We have only a few studies on natural ingredients in endometriosis. I was hoping to see a positive result with this study, but unfortunately, that was not the case. This study was designed to determine if vitamin D and omega-3 fatty acid supplementation improved endometriosis related pelvic pain in adolescents.
Women aged 12-25 with surgically confirmed endometriosis and pelvic pain were enrolled in a double-blind, randomized, placebo-controlled trial. The vitamin D group included 27 girls/young women, and then 20 in the fish oil group and 22 placebo. Doses were 2,000 IU. of Vitamin D, 1,000 mg of fish oil (including 488 EPA and 178 DHA) or placebo tablets, all of which were taken orally for 6 months. The primary outcome measure was worst pain in the past month measured using the validated visual analog scale (VAS) which quantifies pain on a scale of 0-10, with 0 representing no pain and 10 representing severe pain. A clinically relevant change in VAS pain scores was defined as > 1.6. Secondary outcomes included quality of life.
Girls/women in the vitamin D group experienced significant improvement in VAS from baseline to 6 months, but a similar improvement was seen in the placebo group. A more modest improvement was observed in the fish oil arm, but again, not statistically different from placebo. In essence, in girls or young women with endometriosis, supplementation with vitamin D or fish oil did lead to significant changes in pelvic pain, but it was similar in magnitude to placebo. Because there was a strong placebo effect, this suggests that participating in the study and interaction with a clinical team in and of itself, not the supplements, leads to improvement over a 6 month period.
Reference: Nodler J, DiVasta A, Vitonis A, et al. Supplementation with vitamin D or omega 3 fatty acids in adolescent girls and young women with endometriosis (SAGE): a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2020;00:1-8
