Vit D3>125nmol/L min in blood. Info for pwMS

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Re: Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

Postby Cece » Mon Sep 15, 2014 6:22 am

Squeakycat wrote:I also lament the focus on dose not level of so many studies. Surely it is the level that counts, not the amount each person needs to attain a level that has effect.

That is so intuitive and obvious that I am floored to have never questioned the studies being on dose, not level.
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Re: Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

Postby MarkW » Mon Sep 15, 2014 7:27 am

Cece wrote:
Squeakycat wrote:I also lament the focus on dose not level of so many studies. Surely it is the level that counts, not the amount each person needs to attain a level that has effect.

That is so intuitive and obvious that I am floored to have never questioned the studies being on dose, not level.

I need to take some blame that the message on getting D3 above 125nmol/L is a key goal, not the dose. Studies use dose at it is easy to control so this is understandable. A truly scientific study of D3 would give people in the study 5000iu/day and measure their D3 levels. Only people with D3 above 125nol/L would be allowed to continue with the trial. The reasons why a higher D3 level is not achieved are many.
For pwMS I hope they get a baseline of D3, then take 5000iu/day, then re-measure. If D3 levels are not raised then the checks on essential minerals should be undertaken (see Jimmylegs posts) before increasing the D3 dose. While Europeans are permitted to take 10,000IU/day this is considered a mega-dose in USA/Aus. The evidence says that pwMS with higher level of D3 do better than pwMS with lower levels. Not that pwMS who take D3 do better.
I hope that the Hayes study using pulses of Calcitriol, ensures subjects have D3 above 125nmol/L before a Calcitriol pulse is given. Ed (squeakycat)is involved in that study, so I trust they know this.
Kind regards,
MarkW
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

Postby jimmylegs » Tue Sep 16, 2014 6:59 pm

this link will land any interested new readers in the thick of the debate, specifically problems with the statement "If D3 levels are not raised then the checks on essential minerals should be undertaken" post223430.html#p223430
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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Calcitriol + Vitamin D3

Postby MarkW » Tue Oct 21, 2014 10:13 am

Hello 1eye, PointsNorth and Squeakycat,
I have copied a chunk of another post with two different suggestions (15mcg and 20mcg) for the pulse dose of Calciriol to be added to my D3 (blood level is 150nmol/L from summer sun and supplement). I am only 140 pounds (64kg) if your suggestions are body size related.
I will truly appreciate any input.
Kind regards,
MarkW

=======================================================
Postby MarkW » Thu Aug 21, 2014 2:22 pm
PointsNorth wrote:
Perhaps using a large pulse dose of Calcitriol followed by D3 for affected IJV/valve?
https://www.google.ca/#q=endothelial+dy ... calcitriol
My understanding of Calcitriol pulse plus raising Vit D3 blood level also impacts the immune system (see Prof Hayes work posted by SqueakyCat in D3 thread). Personally I would try this if an effective pulse dosage of Calcitriol in humans was known.
Kind regards,
MarkW
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/83598 ... minds.html
--------------------------------------------------------------------------------
Re: VitaminD promotes vascular regeneration
Postby PointsNorth » Thu Aug 21, 2014 7:53 pm
Mark,
15mcg Calcitrol was enough to strengthen my right quad muscle & eliminate clonus. spasticity was greatly reduced at 4 weeks post dosing. Was taking 10Kiu D3 daily. All improvement was lost after discontinuing D3 for 1 week. A member of our group experienced complete elimination of clonus and spasticity within 1 week of his dosing and reported his walking was greatly improved.
PN
Albany 2010. Brooklyn 2011
Hayes inspired Calcitriol+D3 2013-2014
Coimbra Protocol 2014-
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Re: VitaminD promotes vascular regeneration
Postby 1eye » Fri Aug 22, 2014 12:44 pm
I think my right quad muscle has responded very well to 2 days' riding on my recumbent tricycle (yesterday was ~10k). My clonus and spasticity comes and goes, without D3 or Calcitriol. It also tends to respond to small occasional doses of baclofen.
I intend to try a few of these things, and any report of improved walking is welcome to me. My whole left side is weak. I am dizzy when tired.
All improvement was lost after discontinuing D3 for 1 week.
I am wary of any treatment whose benefits go away after such a short time. I am not likely to take Calcitriol or megadoses of D3, if it is not much less temporary than baclofen in its effects. The last thing I need is another symptomatic treatment that requires a lifetime prescription. D3, if it were all that was needed, is at least cheap.
I believe what you say, it's just a lot more information is needed.
--------------------------------------------------------------------------------
Re: VitaminD promotes vascular regeneration
Postby PointsNorth » Sat Aug 23, 2014 12:31 pm
1eye,
15mcg Calcitriol was enough to trigger positive changes re: clonus, muscle strengthening (one) and reduction in spasticity. A trial will hopefully be done to measure changes to the immune profile. If I were you I'd try a 15mcg pulse of Cal while on 10kiu D. I would probably try 20mcg. I could Skype you if your're interested.
Best, PN
Hayes inspired Calcitriol+D3 2013-2014
=================================================================================
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

Postby PointsNorth » Sat Oct 25, 2014 11:55 am

After a blood draw on Sept. 5 and finding calcium, phosphorous, PTH WNL I commenced my Coimbra protocol at 40kiu daily. Had some improvement in clonus/spasticity at weeks 3 & 5 but no improvement since.

Blood draw Oct 17 reveals everything WNL. Increased daily dosing to 60kiu. If still no improvement and blood remains WNL I will consider increasing dose to 80Kiu. Reports of Coimbra using up to 140Kiu.

One trusted individual (SPMS) who was doing Calcitriol+D3 with me said from his research that results (hi-dosing D3) wouldn't be seen for 8-9 weeks.

PN
Albany 2010. Brooklyn 2011
Hayes inspired Calcitriol+D3 2013-2014
Coimbra Protocol 2014-16
DrG B12 Transdermal Spray 2014-16
Progesterone 2015-16
Low-Dose Immunotherapy 2015-16
My Current Regimen http://www.thisisms.com/forum/regimens-f22/topic25634.html
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Re: Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

Postby PointsNorth » Sat Oct 25, 2014 12:16 pm

@ MarkW. Sorry, I misread your post. When first trailing Calcitriol I started at 5mcg and I did not reach the LED lowest effective dose until I reached 15mcg. Above 22.5mcg gave me loose stool. If I were to give advice I would try 20mcg. If you get a result DO NOT stop your D3 supplementation as per Hayes' trial (sept 2013).
Albany 2010. Brooklyn 2011
Hayes inspired Calcitriol+D3 2013-2014
Coimbra Protocol 2014-16
DrG B12 Transdermal Spray 2014-16
Progesterone 2015-16
Low-Dose Immunotherapy 2015-16
My Current Regimen http://www.thisisms.com/forum/regimens-f22/topic25634.html
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Re: Vit D3>125nmol/L min in blood. Info for pwMS

Postby MarkW » Thu Jul 30, 2015 2:12 pm

My advice (started thread in Dec 2010) has a new title. I plan to revive the thread and copy comments from other threads to give pwMS a big picture view of D3. Please note this level applies before and after de-stenosis:
Vital step is to take Vitamin D3, minimum level for pwMS is 125 nmol/L of 25-hydroxyvitamin D in blood (50ng/ml):
- Take 5 to 10,000 IU a day of D3. It is very cheap and safe for adults.
- Target level (minimum for pwMS) is 125 nmol/L of 25-hydroxyvitamin D in blood (50ng/ml). Adjust your dose to achieve the target level.
This long thread contains lots of info on this subject.
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Vit D3>125nmol/L min in blood. Info for pwMS

Postby MarkW » Mon May 02, 2016 9:39 am

After a long time of no posts from me, some more info, with sources highlighted. Now experts have caught up with This Is MS, as our thread started in 2010:

http://multiplesclerosisnewstoday.com/2016/04/25/experts-agree-on-benefits-of-vitamin-d-supplements-despite-circumstantial-evidence/

#CMSC16 – MS Experts Agree on Benefits of Vitamin D Supplements, Despite Mostly Circumstantial Evidence
April 25, 2016 Magdalena Kegelby


A roundtable discussion, provided as a webinar activity organized by the Consortium of Multiple Sclerosis Centers (CMSC) in advance of its June conference, considered the role of vitamin D in multiple sclerosis (MS). Researchers concluded that, while evidence is only circumstantial as to the vitamin’s ability to prevent disease relapses, its multiple health benefits justify its recommended use by all MS patients.

Discussion concerning the link between MS and vitamin D was conducted by Dr. Emmanuelle Waubant, a professor of Clinical Neurology and Pediatrics at the University of California, San Francisco, and Dr. Ellen Mowry, an associate professor of Neurology and Epidemiology at Johns Hopkins University in Baltimore, and moderated by June Halper, the chief executive officer of CMSC.

According to Dr. Waubant, research on the role of vitamin D in MS needs to take several factors into account, in addition to vitamin intake. Transport proteins, enzymes, hormones, and transcription factors are involved in the processing of vitamin D, and might affect the outcomes of supplements consumed.

Nevertheless, the vitamin has receptors scattered throughout the body, including on immune cells such as microglia, macrophages, and B- and T-cells — all key components of MS pathology.

Scientists know that vitamin D is crucial for many aspects of the immune response, and studies have shown that its levels in patients’ blood can determine the frequency and severity of infections. On the cellular level, vitamin D prompts cells to take on a more anti-inflammatory appearance, by secreting less inflammatory and more anti-inflammatory signaling factors. It also shifts T-cell composition to a more anti-inflammatory state, and prevents activated T-cells from entering the brain.

There is, therefore, little doubt that vitamin D provides a range of valuable health effects — effects of importance to everyone, but of particular importance to people with MS.

An entirely different question is whether vitamin D has specific benefits in MS, either by preventing disease development or by hindering relapses in people who are already ill.

Studies showed that children who have lower vitamin D levels more often develop MS as adults. And, as Dr. Waubant pointed out, the supplement levels often recommended in children to prevent deficiency syndromes, like rickets, are far lower than those recommended for children at high risk of developing MS.

Several observational studies also demonstrated that MS patients who have higher blood levels of vitamin D tend to relapse less frequently, according to Dr. Mowry. These studies often find a linear relationship between the two — that is, for every unit of increase in vitamin D levels, the risk for relapse decreases accordingly.

Studies using magnetic resonance imaging (MRI) to determine MS progression have also seen a link between blood levels of the vitamin and the prevention of new lesions. One study showed that vitamin D levels were linked to the loss of gray matter in the brain. If these results are confirmed in other studies, they would indicate that vitamin D has rather strong neuroprotective properties.

“Since loss of neurons seems to drive MS progression, perhaps vitamin D could be … test[ed] in individuals with progressive MS to see if it has any impact on worsening in those patient populations,” said Dr. Mowry.

One study did test the safety of high-dose supplements. Participants receiving up to 40,000 IU per day did not have a dangerous increase in serum calcium levels, the scenario clinicians worry about when prescribing high doses of vitamin D. However, Dr. Waubant warned MS patients against increasing the dose of supplements on their own, as there are no studies investigating long-term effects of very high doses — and too much of a potentially good thing does not necessarily produce better effects.

A particular group of patients needs to be mentioned in this context — pregnant women with MS. Currently, no studies have explored relapse risk and vitamin levels in this group, although neurologists recommend a 50 percent to 100 percent increase in supplementation.

“OBGYNs tend to be conservative about vitamin D, because there are some data in animal models of pregnant animals [showing] that too high vitamin D levels could have a negative impact on the development of the nervous system. But we’re talking here about levels that are really way below that risk,” Dr. Waubant said.

Nevertheless, the findings are observational only, and cannot tell us anything about the cause of a lowered relapse risk. The association between higher vitamin D blood levels and lower relapse rates might be explained by other factors, such as UV-light or melatonin, another factor produced in the skin that is dependent on sunlight. Studies have shown that UV-light seems to be protective in MS, independent of vitamin D levels.

To really conclude that vitamin D impacts the disease, randomized prospective clinical trials are needed. One such trial, the VIDAMS study, is currently underway. The study explores if high-dose supplements — 5000 IU per day — differ from standard 600 IU/day treatment in terms of relapse prevention and MRI measures. (This study, being conducted at a number of U.S. sites, is actively recruiting patients.)

It is crucial for researchers to investigate vitamin D’s impact, regardless of underlying MS treatment. One study found an effect in MS patients receiving interferon beta, but not in non-treated patients. This line of inquiry has not been explored with other treatments.

Studies also need to explore if effects differ depending on gender and ethnicity. Dark-skinned people have a lower production of vitamin D when exposed to sunlight, and physicians sometimes report they also have poorer outcomes.

A key point underscored by the researchers is the need for patients to stay on the supplements prescribed them. “It’s not something that you can just sort of rebuild the bank and then it’s fine. You really have to continue on the vitamin D if you want your levels to be maintained at a specific level,” Dr. Mowry said.

Many patients prefer to improve their vitamin D levels naturally, rather than by taking supplements. Studies, however, show that this is not an easy task considering modern lifestyles. “So, it’s pretty rare to find somebody who is able to maintain an adequate vitamin D level from food alone,” said Dr. Mowry.

The researchers also agreed that it is not advisable to stop taking supplements even during the summer months, when people spend more time in the sun.

“In terms of sun exposure, I think really we tend to overestimate the amount of sun exposure that we’re receiving, in terms of how much can have an effect on the vitamin D levels,” Dr. Waubant concluded.

The possible link between MS and vitamin D levels will also be discussed at the CMSC 2016 Annual Meeting in Maryland on June 1–4.
Last edited by MarkW on Wed May 25, 2016 10:27 am, edited 1 time in total.
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Vit D3>125nmol/L min in blood. Info for pwMS

Postby MarkW » Mon May 02, 2016 10:35 am

Study Associates Obesity in Youth, Low Vitamin D Levels with MS Onset and Progression
April 13, 2016 Alisa Woods, PhD


http://multiplesclerosisnewstoday.com/2016/04/13/factors-associated-with-onset-relapses-or-progression-in-multiple-sclerosis-a-systematic-review/?utm_source=Multiple+Sclerosis&utm_campaign=1f1f98ba7c-RSS_WEEKLY_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_b5fb7a3dae-1f1f98ba7c-71285721

A systematic review of existing medical literature on multiple sclerosis (MS) could shed light on MS causes and predictors for disease progression, and on lifestyle changes — ranging from vitamin D intake to weight loss — that might reduce a person’s risk. The report, “Factors associated with onset, relapses or progression in multiple sclerosis: A systematic review,“ appeared in the journal NeuroToxicology.

Led by Kyla A. McKay of the Division of Neurology, Faculty of Medicine, Djavad Mowafaghian Centre for Brain Health at University of British Columbia, Vancouver, the researchers reviewed existing medical literature to uncover potential MS risk factors. Studies included those published between 1960 to 2012. The investigators used a total of six databases, and focused on those risk factors that can be modified by lifestyle changes or treatment. They identified 15 systematic reviews and 169 original articles.

Overall, the scientists uncovered several factors that could lead to MS onset and progression. These included Epstein-Barr virus exposure, smoking, low serum vitamin D levels, and adolescent obesity. MS relapse increased with low sunlight exposure, low serum vitamin D levels, upper respiratory infections, and stress. Interestingly, relapses dropped during pregnancy, for unclear reasons. Cigarette smoking also increased long-term MS-associated disability.

Investigators noted that obesity may be the most important factor uncovered by their study. “Emerging research with the greatest potential to impact public health was the suggestion that obesity during adolescence may increase the risk of MS; if confirmed, this would be of major significance,” they wrote.

Clearly, reducing obesity rates should be a major health priority for several reasons, including the impact on the onset of MS. The study also indicated several other lifestyle factors that can be modified to reduce MS risk or severity, including exposure to sunlight, increased vitamin D intake, smoking cessation, and stress reduction. Further studies that prospectively assess these factors, and their impact on MS progression and relapse, are warranted.

MS is an autoimmune disease characterized by inflammation. Immune cells attack the body’s own myelin, an insulating substance that helps nerve cells to conduct impulses. MS is the most common cause of neurological disability in young adults. There is increasing evidence that neuron death and loss of the axons that extend from neurons also occurs in MS, due to inflammation. MS causes several symptoms, including sensory problems, cognitive deficits, emotional issues, pain, fatigue, balance problems, walking difficulties, and bladder problems.
Last edited by MarkW on Wed May 25, 2016 10:20 am, edited 1 time in total.
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Vit D3 levels in blood. Info for pwMS

Postby MarkW » Wed May 18, 2016 1:22 pm

A paper in:
Neurology. 2016 Jan 26;86(4):382-90. doi: 10.1212/WNL.0000000000002316. Epub 2015 Dec 30.
Safety and immunologic effects of high- vs low-dose cholecalciferol in multiple sclerosis.

Sotirchos ES1, Bhargava P1, Eckstein C1, Van Haren K1, Baynes M1, Ntranos A1, Gocke A1, Steinman L1, Mowry EM1, Calabresi PA2.
Abstract
OBJECTIVE:
To study the safety profile and characterize the immunologic effects of high- vs low-dose cholecalciferol supplementation in patients with multiple sclerosis (MS).
METHODS:
In this double-blind, single-center randomized pilot study, 40 patients with relapsing-remitting MS were randomized to receive 10,400 IU or 800 IU cholecalciferol daily for 6 months. Assessments were performed at baseline and 3 and 6 months.
RESULTS:
Mean increase of 25-hydroxyvitamin D levels from baseline to final visit was larger in the high-dose group (34.9 ng/mL; 95% confidence interval [CI] 25.0-44.7 ng/mL) than in the low-dose group (6.9 ng/mL; 95% CI 1.0-13.7 ng/mL). Adverse events were minor and did not differ between the 2 groups. Two relapses occurred, one in each treatment arm. In the high-dose group, we found a reduction in the proportion of interleukin-17(+)CD4(+) T cells (p = 0.016), CD161(+)CD4(+) T cells (p = 0.03), and effector memory CD4(+) T cells (p = 0.021) with a concomitant increase in the proportion of central memory CD4(+) T cells (p = 0.018) and naive CD4(+) T cells (p = 0.04). These effects were not observed in the low-dose group.
CONCLUSIONS:
Cholecalciferol supplementation with 10,400 IU daily is safe and tolerable in patients with MS and exhibits in vivo pleiotropic immunomodulatory effects in MS, which include reduction of interleukin-17 production by CD4(+) T cells and decreased proportion of effector memory CD4(+) T cells with concomitant increase in central memory CD4(+) T cells and naive CD4(+) T cells.
CLASSIFICATION OF EVIDENCE:
This study provides Class I evidence that cholecalciferol supplementation with 10,400 IU daily is safe and well-tolerated in patients with MS and exhibits in vivo pleiotropic immunomodulatory effects.
© 2015 American Academy of Neurology.
PMID:
26718578
[PubMed - in process]
PMCID:
PMC4776090
[Available on 2017-01-26]
Last edited by MarkW on Wed May 25, 2016 10:19 am, edited 2 times in total.
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Pregnancy & Vit D3. Info for pwMS

Postby MarkW » Wed May 18, 2016 1:35 pm

JAMA Neurol. 2016 May 1;73(5):515-9. doi: 10.1001/jamaneurol.2015.4800.
Vitamin D Status During Pregnancy and Risk of Multiple Sclerosis in Offspring of Women in the Finnish Maternity Cohort.
Munger KL1, Åivo J2, Hongell K2, Soilu-Hänninen M2, Surcel HM3, Ascherio A4.
Author information
Abstract
IMPORTANCE:
Vitamin D has been associated with a decreased risk of multiple sclerosis (MS) in adulthood; however, some, but not all, previous studies have suggested that in utero vitamin D exposure may be a risk factor for MS later in life.
OBJECTIVE:
To examine whether serum 25-hydroxyvitamin D (25[OH]D) levels in early pregnancy are associated with risk of MS in offspring.
DESIGN, SETTING, AND PARTICIPANTS:
Prospective, nested case-control study in the Finnish Maternity Cohort conducted in May 2011. We identified 193 individuals with a diagnosis of MS before December 31, 2009, whose mothers are in the Finnish Maternity Cohort and had an available serum sample from the pregnancy with the affected child. We matched 176 cases with 326 controls on region of birth in Finland, date of maternal serum sample collection, date of mother's birth, and date of child's birth.
MAIN OUTCOMES AND MEASURES:
Maternal serum 25(OH)D levels were measured using a chemiluminescence assay. The risk of MS among offspring and association with maternal 25(OH)D levels were the main outcomes. Conditional logistic regression was used and further adjusted for sex of the child, gestational age at the time of sample collection, and season of sample collection to estimate the relative risks and 95% CIs.
RESULTS:
Of the 193 cases in the study, 163 were female. Of the 331 controls in the study, 218 were female. Seventy percent of serum samples were collected during the first trimester of pregnancy. The mean (SD) maternal vitamin D levels were in the insufficient vitamin D range, but higher in maternal control than case samples (15.02 [6.41] ng/mL vs 13.86 [5.49] ng/mL [to convert to nanomoles per liter, multiply by 2.496]). Maternal vitamin D deficiency (25[OH]D levels <12.02 ng/mL) during early pregnancy was associated with a nearly 2-fold increased risk of MS in the offspring (relative risk, 1.90; 95% CI, 1.20-3.01; P = .006) compared with women who did not have deficient 25(OH)D levels. There was no statistically significant association between the risk of MS and increasing serum 25(OH)D levels (P = .12).
CONCLUSIONS AND RELEVANCE:
Insufficient maternal 25(OH)D during pregnancy may increase the risk of MS in offspring.
PMID: 26953778 [PubMed - in process]
PMCID: PMC4861670 [Available on 2017-05-01]
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Experts Catching Up???

Postby MarkW » Wed May 18, 2016 1:54 pm

The possible link between MS and vitamin D levels will be discussed at the CMSC 2016 Annual Meeting in Maryland on June 1–4. 2016.
Multiple Sclerosis News Today will offer its readers onsite and continuous meeting coverage, including feature articles, interviews, and social media coverage on Facebook, Twitter, and Pinterest. Social media accounts for Multiple Sclerosis News Today can be found in the upper righthand corner of its homepage.

In preparation, a roundtable discussion, provided as a webinar activity organized by the Consortium of Multiple Sclerosis Centers (CMSC) in advance of its June conference, considered the role of vitamin D in multiple sclerosis (MS). Researchers concluded that, while evidence is only circumstantial as to the vitamin’s ability to prevent disease relapses, its multiple health benefits justify its recommended use by all MS patients.

Discussion concerning the link between MS and vitamin D was conducted by Dr. Emmanuelle Waubant, a professor of Clinical Neurology and Pediatrics at the University of California, San Francisco, and Dr. Ellen Mowry, an associate professor of Neurology and Epidemiology at Johns Hopkins University in Baltimore, and moderated by June Halper, the chief executive officer of CMSC.

According to Dr. Waubant, research on the role of vitamin D in MS needs to take several factors into account, in addition to vitamin intake. Transport proteins, enzymes, hormones, and transcription factors are involved in the processing of vitamin D, and might affect the outcomes of supplements consumed.

Nevertheless, the vitamin has receptors scattered throughout the body, including on immune cells such as microglia, macrophages, and B- and T-cells — all key components of MS pathology.

Scientists know that vitamin D is crucial for many aspects of the immune response, and studies have shown that its levels in patients’ blood can determine the frequency and severity of infections. On the cellular level, vitamin D prompts cells to take on a more anti-inflammatory appearance, by secreting less inflammatory and more anti-inflammatory signaling factors. It also shifts T-cell composition to a more anti-inflammatory state, and prevents activated T-cells from entering the brain.

There is, therefore, little doubt that vitamin D provides a range of valuable health effects — effects of importance to everyone, but of particular importance to people with MS.

An entirely different question is whether vitamin D has specific benefits in MS, either by preventing disease development or by hindering relapses in people who are already ill.

Studies showed that children who have lower vitamin D levels more often develop MS as adults. And, as Dr. Waubant pointed out, the supplement levels often recommended in children to prevent deficiency syndromes, like rickets, are far lower than those recommended for children at high risk of developing MS.

Several observational studies also demonstrated that MS patients who have higher blood levels of vitamin D tend to relapse less frequently, according to Dr. Mowry. These studies often find a linear relationship between the two — that is, for every unit of increase in vitamin D levels, the risk for relapse decreases accordingly.

Studies using magnetic resonance imaging (MRI) to determine MS progression have also seen a link between blood levels of the vitamin and the prevention of new lesions. One study showed that vitamin D levels were linked to the loss of gray matter in the brain. If these results are confirmed in other studies, they would indicate that vitamin D has rather strong neuroprotective properties.

“Since loss of neurons seems to drive MS progression, perhaps vitamin D could be … test[ed] in individuals with progressive MS to see if it has any impact on worsening in those patient populations,” said Dr. Mowry.

One study did test the safety of high-dose supplements. Participants receiving up to 40,000 IU per day did not have a dangerous increase in serum calcium levels, the scenario clinicians worry about when prescribing high doses of vitamin D. However, Dr. Waubant warned MS patients against increasing the dose of supplements on their own, as there are no studies investigating long-term effects of very high doses — and too much of a potentially good thing does not necessarily produce better effects.

A particular group of patients needs to be mentioned in this context — pregnant women with MS. Currently, no studies have explored relapse risk and vitamin levels in this group, although neurologists recommend a 50 percent to 100 percent increase in supplementation.

“OBGYNs tend to be conservative about vitamin D, because there are some data in animal models of pregnant animals [showing] that too high vitamin D levels could have a negative impact on the development of the nervous system. But we’re talking here about levels that are really way below that risk,” Dr. Waubant said.

Nevertheless, the findings are observational only, and cannot tell us anything about the cause of a lowered relapse risk. The association between higher vitamin D blood levels and lower relapse rates might be explained by other factors, such as UV-light or melatonin, another factor produced in the skin that is dependent on sunlight. Studies have shown that UV-light seems to be protective in MS, independent of vitamin D levels.

To really conclude that vitamin D impacts the disease, randomized prospective clinical trials are needed. One such trial, the VIDAMS study, is currently underway. The study explores if high-dose supplements — 5000 IU per day — differ from standard 600 IU/day treatment in terms of relapse prevention and MRI measures. (This study, being conducted at a number of U.S. sites, is actively recruiting patients.)

It is crucial for researchers to investigate vitamin D’s impact, regardless of underlying MS treatment. One study found an effect in MS patients receiving interferon beta, but not in non-treated patients. This line of inquiry has not been explored with other treatments.

Studies also need to explore if effects differ depending on gender and ethnicity. Dark-skinned people have a lower production of vitamin D when exposed to sunlight, and physicians sometimes report they also have poorer outcomes.

A key point underscored by the researchers is the need for patients to stay on the supplements prescribed them. “It’s not something that you can just sort of rebuild the bank and then it’s fine. You really have to continue on the vitamin D if you want your levels to be maintained at a specific level,” Dr. Mowry said.

Many patients prefer to improve their vitamin D levels naturally, rather than by taking supplements. Studies, however, show that this is not an easy task considering modern lifestyles. “So, it’s pretty rare to find somebody who is able to maintain an adequate vitamin D level from food alone,” said Dr. Mowry.

The researchers also agreed that it is not advisable to stop taking supplements even during the summer months, when people spend more time in the sun.

“In terms of sun exposure, I think really we tend to overestimate the amount of sun exposure that we’re receiving, in terms of how much can have an effect on the vitamin D levels,” Dr. Waubant concluded.

The possible link between MS and vitamin D levels will also be discussed at the CMSC 2016 Annual Meeting in Maryland on June 1–4. Multiple Sclerosis News Today will offer its readers onsite and continuous meeting coverage, including feature articles, interviews, and social media coverage on Facebook, Twitter, and Pinterest. Social media accounts for Multiple Sclerosis News Today can be found in the upper righthand corner of its homepage.
Last edited by MarkW on Wed May 25, 2016 10:22 am, edited 3 times in total.
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Video: Dr. Michael F. Holick intro-European Neurological Rev

Postby MarkW » Wed May 18, 2016 2:10 pm

https://www.youtube.com/watch?v=H71_l_-5-7g&feature=youtu.be
In this video, Dr. Michael F. Holick introduces a recently published article in the European Neurological Review, concerning vitamin D deficiency and its possible role in multiple sclerosis development.
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Re: Vit D3>125nmol/L min in blood. Info for pwMS

Postby MarkW » Thu Mar 16, 2017 2:46 pm

Another paper on Vit D3

High dose Vitamin D intake and quality of life in relapsing-remitting multiple sclerosis: a randomized, double-blind, placebo-controlled clinical trial.
Ashtari F1, Toghianifar N2, Zarkesh-Esfahani SH3, Mansourian M4.
Author information
Abstract
BACKGROUND:
Low level of vitamin D is associated with a more severe course and low quality of life in relapsing-remitting multiple sclerosis (RRMS). Low dose vitamin D intake has improved quality of life in RRMS patients.
OBJECTIVE:
This study explored the effect of high dose vitamin D intake on quality of life in RRMS patients in a double blind randomized clinical trial.
METHODS:
94 RRMS patients were randomized to two groups. One group received 50,000 IU vitamin D3 every five days for 3 months. The other group received placebo. Interferon-β (IFN-β) continued as the main treatment in both groups. Quality of life was assessed using MSQOL-54 Persian version at the beginning and at the end of the study.
RESULTS:
After 3 months, the vitamin D group had a significant difference in mental health composite with placebo group, 62.41 ± 13.99 vs. 60.99 ± 17.99 (p-value = 0.041). Change in health was 75.74 ± 25.73 and 70.59 ± 26.45 in vitamin D and placebo group, respectively (p-value = 0.036).
CONCLUSIONS:
Mental QOL improved significantly after taking high dose vitamin D for 3 months in vitamin D group relative to placebo.
KEYWORDS:
Mental health; Multiple sclerosis; Physical health; Quality of life; Vitamin D
PMID:
27597724
Mark Walker - Oxfordshire, England. Retired Pharmacist. 12 years of study around MS.
Mark's CCSVI Comment:
http://www.telegraph.co.uk/news/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Vit D3>125nmol/L min in blood. Info for pwMS

Postby jimmylegs » Thu Mar 16, 2017 4:08 pm

nuances from the TiMS vit d3 forum
natural-approach-f27/topic18559-975.html
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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