This Is MS Multiple Sclerosis Knowledge & Support Community

i should also clarify that toxicity from vit d takes a LOT of excess. i do not believe 10,000 IU per day is a problem. i will gather up some info (if it does not duplicate prev. posts) and we can discuss.

also how is 1000 IU a high dose. did u mean 10,000iu?

the stuff i am hoping to get a prescription for is 1,000,000 IU/g, so you take 1/20th of a gram (50,000 IU) per day, via oral syringe, for 10 days. dangerous stuff. WAY out of the 1000 league.

ta ta,

d

jimmylegs wrote:nhe i too worry about vitamin a. bugger. however i heard you can get 10000 iu of A from a freakin carrot, ie beta carotene, which does the same deal as d, ie your bod makes what it needs and offs the remainder.

Perhaps, but the vitamin A from cod liver oil is not equivalent to the vitamin A from beta carotene. Beta carotene will only be converted into vitamin A if your body has a need for it. However, with cod liver oil you are getting the active form of vitamin A. One can think of beta carotene as a "provitatim A" since it's a vitamin A precursor and not actually vitamin A itself.

NHE

hi yea i know about the beta-carotene not being a form of A ppl can od on. thanks! i didn't mean i was worried about getting too much A from a carrot, i meant if you get too much A when trying to meet D requirements from cod liver oil, you can get A safely from carrots and D from the sun. if it's cooperating. otherwise i think to get enough cholecalciferol that straight supplements, not CLO, may be the best option.

To lyndarcarol and all on this thread,

Sorry I dropped off posting because I was on vacation, and how nice that was! I wanted to respond to lyndcarol's question as to whether Vitamin D synthesis is the only benefit from sun exposure, or sunlight has other effects.

That's a great question, and although vitamin D is probably the best studied as far has hormones go, there is another angle of possible interest. About a near ago I read a neat book called "The Healing Sun" (can't remember the author) which was about the history of sunlight exposure in treatment of diseases, most notably tuberculosis. Starting in the mid 1800s and up until the early mid 1900s, sunlight exposure was used to treat TB, particularly the skin and bone infections. In the pre-antibiotic era, people were big believers in sunlight and fresh air (and good nutrition) to treat illness, then along came antibiotics and the focus on sunlight and UV radiation as treatments of choice went by the wayside. The old photos in this book were quite stunning, children coming in crippled and humpbacked with spinal TB were obviously cured after two years of treatment. There were Nobel prizes given out investigating UV radiation as treatment. There have been some very recent papers about UV radiation being revisited to kill TB organisms. For those interested in the infectious angles on MS, this might raise some interesting speculations. There have also been recent British studies on vitamin D levels in immigrants to Britain that have TB - many have extremely low, and in some cases, nondetectable Vitamin D levels and there is current discussion as to whether low Vitamin D levels is a risk factor for contracting TB. If people are more interested about this I'll post more, but it may be a bit off the MS topic for some others.

As to whether there have been epidemiological studies on sunlight exposure and MS prevalence and mortality, as I believe bromley asked, there have been, and they have generally shown significantly reduced MS occurrence among people with predominately outdoor occupations. In our modern lives, outdoor occupations are in the minority, so they are the best comparison group for all us office workers. If people are interested, I'll dig those out and post. Some are old NIOSH mortality surveys of occupations, and aren't available online.

Lisa

Great thread gang

Certainly the initial article of this thread contains some inaccuracies but it’s still positive to see, as Vieth put it, an evolution in thinking with regard to sun safety and its ramifications.

I feel the author has unwittingly provided some valuable food for thought. Thus it’s worth examining the relationship between skin cancer, ultra violet radiation (UVR) exposure and MS.

For instance, this study considered skin cancer in people with multiple sclerosis and found that solar radiation may have a protective influence on the development of MS. The abstract is below.

Skin cancer in people with multiple sclerosis: a record linkage study
Objective: The prevalence of multiple sclerosis (MS) varies with latitude: it increases with distance from the equator in both hemispheres. To seek evidence on whether solar radiation is a protective factor for MS, this
study investigated whether skin cancer, as an indicator of solar radiation, is less common in people with MS than in others.
Design: Analysis of a database of linked hospital records and death certificates.
Setting: The Oxford Region of the National Health Service, England.
Subjects: A cohort comprising all people in the database with MS, and comparison cohorts of people with
other diseases.
Results: Skin cancer was significantly less common in people with MS than in the main comparison cohort (rate ratio 0.49; 95% confidence interval 0.24 to 0.91). There was no general deficit of cancer in the MS cohort, and no deficit of skin cancer in cohorts of people with other autoimmune or neurological diseases.
Conclusion: The findings support the hypothesis that solar radiation may have a protective influence on the development of MS.

Even more significant is this study out of Australia. The authors found that the link between UVR and skin cancer wasn’t as strong as the link between UVR and MS. Ergo if you think UVR causes skin cancer (whish has only been proven with circumstantial evidence) then you are forced to believe a lack of UVR causes MS. See below for the abstract.

MS prevalence data for six Australian regions were compared with UVR levels of the largest city in each region, with some other climatic variables and with the melanoma incidence in the same regions. A close association was found between the theoretical MS prevalence predicted from UVR levels and the actual prevalence. Furthermore, the negative correlation between UVR and MS prevalence (r= -0.91) was higher than the positive correlation observed for UVR and malignant melanoma incidence (r = 0.75 for males and r = 0.8 for females). This study demonstrates that the regional variation in MS prevalence in the continent of Australia could be closely predicted by regional UVR levels. It is consistent with the hypothesis that UVR exposure may reduce the risk of MS.

Cheers
Nick

Well, Nick beat me out on some of them , but here is another:

Ooops it is the same as one of Nick's! Nope, I checked again, a this is a different van der Mei paper. Oh well, I'll leave it in....

*********

BMJ. 2003 Aug 9;327(7410):316. Related Articles, Links


Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study.

van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Simmons R, Taylor BV, Butzkueven H, Kilpatrick T.

Menzies Centre for Population Health Research, University of Tasmania, Hobart, TAS 7000, Australia. Ingrid.vanderMei@utas.edu.au

OBJECTIVE: To examine whether past high sun exposure is associated with a reduced risk of multiple sclerosis. DESIGN: Population based case-control study. SETTING: Tasmania, latitudes 41-3 degrees S. PARTICIPANTS: 136 cases with multiple sclerosis and 272 controls randomly drawn from the community and matched on sex and year of birth. MAIN OUTCOME MEASURE: Multiple sclerosis defined by both clinical and magnetic resonance imaging criteria. RESULTS: Higher sun exposure when aged 6-15 years (average 2-3 hours or more a day in summer during weekends and holidays) was associated with a decreased risk of multiple sclerosis (adjusted odds ratio 0.31, 95% confidence interval 0.16 to 0.59). Higher exposure in winter seemed more important than higher exposure in summer. Greater actinic damage was also independently associated with a decreased risk of multiple sclerosis (0.32, 0.11 to 0.88 for grades 4-6 disease). A dose-response relation was observed between multiple sclerosis and decreasing sun exposure when aged 6-15 years and with actinic damage. CONCLUSION: Higher sun exposure during childhood and early adolescence is associated with a reduced risk of multiple sclerosis. Insufficient ultraviolet radiation may therefore influence the development of multiple sclerosis.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 12907484 [PubMed - indexed for MEDLINE]

And another, by US researchers this time:

**********

Occup Environ Med. 2000 Jun;57(6):418-21. Related Articles, Links


Mortality from multiple sclerosis and exposure to residential and occupational solar radiation: a case-control study based on death certificates.

Freedman DM, Dosemeci M, Alavanja MC.

Radiation Epidemiology Branch, National Cancer Institute, 6120 Executive Boulevard, Bethesda, Maryland 20892, USA. mf101e@nih.gov

OBJECTIVES: To explore whether mortality from multiple sclerosis is negatively associated with exposure to sunlight. METHODS: Two case-control studies based on death certificates were conducted for mortality from multiple sclerosis and non-melanoma skin cancer (as a positive control) to examine associations with residential and occupational exposure to sunlight. Cases were all deaths from multiple sclerosis between 1984 and 1995 in 24 states of the United States. Controls, which were age frequency matched to a series of cases, excluded cancer and certain neurological deaths. The effects of occupational exposure to sunlight were assessed among subjects with usual occupations requiring substantial activity, so as to exclude those whose indoor jobs resulted from disabilities subsequent to the onset of the disease. Multiple logistic regression analyses were applied, with adjustment for age, sex, race, and socioeconomic status. RESULTS: Unlike mortality from skin cancer, mortality from multiple sclerosis was negatively associated with residential exposure to sunlight (odds ratio (OR)=0.53 (multiple sclerosis) and OR=1.24 (skin cancer)). Odds ratios for the highest occupational exposure to sunlight were 0.74 (95% confidence interval (95% CI) 0.61 to 0.89) for mortality from multiple sclerosis, compared with 1.21 (1.09 to 1.34) for mortality from non-melanoma skin cancer. The OR was 0.24 for the combined effect of the highest levels of residential and occupational exposure to sunlight on multiple sclerosis, compared with an OR of 1.38 for skin cancer. CONCLUSIONS: In this exploratory study, mortality from multiple sclerosis, unlike mortality from skin cancer, was negatively associated with both residential and occupational exposure to sunlight.

PMID: 10810132 [PubMed - indexed for MEDLINE]

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Dear all,

At the EBV think tank I attended, Vit D was mentioned and also the point that skin cancer is much lower in those with MS. But there may be a simple answer to this - many MS patients end up having to use wheelchairs and some are confined to bed. Sporting activities e.g. sailing, tennis in the sun would probably be limited. Also, despite the claims, I still doubt that many with MS really have a near normal life-span. I know that relatives in Australia started getting skin cancer in their 60s and 70s - which again may explain why those with MS have a lower incidence (i.e. if you died from MS in your 50s).

I mentioned before that there must be some good case studies - nuns, prisoners, muslim women. There must also be the potential to analyse those with MS against thier jobs. One would expect the incidence to be lower for those with outside jobs - builders, gardeners etc. Given that more and more jobs are now inside (in offices) one would expect those with such jobs to have a higher incidence. These must be fairly easy to check for a willing researcher.

Vit D must have a role - given the incidence in Australia (lower rates as you get nearer to the equator). Higher rates in Tasmania in the South. I'm certainly encouraging my young children to get in the sun as much as possible. In the UK the incidence is much higher in Scotland where there is much less sun than in England, particularly southern England. But of course genes also have a role which means that the story will never be that simple i.e. Vit D is the answer.

Ian

By coincidence an article about Australian research and Vit D.

A question of degrees

Multiple sclerosis is being mapped in Australia as a key part of global research into the disease.

The battle to conquer the debilitating auto-immune disease known as multiple sclerosis is a multidisciplinary, international, 24-hour-a-day enterprise.

As scientists in Australia are putting on their PJs, others in Los Angeles are throwing down their first coffee and getting ready for work. Researchers in Stockholm are already at the lab and teams in Britain are knuckling down to the afternoon shift.

These researchers come from fields as diverse as genetics, proteomics, epidemiology, pharmacology, neurobiology and stem cell research, and they're making progress - though it probably seems too slow for those who have MS, including 16,000 people in Australia.

Among the more promising developments is Tysabri, a drug from the US that in clinical trials overseas and in Australia has been shown to markedly slow the progress of the relapsing-remitting form of MS.

Tysabri works by preventing inflammatory white blood cells from leaving the blood stream and entering the central nervous system, where they attack (and scar, hence the term "sclerosis") the protective coating on the nerve fibres.

"Tysabri appears to be a quantum leap better than interferon beta [the best treatment available at present]," says Dr David Booth, a research scientist at Westmead's Millennium Institute working on the genetics of MS.

Tysabri became available in the US in 2004 but was withdrawn last year after two drug-trial participants died from a rare neurological condition. (For perspective, more than 8000 people had by that time been taking the drug, according to Biogen, its manufacturer.)

The drug is being re-evaluated by the US Federal Drug Administration and Biogen expects to hear about its findings by the end of the month.

However, it needs to proceed through the Therapeutic Goods Administration and the Pharmaceutical Benefits Scheme before introduction into Australia, and that may take between 18 months and three years, says Jeremy Wright, the executive director of Multiple Sclerosis Research Australia.

Australia's contribution to MS research is relatively small in terms of numbers of scientists but "punches well above its weight", Wright says. "We are connected to probably all the major [MS] studies [in the world] in one way or another."

One of the more notable Australian research projects is the Ausimmune study.

With bases in Brisbane, Newcastle, Geelong and Tasmania, its aim is to examine the influence of environmental factors on immunity and how the occurrence of auto-immune diseases, including MS, varies according to latitude.

Australia's long north-to-south reach and relatively homogenous population make it an excellent laboratory in which to study the effects of environmental factors, such as climate, on health, the study's organisers say.

Our nationwide health-care system makes it easier to be systematic about finding people with early symptoms of auto-immune disease who might take part.

For the study, people who have had a "first demyelinating event" - an early symptom that may be a forerunner of MS - and other people from the general community who act as controls are asked a comprehensive range of questions about their life and medical history.

The data from both sets of people are then compared to see if there are any significant differences between the two.

Preliminary data already shows that "for every degree of latitude you go south, there is a 6 to 8 per cent increase in the number of first demyelinating events", says Dr Robyn Lucas, an epidemiologist at the National Centre for Epidemiology and Population Health, which is running the study.

"Then you have to wonder what things are different by latitude. Hobart is colder, wetter and has less sun than Queensland. You probably get more infections in colder climates you probably eat a different diet. So there are lots of things that vary by latitude and we are trying to look at all of those."

Booth says: "A dominant theory [about the link between latitude and MS] is that you get more vitamin D where you get more sunlight, and this has an impact on the immune system."

This is the basis for Booth's ongoing studies into vitamin D receptor genes and MS.

The Ausimmune team hopes to publish its findings by the end of next year, Lucas says, and "the best hope we have is to find some clear-cut environmental risk factors that are amenable to some sort of intervention".

Wright says there is already a prevention strategy being considered that will involve providing pregnant women from families with a strong genetic link to MS with more vitamin D during their pregnancy.

There is little doubt among the scientific community, however, that MS involves a number of genetic and environmental factors, so no single discovery is likely to provide a definitive answer.

Source: The Sydney Morning Herald Copyright © 2006.

bromley

If you look at the Freeman abstract, they at least partially controlled for the bias of disability in MSers being confined to indoor jobs by only comparing those with outdoor jobs to those with indoor jobs that required considerable physical activity. That is, they controlled for the possibility that people ultimately with MS would have already gravitated to indoor jobs due to physical limitations, by only comparing outdoor to indoor but physically demanding jobs.

I agree with you and the Australian article, that Vitamin is a factor for developing MS, and is not a singular cause. If vitamin D deficiency alone caused MS, a much larger percentage of the world would have MS, as Vitamin D deficiency is pretty pervasive all over the world. However, there appears to be several lines of evidence that increasing Vitamin D levels.

It is hurricane season again in my corner of the globe. I think of MS like a hurricane - several factors have to come together, like warm water, favorable wind patterns, lack of a competing weather system, etc. to allow a hurricane to form. I'm sure a meteorologist could come up with several more. If just one important factor is missing (warm water), there is no hurricane. It is probable that vit D deficiency is one of the contributors to MS, but not alone.

Lisa

i agree that low vitamin d status is not the only thing. i think low status highlights little genetic variations and possibly environmental or viral situations that then manifest themselves in an array of disease conditions, including ms.

LisaBee wrote:bromley

I agree with you and the Australian article, that Vitamin is a factor for developing MS, and is not a singular cause. If vitamin D deficiency alone caused MS, a much larger percentage of the world would have MS, as Vitamin D deficiency is pretty pervasive all over the world. However, there appears to be several lines of evidence that increasing Vitamin D levels.

It is hurricane season again in my corner of the globe. I think of MS like a hurricane - several factors have to come together, like warm water, favorable wind patterns, lack of a competing weather system, etc. to allow a hurricane to form. I'm sure a meteorologist could come up with several more. If just one important factor is missing (warm water), there is no hurricane. It is probable that vit D deficiency is one of the contributors to MS, but not alone.

Lisa

My sentiments exactly LisB. Predisposition + abundant causal factors+ deficincy of vit D.

However I think it is quite evident that vitamin D is overwhelmingly the most influential of these components. So much so that it is not stretching fact to ascertain that a deficiency of vitamin D is the cause of MS in predisposed folks. From a preventative perspective, the existing data implies vitamin D is unsurpassed in effectiveness for preventing MS. The problem here is that there is little emphasis placed on prevention and of course the absence of a financial motive.

Ian

Muslim women that keep covered and that live in the London have been shown to be vitamin D deficient. I can't find this research paper on the DIRECT-MS site since it was reorganized though. Consider that Muslim women might not be susceptible, hence a D deficiency wouldn't necessarily be expressed as MS, however other conditions of D deficiency would.

There's also the issue of timing of vitamin D abundance and disease formation. Covered Muslim women weren't born with a cloak on you know;)

PS I’m not an expert but I’m sure that the majority of nuns don't wear the gothic garb of tradition anymore ;)

You might find this article below of interest.

Cheers
Nick

http://www.direct-ms.org/pdf/VitDMS/Freedman.pdf

Mortality from multiple sclerosis and exposure to
residential and occupational solar radiation:
a case-control study based on death certificates

Abstract
Objectives—To explore whether mortality from multiple sclerosis is negatively associated
with exposure to sunlight.
Methods—Two case-control studies based on death certificates were conducted for
mortality from multiple sclerosis and non-melanoma skin cancer (as a positive
control) to examine associations with residential and occupational exposure to
sunlight. Cases were all deaths from multiple sclerosis between 1984 and 1995 in 24
states of the United States. Controls, which were age frequency matched to a
series of cases, excluded cancer and certain neurological deaths. The effects of
occupational exposure to sunlight were assessed among subjects with usual occupations
requiring substantial activity, so
as to exclude those whose indoor jobs resulted from disabilities subsequent to
the onset of the disease. Multiple logistic regression analyses were applied, with
adjustment for age, sex, race, and socioeconomic status.
Results—Unlike mortality from skin cancer, mortality from multiple sclerosis was
negatively associated with residential exposure to sunlight (odds ratio (OR)=0.53
(multiple sclerosis) and OR=1.24 (skin cancer)). Odds ratios for the highest
occupational exposure to sunlight were 0.74 (95% confidence interval (95% CI)
0.61 to 0.89) for mortality from multiple sclerosis, compared with 1.21 (1.09 to 1.34)
for mortality from non-melanoma skin cancer. The OR was 0.24 for the combined
effect of the highest levels of residential and occupational exposure to sunlight on
multiple sclerosis, compared with an OR of 1.38 for skin cancer.
Conclusions—In this exploratory study, mortality from multiple sclerosis, unlike
mortality from skin cancer, was negatively associated with both residential and occupational
exposure to sunlight.
(Occup Environ Med 2000;57:418–421)
Keywords: multiple sclerosis; aetiology;

LisaBee, Nick etc,

I think we all agree that Vit D plays a role - perhaps a deficiency that triggers MS, or that Vit D is protective in some way.

There is general agreement that there is a genetic susceptibility.

There is general agreement that hormones play some role - given that more woman than men get MS.

There is possibly an infectious agent - perhaps a virus. The Australian research showed that people were more likely to pick up colds etc the further from the equator (damper environment).

The other issues are age - very young children get MS and some people are not diagnosed until much later in life. The different types - which may be also linked to genetics.

So there are lots of possbile factors, but the timing, importance, weighting of each is not yet known - and may be different in different people.

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.

Solving MS has been described as trying to do a jigsaw, made of paper, outside, during a tornado. I'm starting to see why.

This weekend is forecast to be in the high 80s in the South East of England. Apart from watching England in the world cup, I'll mainly be outside in the garden in my new deckchair.

Have a good weekend

Ian

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)

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

What does "et al" mean?

Brock