Vitamin D

Dr. Kantor, what is your opinion of the role that Vitamin D may play in the development of MS, and, what is your view on supplementation for MS patients?  

Do you think that high doses of Vit D may help to alleviate symptoms and/or disease progression?  Are you aware of  any studies currently underway that are looking at this?

Given it is fat soluble, is it preferable to take these supplements on a daily basis, or is the same benefit derived from a once weekly higher dosage?

I am currently taking 3000 iu per day.  6 months ago I tested in the moderatly deficient range.  Since starting supplementation, I am now in the low end of the normal range.  My neurologist did not recommend a dose this high but then does not object to it either.   I am aware this amount is several times higher than the RDA, but I understand this is still considered a safe amount.  What do you think?

Many thanks,
~doublevision~

[Dr. Daniel Kantor, MD]

We are actually currently writing a grant for submission to the NIH (National Institutes of Health)  to study this exact question.

There are currently studies underway as well -- see clinical trials dot gov for more details (the Canadian group is especially active).

The question may be split into several questions:

1. Does Vitamin D deficiency lead to MS?
2. Can supplementing with Vitamin D treat MS?
3. What is the correct dosage of Vitamin D?

My answers are below:

1. The data surrounding Vitamin D has a long history but it received recent press when the blood from soldiers entering the military were looked back at later and it was found that those with a low Vitamin D level were more likely to go on to be diagnosed with MS int he future.

This suggests a possible association, not necessarily a cause and effect.

Low Vitamin D levels are associated with many diagnoses, including Parkinson disease.

2. Even if a low Vitamin D level in childhood contributed to the development of MS, the question is whether supplementing it in adulthood repair the damage already done and destined to happen (because the MS has been set into motion) or would it be "too little, too late."

3. The RDA is 400 IU. Some people suggest increasing that to 800 IU to 1000 IU. Doses of 10,000 IU or greater should not be given for longer than 6 months because Vitamin D can be toxic.3000 IU is on the high side and I cannot comment on it for you because I do not know your particular situation and it sounds like you are not only trying to use Vitamin D as a treatment for MS, instead you are trying to replete your low levels. I highly recommend that you see an endocrinologist.

Oral Vitamin D reaches a physiologic steady state in approximately 2 months -- so it takes that long to be up to a good level.

[biowham]

Dr. Kantor--If you've haven't already, you might want to check out the new PLOS Genetics pub on MS x vit D and HLA-DRB1. Interesting proposed mechanism of missed culling during central deletion as a result of low vit D levels =  lower expression of self antigen.

Bio

[doublevision1]

Thanks for your reply.  Quite a coincidence that we were discussing this just a day prior to the media coverage of the latest study.

Can you comment generally as to whether it is preferable to take Vitamin D supplements on a daily or on a weekly (ie: 7x the daily amount) basis; or, is there no significant difference in terms of overall long term benefit?

[Dr. Daniel Kantor, MD]

This is unknown. I suggest speaking to an endocrinologist.

[monotreme]

There is a study published on your question about daily or weekly doses.  The results are on the internet.  It charts out the findings, but I am not confident in giving them to you.  Hopefully you will find it.   You might also want to check out the studies published in Journal of Clinical Nutrition discussing what happens to people when their D levels get to 100 and whether or not tixicity develops.  That too has been done and published.  Again, it would be better if you find the results on your own.  I don't want to give out inaccurate information.

Elaine

[orionsgma]

A related discussion, Vit D3 was started.