MS Patients Get One More Reason To Take Vitamin D

Jan 20 2014 - 4:39pm
MS and vitamin D
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Scientists have uncovered several positive factors about the benefits of vitamin D for individuals with multiple sclerosis (MS). Now a Harvard School of Public Health study provides yet one reason why MS patients should make this nutrient a part of their treatment plan.

Why MS patients need vitamin D
The new study, which appears in JAMA Neurology, is especially important because it involved patients with MS and not animal models. Scientists set out to determine whether the blood concentration of vitamin D (25-hydroxyvitamin D, or 25-[OH]D) was associated with progression and activity of MS among individuals who had a first event suggestive of the disease.

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Measurements of 25-(OH)D levels were taken in 465 patients with MS who were treated with interferon beta-1b. The patients were followed for up to five years using magnetic resonance imaging.

The researchers found that an increase of 50 nmol/L in vitamin D levels within the first year was associated with the following:

  • 57 percent reduced risk of new active brain lesions
  • 57 percent reduced risk of disease relapse
  • 25 percent reduced annual increase in T2 lesion volume. These lesions are detectable on magnetic resonance imaging (MRI) and their presence is used to monitor progression of the disease
  • A 0.41 percent annual loss in brain volume from years 1 to 5

The authors concluded that “Among patients with MS mainly treated with interferon beta-1b, low 25[OH]D levels early in the disease course are a strong risk factor for long-term MS activity and progression.” Interferon beta-1b drugs include the injectables Betaseron and Extavia.

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Other benefits of vitamin D for MS
Here is what some previous studies have shown us about how vitamin D may have a positive impact on MS patients.

  • In a mouse study conducted at Johns Hopkins, vitamin D seemed to help stop certain cells (T-cells) from entering the brain and causing damage to myelin. The myelin is the protective coating on nerve cells, and when it is compromised it can result in symptoms of MS such as pain, tingling, visual problems, weakness, difficulty talking and swallowing, and bladder conditions.
  • Another Johns Hopkins study found that individuals with MS who had low levels of vitamin D had more active disease and more brain lesions than their peers who had higher amounts of the vitamin.
  • On the flip side, a Swedish study found that higher levels of vitamin D are associated with a lower risk of developing MS.
  • In yet another animal study, a team at the University of Wisconsin-Madison found that a single dose of calcitriol (vitamin D3) followed by daily supplements of vitamin D resulted in remission by all of the treated mice. Whether people with MS will respond in the same way is not yet known.

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MS and vitamin D dosing
The definition of a healthy level of vitamin D in the blood varies among experts. The Food and Nutrition Board, for example, says values greater than 20 ng/ml are sufficient for good health while the Vitamin D Council recommends 40 to 80 ng/ml and the Endocrine Society suggests 30 to 100 ng/ml.

If you have MS and your doctor has not discussed vitamin D supplementation with you, it may be time to bring up the topic. You should ask your doctor to test your vitamin D levels before starting any supplementation program to determine the level of dosing necessary to achieve a healthy level.

Sources
Ascherio A et al. Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurology 2014 Jan 20 Online
Nashold FE et al. One calcitriol dose transiently increases Helios+FoxP3+ T cells and ameliorates autoimmune demyelinating disease. Journal of Neuroimmunology 2013 Aug 6.
Vitamin D Council

Image: Pixabay

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Comments

How do the blood levels of vitamin D translate in amount of oral vitamin D taken orally? Do you, instead have to measure the vitamin D in your blood and adjust the oral vitamin D, maybe several times.
David: Thank you for the question. It is generally recommended that people have their vitamin D levels checked (25(OH)D) and then have any supplement doses geared toward their needs. Adequate sun exposure is the most natural way to get your vitamin D, and health professionals often recommend individuals combine time in the sun with their supplement program. People who are deficient may be given up to 50,000 IU once weekly for up to 8 weeks, then rechecked, and then have their dosage adjusted accordingly. One or more vitamin D measurements are typically taken. Each person's needs are different. Decisions regarding dosing with vitamin D should be made by a medical professional.
What is the target level of Vitamin D in the blood?
David: That's a good question, and one I wish experts would agree on. Sufficient blood levels of vitamin D are as follows, according to the following professionals/organizations: 40-80 ng/mL (Vitamin D Council); 30-100 ng/mL (The Endocrine Society); more than 20 ng/mL (Food and Nutrition Board). Most experts seem to agree that the Food and Nutrition Board recommendation is too low.