy win for oranges.

    So, adding up the sections, a clear win for oranges. But, by all means, enjoy either or both! Diversity is good.

    Want to learn more?

    You might like to read:

    From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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  • Ageless – by Dr. Andrew Steele

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    The 10almonds Team

    So, yet another book with “The new science of…” in the title; does this one deliver new science?

    Actually, yes, this time! The author was originally a physicist before deciding that aging was the number one problem that needed solving, and switched tracks to computational biology, and pioneered a lot of research, some of the fruits of which can be found in this book, in amongst a more general history of the (very young!) field of biogerontology.

    Downside: most of this is not very practical for the lay reader; most of it is explanations of how things happen on a cellular and/or genetic level, and how we learned that. A lot also pertains to what we can learn from animals that either age very slowly, or are biologically immortal (in other words, they can still be killed, but they don’t age and won’t die of anything age-related), or are immune to cancer—and how we might borrow those genes for gene therapy.

    However, there are also chapters on such things as “running repairs”, “reprogramming aging”, and “how to live long enough to live even longer”.

    The style is conversational pop science; in the prose, he simply states things without reference, but at the back, there are 40 pages of bibliography, indexed in the order in which they occurred and prefaced with the statement that he’s referencing in each case. It’s an odd way to do citations, but it works comfortably enough.

    Bottom line: if you’d like to understand aging on the cellular level, and how we know what we know and what the likely future possibilities are, then this is a great book; it’s also simply very enjoyable to read, assuming you have an interest in the topic (as this reviewer does).

    Click here to check out Ageless, and understand the science of getting older without getting old!

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