Lack of vitamin D linked to multiple sclerosis

Saturday, September 20, 2008

Published: 7 hours ago

Children later diagnosed with multiple sclerosis had far lower levels of vitamin D than other youngsters, Canadian researchers reported yesterday in studies showing more links between the "sunshine" vitamin and disease.

These were the first studies to show the effects in children, although others have shown that adults who live in northern latitudes, who get less sun exposure, may have a higher risk of MS.

They also support a growing body of studies linking low vitamin D levels with disease, including cancer, heart disease, diabetes and tuberculosis.

Vitamin D, produced by the body when skin is exposed to sunlight, and also found in fatty fish, is added to other foods in many countries. Evidence suggests it helps lower blood pressure and boost the immune system.

Several studies presented at a meeting on MS in Montreal showed that children had low levels of vitamin D when they began to show evidence of the disease.

"Three-quarters of our subjects were below optimal levels for vitamin D," said Heather Hanwell, a graduate student in nutritional sciences at the University of Toronto, who led one study.

Hanwell's team studied 125 kids who had evidence of MS symptoms such as numbness. Twenty of the children were diagnosed with MS within the next year, Hanwell said. Blood tests showed 68 per cent of those children had vitamin D insufficiency.

On average, the children with MS had much lower levels of the vitamin than children who did not experience any other MS-like symptoms.

A study led by Brenda Banwell of Toronto's Hospital for Sick Children showed similar results.

"Seventeen of 19 children who had been diagnosed with MS had vitamin D levels below the target level," Banwell said.

The next step is to see if giving vitamin D supplements prevents MS or helps relieve symptoms, Banwell said. She said it was not clear how lacking vitamin D might be linked with MS.

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Vitamin D and Multiple Sclerosis

Our Friend in the Battle Against Osteoporosis

By Julie Stachowiak, Ph.D., About.com

Updated: June 23, 2008

Along with vitamin B12 deficiencies, many of us with multiple sclerosis (MS) also have deficiencies in vitamin D. Perhaps you have heard that research is revealing that low vitamin D levels may have made us susceptible to MS. Even so, we still need to take vitamin D, even if we already have MS and prevention is no longer an option.

There is some speculation and tenuous support from tiny studies and animal research that vitamin D could help slow down the MS disease process. However, there is irrefutable, concrete evidence that we all need vitamin D to help prevent osteoporosis – that’s enough for me to get with the vitamin D program. I urge all of you to consider joining me.

Why Should People with MS Care About Vitamin D?

The majority of people with MS have some degree of vitamin D deficiency. People who live in northern regions commonly have a vitamin D deficiency for 4 to 6 months of the year. Interestingly, relapses tend to happen more in the spring when vitamin D levels reach their lowest, as stores have been depleted.

What Is Vitamin D in MS for?

Osteoporosis: Vitamin D deficiency leads to osteoporosis, which is also very common in people with MS. In a study of women with MS, the average bone density and vitamin D levels were much lower than a control group without MS. Forty percent of study participants reported that they got very little to no exposure to sunlight.

Help for the Immune System: Animal studies (using EAE, the experimental animal form of MS) show that vitamin D deficiency worsened severity of symptoms and supplementation helped reduce symptoms.

MS Prevention? I imagine for most people reading this, MS is already a done deal – a diagnosis has been made and it is too late for prevention. However, it is interesting that in the Nurses’ Health Study, women who took vitamin D supplements had a 40% lower risk of MS. It has also been well-documented that MS is geographically distributed in such a way as to indicate that people without adequate vitamin D exposures from the sun are at higher risk for developing MS.

How Does Vitamin D Work?

Vitamin D helps with calcium absorption and works to prevent osteoporosis. Vitamin D also increases lymphocytes and reduces proinflammatory cytokines, meaning it works to reduce inflammation and possibly autoimmune activity.

How Effective Is It?

Although it has been suggested by epidemiological studies that vitamin D deficiencies increase the risk of developing MS, there is really no strong evidence to indicate that supplementing with vitamin D in people that already have MS will have much of a benefit in terms of disease progression. One very small study (11 people) showed a reduction in relapse rate in participants taking a combination of magnesium, calcium and fish oil with high levels of vitamin D. Another small study failed to show any effect of vitamin D supplementation. There are currently some long-term trials in progress to look at the role of vitamin D in MS.

What is the Usual Dosage of Vitamin D/How Is It Taken?

Vitamin D is a fat-soluble vitamin. It is naturally present in very few foods, which include:

• Eggs (naturally found in yolks)
• Liver
• Fatty fish, such as sardines, salmon, tuna, mackerel

It is added as a fortification to other foods, such as:

• Some ready-to-eat cereals
• Milk and other dairy products
• Other “fortified” products, such as orange juice, soy milk, rice milk, bread and flour

As a supplement, vitamin D should be taken in combination with calcium supplements, as calcium is not useful for bone health without vitamin D. 200 to 600 IU of vitamin D should be taken in combination with 1,000 to 1,200 milligrams of calcium daily. In addition, people should strive to get 10 to 15 minutes of sun exposure each day.

Side Effects of Vitamin D

High doses of vitamin D (over 1,500 micrograms per day) should not be taken, as this can cause:

• High blood pressure
• Nausea and vomiting
• Fatigue
• Kidney damage

Potential Interactions and Warnings

Vitamin D supplementation should be undertaken with caution or avoided in people with:

• Abnormal levels of calcium (hypercalcemia and hypocalcaemia)
• Kidney disease
• Sarcoidosis
• Hypoparathyroidism

Vitamin D has also been shown to interact with some medications for the heart, called cardiac glycosides. These include digoxin (Lanoxin) and digitoxin (which has been discontinued in the US).

Costs

Vitamin D is extremely inexpensive and should be included in a calcium supplement.

My Bottom Line:

Will I take a vitamin D supplement? Well, sure. Despite having heard this for years, it finally just sunk in that a calcium supplement without vitamin D is pretty useless for preventing osteoporosis. I’m going to rethink my calcium supplement and make sure that it contains at least 200 mcg of vitamin D per day. I’m also going to make sure that I get at least 15 minutes of exposure to sunlight a day – guess I’ll have to start having my morning coffee outside, before it gets too hot to justify staying in the sun for any amount of time.

_Sources:

_{Schwarz S, Leweling H. Multiple sclerosis and nutrition. Multiple Sclerosis. 2005 Feb;11(1):24-32.}

_{Bowling, Allen C. Complementary and Alternative Medicine and Multiple Sclerosis. 2nd ed. Demos Publishing: New York. 2007.}

<sub>Bowling, Allen C. and Stewart, Tom. So, what’s new about Vitamin D? InsideMS. October-November 2006. 57-58.

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Vitamin D: Builds Bones And Much More

ScienceDaily (July 15, 2008) — Vitamin D is essential to strong bones. Inadequate vitamin D can lead to osteoporosis, a brittle bone disease.

Recently, researchers have found that vitamin D may help reduce the risk of other diseases.

Fall prevention: With age, decreasing muscle strength can increase the risk of falls and bone fractures. Several studies have found that vitamin D supplements may benefit muscle strength and balance, helping older adults stay steadier on their feet.

Cancer prevention: Observational research indicates that low levels of vitamin D increase the risk of some cancers — including those of the breast, colon, rectum, ovary, kidney, lung and uterus. Although unclear why, vitamin D in adequate amounts appears to help regulate cellular growth, potentially preventing cells from becoming cancerous.

Chronic pain prevention: Vitamin D deficiency is increasingly recognized as an important cause of muscle pain and weakness.

Protection against autoimmune diseases: Evidence is mounting that vitamin D may offer protection from type 1 diabetes, multiple sclerosis and rheumatoid arthritis by reducing inflammation and strengthening the immune system. In one study, researchers found a 40 percent lower risk of multiple sclerosis in women who supplemented their diet each day with at least 400 international units (IU) of vitamin D.

Reduced risk of cardiovascular disease: Some research indicates that lower vitamin D levels are associated with a number of factors that affect cardiovascular health, including coronary artery calcification and, possibly, congestive heart failure.

So, how much vitamin D is enough?

Recommendations from medical groups vary, but a daily intake in the range of 800 to 1,000 IU is likely to benefit most adults. The body produces vitamin D when exposed to ultraviolet rays, but many people need a supplement to reach recommended levels. Many multivitamins contain vitamin D. This nutrient also can be purchased alone or combined with calcium.

The July issue of Mayo Clinic Women’s HealthSource reports further information and guidelines on how much vitamin D is enough.

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