Vitamine D and Multiple Sclerosis (MS)

Vitamin D is an essential nutrient for bones and metabolism of calcium. However, its deficiency has been related to many disorders and to higher risks of mortality. Vitamine D regulates the activity of 2000 genes and its production is enhanced by the exposition to the sun.
Vitamin D deficiency or insufficiency has been defined as a serum level of 25(OH)D <50 nmol/L or 52.5–72.5 nmol/L, respectively. Deficiency is common across all age groups, especially in case of limited exposure to the sun. The daily intake should be of 400-800IU/day and commonly prescribed regimen consists of 2000-3000IU/day (in order to achieve optimal serum levels even in obese patients). Vitamin D toxicity is very rare, with none seen at doses up to 20000 IU/day.
There is enough evidence for the protective role of vitamine D for patients with autoimmune diseases including MS. The vitamin D interacts with the major histocompatibility complex of the immune cells and contributes to the production of interleukins and immunoglobulins.
Actually, a higher level of sun exposure and vitamin D intake as well as higher serum levels of 25(OH)D, are known to associate with a lower risk of MS. Data from some clinical studies indicate that Vitamine D (alone or in conjunction with interferon) improves the clinical course of MS, such as lowering the risk of relapses and reducing MRI brain lesions. Although this data should be further confirmed in specifically designed randomized clinical study we already propose vit D supplementation as an add-on treatment to standard immunomodulatory drugs to patients with multiple sclerosis. As vitamine D supplements, we believe that, finally, there is nothing to lose for patients with MS.

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