Abstract
Mounting evidence correlate vitamin D3 (cholecalciferol) supplementation or higher serum levels of vitamin D (25(OH)D) with a lower risk of developing multiple sclerosis (MS), reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU)/day and escalated to 100 mcg (4000 IU)/day in September 2004 and then to 150 mcg (6000 IU)/day in December 2005. Vitamin D3 intake reduced muscular pain and improved ambulation from 1 (February 2000) to 14 km/day (February 2008). Vitamin D intake over 10 years caused no adverse effects: no hypercalcaemia, nephrolithiasis or hypercalciuria were observed. Bowel problems in MS may need to be addressed as they can cause malabsorption including calcium, which may increase serum PTH and 1,25(OH)2D levels, as well as bone loss. We suggest that periodic assessment of vitamin D3, calcium and magnesium intake, bowel problems and the measurement of serum 25(OH)D, PTH, Ca levels, UCa/Cr and bone health become part of the integral management of persons with MS.
Highlights
Vitamin D metabolism influences many tissues as most cells have vitamin D receptors [1], including immune and neural cells
An Australian study reported that a 10 nmol/L increase in the vitamin D level may reduce the risk of a relapse up to 12%; the data implied that increasing serum 25(OH)D levels by
We have focused our attention on the clinically meaningful outcome measures: ambulation and muscular pain, and on the surrogate outcome measures: Bone Mineral Density (BMD) [51], serum levels of
Summary
Vitamin D metabolism influences many tissues as most cells have vitamin D receptors [1], including immune and neural cells (for reviews, [2,3,4]). Mounting evidence correlate sun exposure, vitamin D3 (cholecalciferol) intake or higher serum levels of vitamin D (25(OH)D) with a lower risk of developing multiple sclerosis (MS), reduced relapse rate, slower progression of MS or lower development of new lesions on brain magnetic resonance imaging (MRI) [5,6,7,8,9,10,11,12,13,14,15], even in paediatric-onset MS [16]. An association between 25(OH)D levels and a decline in MRI brain lesions and brain atrophy has been reported [14,15]
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