Research over the years has shown that maintaining adequate levels of vitamin D may have a protective effect and lower the risk of developing multiple sclerosis (MS). A number of studies have shown that people who get more sun exposure and vitamin D in their diet have a lower risk of MS. Therefore, vitamin D supplementation is considered an important modifiable environmental risk factor for development of multiple sclerosis.
Vitamin D could cure MS
Some studies suggest that for people who already have MS, vitamin D may offer some benefits. These benefits include lessening the frequency and severity of their symptoms, improving quality of life, and lengthening the time it takes to progress from relapsing-remitting multiple sclerosis to the secondary-progressive phase. But the evidence isn't conclusive. Vitamin D supplementation in people with MS appears to be safe but at high doses can lead to changes in calcium levels. More research is needed to determine whether it's truly beneficial.
Experts also need to better understand how vitamin D might affect MS. When a person has MS, his or her immune system attacks the coating that protects the nerve cells (myelin). Research suggests that a connection between vitamin D and MS could be tied to the positive effects vitamin D has on the immune system.
The Institute of Medicine recommends 600 international units (IUs) of vitamin D a day for adults up to age 70. The recommendation increases to 800 IUs a day for adults age 71 and older. The recommendation for women who are pregnant or breast-feeding is 600 IUs per day. However, the Institute of Medicine recommends avoiding taking more than 4,000 IUs a day.
If you are diagnosed with vitamin D deficiency, it may be appropriate to use up to 50,000 IUs weekly for up to three months until your vitamin D levels become normal, and then switch to a maintenance dose. The maintenance dose varies, but is usually between 2,000 and 5,000 IU daily.
Very large doses of vitamin D over an extended period can result in toxicity. Signs and symptoms include nausea, vomiting, constipation, poor appetite, weakness and weight loss. In addition, vitamin D toxicity can lead to elevated levels of calcium in your blood, which can result in kidney stones.
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We know MS is more common in countries further away from the equator. There are many possible reasons for this pattern. But researchers are particularly interested in the role that sunlight (and therefore vitamin D) could play in MS.
In 2015 scientists demonstrated a clear link between low vitamin D and MS. They found that people who naturally had lower levels of vitamin D (because of their genetics) were more likely to develop MS. Researchers in Oxford have also discovered that vitamin D could affect the way a gene linked to MS behaves. They showed that when vitamin D was present, the gene was more active. This groundbreaking research could help us understand more about the role vitamin D plays in developing MS.
While there are still a lot of unanswered questions, the evidence is growing that there is a protective role for vitamin D in MS. Researchers have looked to see if low levels of vitamin D at different stages of development can affect someone's future risk of MS.
The study did not find that increasing levels of vitamin D beyond the recommended levels reduced the risk of developing the condition though. This adds to previous research linking the month you were born in and the risk of developing MS. In 2016 a large and very detailed study was carried out, involving over 21,000 people with MS. Researchers found that people who had been born in November were less likely to have developed MS than those born in April.
Research shows a lack of vitamin D in early childhood might increase the risk of developing MS later in life. Studies show people who have moved to a new country during childhood adopt the risk of the country they move to. But if people migrate later in life (in their twenties or later), they keep the risk profile of their country of birth.
There is some evidence that lower levels of vitamin D are associated with higher relapse rates in MS. One study found that people with higher levels of vitamin D (above 50 nmol/l) were less likely to have relapses or new MRI lesions after five years.
A 2015 study found that high dose vitamin D could affect the immune system. Taking 10,400 international units (IU) of vitamin every day for six months reduced the number of certain immune cells that are known to cause damage in MS. The trial involved 40 people with relapsing MS, but didn't test if vitamin D reduced relapses or slowed progression.
In 2015, scientists at our Cambridge Centre for Myelin Repair revealed a role for vitamin D in promoting myelin repair. They found that adding vitamin D boosted the number of myelin-making cells present in the brain by 80% in rats. The vitamin D receptor protein pairs with an existing protein already known to be involved in myelin repair, called RXR gamma.
In July 2016 the UK Government recommended that everyone take vitamin D supplements to promote bone health (10 micrograms/400 IU per day if you're older than one). This includes women who are pregnant or breastfeeding but was not specific to people with MS.
Low vitamin D levels in newborns could increase their future risk of MS, according to new research. Scientists found that children born with very low levels of vitamin D were more likely to develop MS in later life.
Vitamin D is fat soluble vitamin. It helps regulate calcium metabolism. It is important in promoting absorption of calcium/phosphorus in the gut to support bone integrity. Vitamin D is synthesized by the skin from sunlight. Vitamin D needs toundergo conversion from its inert state by process of hydroxylation initially in the liver.
Converting to 25-hydroxyvitamin D(25 OH D) and then in the kidney which produces the active form 1,25 dihydroxy vitamin D (calcitriol). Vitamin D is also found in certain foods and pill supplements. A wide array of clinical and basic science literature has established the importance of adequate levels of vitamin D in the prevention of rickets in children, and osteoporosis, osteopenia, hip fracture and osteomalacia in older adults.
Animal studies have been able to demonstrate that EAE (experimental autoimmune encephalomyelitis) could not be elicited in mice that had sufficient Vitamin D levels. It is theorized that the amount of sunlight exposure affects the production of Vitamin D and the hormonal form of Vitamin D may be a selective immune regulator and potentially could inhibit the development of the disease. Some studies indicate that relapse rates were decreased in MS patients taking higher oral supplements of Vitamin D but the data is limited. There have been retrospective studies that suggest that EDSS (Expanded Disability Status Scale) scores increased in patients that had Vitamin D deficiency. A recent study done in Australia indicates that sunlight exposure and Vitamin D intake may be independent factors affecting risk for CNS demyelination. There is currently a significant interest in Vitamin D and researchers are continuing to study what role Vitamin D may play in diseases including Multiple Sclerosis. For example, evidence points to the direct and indirect regulation of T cell development and function by vitamin D. In animal models, in the absence of vitamin D and signals delivered through the vitamin D receptor, auto reactive T cells develop and in the presence of active vitamin D (1,25(OH)(2) D(3) ) and a functional vitamin D receptor the balance in the T cell response is restored and autoimmunityavoided.
There is currently no evidence that this vitamin deficiency is the cause of Multiple Sclerosis. There has been increased interest that Vitamin D deficiency is prevalent in areas where there is less sunlight exposure and being further away from the equator in both directions. We also know that Multiple Sclerosis is more often found in northern climates (above 40 degrees latititude). The highest incidence of Multiple Sclerosis is found in Scandinavian countries wherethere is lower sunlight exposure. The correlation of decreased sunlight and decreased Vitamin D synthesis in immune system function is not fully understood at this time.
Patients with hypercalcemia, hypervitaminosis D, malasorption syndrome, decreased renal function. Caution needs to be exercised with use of Vitamin D supplements in patients with heart disease, renal calculi, or arterosclerosis.
At the Mellen Center we feel that the preponderance of accumulated data means that we should be focusing on vitamin D supplementation and recommend trying to get patients into the normal range of vitamin D levels unless there are countervailing contraindications.
You might have heard that vitamin D helps to lower the risk for multiple sclerosis (MS). Or that it helps lessen symptoms in people who already have the disease. Evidence suggests that getting enough of this vitamin might protect against MS by holding back your immune system from attacking your own nerve cells. 2ff7e9595c
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