Vitamin D Supplementation in Multiple Sclerosis

Vitamin D Deficiency and Multiple Sclerosis

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Scientific evidence suggests a strong link between vitamin D deficiency and multiple sclerosis (MS). In fact, research suggests that vitamin D deficiency may be a risk factor for developing MS.

One of the most compelling clues in this connection is the geographic distribution of MS. Multiple sclerosis is much more prevalent in northern latitudes, where there is less intense sunlight and colder weather. Since our skin produces vitamin D from exposure to the sun's ultraviolet rays, little sun exposure can lead to a deficiency in vitamin D.

In addition, studies have shown that vitamin D may play a role in how a person's MS progresses. For instance, vitamin D has been found to reduce MS relapses.

There is also solid evidence that vitamin D, especially when taken with calcium, can help prevent osteoporosis, a disease of bone weakening that is common in people with MS. Therefore, preventing osteoporosis and subsequent bone breaks is another potential benefit of vitamin D supplementation in MS.

Supplementing With Vitamin D in MS

Based on the link between vitamin D deficiency and MS, it's not surprising that many neurologists check vitamin D levels and/or recommend vitamin D supplementation for their patients. That said, the research supporting an actual benefit with vitamin D supplementation in people with MS is scant, although there are a number of ongoing trials.

To date, there is currently no standard guideline stating exactly what a "normal" or "target" vitamin D level is for a person with MS, and how much a person should take based on their unique level.

There is, however, advice from professional societies, like the Institute of Medicine (IOM) and Endocrine Society, regarding sufficient levels for the general population. The IOM reports that a vitamin D (25OHD) 20ng/mL or greater is "sufficient." Alternatively, the Endocrine Society reports a vitamin D level of 30ng/mL or more as "sufficient" for children and adults, levels of 40 to 60 ng/mL as "ideal" and levels up to 100ng/mL as "safe."

Typical Dosing Strategies

If your doctor does recommend vitamin D supplementation, he or she will likely calculate your dose based on your vitamin D level, where you live, and the time of year—you may need more vitamin D during the winter months when there is less sunlight.

While not a hard and fast rule, a typical vitamin D dose is between 1,000 IU and 2,000 IU of vitamin D daily. Some doctors may even recommend a maximum daily dose of 4000 IU daily. If your vitamin D level is very low to start, your doctor may also prescribe a higher dose, like 50,000 IU vitamin D weekly for 6 to 8 weeks, and then a lower daily dose, like 2000 IU.

Again, the dosing is highly variable at this time and is mostly tailored to the individual patient.

What Happens If You Take too Much

The main consequence of vitamin D toxicity is hypercalcemia, which means that there is too much calcium in your blood. The signs and symptoms of hypercalcemia include:

  • Nausea and/or vomiting
  • Irritability and/or confusion
  • Constipation
  • Fatigue
  • Decreased appetite
  • Weakness
  • Kidney stones

The treatment for vitamin D toxicity is stopping vitamin D supplements and potentially other medical interventions to bring down the calcium levels in your blood.

A Word From Verywell

All in all, the topic of vitamin D dosing and supplementation in MS is still not totally clear at this time. More scientific studies need to be done to clarify how and when doctors should monitor and treat vitamin D levels in MS. For you, this means that it's best to only take vitamin D under the care of your personal MS doctor.

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