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Optic neuritis progession into Multiple Sclerosis reduced 68 percent by 50,000 IU of vitamin D weekly

Update Oct 2017: Clinical trial being started for Optic Neuritis and Vitamin D: 50,000 IU/d of oral vitamin D3 x 5 days followed by 10,000 IU/d of oral vitamin D3 x 85 days Results are due 2023

Optic neuritis progession into Multiple Sclerosis reduced 68 % by 50,000 IU of vitamin D weekly- 2013

Preventive effect of vitamin D3 supplementation on conversion of optic neuritis to clinically definite multiple sclerosis: a double blind, randomized, placebo-controlled pilot clinical trial
Acta Neurol Belg. 2013 Sep;113(3):257-63. doi: 10.1007/s13760-012-0166-2. Epub 2012 Dec 19.
Derakhshandi H 1, Etemadifar M, Feizi A, Abtahi SH, Minagar A, Abtahi MA, Abtahi ZA, Dehghani A, Sajjadi S, Tabrizi N.
1 Isfahan Eye Research Center (IERC), Feiz Hospital, Isfahan University of Medical Sciences, SHARNOS Co. No. 9, Boroomand. Seyed-Alikhan, Chaharbagh Abbasi, 81448-14581, Isfahan, Iran.

Multiple sclerosis (MS) presents with optic neuritis (ON) in 20 % of cases and 50 % of ON patients develop MS within 15 years. In this study, we evaluated the preventive effects of vitamin D3 administration on the conversion of ON to MS (primary outcome) and on the MRI lesions (secondary outcome) of ON patients with low serum 25 (OH) D levels. Thirty ON patients (15 in each of 2 groups, aged 20-40 years) with serum 25 (OH) D levels of less than 30 ng/ml were enrolled in a double blind, randomized, parallel-group trial. The treatment group (cases) received 50,000 IU of vitamin D3 weekly for 12 months and the control group (controls) received a placebo weekly for 12 months. Finally, the subsequent relapse rate and changes in MRI plaques were compared between the two groups.

Risk reduction was 68.4 % for the primary outcome in the treatment group (relative risk = 0.316, p = 0.007).

After 12 months, patients in the treatment group had a significantly lower incidence rate of cortical, juxtacortical, corpus callosal, new T2, new gadolinium-enhancing lesions and black holes.

The mean number of total plaques showed a marginally significant decrease in the group receiving vitamin D3 supplementation as compared with the placebo group (p = 0.092). Administration of vitamin D3 supplements to ON patients with low serum vitamin 25 (OH) D levels may delay the onset of a second clinical attack and the subsequent conversion to MS.

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All Optic Neuritis subjects had low vitamn D levels - Oct 2022

Serum Vitamin D Levels and Status in Thai Optic Neuritis Subjects: A Case-Control Study
Clinical Ophthalmology » Volume 16 DOI https://doi.org/10.2147/OPTH.S383703
Authors Puangsricharoen B, Vanikieti K, Jindahra P, Padungkiatsagul T

  • 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Correspondence: Tanyatuth Padungkiatsagul, Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand, Tel +662 201 1526, Fax +662 201 2729, Email blu_c16 at hotmail.com

Objective: To measure serum total vitamin D or 25-hydroxyvitamin D [25(OH)D] levels and status in immune-based optic neuritis (ON) including neuromyelitis optica spectrum disorder (NMOSD)-ON, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)-ON, autoimmune-ON, and idiopathic-ON and compare them with age- and sex-matched healthy controls. The secondary objective was to analyze the association between serum 25(OH)D levels and ON attack severity (nadir best-corrected visual acuity; nadir BCVA).

Materials and Methods: This was a single-center, case–control study. We enrolled 59 subjects (19 NMOSD-ON, 6 MOGAD-ON, 11 autoimmune-ON, 23 idiopathic-ON) diagnosed with acute immune-based ON (any ON attacks) over 11 years. Electronic medical records were reviewed and demographic data (age at sampling, sex, aquaporin-4 immunoglobulin (AQP4-IgG); myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG); other biomarkers of autoimmune disorders), ON attack severity (nadir BCVA), and serum 25(OH)D levels in the acute phase of ON were collected. Serum 25(OH)D levels of 236 age- and sex-matched healthy controls were assessed.

Results: Mean serum 25(OH)D levels were significantly lower in each group of immune-based ON compared with healthy controls (p < 0.001 for each ON group).
However, mean serum 25(OH)D levels were not significantly different between four ON groups

  • NMOSD-ON, 20.18± 5.90 ng/mL;
  • MOGAD-ON, 23.07± 4.94 ng/mL;
  • autoimmune-ON, 21.14± 5.29 ng/mL;
  • idiopathic-ON, 19.56± 5.12 ng/mL; p = 0.525).

All immune-based ON subjects had vitamin D insufficiency or vitamin D deficiency. The prevalences of vitamin D insufficiency and vitamin D deficiency were significantly higher than in healthy controls in each ON group (both p < 0.05 in each ON group). No associations were observed between serum 25(OH)D levels and ON attack severity (nadir BCVA).

Conclusions: Thai immune-based ON subjects had lower serum 25(OH)D levels and higher prevalence of vitamin D insufficiency and vitamin D deficiency compared with age- and sex-matched healthy controls. Serum 25(OH)D levels were not associated with ON attack severity (nadir BCVA). We highly recommend that serum 25(OH)D levels be screened in all subjects with acute immune-based ON.
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A prospective cohort study of vitamin D in optic neuritis recovery - 2017

Mult Scler. 2017 Jan;23(1):82-93. doi: 10.1177/1352458516642315. Epub 2016 Jul 11.
Burton JM1, Eliasziw M2, Trufyn J3, Tung C4, Carter G5, Costello F6.
1 Dept of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, U. of Calgary, Calgary, AB, Canada.
2 Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
3 Neurosciences Graduate Program, University of Calgary, Calgary, AB, Canada.
4 Biological Sciences Undergraduate Sciences Program, University of Calgary, Calgary, AB, Canada.
5 Eye Clinic, Rockyview General Hospital, Calgary, AB, Canada.
6 Dept of Clinical Neurosciences and Department of Surgery (Ophthalmology), Hotchkiss Brain Institute, U. of Calgary, Calgary, AB, Canada.

BACKGROUND:
Vitamin D sufficiency is associated with better inflammatory outcomes in multiple sclerosis (MS). We hypothesize that it is also associated with better long-term neurodegenerative measures.

OBJECTIVES:
To show that vitamin D sufficient patients (25-hydroxy vitamin D (25(OH)D) > 80 nmol/L) have better optical coherence tomography (OCT) neuroaxonal measures of ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness after optic neuritis.

METHODS:
In this prospective cohort study, acute optic neuritis patients underwent OCT and serum 25(OH)D assessments at baseline and at month 6, with comparisons between vitamin D sufficient and insufficient patients, and men and women. Potential confounding variables were evaluated.

RESULTS:
Of 49 enrolled, 36 had complete, analyzable data. At baseline, vitamin D insufficiency was associated with greater RNFL thickness (134.3 vs. 95.2 µm; p = 0.003) in affected eyes. At month 6, insufficient patients had greater GCL thinning (GCL inter-eye difference: 14.2 vs. 4.0 µm, p = 0.008). Men had greater RNFL and GCL thinning than women (GCL: 61.2 vs. 69.6 µm, p = 0.036).

CONCLUSION:
Acutely, in optic neuritis, RNFL thickness is increased with vitamin D insufficiency. Chronically, neuronal, and possibly axonal loss are associated with vitamin D insufficiency and male gender, suggesting vitamin D and female gender may confer neuroprotection in optic neuritis, and possibly, central nervous system (CNS) inflammatory disease.

PMID: 27037181 DOI: 10.1177/1352458516642315


See also VitaminDWiki

Overview MS and vitamin D contains the following summary
Clinical interventions have shown that Vitamin D can prevent, treat, and even cure Multiple Sclerosis, at a tiny fraction of the cost of the drugs now used to treat it, and without side effects.

Summary: lack of consensus on how much to prevent, treat, or cure MS.

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