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    Jerry W. Swanson, M.D.

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Question

Vitamin D and MS: Is there any connection?

Is there any proof that vitamin D supplements can prevent MS or keep symptoms of MS from worsening?

Answer

from Jerry W. Swanson, M.D.

Several studies have suggested that maintaining adequate levels of vitamin D may have a protective effect and lower the risk of developing multiple sclerosis (MS). Other studies suggest that for people who already have MS, vitamin D may lessen the frequency and severity of their symptoms. More research is needed to assess these findings.

When a person has MS, his or her immune system attacks the coating that protects the nerve cells. Research suggests that a connection between vitamin D and MS could be tied to the positive effects vitamin D has on the immune system.

The link between vitamin D and MS is strengthened by the association between sunlight and the risk of MS. The farther away from the equator a person lives, the higher the risk of MS. Sunlight is the body's most efficient source for vitamin D — suggesting that exposure to sunlight may offer protection from MS.

The Institute of Medicine recommends 600 international units (IUs) of vitamin D a day for adults ages 19 to 70. The recommendation increases to 800 IUs a day for adults age 71 and older.

Some doctors question whether these levels are adequate and think that getting more vitamin D would benefit many people. However, the Institute of Medicine recommends that adults avoid taking more than 4,000 IUs a day.

Very large doses of vitamin D over an extended period can result in toxicity. Signs and symptoms include nausea, vomiting, constipation, poor appetite, weakness and weight loss. In addition, vitamin D toxicity can lead to elevated levels of calcium in your blood, which can result in kidney stones.

If you're concerned that you're getting too little — or too much — vitamin D, talk with your doctor about what's right for you.

Next question
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References
  1. Raghuwanshi A, et al. Vitamin D and multiple sclerosis. Journal of Cell Biochemistry. 2008;105:338.
  2. Ramagopalan SV, et al. Expression of the multiple sclerosis-associated MHC class II allele HLA-DRB1*1501 is regulated by vitamin D. PLoS Genetics. 2009;5:e1000369. http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1000369. Accessed July 26, 2010.
  3. Pierrot-Deseilligny C. Clinical implications of a possible role of vitamin D in multiple sclerosis. Journal of Neurology. 2009;256:1468.
  4. Smolders J, et al. Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis. PLoS One. 2009;4:e6635. http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006635. Accessed July 26, 2010.
  5. Dietary supplement fact sheet: Vitamin D health. Office of Dietary Supplements. National Institutes of Health. http://ods.od.nih.gov/factsheets/vitamind.asp. Accessed Dec. 2, 2010.
  6. Dietary Reference Intakes for calcium and vitamin D. Institute of Medicine. http://www.iom.edu/vitamind. Accessed Dec. 2, 2010.
  7. Vitamin D. The Merck manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec01/ch004/ch004k.html. Accessed Aug. 11, 2010.
AN01894 Dec. 4, 2010

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