Will there be Enough Evidence to offer Vitamin D Supplementation to Patients with Multiple Sclerosis in 2024?
Journal of Neurology Research Reviews & Reports doi.org/10.47363/JNRRR/2024(6)204
Hans Klaus Goischke Internal medicine, rehabilitation, social medicine, D-97769
Bad Bruckenau, Hochwaldstra Be 2, Germany
This narrative overview discusses the scientific findings of the biochemical and metabolic effect of vitamin D on multiple sclerosis up to 2024 with selected targets.
Since the clinical outcome of multiple sclerosis cannot be predicted in individual patients and there may still be a phase of “success and failure”, vitamin D as an add-on therapy could make an early and lasting contribution to the control of dysregulatory inflammatory responses. . As an additional therapy to disease modifying therapies (currently 20 drugs are available, for example ocrelizumab, ofatumumab,ublituximab, rituximab, natalizumab), the B cell kinetics and radiological activity could also be influenced.Some negative vitamin D supplementation studies with zero results could be viewed retrospectively in a more differentiated way through the findings of the three immunologically different phenotypes of multiple sclerosis and with an accentuation of (severe) obesity. This new classification will open up an individualized therapeutic strategy through the targeted immunological effect of 1,25-dihydroxy-vitamin D 3. The relationship between high body mass index and response to vitamin D supplementation and metabolism and the weighting in supplementation studies will become more important in studies.
In an international consensus, daily oral cholecalciferol is preferred due to its safety and minimal need for monitoring in autoimmune diseases. 25-Hydroxyvitamin D3 (25(OH)D in serum is the recognized biomarker for vitamin D status. A connection between vitamin D status and the immune system is recognized. Genetically predicted low levels of 25(OH)D increase the risk of developing multiple sclerosis in adolescence or adulthood.
The findings of the complex pathobiological mechanisms of vitamin D through the immunomodulatory effects on autoimmune diseases in general and on multiple sclerosis in particular in 2024 justify integrating vitamin D supplementation into the multimodal approach to personalized medicine without the risk of significant side effects.
Download the PDF from VitaminDWiki
Asked Perplexity AI: Why does the attached study believe that Vitamin D can treat MS?
Asked on the comprehensive review provided in the attached study, there are several key reasons why the authors believe vitamin D supplementation can be beneficial for treating multiple sclerosis (MS):
- Immunomodulatory effects: Vitamin D, particularly its active form 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), has significant immunomodulatory effects on both the innate and adaptive immune systems. It can suppress inflammatory responses and promote regulatory T cell function, which is relevant to MS pathophysiology.
- Impact on MS risk and disease activity: Higher vitamin D levels are associated with lower risk of developing MS and reduced disease activity in established MS.
- Effects on specific immune cells: Vitamin D influences various immune cells involved in MS pathology, including:
- Suppressing pro-inflammatory Th1 and Th17 cells
- Promoting regulatory T cells
- Modulating B cell and NK cell functions - Neuroprotective effects: Vitamin D may have neuroprotective properties, potentially reducing brain atrophy and supporting neuronal health[.
- Influence on Epstein-Barr virus (EBV): Vitamin D supplementation can alter immune responses to EBV, which is strongly associated with MS risk.
- Addressing common deficiency: Vitamin D deficiency is prevalent in MS patients and the general population, making supplementation a logical intervention.
- Safety profile: High-dose vitamin D supplementation is generally well-tolerated and safe, with minimal side effects compared to other MS treatments.
- Potential synergy with disease-modifying therapies (DMTs): Vitamin D may enhance the effects of standard MS treatments and help address some of their limitations.
- Impact on MS symptoms: Vitamin D supplementation may help alleviate common MS symptoms like fatigue and depression.
- Early intervention potential: Vitamin D could be beneficial in early stages of MS or even in the prodromal phase, potentially delaying or preventing disease progression.
While the authors acknowledge that some studies have shown mixed results, they argue that the totality of evidence, including pathophysiological mechanisms and observational data, supports the use of vitamin D supplementation as part of a comprehensive approach to MS treatment. They emphasize the need for adequate dosing and early intervention to achieve optimal effects.
Note: Vitamin D has been treated by the Coimbra protocol since about 2010
40+ VitaminDWiki pages have COIMBRA in the title
The list is automatically updated
VitaminDWiki – Overview MS and vitamin D contains
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.
- Fact: Low Vitamin D results in higher risk of getting MS
Increase latitude leads to decreased Vitamin D, which leads to increased risk of MS
Dark skinned people are far more likely to get MS (dark skin people typically have low vitamin D)
Elderly (who typically have low vitamin D) are more likely to get MS
Is there increased risk in people who already have diseases associated with low vitamin D - TB, for example ? ? ?
Women typically have 3X increased MS risk then men (note: women typically have 20% lower levels of vitamin D than men)
Exception: women in very sunny climates and dark-skinned women have the same MS risk as men
Obese [http://www.ncbi.nlm.nih.gov/pubmed/19169174|are 60% more likely to get MS]
Multiple Sclerosis 42X more likely if light brown skin and smoke (both associated with low vitamin D) – July 2020
MS recurrence is much higher in spring - the lowest time of the year for vitamin D
increase in clouds/rainfall (which reduces available Vitamin D) is associated with increased risk of MS (Scotland, Western Washington)
MS incidence has increased 70% in a decade while the incidence of vitamin D deficiency doubled
[www.vitamindwiki.com/dl1188|Less MS in those with outdoor occupations] PDF file, not a web page - Fact: MS uses up Vitamin D
- Fact: Lower vitamin D (due to MS using up Vitamin D while fighting the disease) results in many other health problems (such as broken bones), so depleted vitamin D levels must be restored.
- Fact: Vitamin D looks so promising for preventing and treating MS that there were [http://clinicaltrials.gov/ct2/results?term=%22multiple+sclerosis%22+&recr=&rslt=&type=&cond=&intr=%22vitamin+d%22&outc=&spons=&lead=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&rcv_s=&rcv_e=&lup_s=&lup_e=|25 INTERVENTION clinical trials as of Feb 2014]
- Fact: Vitamin D reduced the MS relapse rate far better than Fingolimod which is now used for that purpose.
- Note: [http://www.ajmc.com/publications/ajpb/2011/AJPB_NovDec2011/Cost-Effectiveness-of-Fingolimod-in-Treating-Patients-with-Relapsing-Remitting-Multiple-Sclerosis| Fingolimod costs $25,000/year] while vitamin D, which works better and has no side effects is 1000 times less expensive.
- Fact: 98% of the genes affected by Interferon are also affected by Vitamin D
- Note: 1 week of Interferon = $4,700, 1 week of vitamin D 10,000X lower cost
- Fact: MS Doctors in Brazil recommending 40-100 ng/mL of Vitamin D
- Fact: Many MS forums are recommending vitamin D to treat MS, with some [http://www.msworld.org/forum/showthread.php?t=103191|taking 5,000 to 10,000 IU daily]
Observation: Risk of going from pre-MS to MS reduced 68 percent with 7100 IU vitamin D – RCT Dec 2012- This is an observation instead of a fact - it has not yet been confirmed.
- Fact: [https://vitamindwiki.com/tiki-index.php?page_id=5279|VERY LARGE doses of vitamin D have CURED 2,000 people of MS in Brazil]
- Controversy: [https://www.vitamindwiki.com/tiki-index.php?page_id=1267|UVB fron sunlight or UVB bulb may be BETTER than Vitamin D for reducing the risk of getting MS]
- Hypothesis: In addition to Vitamin D there are many other photoproducts produced by UVB that may promote health.
Summary: lack of consensus on how much to prevent, treat, or cure MS.
- Coimbra Protocol (using Vitamin D) is safe and effective for Multiple Sclerosis and Autoimmune diseases – April 2022
- 54,000 IU of vitamin D daily with no Calcium (1,000 IU per kg: Coimbra protocol) – July 2024
- How much Vitamin D to prevent many diseases - such as MS
- How much Vitamin D is needed to treat MS? There is currently no agreement
The recommendations range from 40 to 100 ng - which can result of a dose ranging from 3,000 to 20,000 IU/day - How Vitamin D is needed to Cure MS?: It appears that 20,000-140,000 IU daily may be needed to CURE the disease
You must be under the supervision of a doctor who knows what to watch for in your individual situation.
High doses of Vitamin D cannot be used as a monotherapy.
You will need to adjust the cofactors: Typically increasing Magnesium and Vitamin K2, and reducing Calcium intake.
Your doctor will monitor these and might increase your intake of Vitamins B2, C, as well as Omega-3 - Epstein-Barr virus increases risk of Multiple Sclerosis by 32X - Jan 2022
- Multiple Sclerosis treated by Vitamin D, recommends investigating high dose Coimbra - Oct 2021
- Multiple Sclerosis patients had fewer COVID-19 problems (Note: many MSers take Vitamin D) – April 30, 2021
- Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021
- Multiple Sclerosis relapses cut in half by 100,000 IU of Vitamin D every 2 weeks– RCT 2019
VitaminDWiki – Multiple Sclerosis 32 percent less likely among those with more than 32 ng of vitamin D – Dec 2019
- Overview MS and vitamin D
- An opportunity - use Vitamin D to treat Multiple Sclerosis (has been used for 14 years) - Feb 2022
- Multiple Sclerosis treated when use high doses of vitamin D – meta-analysis May 2018
- Multiple Sclerosis: 10 percent fewer relapses for each 10 ng higher level of vitamin D – Meta-analysis April 2020
- Multiple Sclerosis: number needed to treat with vitamin D may be as low as 1.3 – Meta-analysis Oct 2013
- Multiple Sclerosis more likely if poor vitamin D genes - 22nd study – Aug 2017
- Multiple Sclerosis relapses cut in half by 100,000 IU of Vitamin D every 2 weeks– RCT 2019
UV and Sunshine reduces MS risk
- Multiple Sclerosis 2X more likely if low winter UV – June 2018
- Multiple Sclerosis half as likely if get plenty of sunshine (not a news item) – March 2018
Other things also help
- Multiple Sclerosis treated by 50,000 IU Vitamin D bi-weekly plus Omega-3 – RCT July 2018
- Multiple Sclerosis 40 percent less likely if consume tinned fish (Vitamin D and Omega-3) – Sept 2019
- Resveratrol treats Multiple Sclerosis and other autoimmune diseases – many studies
- Not a single case of multiple sclerosis in 15,000,000 people (plant-based diets)
High Dose Vitamin D and cofactors
- Coimbra protocol using high-dose Vitamin D is safe – April 2022
- The use of high dose Vitamin D (Coimbra Protocol) for multiple sclerosis in Germany – 2019
- Comparing High-dose vitamin D therapies MS and other health problems
Number of MS studies which are also in other categories
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22 studies in Genetics - genes can restrict Vitamin D getting to the blood and to the cells 16 studies in Vitamin D Receptor - gene which restricts D from getting to the cells 7 studies in Vitamin D Binding Protein - gene which restricts D from getting to the cells 22 studies in Ultraviolet light - may be even better than Vitamin D in preventing and treating MS 9 studies in Omega-3 - which helps Vitamin D prevent and treat MS Multiple Sclerosis is treated by Vitamin D – 10 reasons – Sept 2024(Cached) Printer Friendly Follow this page for updates2296 visitors, last modified 23 Sep, 2024, This page is in the following categories (# of items in each category)