RAY OF SUNSHINE
New vitamin D recommendations offer needed guidance for people living with MS
Browse a magazine or website dedicated to health and you’ll often hear that familiar commandment: take your supplements! And with good reason — minerals and vitamins play an important role in the body’s ability to fight disease and recover from illness.
For those either living with, or at risk of, multiple sclerosis (MS), for example, there is reason to take that direction seriously. The MS Society of Canada recently published recommendations regarding vitamin D supplementation, the intake of which may help those with the disease or potentially help prevent its development.
MS is a chronic autoimmune condition in which the body attacks myelin, a coating that protects nerves. The resulting nerve damage produces an unpredictable and dizzying array of symptoms, from pain or numbness, vision or bladder problems, to fatigue or the loss of mobility.
The focus on vitamin D and MS emerged from the fact that Canadians tend to have proportionally higher rates of MS, as do other countries further from the equator. Exposure to sunlight is the primary way we get vitamin D, so the connection not only seemed reasonable but also generated curiosity amongst MS researchers, and those affected by the disease.
The push for the recommendations thus came from a simple place: people clearly wanting to know more.
“We saw that any time we posted anything related to vitamin D on our social media, people would always ask us ‘how much should I be taking?’ ” says Dr. Karen Lee, vice-president of research at the MS Society of Canada.
“We recognized that there were no clear recommendations out there,” says Dr. Lee, “so we thought it was really important to have recommendations for people living with MS and those who may be at risk.”
The recommendations were created after a group of experts came together to review the evidence on vitamin D and MS. Dr. Ruth Ann Marrie from the University of Manitoba, who was part of that group, noted that there’s a growing body of evidence that how much vitamin D a person takes in may contribute to a set of risk factors for MS. But it also may help those currently living with the disease.
“We made recommendations for individuals to take vitamin D on a regular basis for those with MS, basing those directions on age and as well safety,” Dr. Marrie says.
Key to that point is that while vitamin D appears to have benefits, there is an upper safety limit, as too much vitamin D can be harmful. As such, most MS specialists suggest that the optimal dose for adults with MS is between 600 and 4,000 IU a day.
Children and adolescents with MS should take 600 to a 1,000 IU a day. For adults at increased risk of MS, such as those with an immediate family member with the disease, it is suggested that taking a similar dose to adults with MS may decrease the risk of developing the disease. For children and teens, the recommendations vary with age and risk.
While supplements are the most obvious path for most people, safe exposure to sun still helps, as does eating foods rich in vitamin D like fatty fish (such as salmon), egg yolks, and milks and cereals that have been enriched.
Increasing intake helps people living with MS in a couple of key ways. One is that MS is associated with an increased risk of falls and osteoporosis, and vitamin D helps the body absorb calcium, which in turn promotes bone health.
Dr. Marrie suggests the second way it is helpful may be a direct effect on MS itself. “There are also a number of observational studies that suggest vitamin D may be associated with reduced disease activity and reduced brain atrophy,” she says.
It is important to note that there are no clinical trials that prove this link between the two beyond a shadow of a doubt. But Dr. Marrie notes that there are vitamin D receptors on many cells in the body, including the brain, so we know it can have widespread effects.
For now, the aim is to have those with MS and those at risk maintain optimal vitamin D levels. At a minimum, it will promote good bone health. But as we continue to learn more about this complex disease, it may prove to be one more weapon in the fight against MS.
VITAMIN D MAY BE ASSOCIATED WITH REDUCED DISEASE ACTIVITY