WW
I think you're on the right track from what you have stated for prevention.
Indeed there is a phenomenon that occurs in pregnancy that can induce remission in women with autoimmune diseases. It has been documented that this effect occurs in the third trimester.
A
study addressing this peculiarity analyzed the blood of pregnant women and found elevated levels of various hormones thought to be the effective agents of remission. The trial studied 18 women with normal pregnancies in their third trimester and during the early postpartum period.
They measured the content of pro-inflammatory cytokines IL-12 and TNF during the third trimester and postpartum. It found that during the third trimester pregnancy, IL-12 production was about 3-fold and TNF-alpha production was approximately 40% lower than postpartum values. Recently, excessive productions of IL-12 and TNF-alpha were causally linked to rheumatoid arthritis and multiple sclerosis.
The study also documented the increase in levels of the stress hormones cortisol, norepinephrine (formerly adrenalin) and 1,25 hydroxyvitamin D3. These hormones were two to three times higher in the third trimester than they were after the women had given birth.
It is a reasonable assumption that a drop in IL-12 and TNF can be responsible for remission of MS during pregnancy. You could also infer that the rise in cortisol, norepinephrine and 1,25 hydroxyvitamin D3, either by one or a combination of these hormones, are responsible for this remissive state of MS during pregnancy.
I believe the reason women with MS, who are pregnant and are able to achieve remission, is because they typically have low-grade symptoms induced by inflammation rather than serious disability caused by nerve damage. (There aren’t too many women with progressed MS who get pregnant, are there?) Should the pro-inflammatory cytokines be markedly reduced then this has an obvious impact on conditions where nerve inflammation comprises a majority role in the content of neurological impairment. Where there is nerve damage and inflammation then perhaps only minor improvements or stability can be hoped for during pregnancy.
DIRECT-MS is a proponent that
vitamin D3 can play a crucial role in immunoregulation and its deficiency is one of the contributing factors in autoimmune disease. It is notable that 1,25 hydroxyvitamin D3, which is final hormone derived from vitamin D3 intake (either by ultraviolet radiation exposure or pills), is deficient in PwMS on a daily basis throughout the year. It has also been documented that vitamin D3
inhibits not only IL-12-generated IFN-gamma production, but also
suppresses TNF.
Perhaps it is all three hormones or only two or one which induce remission during pregnancy. It has been shown though that vitamin D3 by itself can induce immunosuppression. You can easily obtain D3 from either sunshine or inexpensive supplements while increasing cortisol and norepinephrine would likely require taking drugs. Vitamin D maintenance (an internal level of at least 100 nmol/L or a daily intake of 4,000 IU/d ) is safe, inexpensive and easily implemented.
You can also derive some vitamin D and heaps of anti-inflammatory, essential fatty acids from fish oil. If you are going to breast-feed think of the benefits these oils will have upon your infant in addition to
benefiting you in your struggle with MS.
An article in the Canadian news last month addressed recommended amounts of vitamin D for pregnant and lactating women. While it it not an issue related to MS it certainly is relevant.
Experts prescribe massive increase
of vitamin D: Nursing, pregnant women need 10 times more than current recommendation, says Canadian Paediatric Society
SHARON KIRKEY
CANWEST NEWS SERVICE
A move to feed pregnant and nursing women 10 times more vitamin D than they get today may still not be enough to protect their babies from chronic diseases, especially in obese women, a top expert says.
The Canadian Paediatric Society is recommending pregnant and lactating women consider taking 2,000 IU (international units) of vitamin D daily, especially during winter, to protect their babies from a litany of illnesses later in life.
The current Health Canada recommendation is 200 IU a day for adults under 50 — including pregnant and nursing mothers.
Dr. Bruce Hollis, professor of pediatrics and director of pediatric and nutritional sciences at the Medical University of South Carolina who has studied vitamin D in humans for 30 years, called the society’s new position statement “a remarkable change.”
But he said many women of childbearing age, especially in Canada, are “absolutely deficient” in vitamin D. “To say (2,000 IU) daily will replete everybody probably isn’t totally accurate, and I say with confidence it’s not enough to ensure breastfeeding infants get enough (vitamin D) through human milk.”
Vitamin D deficiencies in early life have been linked with an increased risk of small babies, asthma, diabetes, autoimmune diseases such as rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease, dental malformations and the development of certain cancers.
In two U.S. government funded studies, Hollis is studying vitamin D supplementation of up to 6,000 IU daily in nursing women, and 4,000 units per day in pregnant women. So far “not one single adverse event” has been observed in women on the highest doses, he said.
The pediatric society says even experimental doses of up to 10,000 IU per day for five months in pregnancy didn’t lead to levels in the toxic range.
After years of telling people to screen out the sun, doctors are finding a host of reasons to load up on the “sunshine vitamin.”
First came cancer: In June, the Canadian Cancer Society for the first time recommended adult Canadians lower their cancer risk by taking 1,000 IU daily. The vitamin has been linked with a lower risk of cancers of the breast, lung and colon.
Now, pregnancy: Vitamin D deficiency in mothers and babies continues to be a problem in Canada, particularly among aboriginal women, the pediatric society says, and infants under one are especially vulnerable if they are breastfed.
Hollis said vitamin D is important for brain development and to build tolerance against autoimmune diseases. It also protects the mother from uterine infections that can lead to pre-eclampsia — a common disorder that causes high blood pressure and can lead to poor fetal growth and fatal complications in moms and babies if not treated.
Oily fish such as salmon and sardines contain vitamin D and the vitamin is in fortified milk and margarine. But food alone can’t provide sufficient vitamin D, especially in babies.
A daily vitamin D supplement of 400 IU per day has been recommended for breastfed infants in Canada for decades, largely to prevent rickets, 104 confirmed cases of which were reported in Canada between 2002 and 2004.
But the pediatric society says the emphasis now goes far beyond the debilitating bone disease, which requires just a small dose of vitamin D. Severe asthma in three-year-olds and an increased risk of Type I diabetes have been linked to low vitamin D status during fetal life.
Still, Health Canada is refusing to budge, calling the pediatric society’s new recommendation “premature” and warning of health risks with taking too much vitamin D.
“They’re the only ones who seem to be saying it’s premature,” said Dr. John Godel, principle author of the new recommendation and professor emeritus in pediatrics at the University of Alberta.
He said Health Canada made it clear at a meeting two weeks ago they were “quite loath” to recommend pregnant and nursing women boost their vitamin D intake 10-fold.
Health Canada has set the upper tolerable limit for adults at 2,000 IU a day from all sources of vitamin D, including milk and supplements.
Godel said “there is a lot of evidence” that even 2,000 IU daily isn’t enough, but that “even at 2,000 we found we were in trouble with Health Canada.
“If we went to 4,000 (IU per day) right away we might run into problems and besides that, the evidence wasn’t all in at this time.”
The pediatric society recommends total vitamin D intake from all sources during the first year of life should be 400 IU per day in full-term infants and 200 units for premature babies, with an increase to 800 IU daily between October and April north of the 55th parallel (about the latitude of Edmonton).
They recommend pregnant and nursing women have their blood checked periodically to see whether they’re getting sufficient vitamin D. Hollis said that, for reasons that aren’t clear, obese people need much more vitamin D to maintain their levels.
As well, he said every breastfeeding infant “absolutely needs a vitamin D supplement” even if the mother is supplementing herself with 2,000 IU per day.
He recommended vitamin D3, or cholecalciferol, the kind produced in the skin in response to sunlight.
The pediatric society says infants and children should be exposed to sunlight for short periods, probably less than 15 minutes a day.
Good luck!
Cheers
Nick
). I know a woman getting IVIGs for another reason and she says it's okay, she's fine. By the way, in Germany IVIGs as an MS treatment are only for "exceptional cases", "off-label use". (e.g. breastfeeding women). 