People with Multiple Sclerosis who have gut problems should take gut-friendly Vitamin D (many suppliers)
Types of gut problems
Claude AI - Oct 2026
Bowel symptoms from the neurological damage. These are very common and often under-reported. In a 1990 survey of 280 MS outpatients, 43% had constipation, 51% had at least one episode of fecal incontinence in the prior 3 months, and 68% had one or both. These problems were common even in patients with little disability [Hinds 1990]. A 2023 Italian cohort of 447 patients found bowel dysfunction in 53.7%. It was worse in progressive MS than in relapsing-remitting MS and increased with disease duration and disability [Tavazzi 2023]. In a Mayo motility study, 88% of patients with bladder symptoms also had constipation or incontinence. The lower gut is hit hardest because MS disrupts the central pathways controlling sacral parasympathetic outflow [Mayo 2022]. Swallowing problems also occur: a Pittsburgh cohort reported dysphagia in about 21% [Pittsburgh 2013].
Gut disease and gut biology. People with MS develop other gut conditions more often than expected:
- Inflammatory bowel disease. A meta-analysis found roughly a 50% higher risk of IBD in MS patients, and a similar higher risk of MS in IBD patients, with no difference between Crohn's and ulcerative colitis [Kosmidou 2017].
- Irritable bowel syndrome. IBS affects more than 10% of people with MS and is more common than in the general population [Marrie 2015].
- Leaky gut. In a small pilot study using the lactulose/mannitol test, 73% of relapsing-remitting patients had increased intestinal permeability, compared with 28% of controls [Buscarinu 2017]. A Swedish study also found higher permeability in MS but normal fecal calprotectin. The authors suggested the leakiness may come from faulty CNS control of the gut's nerves rather than direct inflammation of the gut wall [Sjöström 2021].
- Microbiome. The largest study compared 576 patients with healthy people living in the same households, to control for diet. Patients had more Akkermansia muciniphila, Ruthenibacterium lactatiformans, Hungatella hathewayi and Eisenbergiella tayi, and less Faecalibacterium prausnitzii and Blautia [iMSMS 2022].
Is the gut a cause or a consequence? Probably some of both. One study looked at 34 pairs of identical twins in which only one twin had MS. Gut bacteria from the twin with MS, transplanted into mice bred to be prone to brain autoimmunity, caused autoimmune disease more often than bacteria from the healthy twin [Berer 2017]. That points to a causal role. Still, the iMSMS authors acknowledge the disease itself could be driving the microbiome changes, and MS drugs also shift the microbiome, which complicates comparisons between treated patients and controls.
Related in VitaminDWiki
Coimbra Protocol
- Coimbra Protocol and Autoimmune Disease - video and summary
- Coimbra Multiple Sclerosis - great 11 year experience by an individual
- Coimbra high-dose vitamin D protocol - many studies
Doctors often unaware that MS is strongly associated with a poor Vitamin D Receptor
- Multiple sclerosis (relapsing-remitting) decreases activation of Vitamin D Receptor by 6.6 X
- Multiple Sclerosis 2X-3X more likely if poor Vitamin D Receptor – Meta-analysis
- Risk of Multiple Sclerosis varies with the Vitamin D Receptor – meta-analysis
- Multiple Sclerosis: is strongly related to poor Vitamin D receptors – umbrella review
Supplements that activate the Vitamin D receptor get more D to the mitrochondria
- Multiple Sclerosis and Vitamin D Receptor Activators: Omega-3, Curcumin, Resveratrol, etc.
- Multiple Sclerosis and Vitamin D Receptor super enhancers
Giving LOTS of Vitamin D is another way to get past the Vitamin D Receptor