Neurol Sci. 2018 Aug;39(8):1467-1470. doi: 10.1007/s10072-018-3440-0. Epub 2018 May 13.
Ferre' L1,2, Clarelli F2, Sferruzza G1,2, Rocca MA1,3, Mascia E2, Radaelli M1, Sangalli F1, Dalla Costa G1, Moiola L1, Aboulwafa M3, Martinelli Boneschi F1,2, Comi G1,2, Filippi M1,3, Martinelli V1, Esposito F4,5.
Fact: MS + fingolimod+ > 40 ng Vitamin D ==> better outcomes
Fact: MS + 150 ng Vitamin D (Coimbra Protocol) ==> MS "curred"
Recommendation: All MSers should increase their Vitamin D levels to at least 40 ng
- Overview MS and vitamin D
- MultiplesSclerosis category listing has
334 items along with related searches
- Multiple sclerosis helped some by 10,000 IU of vitamin D daily avg. for 3 months – RCT Sept 2016
- Vitamin D is the real Multiple Sclerosis Therapy, not an alternative therapy – Coimbra July 2018
- Multiple Sclerosis relapse rate reduced by half if add some vitamin D – July 2017
- Vitamin D is the only dietary supplement which significantly benefits MS – JAMA April 2018
- Multiple Sclerosis, Alzheimer’s and Parkinson’s need more than 30 ng of Vitamin D – review Nov 2017
PDF is available free at Sci-Hub 10.1007/s10072-018-3440-0
BACKGROUND: Several studies have shown an association between 25-hydroxyvitamin D (25[OH]D) levels and multiple sclerosis (MS) susceptibility and/or level of disease activity in patients treated with first line drugs.
AIMS: To investigate whether baseline 25[OH]D values could influence disease activity also during treatment with the second-line drug fingolimod (FTY).
PATIENTS AND METHODS: We enrolled 176 MS patients who started FTY at the San Raffaele Hospital (OSR) MS center with available 25[OH]D measurement at the time of treatment start. We then prospectively followed them for 2 years with periodic clinical examinations and MRI scans.
We found no linear correlation between baseline 25[OH]D levels and annualized relapse rate (ARR) or time to first relapse. However, we observed that patients with serum 25[OH]D ≥ 100 nmol/l showed a lower number of Gd+ and combined unique activity (CUA) lesions at baseline compared to patients with the lowest 25[OH]D levels (less than 50 nmol/l, p value < 0.05). Moreover, they showed fewer CUA lesions at 2-year follow-up also when accounting for baseline level of disease activity (p value < 0.05).
In patients treated with FTY, those with the highest baseline 25(OH)D levels had a significantly lower number of active lesions at baseline; the same effect, even if weaker, was observed also at 2-year follow-up when adjusting for baseline disease activity. Given Vitamin D supplementation safety profile, also if a causal effect has not yet been shown, most of MS patients could probably benefit from 25[OH]D levels above those currently considered to be sufficient.
- 1. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A (2006) Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 296(23):2832–2838
- 2. Martinelli V, Dalla Costa G, Colombo B, Dalla Libera D, Rubinacci A, Filippi M, Furlan R, Comi G (2014) Vitamin D levels and risk of multiple sclerosis in patients with clinically isolated syndromes. Mult Scler 20(2):147–155
- 3. Tuzun1 E, Kucukhuseyin O, Kurtuncu M et al (2015) Reduced serum vitamin D levels in neuromyelitis optica. Neurol Sci 36(9):1701–1702. https://doi.org/10.1007/s10072-015-2229-7
- 4. Runia TF, Hop WC, de Rijke YB, Buljevac D, Hintzen RQ (2012) Lower serum vitamin D levels are associated with a higher relapse risk in multiple sclerosis. Neurology 79(3):261–266
- 5. Ascherio A, Munger KL, White R, Köchert K, Simon KC, Polman CH, Freedman MS, Hartung HP, Miller DH, Montalbán X, Edan G, Barkhof F, Pleimes D, Radü EW, Sandbrink R, Kappos L, Pohl C (2014) Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurol 71(3):306–314
- 6. Fitzgerald KC, Munger KL, Kochert K et al (2015) Association of vitamin D levels with multiple sclerosis activity and progression in patients receiving interferon beta-1b. JAMA Neurol 72(12):1458–1465
- 7. Rotstein DL, Healy BC, Malik MT, Carruthers RL, Musallam AJ, Kivisakk P, Weiner HL, Glanz B, Chitnis T (2015) Effect of vitamin D on MS activity by disease-modifying therapy class. Neurol Neuroimmunol Neuroinflamm 2(6):e167
- 8. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302
- 9. Bliss CI (1958) Periodic regression in biology and climatology. Conn Agric Exp Station 615:3–55
- 10. Hupperts R (2016) High dose cholecalciferol (vitamin D3) oil as add-on therapy in subjects with relapsing-remitting multiple sclerosis receiving subcutaneous interferon beta-1a. ECTRIMS congress, London