From the annual meeting of the American Academy of Neurology, Toronto, Canada:
Multiple sclerosis is always an important topic at the AAN meeting, but in covering the poster sessions, I was surprised by the generous sprinkling of posters related to vitamin D. I guess I shouldn’t have been. Previous research has show that vitamin D deficiency is a risk factor in the development of multiple sclerosis (MS), and it might affect the disease course of MS. How are vitamin D levels related to MS? No one knows for sure, but it looks like many researchers are trying to find out.
One poster by Dr. Asfa Y. Shad, a neurologist in Detroit, and her colleagues simply noted that, compared with 304 controls, 238 MS patients were significantly more likely to have insufficient vitamin D levels, regardless of gender, MS type, or MS duration.
In another poster, Dr. Fredric K. Cantor, a Bethesda, Md.-based neurologist, and his colleagues suggested that vitamin D levels might play a role in the occurrence of relapsing-remitting MS (RRMS), after comparing MRI contrast-enhancing lesions (markers of acute inflammation) and vitamin D levels in patients with RRMS. Data from this study showed that lesions were present in 48% of vitamin D-deficient patients, 35% of vitamin D-insufficient patients, and 21% of patients with adequate vitamin D levels.
In a third poster, Dr. Jodie Benton conducted a meta-analysis to identify possible nongenetic risk factors in MS patients that might impair vitamin D activity. She found that anticonvulsant use, vitamin A, pregnancy, and type 2 diabetes appeared to be risk factors for low vitamin D in MS patients, as did obesity and a high body mass index. Dr. Burton noted that megadoses of as much as 50,000 IU per week are becoming common in MS treatment centers, and her study results support increased vitamin D supplementation.
Taken together, the take-home message I got from these posters is that if clinicians who treat MS patients are able to modify any of the risk factors for vitamin D deficiency and promote high doses of vitamin D supplementation, they might have a relatively simple way to improve their patients’ health.
Most people (with or without MS) could benefit from more vitamin D, Dr. Benton told me. The current U.S. guidelines for adequate intake (200-400 IU for adults) are outdated, she said.
So I guess this is another reason to get outside for (moderate) vitamin D exposure, and maybe keep some of those chewy chocolate vitamin D supplements on hand (Mmm, chocolate!).
Food for thought: Doctors, are you checking vitamin D levels in patients more often and prescribing more supplements than you used to?
–Heidi Splete (on twitter @hsplete)