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Anorexia, Bone Pain, Joint Pain, and Body Aches

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Anorexia nervosa (AN) is a serious eating disorder that affects both the mind and the body. People with anorexia nervosa often have pain throughout the body, including bone and joint pain and muscle and backaches. 

There are several reasons why these body aches and pains can occur in people who have anorexia nervosa.

Anorexia, Bone Pain, Joint Pain, and Body Aches

Vitamin and Mineral Deficiencies Commonly Seen in Anorexia

We get the nutrients our bodies need to function properly from food, which is digested through the gastrointestinal (GI) tract. The GI tract, in turn, breaks down food, and nutrients are then transported throughout the body to where they are needed. 

Since those with anorexia severely limit the amount of food they eat, their bodies don’t get the vitamins and minerals they need to perform vital functions. 

Severely malnourished anorexia nervosa patients in recent studies were found to have the following nutrient deficiencies: (1) 

  • Vitamin A
  • Vitamins B1, B9, and B12
  • Vitamin C
  • Vitamin D
  • Vitamin K
  • Calcium
  • Copper
  • Iron
  • Magnesium
  • Manganese
  • Phosphorus
  • Potassium
  • Selenium
  • Thiamine
  • Zinc

These vitamin and mineral deficiencies can cause all kinds of problems in the body for those with anorexia. Aches, pains, and weakness in the muscles, joints, bones, and other parts of the body that make up the musculoskeletal system are just a few that deficiencies in vitamins B, C, D, and K, as well as many minerals, can lead to. (2,3)

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Joint Pain and Anorexia

Joints need many nutrients to function effectively, including vitamins C and D. The vitamin C deficiency that occurs in anorexia can cause joint pain. The tissue that is contained in joints and connects bones and muscles together contains collagen. Collagen becomes fragile when there’s a vitamin C deficiency, which results in joint pain. 

Vitamin D deficiency is also associated with knee aches and weakness. (4) Studies have shown that higher levels of vitamin D can stop inflammation in the joints. 

When muscles waste away, as often happens in people who have anorexia, joints weaken without the muscle mass to support them. Magnesium supplementation has been found to improve the ability to move and walk in those who have lost muscle mass. 

A manganese deficiency can also cause joint pain. This trace mineral is needed for the body to make its own chondroitin sulfate and glucosamine, which help prevent joint pain. Many people take chondroitin sulfate and glucosamine supplements for joint health.

Joints also need silica for cartilage. Although there isn’t currently any measurement tool for silica as a nutrient, supplements such as diatomaceous earth have been found to help bones and joints heal.

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Bone Pain and Anorexia

Vitamin D helps the body absorb calcium. Without enough vitamin D, the body can’t absorb calcium, which promotes bone growth. Low calcium, vitamin D,and vitamin B12 levels in those who have anorexia result in loss of bone density (osteoporosis) and weakened bones (osteomalacia) over time,causing fractures to occur. It’s estimated that up to 90% of women with anorexia have low bone mineral density associated with risk of fracture. (7) Thus, bone pain may be directly related to vitamin and mineral deficiencies. 

But restoring healthy bones is possible.

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Anorexia Body Aches 

The aches and pains people with anorexia frequently experience may be caused by inflammation in the body. Inflammation, in turn, is caused by deficiencies in Vitamin D and omega 3 fatty acids, which inhibit prostaglandin E2, which causes inflammation in the body. So those with low vitamin D levels generally experience  more pain. Supplements can help reduce muscle  pain. (8)

Magnesium also stops pain by blocking NMDA receptors that send pain signals into the body. Many people with anorexia have a magnesium deficiency, so they tend to feel more pain, since pain signals are not suppressed.

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Back Aches, Body Pain, and Anorexia 

The vitamin D deficiency common in anorexia can also contribute to back aches, rib pain, leg pain, and widespread pain in the body, such as what happens in fibromyalgia. (9) A thiamine deficiency can also contribute to pain.

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Muscle Pain and Weakness 

Deficiencies in vitamin D, thiamine, and phosphorus can cause muscle weakness throughout the body, too. This pain and general weakness is experienced by many people with anorexia nervosa.

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When to Get Help for Anorexia

It’s never too early or late to get help for anorexia nervosa.This eating disorder can do serious life-long damage to the body, and even be deadly if left untreated for too long. However, early intervention and an individualized treatment approach can be very effective and lead to lasting recovery. If you are looking for help overcoming anorexia nervosa,, please reach out for professional help immediately. The clinical care team at Within Health offers highly specialized, personalized care for eating disorders. We’re here for you when you’re ready.

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Frequently asked questions

Resources

  1. Hanachi, M., Dicembre, M., Rives-Lange, C., Ropers, J., Berner, P., Zazzo, J., Poupon, J., Dauvergne, A., Melchior, J. Micronutrients deficiencies in 374 severely malnourished anorexia nervosa inpatients. Nutrients. 2019 Apr 5;11(4):792. Accessed January 14, 2022.  https://pubmed.ncbi.nlm.nih.gov/30959831/
  2. Urano, A., Hotta, M., Ohwada, R., Araki, M. Vitamin K deficiency evaluated by serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa with bone loss. Clinical Nutrition. 2015 Jun;34(3):443-8. Accessed January 14, 2022.  https://pubmed.ncbi.nlm.nih.gov/24909585/
  3. Woodruff, P.W., Morton, J., Russell, G.F. Neuromyopathic complications in a patient with anorexia nervosa and vitamin C deficiency. International Journal of Eating Disorders. 1994 Sep;16(2):205-9. Accessed January 15, 2022.  https://pubmed.ncbi.nlm.nih.gov/7987355/
  4. Mat, S., Jaafar, M.H., Sockalingam, S., Raja, J., Kamaruzzaman, S.B., Chin, A., Abbas, A.A., Chan, C.K., Hairi, N.N., Othman, S., Cumming, R., and Tan, M.P. Vitamin D deficiency is associated with ethnicity and knee pain in a multi-ehtnic South-East Asian nation: Results from Malaysian Elders Longitudinal Research (MELoR). International Journal of Rheumatic Diseases. 2018 May21(5):930-936. Accessed January 14, 2022.  https://pubmed.ncbi.nlm.nih.gov/29611292/https://pubmed.ncbi.nlm.nih.gov/12346313/
  5. Fazeli, P.K. Low bone mineral density in anorexia nervosa:  Treatments and challenges. Clinical Reviews in Bone and Mineral Metabolism. 2019 Jun;17(2):65-76. Accessed January 14, 2022. https://pubmed.ncbi.nlm.nih.gov/31938025/
  6. Heide-Frankling M, Bjorkhem-Bergman L. Vitamin D in pain management. Int J Mol Sci. 2017 Oct 18;18(10):2170. Accessed January 13, 2022.  https://pubmed.ncbi.nlm.nih.gov/29057787/
  7. Doulberis, M., Papaefthymious, A., Kountouras, J., Polyzos, S.A., Srivastava, S., Klokowska-Roetzler, J., Perrig, M., Papoutsi, S., Exadaktylos, A.K., Srivastava, D.S. Vitamin D deficiency and unclear abdominal pain in patients from low- and middle-income countries. International Journal of Environmental Research and Public Health. 2019 Nov 20;16(23):4607. Accessed January 13, 2022.  https://pubmed.ncbi.nlm.nih.gov/31757059/
  8. Heidari, B., Shirvani, J.S., Firouzjahi, A., Heidari, P., Hajian-Tilaki, K.O. Association between nonspecific skeletal pain and vitamin D deficiency. International Journal of Rheumatic Diseases. 2010 Oct;13(4):340-6. Accessed January 14, 2022.  https://pubmed.ncbi.nlm.nih.gov/21199469/
  9. Linus Pauling Institute. Accessed January 14, 2022. https://lpi.oregonstate.edu
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