This Is MS Multiple Sclerosis Knowledge & Support Community

Nick,
Thanks for posting that information. I had not run across that article before. The data plot clearly indicates an inverse relationship between vitamin D levels and relapse frequency.

I did have one point to note though, the authors of that study are advocating a daily vitamin D dosage level of 100µg/d (4000IU/d). A comment by Frits AJ Muskiet et al. to one of the authors', Reinhold Vieth, prior papers notes that it's not necessary to use this high of a dosage to achieve Vieth's target serum vitamin D concentration of 100 nmol/L. Muskiet et al. cite several sources where much lower doses, e.g., 17.5µg/d (700IU/d), given over a long period of time, 3 years, can be effective. They also state that these lower doses are probably safer for long term supplementation due to vitamin D's tendency to be stored in adipose tissue.

All and all, these references are still great information and I don't mean to discount vitamin D's potential role in helping MS in any way. To the contrary, I discovered some of the most notable effects of my own supplement regimen some time ago when I was just taking vitamin E and cod liver oil (which provides vitamins A & D and omega 3 fatty acids DHA & EPA). As I was just getting started with my supplement regimen, there were occasions where I would forget to take them for a couple of days. During this time I noticed that I became rather tired and these low energy levels dissipated shortly after returning to a regular supplement routine. Now, I can't directly attribute these effects solely to vitamin D due to the presence of the other supplements. However, it does make a strong case, at least for me, that careful use of dietary supplements can modify my day-to-day experience living with the MS monster.

NHE

Prof Jelinek makes a big play for VitD supplementaion in his book Taking Conrol of Multiple Sclerosis ( I've never found any net references I'm afraid). Here's some quotes:

I recommend that you get 15 minutes of all over sun, that is in a bathing suit, 3-5 times a week. The sun should be about UV index 7 or higher. If it is lower, you will need more of it to get the theraputic amount of Vit D.

Goldberg estimates you need 3800IU per day to prevent MS. This is about 10 times the recommended daily allowance, determined by the amount needed to prevent rickets in children. Vieth says about 10000IU [ten thousand JFH] is the most that can be produced naturally by the skin. That is the limit. This dose is useful for maximal immune suppression, and can be achieved by the mininal erythemal dose of UV.. .
Goldberg P. Multiple Sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and Vit D. med Hypothesis 1986;21:193-200
Vieth R. Vit D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69:842-56

Fortunately many places still have solariums left over from the days when tanning was all the rage. .. Because the UV is so concentrated, you need only a short treatment. .. Around ten minutes is probably optimal. The right amount is called the minimal erythemal dose, that is just short of what would make the skin go slightly pink.

If you are taking cod liver oil you will be getting around 400IU per 5mL dose. I take an additional 1000IU tablet of Vit D3 (not D2 which is synthetic) on really overcast days ... although some authorities recommend 3000-4000IU.

My experience is that comparing how I feel now, December, in SE England with how I felt in August in S Spain I long for the sun - but maybe that's because I was on vacation then

[I've checked the numbers in the quotes but of course any typos are mine and I apologise for now. JFH]

Good discussion going on here. I will reply to any posts later but this week I am swamped both at work and home.

Cheers
Nick

thanks NHE, we'll look forward to your thoughts

Hi Arron

I think it is very important to maintain an internal concentration of vitamin D3 both as a preventative measure and for active therapy. The current data set implies vitamin D3, in sufficient amounts, can be an extremely effective immunoregulator in preventing MS. In spite of the limited information regarding the use of D3 as an active therapy, the relationship depicted between D3 and MS lesion activity in the graphic I posted above certainly compels a person w/ MS to keep their serum content > 100 nmol/L.

My feeling is that once autoimmunity is entrenched (i.e. diagnosed) vitamin D3 maintenance will not be enough to completely halt MS activity. In this case the causal environmental factors have to be addressed. For me diet revision propelled me into remission and feeling very well. It wasn’t until three years after diet revision that I incorporated vitamin D into my routine. I can’t claim to feel better for it, yet I consider it akin to insurance. Mind you my MS was quite advanced at the time, perhaps someone not so progressed would see impressive results with D3 alone.

In 1986 Goldberg et altreated a group of young patients having multiple sclerosis with dietary supplements containing calcium, magnesium and vitamin D for a period of one to two years. The number of exacerbations observed during the program was less than one half the number expected from case histories.

Not a proper clinical trial but it does serve to lend credence to the relationship.

Bear in mind that regardless of the source of vitamin D3 (solar UVR exposure and/or tanning bed and/or vitamin supplements) the effect on your internal levels are cumulative. Such elements as latitude, time of year, time of day, amount of exposed skin, skin pigmentation, intensity of the sun and exposure durations are proportionate to the D3 generated.

Where I reside, in Calgary Canada, despite it being sunny for most of the wintertime, sun exposure produces zero vitamin D3 (Webb et al, 1998),largely because of the low altitude of the sun in our winter sky.

John

Good info. The time for our bodies to convert UVR exposure into the vitamin D hormones is one to two months. Holick has recently claimed that UVR exposure immediately produces endorphins. Perhaps this was the means of your feeling of well-being in Spain.

NHE

Thanks for the reference to Frits AJ Muskiet et al. They state

We question whether there is at present any evidence-based medicine showing that a vitamin D intake of 100 µg/d is necessary to prevent disease either in the short term or in the long run.

Not surprising, their opinion is, considering the general ignorance of vitamin D and immunoregulation. I suspect their stance is borne of their unknowingness yet there is enough circumstantial evidence, in my opinion, to consider advocating vitamin D3 as useful in preventing diseases of autoimmunity.

Here are some compelling observational studies which indicate the need for immediate vitamin D observance to prevent MS, rheumatoid arthritis, etc. Not definitive proof but there is enough evidence methinks to merit advocating a safe, inexpensive and easy therapy such as vitamin D observance.

van der Mei et aldemonstrated that the regional variation in MS prevalence in the continent of Australia could be closely predicted (with a 95 % degree of confidence) by variations in regional ultraviolet radiation levels (i.e. vitamin D supply). In comparison, the positive correlation observed for UVR and malignant melanoma incidence was in the seventies. You certainly see consistent advice to stay out of the sun in order to thwart skin cancer despite the lack of concrete clinical evidence implicating UVR exposure. It’s circumstantial, as is the wealth of information implicating vitamin D deficiency and MS.

I mentioned earlier that this paper discusses how Hammond et al. (2000) recently documented that British and Irish immigrants to Queensland, Australia, situated at latitude 12-28 degrees, had a striking 75% reduction in their risk of developing MS when compared with that of their native countrymen. Importantly, this reduction affected both adult and child immigrants.

Consider that these migrants benefited from incidental exposure to the powerful Aussie sun and not necessarily intentional exposure. One can only speculate on a 100 % risk reduction had these migrants purposefully got regular sun exposure.

A observational study by Ascherio et al found women who get 400 IU of vitamin D supplements are 40 per cent less likely to develop multiple sclerosis than women who don't take supplements. Consider again what the reduced risk factor would be had these women been proactively taking an optimal immunoregulatory amount of 4,000 IU/d.

As an aside, Ascherio et al were not even considering including vitamin D in their assessment of this study population. It wasn’t until Embry caught wind of this oversight, presented them with the evidence surrounding vitamin D deficiency and MS and then the authors decided to include it in their questionnaire. As it turns out, vitamin D was the only lifestyle component they queried for that was influential wrt to MS.

MS is not unique among autoimmune diseases wrt to vitamin D. Merlino et al that greater intake of vitamin D was inversely associated with risk of rheumatoid arthritis. Andjelkovic et al showed vitamin D therapy had a positive effect on disease activity in 89% of the patients (45% or 9 pts. with complete remission and 44% or 8 pts. with a satisfactory effect). Only two patients (11%) showed no improvement, but no new symptoms occurred.

Without droning on, observational studies on IDDM (juvenile diabetes) and vitamin D could also be included here.

Cheers
Nick

PS DIRECT–MS has the following offer at our website. For any North American readers, Advanced Nutritional Innovations, Inc. of Fallon, Nevada (US) announced a program to give away free bottles of its premium, high quality calcium/ magnesium supplement to help people with MS. The product has relatively high level of Vitamin D as part of a complex formulation designed to optimize the absorption and utilization of the calcium and magnesium. The product has been distributed at major U.S. retailers like GNC, SavOn Drugs, Osco Drugs, Eckerd Drug, Target, Ralphs Supermarket and many other stores. You just need to fax in this pdf form and the bottles will be shipped to you free of charge, no strings attached. You must be diagnosed with and/or are being treated for MS. They apparently have received some positive feedback from people with MS and decided in the spirit of the holidays to give away some product to people it may help.