Multiple Sclerosis (MS) is an autoimmune, neurodegenerative and inflammatory condition that attacks the central nervous system (CNS). It corrupts the immune system, making it work against the body.
Although there are various factors contributing to the development and progression of MS, including genetic predisposition, environmental factors, and immune dysregulation, it is the role of vitamin D that has garnered significant attention in recent years. This may be due to its potential influence on both MS risk and disease activity. Through this comprehensive blog, we will throw light on the connection between vitamin D and multiple sclerosis, as well as examine the evidence supporting the former’s role in the development and progression of the disease.
What is Vitamin D?
Vitamin D is a fat-soluble vitamin that plays a crucial role in various physiological processes, including bone health, immune function, and regulation of calcium and phosphorus metabolism. There are two primary forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 is synthesized by plants, while vitamin D3 is produced in the skin upon exposure to ultraviolet B (UVB) sunlight and is also found in some animal-based foods.
Sources of Vitamin D
The following are the main sources of vitamin D:
Sunlight: The primary source of vitamin D is sunlight exposure, which triggers the synthesis of vitamin D3 in the skin. Spending time outdoors during peak sunlight hours can help maintain adequate vitamin D levels.
Dietary sources: Vitamin D can also be obtained through dietary sources, including fatty fish (such as salmon, mackerel, and tuna), egg yolks, fortified dairy products (such as milk and yogurt), fortified cereals, and some fortified plant-based milk alternatives.
In cases where adequate sun exposure and dietary intake are insufficient to meet vitamin D requirements, supplementation with vitamin D supplements may be prescribed by doctors.
Who is at Risk of Vitamin D Deficiency?
There are several factors that can increase the potential risk of vitamin D deficiency. These include:
- Limited sunlight exposure
- Darker skin pigmentation
- Age
- Limited dietary intake
- Obesity
- Existing medical conditions that impact fat absorption (celiac disease, Crohn’s disease, and cystic fibrosis)
- Liver or kidney disease
- Certain medications (corticosteroids and anticonvulsants)
Vitamin D and Multiple Sclerosis: At First Glance
Vitamin D is often referred to as the “sunshine vitamin.” It plays a critical role in calcium metabolism, immune regulation, as well as overall health. Primarily, it is synthesized in the skin post exposure to sunlight. Additionally, vitamin D may also be obtained through dietary sources and supplements.
In the past few years, epidemiological studies have provided compelling evidence corroborating the link between vitamin D and MS risk. The prevalence of MS is higher in populations living at higher latitudes, where sunlight exposure is limited, as compared to those residing closer to the equator. Moreover, individuals with MS have even been known to exhibit lower vitamin D levels compared to healthy controls. This further cements the potential protective effect of vitamin D against the development of MS.
The optimal vitamin D level in the blood can vary based on individual factors and health conditions. However, doctors recommend aiming for a blood level of 25-hydroxyvitamin D, also known as 25(OH)D, between 30 to 50 ng/mL (nanograms per milliliter) for general health and disease prevention. For MS patients, maintaining vitamin D levels in the range of 40 to 60 ng/mL (nanograms per milliliter) of 25-hydroxyvitamin D (25(OH)D) in the blood is beneficial.
It is important to keep in mind that the optimum vitamin D for an individual must be based on factors such as age, overall health status, and existing medical conditions.
How Does a Vitamin D Deficiency Lead to Multiple Sclerosis?
There are several multifaceted mechanisms underlying the relationship between vitamin D deficiency and multiple sclerosis. These factors include inflammation regulation, immune modulation, and neuroprotection.
Vitamin D is particularly important for its effects on the immune system through various pathways. It helps modulate T-cell function, promote regulatory T-cell activity, and suppress or inhibit pro-inflammatory cytokines. Studies have shown vitamin D can also enhance remyelination and repair processes in the CNS. This is a critical mechanism when it comes to mitigating the neurological damage that accompanies MS.
Vitamin D Supplementation in Multiple Sclerosis
Individuals with lower vitamin D levels at the time of MS diagnosis are at risk of more frequent relapses, higher disability progression, and increased disease activity.
This is why Vitamin D supplements may be prescribed to help lower relapse rates as well as enhance treatment response in MS patients. However, vitamin D supplements cannot be prescribed to everyone. There are certain eligibility criteria that need to be met. Let’s take a look at these.
Vitamin D Supplementation Eligibility
Although vitamin D supplementation is generally safe and beneficial for most of us, there are certain populations who may not be eligible for supplementation, and some who may require careful monitoring:
- Individuals with hypercalcemia (elevated blood calcium levels)
- Individuals with conditions predisposing them to hypercalcemia (primary hyperparathyroidism or certain types of cancer)
- Individuals with hypervitaminosis D (elevated levels of vitamin D in their blood) (hypervitaminosis D)
Please do not start on any dietary supplement without consulting your doctor.
How Can Individuals With MS Improve Their Vitamin D Levels?
Here are some tips to help MS patients increase their vitamin D levels:
Sunlight Exposure
Moderate sun exposure can stimulate vitamin D synthesis in the skin. Even 10-30 minutes of sunlight exposure to arms, legs, and face a few times per week can be extremely beneficial. Exposure to sunlight particularly during midday when UVB rays are most intense.
While sunlight is a natural source of vitamin D, it’s important to practice sun safety to prevent skin damage and reduce the risk of skin cancer. Use sunscreen, wear protective clothing, and avoid prolonged sun exposure during peak hours.
Dietary Sources
Nutrient-dense foods that are rich in vitamin D are important. Some examples include fatty fish (salmon, mackerel, tuna), egg yolks, milk, yogurt, paneer (fortified dairy products), and fortified plant-based milk alternatives.
Supplementation
Begin vitamin D supplementation under the guidance of your doctor. It’s essential to have levels monitored regularly to avoid toxicity, the symptoms of which includeL
- Nausea
- Vomiting
- Weakness
- Fatigue
- Loss of appetite
- Constipation
- Excessive thirst
- Frequent urination
- Muscle weakness
- Kidney stones
- Confusion
- Disorientation
Lifestyle Modifications
Regular exercise, stress management techniques, getting adequate sleep, quitting smoking, limiting/quitting alcohol intake can significantly help support overall health and well-being.
The relationship between vitamin D and multiple sclerosis is complex and multifaceted. Optimizing vitamin D status through requisite supplementation and lifestyle interventions can help mitigate MS risk and contribute towards slowing down disease progression. However, just vitamin D supplementation cannot be the sole treatment for MS. It should be viewed as part of a comprehensive approach to MS management.
Regenerative Rehabilitation for Multiple Sclerosis at Plexus
Stem cell therapy using mesenchymal stem cells (MSCs) is an innovative approach to managing MS, providing long-term relief, and even addressing its underlying causes. MSCs, derived from various tissues such as bone marrow and adipose tissue, have shown immunomodulatory properties, making them a potential therapeutic tool for disorders like MS.
At Plexus, our customized regenerative rehabilitation program for multiple sclerosis provides relief from symptoms, slows down disease progression, and improves quality of life.
Below are the features of MSCs that aid in managing MS:
- MSCs secrete anti-inflammatory molecules that can potentially reduce inflammation in the affected tissues. This can help mitigate the destructive impact of autoimmune responses.
- MSCs can modulate the immune system by suppressing the activity of hyperactive immune cells and promoting regulatory T-cell function. They have the ability to create a more balanced and controlled immune response.
- MSCs can repair or regenerate damaged tissues, and contribute to the repair of myelin and nerve fibers, potentially slowing down (and even reverse in some cases) some of the neurological damage associated with the disease.
Our comprehensive rehabilitation for multiple sclerosis also includes:
- Motor relearning program
- Gait training
- Functional strengthening
- Coordination training
- Speech therapy
- Nutritive therapies and more
If you wish to know more about our award-winning rehabilitation program for Multiple Sclerosis, reach out to our team in Bangalore or Hyderabad today.
WhatsApp +91 89048 42087
Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)
FAQs
What are the signs of low vitamin D?
Signs of low vitamin D include:
- Fatigue
- Muscle weakness
- Bone pain
- Frequent illness or infections
- Mood changes (such as depression)
- Impaired wound healing.
Some individuals may also experience hair loss, joint pain, and low mood.
Can vitamin D help with multiple sclerosis?
Vitamin D contributes towards immunomodulation, helps reduce inflammation, and stimulates neuroprotection. All of these help slow down disease progression, and in some cases even improve remyelination. Studies indicate that vitamin D supplementation may even lower relapse rates.
What vitamins are best for MS?
The most commonly prescribed vitamins MS management include vitamin D, vitamin B12, and vitamin B9. Omega-3 fatty acids and antioxidants such as vitamin E and vitamin C have also proved to be beneficial for individuals with MS.
What is the target vitamin D level for MS patients?
The optimal vitamin D level for MS patients is typically higher than the general population – ranging from 40-60 ng/mL (100-150 nmol/L). Attaining and maintaining adequate vitamin D levels can really help reduce MS disease activity as well as improve overall health outcomes.
