Canadians and Vit D

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Postby Nick » Thu Jun 08, 2006 2:24 pm

bromley wrote:
What can we do? Not much about the genes until they identify them. Not much about a possible infectious agent until identified. Maybe something on hormones e.g. testosterone gel for men shown to have good effects in small trial. Boosting Vit D seems a sensible option - although not sure if we have missed the boat i.e. is it too late if you already have it? Definitely worth ensuring that your children are given supplements / sun exposure.


Indeed the matter of vitamin D's influence on active MS is uncertain yet there's enough data to imply it can have an influence. The graph from this paper that I have provided before suggests vitamin D, in high enough concentrations significantly influences disease progression.

Mind you this paper critiques the data Embry et al used (from Aur et al) yet in their study they used PwMS from two continents to address the seasonality of MS activity. Embry's use of Aeur et al's data concerns a group of MS'ers in the same part of Germany. In my mind this was necessary in establishing the link between MS and vitamin D.


bromley wrote:PS All you Americans - don't forget that the US is also playing in the world cup (you call it soccer but it's football really)


Tis a bummer Canada didn't qualify this time around. Maybe next time mate.

Cheers
Nick
Last edited by Nick on Wed Jun 14, 2006 9:34 am, edited 2 times in total.
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Postby viper498 » Thu Jun 08, 2006 2:42 pm

What does "et al" mean?

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Postby LisaBee » Thu Jun 08, 2006 3:13 pm

It's probably some Latin abbreviation.

It means all the other authors on a scientific papers. Many papers have three or more authors (sometimes more than a dozen!), so as example Jones et al. 1993 is a shorthand citation for Jones as the first author, and all the others on that paper. Usually if there are only two authors, like Jones and Smith, it is cited Jones and Smith, 1993.


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Right on, Lisa!

Postby lyndacarol » Thu Jun 08, 2006 3:37 pm

et al. is an abbreviation for the Latin "et alia" which means "and others"

You are absolutely correct, Lisa.
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Postby bromley » Fri Jun 09, 2006 5:38 am

Apologies if the following has been posted before:

http://www.mstrust.org.uk/news/recentst ... sp?id=1092
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Postby LisaBee » Fri Jun 09, 2006 4:48 pm

bromley,

The article is interesting because it mentions that sunlight exposure (leading to vitamin D production) may help prevent MS, or at least some cases. No one says anything about whether it can help delay or prevent progression, or even, dare we say it, cause a remission. No one has has done a systematic study, monitoring 25-OHD and 1,25-OHD levels, as they go, to determine if getting blood levels up to what appear to be optimum, based on the research of Veith and others, and measuring indexes of MS progression/improvement. Below is the closest thing I could find that was published. The results appear a little underwhelming, but it was a short study of less than a year, the active hormone versus the prehormone was administered, and no data was presented on blood level at baseline versus at the end of the study, maybe that is in the body of the paper. The relapse rate was about one fourth the previous year, although the people were selected on the basis of having at least one relapse in the previous year - they weren't randomly selected. THe subjects weren't blinded. I couldn't find other studies where calcitriol (1,25-OHD) was administered as a maintenance oral dose, usually it was administered either intravenously as a pulse dosage, [followed by maintenance with calcidiol (the more familiar D3)] or, in dermally applied creams.


I am looking forward to finding out how the Toronto Vitamin D study is going. Any news?

Lisa
***********

J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1294-6. Related Articles, Links


A pilot study of oral calcitriol (1,25-dihydroxyvitamin D3) for relapsing-remitting multiple sclerosis.

Wingerchuk DM, Lesaux J, Rice GP, Kremenchutzky M, Ebers GC.

Mayo Clinic, Scottsdale, Arizona, USA. wingerchuk.dean@mayo.edu

BACKGROUND: Epidemiological and ecological studies suggest links between vitamin D deficiency and increased multiple sclerosis (MS) prevalence. OBJECTIVE: To evaluate the safety and tolerability of oral calcitriol therapy in an open label pilot study. METHODS: 15 ambulatory patients with relapsing-remitting MS and at least one clinical relapse within the previous 12 months received oral calcitriol (target dose: 2.5 microg/d) for 48 weeks. Dietary calcium was restricted to 800 mg/d. Patients were monitored using frequent clinical and laboratory examinations, the expanded disability status scale (EDSS), and brain magnetic resonance imaging (MRI). RESULTS: Two patients withdrew because of symptomatic hypercalcaemia (serum calcium >3.35 mmol/l in each case) resulting from persistent dietary indiscretion. Two diet compliant patients required temporary dose adjustments for mild asymptomatic hypercalcaemia. Diet compliant patients experienced mild adverse effects. The on-study exacerbation rate (27%) was less than baseline. Four patients experienced five clinical relapses but only one patient worsened by >1 EDSS point. Brain MRI revealed enhancing lesions in five patients at baseline (33%) and in four (29%) at both 24 and 48 weeks. CONCLUSIONS: Oral calcitriol is safe and well tolerated for up to one year by diet compliant relapsing-remitting MS patients. Further study of vitamin D related mechanisms is warranted in MS.

Publication Types:
Clinical Trial

PMID: 16107372 [PubMed - indexed for MEDLINE]
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calcitriol, calcidiol, magnesium, calcium

Postby jimmylegs » Sat Jun 10, 2006 7:58 am

i have seen that calcitriol abstract before. does anyone else think that's a little too narrow an approach? i think, perhaps, that we need D3 in all it's stages, not just the last one, or else why would there be these different forms? maybe they were just trying it out by itself to show that it's not dazzlingly effective on it's own.

Med Hypotheses. 1986 Oct;21(2):193-200.
Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D.
Goldberg P, Fleming MC, Picard EH.

A group of young patients having multiple sclerosis was treated with dietary supplements containing calcium, magnesium and vitamin D for a period of one to two years. The experimental design employed self-pairing: the response of each patient was compared with his/her own case history as control. The number of exacerbations observed during the program was less than one half the number expected from case histories. No side effects were apparent. The dietary regimen may offer a new means of controlling the exacerbation rate in MS, at least for younger patients. The results tend to support a theory of MS which states that calcium and magnesium are important in the development, structure and stability of myelin.
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monkey wrench

Postby jimmylegs » Sat Jun 10, 2006 8:00 am

and just to throw a spanner in it, i just found this

"MS may be associated with primary disorders of BC Clinical forms of Mg depletion with hBC in MS present diurnal exacerbations and relapses during fair seasons. They have been underestimated because they disagree with the dogma of the << latitude gradient >>, presently questioned. "

i did not know the latitude thing was disputed - will investigate and see if i can find some documented anomalies. maybe they are talking about the known pockets of inconsistencies that have already been attributed to higher altitude or high dietary vitamin d?
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ta da!

Postby jimmylegs » Sat Jun 10, 2006 11:36 am

think i've seen this before but what the heck, here it is again if it's already been posted:

Dietary Calcium Is a Major Factor in 1,25-Dihydroxycholecalciferol Suppression of Experimental Autoimmune Encephalomyelitis in Mice1
Margherita T. Cantorna 2 Jean Humpal-Winter and Hector F. DeLuca3
Department of Biochemistry, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, WI 53706

The active form of vitamin D (1,25-dihydroxycholecalciferol) is a potent immune system regulator. Treating mice with 1,25-dihydroxycholecalciferol and feeding them diets high in calcium can completely suppress the induction of experimental autoimmune diseases such as experimental autoimmune encephalomyelitis (EAE). Experiments described here were carried out on mice in which development of EAE was induced. Mice were fed diets containing various amounts of calcium and 1,25-dihydroxychole-calciferol. Variables measured were as follows: 1) incidence and severity of EAE; 2) serum calcium concentrations; 3) body weight; 4) total number of cells in the lymph nodes; and 5) interleukin-4 (IL-4) and transforming growth factor-ß1 (TGF-ß1) mRNA levels. When calcium was removed from the diet, the incidence of EAE was reduced 20% in both males and females. Further, the lower the dietary level of calcium, the higher was the dose of 1,25-dihydroxycholecalciferol required to prevent the symptoms. Thus, 1,25-dihydroxycholecalciferol was found most effective in mice fed a diet adequate or high in calcium. 1,25-Dihydroxycholecalciferol treatment of mice fed high dietary calcium resulted in a decreased number of lymphocytes in the lymph nodes and increased IL-4 and TGF-ß1 mRNA levels. When calcium was omitted from the diet, 1,25-dihydroxycholecalciferol supplementation increased TGF-ß1 mRNA. Increased IL-4 mRNA and decreased lymphocytes in the lymph nodes in response to 1,25-dihydroxycholecalciferol occurred only when dietary calcium was adequate or high. Our results suggest that dietary calcium and 1,25-dihydroxycholecalciferol are both involved in the prevention of symptomatic EAE.

so to link to the whole recent discussion on the sunlight thing, on mice and so forth, and their being fur-covered dark-evolved beasties... this whole calcitriol thing fixing murine EAE has me confused. i don't know how their biochemistry works with vitamin d. i understood that it was a form of vitamin d that is used as rat poison. must be a dosage thing, i suppose.
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Postby viper498 » Thu Jul 06, 2006 2:25 pm

LisaBee and LyndaCarol,

Thanks for the explanation of what et al. means. I've always wanted to know. Sorry I am just now getting back to you with my thanks!

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Postby robbie » Thu Jul 06, 2006 6:03 pm

Please enough is enough...I live in canada and sit in the sun as much as possible and it makes me feel terrible but i just won't give up another thing that i really enjoy.I have a list of everything i've had to give up and i hold on to every one of them as long as possible, ms takes and takes and dosen't give at all..
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Bottom Line Question

Postby notasperfectasyou » Fri Jul 07, 2006 7:29 pm

Bottom Line Question:

How Much Vitamin D or D3 do you take? I'm reading al sorts of numbers. I'm inclined to start out with 2500 IU. Should I get D3 instead of D? Does the dosage change for D3 over D?

I apologize for not having the time to do my normal disernment on this. I will later, but I see the need to get on D now. napay
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d-tails

Postby jimmylegs » Fri Jul 07, 2006 8:20 pm

hey napay, short answer:

yes take d3. plain 'd' supplementation values are meaningless as far as i'm concerned, because there are about 5 different subtypes. so i couldn't say re: dosage. i have settled on a MAINTENANCE value of 4000 IU per day from a supplement (or sunshine on unprotected skin for less than say half an hour, as long as the solar energy reaching your skin is at least 18... crap i forget the units. but basically if it's warm enough to bare your skin outside in the sun it's probably all good.)

you might agree that MAINTENANCE supplementation is insufficient if you're starting out insufficient or deficient. if so, read on for the long answer:

what you do is get your blood tested so you have a decent baseline serum value. the lab requisition should be specifically

25hydroxycholecalciferol

if the doc writes vitamin d3 you can run into problems testing the wrong metabolite. i mean, it's good to know the numbers for the other metabolites but meaningless for long term monitoring.

the supplement you want to take is definitely d3 (cholecalciferol). this form matches that which is naturally synthesized in human skin upon exposure to solar energy. (winter sun isn't strong enough).

d2 (ergocalciferol) is a common alternative synthesized from plants. my view on d2 is, why bother. it is wise to mix in calcium and magnesium when you take your d3 supplement, since d maximizes the body's ability to absorb these nutrients.

regarding supplement amounts, that depends on the result of your baseline 25hydroxycholecalciferol test. also depends on how much patience you have.

i have been advised to get my serum levels up to 125-150 nmol/l. this is a number specified by vieth in his articles, but was relayed to me by one of my health care team. i personally think it could be low, but i'll settle for it for now :)

upon doing some investigation, i found some articles that let me calculate a daily dose to get to 150 nmol/l, from my 'baseline' (i had already been supplementing at 4400 iu for months) of 72 nmol/l, over a period of 5 months. the daily dose would be 4500 IU per day.

i decided to investigate ways to shorten the 5 month period, since i had such a low d level after months at a similar level of supplementation.

50,000IU per day for ten days was suggested by a local drug info centre, as a quick booster of 50 nmol/l. i obtained some highly concentrated liquid (1,000,000 iu/g) from the pharmacy, with my doctor's help, and took 2 drops each day from an oral syringe. i put it in a spoonful of cal-mag-d liquid to take it. that prescription was around $50 CDN.

then i got my level tested again. at first they accidently tested a different metabolite of vitamin d. (1,25 dihydroxycholecalciferol). i had to go in and explain the problem, and then we did another test to get a comparable 25hydroxycholecalciferol level. it was 149 nmol/l.

for maintenance, i have seen 4000 IU/d recommended in the literature. this is also the daily dose recommended by one of my doctors. of course if i get really good sun exposure on most of my body, without sunscreen, for say 20 minutes on a given day, i would consider that i could skip the supplement that day. i have pale skin. the time of exposure gets longer the darker your skin colour.

now i have a new maintenance dose prescription for vitamin D. it is the same potent liquid but it is diluted with olive oil. typically they would use peanut oil but i asked for olive. i have a six month supply and it cost around $80 CDN. because it's prescription, it's covered under my health plan. i still take it in a spoonful of cal-mag-d liquid, and i take extra calcium as well, and there is magnesium in my daily multimineral.

i will be monitoring my serum 25hydroxycholecalciferol quarterly, at first to ensure that the levels stay over 100 nmol/l all year round.

the vit d toxicity level in my mainstream doctor's computer system is 250 nmol/l. the toxicity of this serum value has actually been debunked in human research (i think this paper is posted elsewhere on the site but i can have a look for it if you want) and natural unsupplemented levels upwards of 450 have been found in south indian outdoor workers. (that's from a paper from the 80s which i imagine is referenced in one of my earlier vit d posts).

kay that's it for now :) hope this helps.
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