Wednesday, November 26, 2008

Vitamin D and MS disease activity

In this blog I will comment on the role of vitamin D in multiple sclerosis. Multiple studies have demonstrated an association of low vitamin D levels and increased risk of multiple sclerosis diagnosis and greater severity of symptoms.

We also have more and more evidence that vitamin D is important to health immune function. Furthermore there is an epidemic of vitamin D deficiency. People spend less time outdoors. When they do go outside people apply sun screen to protect them from the sun to decrease the risk of skin cancer. The problem is that sun screen also blocks the skin's ability to make vitamin D. That explains why we have an epidemic of vitamin D deficiency in our children, young adults and those over sixty-five. Thus far every group that has been measured has had an alarming rate of vitamin D deficiency.

If someone has MS or has a family member with MS it is likely that they would benefit by taking supplemental vitamin D. What dose should they take? The recommended daily allowance for vitamin D has been set for only 400 international units (IU). That was when scientists had believed vitamin D's only role was related to bone health. The dose of 400IU was the dose of vitamin D which prevented spontaneous bone fractures.   However vitamin D affects more than bones. The brain is filled with Vitamin D receptors and vitamin D is important to normal immune function.

There is increasing evidence the recommended daily allowance is much too low. If one was outside during the summer long enough so that their skin was slightly pink, but not enough to have even a mild sun burn, 20,000 IU of vitamin D would have been made in the skin. Researchers have recently given MS patients higher doses of vitamin D and then examined the patients for evidence of toxicity and of decreased MS disease activity. Their conclusion was that doses of 10,000 IU each day were well tolerated. Furthermore patients who had been given 10,000 IU experienced less disease activity as measured by the ability to tasks of daily living and the molecular markers of MS related inflammation. 

Based on those study findings taking 10,000 IU per day of vitamin D is likely safe and likely beneficial. Using tanning beds to maintain a tan without burning is an alternative strategy to maintaining adequate vitamin D levels.  Having your personal physician check your calcium level would confirm that the high dose of vitamin D is not causing problems for you. Ensuring that you have sufficient vitamin D is an important strategy to minimize disease activity if one has or is at risk of having MS.


Anonymous said...

I just had my vitamin D checked and it was so low that it wouldn't show on their range level, however they could give me the number. The doctor said to start taking at least 2000 units, but after reading what you wrote, I think I'll increase it. I am to have it rechecked in 4 months so I'll let you know if it goes up and if I feel any better!

Terry Wahls, MD said...

Excellent -- you might also consider using sunlight or tanning booth to make your own vitamin D. Be careful not to burn however.