Zusammenfassung (von Dr. med. Giovanni Ruffo, Zürich):
Der grösste Teil der MS-Patienten, sei es in meiner Praxis, sei es in einer grossen Studie in Paris haben ein deutliches Defizit an Vitamin D. Dieses Defizit orientiert sich bis jetzt an metabolischen Kriterien (Knochengesundheit, Balance der neuromuskulären Funktion). Selbst wenn es sich herausstellen würde, dass Vitamin D keine signifikante Wirkung auf das Entzündungsgeschehen der Mulitplen Sklerose hat, gibt es keinen Grund, den Vitamin Spiegel auch bei MS-Betroffenen einfach so stehen zu lassen und nicht zu optimieren: Denn es profitiert dabei mindestens der Knochen, dann die Vorbeugung des Colon-Carzinoms und nicht zuletzt auch die neuro-muskuläre Funktionseinheit: Es ist dabei zu erwarten, dass der Gang, das Gleichgewicht und die muskuläre Kraft profitieren werden. Natürlich ist dieser Effekt umso wahrscheinlicher, je weniger Vorschädigung des Nervensystems besteht. Weitere Effekte bei MS könnten sein: Weniger Infektionen, weniger Depressionen oder weniger schwere Depressionen und eventuell auch eine Beeinflussung der Müdigkeit. Vitamin D Supplementierung ist sehr kostengünstig und sicher in der Anwendung, was eine neue Studie bestätigt.
http://www.vitamindhealth.org/
(Prof. Dr. Michael Holick, Boston: der wohl grösste Kenner des Vitamin D Metabolismus inklusive dessen Pathophysiologie)
It is known that if you are born above 35° latitude atapproximately Atlanta, Georgia, and live at this latitude for the firstten years of your life that you have a 100% increase risk of developingmultiple sclerosis. Recent studies have suggested that women and menwho increase their vitamin D intake above 400 IU of vitamin D a dayreduces risk of developing multiple sclerosis by approximately 40%. References:Munger KL, Zhang SM, O’Reilly E, Hernan MA, Olek MJ, WillettWC, Ascherio A. Vitamin D intake and incidence of multiple sclerosis. Neurology 2004; 62(1):60-5.Munger KL, Levin LI, Hollis, BW, Howard NS, Ascheino A. Serum25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296:2832-2838.Ponsonby A-L, McMichael A, and van der Mei I. Ultravioletradiation and autoimmune disease: insights from epidemiologicalresearch. Toxocology 2002;181-182:71-78.
MULTIPLE SCLEROSIS Canvitamin D help with the symptoms of multiple sclerosis (MS)? Will Vit Dsupplementation delay the progression of MS in someone who has MS?Response: I have found in my patients with multiple sclerosis that they are often vitamin D deficient. Sincevitamin D deficiency causes muscle weakness, I have found in mypatients that correcting their vitamin D deficiency significantlyimproves overall muscle function. A few of mypatients who had their first symptoms of multiple sclerosis and thenwere treated with 50,000 IU of vitamin D once a week for 8 weeksfollowed by every other week thereafter, several of them have remainedin their honeymoon period. Thus, there is noreason not to be checked for your vitamin D status if you have multiplesclerosis and to be treated for your vitamin D deficiency and toprevent the recurrence of vitamin D deficiency.
Any recommendations for someone w/ a “probable MS” diagnosis in terms of preventing further disease progression?Response: Asnoted in my response to the last question above, I have found from myclinical practice that some patients with a probably diagnosis ofmultiple sclerosis or who have evidence based on MRIof multiple sclerosis have no further symptoms when I treat theirvitamin D deficiency and maintain their 25-hydroxyvitamin D > 30ng/ml. There are no prospective studies that have evaluated whether vitamin D will prevent further progression of the disease.
What is the link between Vit D deficiency and Multiple Sclerosis (MS)?Response: Thelink between vitamin D deficiency and multiple sclerosis was firstobserved when it was appreciated that if you live above 37° N latitudewhich is about the latitude of Atlanta, Georgia for the first ten yearsof your life, you have a 100% increase of developing multiple sclerosisfor the rest of your life no matter where you live. Theseepidemiologic evaluations were then followed up by further observationsto suggest that women who ingested more than 400 IU of vitamin D/dreduced their risk of developing multiple sclerosis by 42% compared towomen that were not taking vitamin D supplementation. Inaddition, studies in both men and women have shown an inverseassociation with increased risk of developing multiple sclerosis withthe serum 25-hydroxyvitamin D level.
J Neurol. 2009 Sep;256(9):1468-79. Epub 2009 Apr 28.
Clinical implications of a possible role of vitamin D in multiple sclerosis.
Pierrot-Deseilligny C.
Service de Neurologie 1, Hôpital de la Salpêtrière, Assistance Publique, Hôpitaux de Paris, 75657 Paris Cedex 13, France. cp.deseilligny@psl.aphp.fr
Abstract
Hypovitaminosis D is currently one of the most studied environmental risk factors for multiple sclerosis (MS) and is potentially the most promising in terms of new clinical implications. These practical consequences, which could be applied to MS patients without further delay, constitute the main purpose of this review. Vitamin D is involved in a number of important general actions, which were not even suspected until quite recently. In particular, this vitamin could play an immunomodulatory role in the central nervous system. Many and varied arguments support a significant role for vitamin D in MS. In animal studies, vitamin D prevents and improves experimental autoimmune encephalomyelitis. Epidemiologically, latitude, past exposure to sun and the serum level of vitamin D influence the risk of MS, with, furthermore, significant links existing between these different factors. Clinically, most MS patients have low serum levels of vitamin D and are in a state of insufficiency or even deficiency compared to the international norm, which has been established on a metabolic basis. Large therapeutic trials using vitamin D are still lacking but the first results of phase I/II studies are promising. In the meantime, while awaiting the results of future therapeutic trials, it can no longer be ignored that many MS patients have a lack of vitamin D, which could be detected by a serum titration and corrected using an appropriate vitamin D supplementation in order to restore their serum level to within the normal range. From a purely medical point of view, vitamin D supplementation appears in this light to be unavoidable in order to improve the general state of these patients. Furthermore, it cannot currently be ruled out that this supplementation could also be neurologically beneficial.
PMID: 19399382 [PubMed - indexed for MEDLINE] PMCID: PMC2733195
BMJ 2010; 340:c1640 doi: 10.1136/bmj.c1640 (Published 29 April 2010) Cite this as: BMJ 2010; 340:c1640 Research Low maternal exposure to ultraviolet radiation in pregnancy, month of birth, and risk of multiple sclerosis in offspring: longitudinal analysis
OPEN ACCESS Judith Staples, student1, Anne-Louise Ponsonby, professor2, Lynette Lim, biostatistician1 + Author Affiliations1National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia 2Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia Correspondence to: A-L Ponsonby anne-louise.ponsonby@mcri.edu.au Accepted 12 January 2010 Next SectionAbstract
Objectives To investigate the distribution of month of birth in people with multiple sclerosis in Australia. To use the large regional and seasonal variation in ambient ultraviolet radiation in Australia to explore the association between exposure to ultraviolet radiation during pregnancy and subsequent risk of multiple sclerosis in offspring.
Design Data were gathered on birth month and year (1920-1950), sex, and state of birth for all patients surveyed in 1981 in Queensland, Western Australia, New South Wales (including Australian Capital Territory), South Australia, and Hobart (Tasmania). Population denominators were derived from the 1981 census and supplementary birth registration data. A variable for exposure to ambient ultraviolet radiation “at birth” was generated from monthly averages of daily total ambient ultraviolet radiation for each region. Negative binomial regression models were used to investigate exposure to ambient ultraviolet radiation at birth and at various intervals before birth.