Vitamin D Eases Symptoms Of Multiple Sclerosis

Among the dozens of medical applications of vitamin D, MS (multiple sclerosis) is the latest.

Multiple sclerosis is most common in regions of the world that don't get a lot of sun. Scandinavia, the United Kingdom, and Canada are homes to disproportionately large numbers of people who have MS. Since fair skin and limited exposure to sunlight are risk factors for vitamin D deficiency, researchers long ago started looking for a link between low vitamin D levels and the development of the disease. Low vitamin D levels at diagnosis are predictive of early conversion to a more progressive form of the disease. Only in 2015, however, has research produced solid evidence that taking supplemental vitamin D may ease symptoms of the disease.

Higher Doses of Vitamin D Are Needed for MS Relief

In the recently reported study from the UK, 40 volunteers who have relapsing-remitting multiple sclerosis, a form of the disease in which there are occasional periods of symptom relief with or without treatment, were given either 800 IU or 10,400 IU of vitamin D every other day for six months. Both dosages are higher than the commonly recommended 600 IU per day. 

Over the course of the six-month study, MS patient-volunteers taking the lower dose of vitamin D did not exhibit any benefits from treatment. Patient-volunteers taking the higher dose of vitamin D, however, experienced a 1 percent reduction in destructive T-cells for every 5 nanograms per milliliter increase in vitamin D test numbers. Maximum reduction in the white blood cells that damage neurons occurred with a 40 nanogram per milliliter increase in vitamin D. This kind of increase in bloodstream concentrations of vitamin D is only possible with high-dose supplementation with vitamin D3. There were minimal side effects associated with taking the higher dose.

Scientists at Johns Hopkins University in the United States are conducting large-scale trials of varying doses and different forms of vitamin D supplements to confirm their usefulness in treating multiple sclerosis. There is essentially no downside for anyone with MS to try them. However, the basics of vitamin D supplementation are a little different for MS patients than they are for the mainstream population, beginning with the target vitamin D level.

MS Patients Need Very High Levels of Vitamin D

Someone who does not have vitamin D might be told he or she is vitamin deficient if a vitamin D test indicated a bloodstream concentration of as little as 20 nanograms of vitamin D per milliliter. Doctors typically don't prescribe more vitamin D once bloodstream levels reach just 40 nanograms per milliliter. (Some doctors use a different unit of measurement; 40 nanograms per milliliter is equivalent to 100 nanomoles per liter.)

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MS patients, however, are given supplements to reach a much higher concentration of vitamin D. Any vitamin D level lower than 40 nanograms per milliliter (or 100 nanomoles per liter) is treated as deficient. Doctors usually try to get the vitamin D levels of MS patients up to 80 nanongrams per milliliter (200 nanomoles per liter), twice as high as vitamin D levels for patients who do not have MS.

Most MS Patients Don't Wait For Their Doctors To Tell Them To Take Vitamin D

Most people who have multiple sclerosis, however, don't wait for their doctors to suggest that they take supplemental vitamin D. The typical MS patient is a woman, in the middle of her life, living in an English-speaking country, and well informed about her condition. A survey published in 2015 found that 81 percent of American MS patients took vitamin D, although only 20 percent took 5000 IU per day or more, as some researchers now recommend. Researchers also found that people who take higher doses of vitamin D (more than 2000 IU per day) were also more likely to get intentional sun exposure so their bodies can make vitamin D, and that MS patients who don't take vitamin D were also the least likely to spend planned time in the sun for their health.

What effect does vitamin D supplementation have on quality of life in MS? A study of 1592 people in both the Northern and Southern Hemispheres in 57 countries (but primarily in the US, UK, and Australia) found that:

• Vitamin D supplementation in any amount improved physical and mental health and energy levels. Taking 2000 to 5000 IU per day, however, was almost as beneficial as taking more than 5000 IU per day.
• Living in a northerly (or, in the Southern Hemisphere, southerly) location had a greater effect on energy levels than on objective physical or mental health.
• Living more than 40° north or south of the equator exacerbated symptoms. Just a few hundred miles (or kilometers) closer to the equator would be enough to make a difference in physical and mental health and in energy levels.
• Intentional sun exposure is strongly beneficial both for relieving physical symptoms and for increasing energy levels.
• Remission from symptoms lasted, on average, about six months longer in people with MS who took at least 2000 IU of vitamin D per day. There was very little difference in time in remission between the group that took 2000 to 5000 IU of vitamin D per day and the group that took more than 5000 IU per day.
• Location makes a measurable difference in length of remission in relapsing-remitting MS. Every 1 degree further from the equator corresponds to an approximately 1 percent shorter time in remission. 
• A high level of disability was least common in people with MS who took between 2000 and 5000 IU of vitamin D per day. Researchers do not know, however, whether people with MS tended to increase their dosage of vitamin D when symptoms became severe.

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Other studies have found that:

• Giving vitamin D (specifically, giving vitamin D-rich cod liver oil) to teenagers in families with members who have multiple sclerosis reduced their rates of the disease as adults.
• Giving women who have MS 50,000 IU of vitamin D3 per week during pregnancy reduced relapses during pregnancy and six months after the birth of the child.