951-303-6067 There is convincing scientific evidence that vitamin D plays a role in controlling autoimmunity and MS. Vitamin D status affects chemicals called cytokines that modulate the immune system and this modulation may benefit persons with MS.
Vitamin D, calciferol (kal-SIF-er-ol) is a fat soluble vitamin that is
found in milk products, butter, cereals, veal, beef, egg yolks, liver and
fatty fish although most of the world’s population relies on sunlight to
maintain adequate amounts of vitamin D. Exposure to sunlight is an important
source of vitamin D. Ultraviolet rays from sunlight trigger vitamin D synthesis
in the skin. Exposing the face and arms to the sun for fifteen minutes
three times a week is a way of ensuring adequate (200-400 IU) amounts of
vitamin D although optimal levels (1000 IU) are required in MS. Season,
sunscreens (SPF 8 or higher), time of day, latitude, cloud cover, smog
and clothing effect UV ray exposure. North
Vitamin D exists in several forms, each with a different activity. The animal version is D3 or cholecalciferol (KO-lee-kal-SIF-er-ol), it is synthesized in the skin with exposure to ultraviolet radiation and is also present in fish liver oils. The plant version is D2 or ergocalciferol (er-go-kal-SIF-er-ol). D5 is a synthetic form. Of the three, vitamin D3 is considered the natural form and is the most active. Some forms are relatively inactive in the body and have a limited ability to function as a vitamin. The kidney and liver convert vitamin D to its active hormone form, calcitriol. MS, Sjogren’s syndrome, rheumatoid arthritis, thyroiditis and Crohn’s disease have all been linked to low levels of vitamin D. Deficiency depresses calcium absorption, blood calcium, and bone mineralization, whereas an excess does the opposite. Vitamin D is the most likely of the vitamins to have toxic side effects when consumed in amounts above recommendations on a continuous basis. The importance of discussing this supplement with your physician cannot be overstressed and all sources must be considered. Also magnesium and calcium should accompany vitamin D. Several researchers have noted that MS is far more common in northerly countries and almost non-existent near the equator. Goldberg (1974) was the first of many to postulate that low sunlight areas had increased MS due to low vitamin D production. Goldberg proposed that genetically susceptible individuals may need higher doses of vitamin D during myelin formation and that insufficient amounts during childhood might result in defective myelin that is susceptible to breakdown. In the early 80’s it was found that immune cells carry a receptor for the active hormone of vitamin D and that this hormone likely regulates immune functions (Bhalla et al, 1983). It has been shown that injections of calcitriol hormone form of vitamin D) could protect against or arrest EAE (animal form of MS) in mice. (Lemire and Archer, 1991) Furthermore, immunological analyses and further experiments revealed the following immune regulating actions of calcitriol. (the following points from Vitamin D Supplementation in the Fight Against Multiple Sclerosis, an essay by Ashton F. Embry)
1.Suppresses antibody production by B cells and the proliferation of T
cells in the thymus (Yang et al, 1993)
Note that some of these actions are what Betaseron, Rebif and Avonex do while Copaxone is thought to decoy the immune system and in the US Novantrone suppresses it. Since the vitamin D hormone has proven to reduce inflammatory autoimmune reactions, the reduction of disease activity during pregnancy may be easier to explain. There is a natural increase in the production of calcitriol during pregnancy and a rapid decline afterward. The evidence goes on with genetic data (Fukazaet al 1999) and associations between vitamin D receptor genes and MS. Then there are inarguable evidences like Norway where the rate of MS is higher inland where fish consumption is less than coastal areas. In Switzerland, the rate of MS is high at low altitudes but low at high altitudes where the sun is closer. The Canadian Compendium of Pharmaceuticals recommends 200-400 IU of vitamin D daily although a small study at Penn state and Helen Hayes hospital in New York has shown that 2.5 times the recommended dose for adults causes blood chemistry changes that indicate positive effects for MS patients. Vitamin D is contraindicated when there is decreased renal function so alfacalcidol, calcitriol or dihydrotachysterol is useful for patients with renal failure. When used concurrently, vitamin D interacts with magnesium-containing antacids and with thiazide diuretics. Drug interactions are reported with phenytoin, phenobarbitol and digoxin.
Remember, don’t ever get sunburned and if you already have significant
sun exposure then you should not take cod liver
oil or vitamin D for those months. The safest way to ensure optimal levels
of vitamin D is to do so under the supervision
of your doctor.
1.Whitney, Elanor Noss and Rolfes, Sharon Rady. Understanding Nutrition,
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