Vitamin D can benefit those with multiple sclerosis

VITAMIN D₃ may help regulate the hyperactive immune response of people with multiple sclerosis (MS), a chronic disease that attacks the central nervous system.

The vitamin can be an inexpensive, safe and convenient treatment for people with MS, said study author Peter Calabresi, M.D., director of the Johns Hopkins Multiple Sclerosis Center and professor neurology at the Johns Hopkins University School of Medicine. Results are promising, he said, but further research has to be conducted on more MS patients to understand the mechanisms.

Vitamin D also known as the sunshine vitamin, is a fat-soluble vitamin that can be derived from sun exposure, supplements, and food like fatty fish, beef liver, cheese, and mushrooms, among others.

Low levels of vitamin D in the blood are linked to greater risk of developing MS. People who have MS and low levels of vitamin D are prone to greater disability and more disease activity.

The pilot study involved 40 participants with relapsing-remitting MS were administered with either 10,400 international units or 800 international units of vitamin D3 supplements per day for six months.

Patients with severe vitamin D deficiency were not included in the study. The current recommended daily allowance of vitamin D3 is 600 international units. Blood tests at the start of the study and again at three and six months measured the amount of vitamin D in the blood and the response in the immune system’s T cells, which play a key role in MS.

The ideal level of vitamin D in the blood for people with MS has yet to be determined by the researchers, but they have suggested range of 40 to 60 nanograms per milliliter (ng/ml) as a target. The MS patients in the study took a high dose of vitamin D to levels within the proposed target, while the group taking the low dose did not reach the target.

As to side effects to the supplement, researchers noted that minor ones that are similar to people who take high dose of vitamin D. In their study, one participant in each group relapsed.

The people taking the high dose had a reduction in the percentage of inflammatory T cells related to MS severity, specifically IL-17+CD4+ and CD161+CD4+ cells. When the increase in vitamin D levels in the blood over base line levels was greater than 18 ng/ml, every additional 5 ng/ml increase in vitamin D led to a 1 percent decrease in the percentage of IL-17+CD4+ T cells in the blood. The people taking the low dose did not have any noticeable changes in the percentages of their T cell subsets.

“We hope that these changes in inflammatory T cell responses translate to a reduced severity of disease,” says Dr Calabresi. “Other clinical trials are underway to determine if that is the case.”

The study appears in the December 30 issue of Neurology, the medical journal of the American Academy of Neurology. Aside from Dr Calabresi, also involved in the study were Elias Sotirchos, Pavan Bhargava, Moira Baynes, Achilles Ntranos, Anne Gocke and Ellen Mowry of Johns Hopkins Medicine; Christopher Eckstein of Duke University; and Keith Van Haren and Lawrence Steinman of Stanford University.

The Kenneth and Claudia Silverman Family Foundation, the Montel Williams Foundation, and the National Multiple Sclerosis Society supported the research.