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eventually.

glad those authors specify BONE health at those levels. i need to see some published data on vit d3 and mineral interactions. really looking forward to those.

Hello Jimmylegs and Squeakycat,
Essential Health Clinic in Glasgow say 200nmol/L is OK. I am more comfortable with pwMS being in the range 125-150 nmol/L. Agree with you that above 200nmol/L needs many mineral/salts levels to be checked. BBE says he is being monitored by his doctor so I would not give patient specific advice in such a case.
It would be simple if we could say just take 5000iu/day but our lifestyles, diets and bodies prevent a simple solution. However I am confident that pwMS would benefit if they take 5000iu/day.
Kind regards,
MarkW

Don't know if this has been posted and I do agree with the parental risk factor in many diseases involving the immune system development period with in the womb and soon after birth direct sun exposure!
Still early days of learning here and needs to happen more to find the missing knowledge.
Post birth Vit D is not as important as within the womb, imo.

;)
Nigel
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Soak up Some Sun: Vitamin D Is Good for You!

The longer days mean more time to get out and enjoy the sun—and soak up a little vitamin D. A new study published in Neurology®, the medical journal of the American Academy of Neurology, shows that vitamin D levels in pregnancy may protect expecting mothers against MS.

The study found that pregnant women—and women in general—who have higher levels of vitamin D in their blood may have a lower risk of developing MS than women with lower levels, even though their babies may not see the same protective effect.

The research found that women who had high levels of vitamin D in their blood had a 61 percent lower risk of developing MS, compared to those who had low levels of vitamin D, although no association was found between the mother’s vitamin D level and whether her child would later develop MS.

Sources of vitamin D are diet, supplements, and the sun.


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http://www.aan.com/press/index.cfm?fuse ... lease=1121

re 'monitored by doctor'.. personally, if i left monitoring up to my docs i'd be up 'way up a river of excrement in a Native American water vessel without any means of propulsion'. my doc wouldn't have a clue about where to be, within the very broad normal range for magnesium

From: MedPage Today

Fog Lifting in MS Gender Enigma
By Kathleen Struck, Senior Editor, MedPage Today
Published: March 06, 2013

• Action Points
• Recent discoveries in the laboratory have provided strong clues to the reasons why multiple sclerosis now afflicts mainly women.
• Note that fewer and later pregnancies, vitamin D3 and sunlight, and the female sex hormone estradiol are other notable factors in understanding MS and how it impacts three times as many women as men.
• Recent discoveries in the laboratory have provided strong clues to the reasons why multiple sclerosis now afflicts mainly women, two prominent MS researchers said.

Differences in how the female and male immune systems are "tuned" are the most striking among these findings, but not the only ones, according to Shannon Dunn, PhD, of the University of Toronto, and Lawrence Steinman, MD, of Stanford University, in a "Viewpoint" article published online in JAMA Neurology.

"These discoveries illuminate the pathogenesis of MS, with applications and benefits for both men and women," the authors wrote. "These breakthroughs potentially allow for the repurposing of certain approved drugs for potential use as treatments of MS."

Currently, close to three-quarters of new MS cases occur in women. The biological basis for the gender imbalance has been one of the stubborn mysteries surrounding the disease -- in no small part because it is of relatively recent origin. When MS was first described in the late 19th century, about as many men as women had the condition.

"Over the past 50 years, [the female:male] ratio has been steadily increasing," Dunn and Steinman wrote.

Fewer and later pregnancies, vitamin D3 and sunlight, and the female sex hormone estradiol are other notable factors in understanding how the autoimmune disease works and impacts three times as many women as men, the authors said.

"Something in the environment" must be at work besides genetic changes, then authors explained, because the 50-year trend of increasing female preponderance in MS is not enough time for mutations to present, they said.

Because pregnancy is a known "major protective factor" against MS relapses, fewer pregnancies and a later age for pregnancy and childbearing might allow the hormones involved in MS pathogenesis to flourish.

Vitamin D3 and sunlight -- or lack of them -- are other suspects in the rapid increase in MS among women. Vitamin D3 has been effective in reducing proinflammatory Th1 immune activity in MS, the authors wrote.

A sterol, vitamin D3 thwarts interleukin-17. It and similar cytokines are involved in molecular inflammation in MS. Vitamin D regulates the inflammation by eliminating those cells that attack myelin, the protein coating that protects nerve fibers. Demyelination is the root pathology in MS.

"Surprisingly, vitamin D3 has a greater modulatory effect in women with MS than in men with MS, where it inhibits both Th1 and Th17 pathways to a greater extent," the authors wrote. "This may be due in part to a deficiency in females of the inactivating enzyme, CYP24A1 for vitamin D3, leading to accumulation of more vitamin D3 in target cells."

In experimental autoimmune encephalomyelitis (EAE), the standard animal model of MS, vitamin D3 reduced paralysis in females, "again to a much greater extent than in males," they said.

Squeakycat wrote:From: MedPage Today

Fog Lifting in MS Gender Enigma
By Kathleen Struck, Senior Editor, MedPage Today
Published: March 06, 2013

• Action Points
• Recent discoveries in the laboratory have provided strong clues to the reasons why multiple sclerosis now afflicts mainly women.
• Note that fewer and later pregnancies, vitamin D3 and sunlight, and the female sex hormone estradiol are other notable factors in understanding MS and how it impacts three times as many women as men.
• Recent discoveries in the laboratory have provided strong clues to the reasons why multiple sclerosis now afflicts mainly women, two prominent MS researchers said.

Differences in how the female and male immune systems are "tuned" are the most striking among these findings, but not the only ones, according to Shannon Dunn, PhD, of the University of Toronto, and Lawrence Steinman, MD, of Stanford University, in a "Viewpoint" article published online in JAMA Neurology.

"These discoveries illuminate the pathogenesis of MS, with applications and benefits for both men and women," the authors wrote. "These breakthroughs potentially allow for the repurposing of certain approved drugs for potential use as treatments of MS."

Currently, close to three-quarters of new MS cases occur in women. The biological basis for the gender imbalance has been one of the stubborn mysteries surrounding the disease -- in no small part because it is of relatively recent origin. When MS was first described in the late 19th century, about as many men as women had the condition.

"Over the past 50 years, [the female:male] ratio has been steadily increasing," Dunn and Steinman wrote.

Fewer and later pregnancies, vitamin D3 and sunlight, and the female sex hormone estradiol are other notable factors in understanding how the autoimmune disease works and impacts three times as many women as men, the authors said.

"Something in the environment" must be at work besides genetic changes, then authors explained, because the 50-year trend of increasing female preponderance in MS is not enough time for mutations to present, they said.

Because pregnancy is a known "major protective factor" against MS relapses, fewer pregnancies and a later age for pregnancy and childbearing might allow the hormones involved in MS pathogenesis to flourish.

Vitamin D3 and sunlight -- or lack of them -- are other suspects in the rapid increase in MS among women. Vitamin D3 has been effective in reducing proinflammatory Th1 immune activity in MS, the authors wrote.

A sterol, vitamin D3 thwarts interleukin-17. It and similar cytokines are involved in molecular inflammation in MS. Vitamin D regulates the inflammation by eliminating those cells that attack myelin, the protein coating that protects nerve fibers. Demyelination is the root pathology in MS.

"Surprisingly, vitamin D3 has a greater modulatory effect in women with MS than in men with MS, where it inhibits both Th1 and Th17 pathways to a greater extent," the authors wrote. "This may be due in part to a deficiency in females of the inactivating enzyme, CYP24A1 for vitamin D3, leading to accumulation of more vitamin D3 in target cells."

In experimental autoimmune encephalomyelitis (EAE), the standard animal model of MS, vitamin D3 reduced paralysis in females, "again to a much greater extent than in males," they said.

Perhaps another reason for more women with MS as Dr Scott Rosa explained it to me is that men are stronger muscularly. He believes it is impaired CSF flow that causes MS due to trauma that displaces the Atlas (C1). Mens neck muscles being stronger would more likely to keep their Atlas in the correct position

From MS Guru Terry Wahls;
The Wahls Foundation
VITAMIN D receptors do many things in our bodies. The impact of vitamin D taken by mouth is different than the impact of vitamin D made by your skin. Studies have shown favorable impact on immune cell function with both, but the vitamin D made by your skin has a more favorable impact on immune function. Agree that MS is a complex disease - and the closer we live according to our DNA expectations ( paleo diet, exercise, sun shine, nature time with normalized stress hormone, supportive family) the better our immune function is, the better balance to our chemistry.

NZer1 wrote:From MS Guru Terry Wahls;
The Wahls Foundation
The impact of vitamin D taken by mouth is different than the impact of vitamin D made by your skin. Studies have shown favorable impact on immune cell function with both, but the vitamin D made by your skin has a more favorable impact on immune function.

I would like to see a citation to back up this claim.

There are some studies showing a benefit from sunlight that indicate there may be benefits beyond producing Vitamin D through UV-B radiation. But I haven't seen anything that even suggests there is an added Vitamin D benefit from sunlight.

Squeakycat wrote:

NZer1 wrote:From MS Guru Terry Wahls; The Wahls Foundation
The impact of vitamin D taken by mouth is different than the impact of vitamin D made by your skin. Studies have shown favorable impact on immune cell function with both, but the vitamin D made by your skin has a more favorable impact on immune function.

I would like to see a citation to back up this claim.
There are some studies showing a benefit from sunlight that indicate there may be benefits beyond producing Vitamin D through UV-B radiation. But I haven't seen anything that even suggests there is an added Vitamin D benefit from sunlight.

If true this is bad news for me as I live near Oxford, England. The city is known for its dreaming spires but not its sunny climate. Must book our summer hols.
MarkW

A reply from Dr Jan Doerr (Neuro in Berlin). I need evidence of the big picture on vitamin D and MS (bones as well on immune system) for my reply. Also if anyone has any papers on vit D in healthy people living outside that would be very helpful.
Any help will be much appreciated,
MarkW
================================================
Dear Mark,
thank you very much for your comments on our review on VD in MS. Your feedback and that of others demonstrates that this issue is indeed of interest. I believe we are completely in line that VD levels in MS patients (and not only in those) should be raised and that the 'official' recommendations on VD intake and levels are not sufficient. The problem however remains which levels should be strived for. I agree that there is some evidence that even levels above 100 nmol/l are still beneficial but in unfortunately, the majority of these studies are methodically limited (e.g. small sample size, uncontrolled design, short treatment duration ...). Although I do think that many of these studies are informative in my opinion these data are not yet sufficient to proclaim levels above 100 nmol/l, let alone to persuade the authorities to officially proclaim such levels. On the other hand there is quite a substantial body of scientific evidence for levels between 75 and 100 nmol/l with an option for even higher levels. That's why I wrote "at least 75-100 nmol/l". Personally, I think, that pushing all MS patients to 75-100nmol/l would be an important step forward as it may most probably benefit many patients and should therefore be the next goal. If then evidence for even higher levels is becoming more conclusive, aiming at these higher levels would be the next option.
But, I am afraid, we will not come beyond this point without further, well designed prospective interventional and well powered clinical studies.
Best regards,
Jan
=========================================

Also if anyone has any papers on vit D in healthy people living outside that would be very helpful.

Here you go: both the blog and website from the Vitamin D Council are loaded with interesting information about vitamin D, but here's a direct link to an article on their blog that sites studies about the vitamin D levels of indigenous populations "living naturally" which I assume means living primarily outdoors:

http://blog.vitamindcouncil.org/2012/08 ... ns-part-1/

Many thanks to ThisisMA, now we have references for high levels for Vit D3 (bottom of post).
MarkW

ThisIsMA wrote:

Also if anyone has any papers on vit D in healthy people living outside that would be very helpful.

Here you go: both the blog and website from the Vitamin D Council are loaded with interesting information about vitamin D, but here's a direct link to an article on their blog that sites studies about the vitamin D levels of indigenous populations "living naturally" which I assume means living primarily outdoors:
http://blog.vitamindcouncil.org/2012/08 ... ns-part-1/

Vitamin D Toxicity
http://www.vitamindcouncil.org/about-vi ... -toxicity/
Can too much vitamin D be harmful? Yes, it certainly can - though anything can be toxic in excess, even water. As one of the safest substances known to man, vitamin D toxicity is very rare. In fact, people are at far greater risk of vitamin D deficiency than they are of vitamin D toxicity.

What is vitamin D toxicity?
Vitamin D toxicity is a condition where blood serum concentrations of vitamin D’s storage form, 25(OH)D or calcidiol, become too high, causing adverse systemic effects.

How it happens
There is no risk of vitamin D toxicity due to sun exposure.
Because the body has a built in mechanism for preventing toxicity with vitamin D produced in the skin, there is no risk of vitamin D toxicity due to ultraviolet-B (UVB) exposure - whether from the Sun or a tanning bed.
Supplemental vitamin D bypasses this built-in protection and, if excessive amounts are consumed over a period of time, 25(OH)D blood levels can reach a point where toxicity is possible.

Toxic doses
What exactly constitutes a toxic dose of vitamin D has yet to be determined, though it is possible this amount may vary with the individual.
Published cases of toxicity, for which serum levels and dose are known, all involve intake of ≥ 40000 IU (1000 mcg) per day. 1 Two different cases involved intake of over 2,000,000 IU per day - both men survived. 2 3

Serum levels: upper limit and toxicity threshold
Upper limit for a substance is the amount up to which is considered safe and without risk of adverse effects in the majority of the population.
Toxicity threshold for a substance is the amount beyond which over-saturation occurs and symptoms of toxicity manifest.
These values for 25(OH)D are as follows:
•Toxicity threshold level - 200-250 ng/mL (500-750 nmol/L) 4 5 6 7 8
•Upper limit - 100 ng/mL (250 nmol/L)
The large range between 25(OH)D’s upper limit and its threshold value implies a degree of safety at serum levels up to 100 ng/mL (250 nmol/L), since concentrations twice this amount have yet to ever be associated with toxicity. 4
In animal models, serum concentrations have reached as high as 400-700 ng/mL (1,000-1750 nmol/L) before toxic effects (severe hypercalcemia) were observed. 8 9
Symptoms: toxicity and overdose
Signs of vitamin D toxicity are high urine and blood calcium.
The first sign of vitamin D toxicity is hypercalcuria (excess calcium in the urine) followed by hypercalcemia (high blood calcium). The following symptoms may present:
•nausea
•vomiting
•poor appetite
•constipation (possibly alternating with diarrhea)
•weakness
•weight loss
•tingling sensations in the mouth
•confusion
•heart rhythm abnormalities
The immediate symptoms of vitamin D overdose are:
•abdominal cramps
•nausea
•vomiting
What to do if you think you are vitamin D toxic
Vitamin D is not toxic when used in the amounts Nature intended.
It is fairly difficult to become toxic using vitamin D3. If you think you may be toxic because you are having an adverse reaction to vitamin D but you have not been using excessive amounts like those described above, your symptoms could be due to reasons other than toxicity.
Test serum levels
First thing is to stop supplementation, then have your physician help you determine if you are toxic by testing your 25(OH)D levels. This is the same test used to determine vitamin D deficiency.
Rule out other possibilities
If results indicate levels lower than 200-250 ng/mL (500-750 nmol/L), you are most likely not toxic. In this case, the reaction you experienced may be a result of:
1.An underlying magnesium deficiency. This is the most common reason for symptoms brought on by using vitamin D.
2.Vitamin D hypersensitivity due to pre-existing high blood calcium (hypercalcemia). Often mistaken for vitamin D toxicity, hypercalcemia is a rare condition usually caused by one of the following: ◦primary hyperparathyroidism (most common cause)
◦sarcoidosis
◦granulomatous TB
◦some cancers
If toxic, reduce serum levels
If the results show a serum 25(OH)D level of 200-250 ng/mL (500-750 nmol/L) or more, you could be toxic. The following measures should be taken until vitamin D levels return to normal:
1.avoidance of direct sunlight exposure
2.avoidance of foods and supplements containing vitamin D
3.restriction of calcium intake
4.drinking 8 glasses of water daily
Once 25(OH)D levels have normalized, sunlight exposure and/or vitamin D supplementation can be resumed, taking care not to overdo it.
In most cases, vitamin D toxicity can be corrected without lasting problems, provided the body has not remained in a hypercalcemic state for too long. Hypercalcemia has the potential to cause soft tissue calcification, resulting in deposits of calcium crystals in the heart, lungs, and/or kidneys. With prolonged hypercalcemia, permanent damage is possible if calcification is severe enough.
Page last edited: 03 November 2011
References
1.Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999 May; 69 (5): 842-56.
2.Koutkia, P. Chen, T. C. Holick, M. F. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med. 2001 Jul 5; 345 (1): 66-7.
3.Los Angeles Times Supplements guru sues over his own product. 2010/4/29;
4.Jones, G. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr. 2008 Aug; 88 (2): 582S-586S.
5.Heaney, R. P. Vitamin D: criteria for safety and efficacy. Nutr Rev. 2008 Oct; 66 (10 Suppl 2): S178-81.
6.Vieth, R. Vitamin D toxicity, policy, and science. J Bone Miner Res. 2007 Dec; 22 Suppl 2V64-8.
7.Vieth, R. Critique of the considerations for establishing the tolerable upper intake level for vitamin D: critical need for revision upwards. J Nutr. 2006 Apr; 136 (4): 1117-22.
8.NIH Office of Dietary Supplements Dietary Supplement Fact Sheet: Vitamin D. 2009/11/13;
9.Deluca, H. F. Prahl, J. M. Plum, L. A. 1,25-Dihydroxyvitamin D is not responsible for toxicity caused by vitamin D or 25-hydroxyvitamin D. Arch Biochem Biophys. 2010 Oct 18;

*These statements have not been evaluated by the Food and Drug Administration.

jimmylegs wrote:re 'monitored by doctor'.. personally, if i left monitoring up to my docs i'd be up 'way up a river of excrement in a Native American water vessel without any means of propulsion'. my doc wouldn't have a clue about where to be, within the very broad normal range for magnesium

Sorry to hear this about your doctor, Jimmylegs. I hope he is open to being educated by you.
Kind regards,
MarkW

Different angle;

Too Much Vitamin D?
Carolyn Dean MD ND | Sunday, March 10, 2013
A client emailed that he heard a doctor on a talk show recommending 5,000 IU of Vitamin D instead of the RDA of 400 IU. He asked me what I thought.

I said that everyone thinks there’s a Vitamin D deficiency epidemic but I’m not convinced. The big question is, why all of a sudden are we so deficient. What could Vitamin D be responding to and what do the low levels indicate?

Here’s one possible answer. Vitamin D is really a hormone with a feedback loop to calcium. When the body has enough calcium less Vitamin D is required and the levels drop.

We are a calcified country, so the effect of high calcium may be lower levels of Vitamin D. And without understanding the complex chemistry involved, most people think we just need to take more.

But MORE Vitamin D pulls in more calcium and bumps out magnesium, making people more magnesium deficient.

Taking high dose Vitamin D (anything above 2,000 IU) will also use up your magnesium because this mineral is required to change the supplemental/storage form of Vitamin D into active Vitamin D.

Not everyone is going to suffer from too much Vitamin D and enough people seem to benefit from it (at least in the short term) that it’s not going to ring any alarm bells for many years. After all, it took about 3 decades for us to realize that high dose calcium supplementation was causing heart disease and soft tissue calcification when not properly balanced with magnesium.

Do your research before taking high dose Vitamin D.
http://drcarolyndean.com/2013/03/too-much-vitamin-d/
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I think we are looking at a bit player in the picture of health by singling out Vit D levels. The Synergy required for Life is what has to be investigated on a personal level as well as within a collective like this thing called 'MS'.
We are seeing a Body, Mind and 'Spirit' synergy in motion in every individual and the interplay is huge between systems so to say one piece such as Vit D is a major, is naive.
The more I read around this subject the more I see we are needing to broaden the capture of deficits.

;)
Nigel

@ markw - re my GP specifically, (never mind neuros or other specialists) unfortunately though i am allowed to play with labwork with her aide, i don't think the info is transferred to others. once a new staff member in the office tried telling me over the phone that all my results were normal and i had to get someone on the phone who knew me before i could get actual numbers.

in 2006 i went to a trained dietitian and the questions i had were beyond that person's expertise and i had to research answers on my own.. so who knows about that professional specialty either..