It has been known for some time that there is an association between low/insufficient vitamin D levels and increased risk of developing multiple sclerosis but a newly published study (1) wanted to assess whether vitamin D levels had any influence in patients who already have multiple sclerosis.
I became aware of multiple sclerosis as a condition in my late teens when I did a few weeks volunteer work at a local multiple sclerosis charity centre. Multiple sclerosis is the most common disabling neurological condition affecting young adults. Around 100,000 people in the UK have multiple sclerosis. For more information about the condition please visit the MS society website. The MS Society is the UK’s largest charity for people affected by multiple sclerosis.
Multiple sclerosis is the result of damage to myelin, a protective sheath surrounding nerve fibres of the central nervous system. When myelin is damaged, this interferes with messages between the brain and other parts of the body. For some people, multiple sclerosis is characterised by periods of relapse and remission while for others it has a progressive pattern. For everyone, it makes life unpredictable. Multiple sclerosis, often called MS, is categorised as a type of autoimmune disorder where the body’s own defence system breaks down the protective myelin around nerve fibres. Multiple sclerosis occurs most commonly in adults (those age 18 and over) but a small proportion of cases are diagnosed in children and adolescents.
The current study found that low blood vitamin D levels were associated with a significantly higher risk of relapse attacks in patients who developed the condition during childhood (1). The study found that an increase in vitamin D levels by 10ng/ml blood corresponded with a 34% decrease in the rate of subsequent relapse. The authors of the study explain that potentially raising the vitamin D level of a person with multiple sclerosis by around 15 ng/mL, which requires about 2,000 iu daily of vitamin D supplementation, could theoretically cut a patient’s relapse rate in half (1). However, the study did not look at supplementation so this is just an interesting theoretical prediction by the study scientists.
It is important to reduce replaces, or flare-ups, of MS as much as possible in order to improve the quality of life of the sufferer but also because replaces or flare-ups of multiple sclerosis can be the cause of worsening of old symptoms or causation of new neurological symptoms such as problems with vision, limb numbness or balance. Relapse varies from person to person and can go from being very mild to exceptionally severe.
The results of the study (1) do indicate that there is a strong case for conducting a clinical supplementation trial to see whether vitamin D can reduce relapse rate in multiple sclerosis sufferers. It is also necessary to conduct trials to see how the vitamin D is having an effect, to assess the biological mechanisms of action.
As I was finishing this post I came across another very recent, interesting, study (2). This time it was an association study that links birth month (season) to risk of multiple sclerosis development. The study found that individuals born in the spring seem to have a higher risk of the development of multiple sclerosis later in life. There is a possibility that this has a lot to do with vitamin D levels in the mother during pregnancy. Previous studies have also shown that multiple sclerosis patients are more often born in spring than in any other season, indicating that there is an environmental risk factor for the disease. This recent paper (2) looked at how specific genes (HLA-DRB1 gene) in the body are linked with this seasonal effect. It is known that vitamin D can influence the expression of the specific gene linked to multiple sclerosis and since vitamin D production fluctuates with the seasons, a vitamin D deficit in pregnant mothers could be related to the increased risk of multiple among spring births. However, again, further more detailed studies would be necessary before any conclusions or recommendations could be made.
Vitamin D has been heavily researched over the last 2 years and exciting results have been found with regards many conditions from cancer to heart disease, for more information please visit my past posts on Vitamin D. What is know, as mentioned in my previous posts, is that most people in the UK do not get enough vitamin D and have insufficient/deficient blood levels. There is no current consensus about the amount of daily vitamin D intake necessary to maintain blood levels at around 40-50nmol/l (which is currently seen as optimal by many medical practitioners). I would suggest most adult (age 18 and over) individuals in the UK would require a supplement of around 2000iu vitamin D daily. Higher doses (up to 5000iu daily) may well be useful but I would not recommend such a regimen unless under the supervision of a medical doctor who can monitor blood levels regularly.
(1) Mowry EM et al. 2010. Vitamin D status is associated with relapse rate in pediatric-onset MS. Annals of Neurology. Volume 9999 Issue 999A. DOI 10.1002/ana.21972
Written by Ani Kowal
(2) S. V. Ramagopalan et al. 2009. HLA-DRB1 and month of birth in multiple sclerosis. Neurology. 73: 2107 – 2111
Written by Ani Kowal
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You may find this paper showing the amount of storage of Vitamin D3 in relation to the level of circulating 25(OH)D Calcidiol interesting