Study Reports No Influence of Vitamin D Supplementation on Inflammation in Relapsing-Remitting Multiple Sclerosis

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A recent study of people with relapsing remitting multiple sclerosis (RRMS) found that high-dose oral vitamin D3 supplementation did not influence markers of inflammation. Inflammation is a reaction to bodily injury that may be over-activated in people with multiple sclerosis (MS). The article, titled Vitamin D supplementation and systemic inflammation in relapsing-remitting multiple sclerosis appeared October 1, 2015 in the Journal of Neurology.

In MS the body attacks its own myelin, a fatty substance that covers nerve cells and allows them to conduct impulses. Damage to myelin results in loss of movement, vision, sensory problems and other medical problems. Some research suggests that vitamin D can reduce inflammation in MS, but scientists need to conduct more carefully designed studies.

The researchers, led by Egil Røsjø of Akershus University Hospital, Lørenskog, Norway, wanted to see if inflammation could be blocked by vitamin D in RRMS. They gave high-dose oral vitamin D3 to 68 people with RRMS and measured inflammation using eleven standard markers. They also measured the amount of active vitamin D that was present in the body, at the beginning of the study and at the 96th week of the study.

Blood levels of vitamin D rose in people taking the supplements, but there were no changes in inflammation markers in people with MS taking the supplement when compared to the ones who did not take the supplement (the placebo group). Changes in inflammation were only measured in people who were taking specific medications to block inflammation. These people had significantly higher levels of the anti-inflammation markers known as interleukin-1 receptor antagonist and chemokine (C-X-C motif) ligand 16.

In their study report, the researchers noted “We conclude that in this study of RRMS patients, high-dose oral vitamin D3 supplementation prominently increased serum 25(OH)D levels without affecting markers of systemic inflammation, while a more anti-inflammatory phenotype was found among patients on immunomodulatory treatment.”

The current study does not support a role of vitamin D in blocking inflammation in RRMS. Vitamin D may, however, have other beneficial effects in people with MS which need to be further examined.

Notably, a recent study of sunlight exposure, a source of vitamin D, also failed to support a beneficial effect of vitamin D in MS. Exposure to sunlight was associated with an increase in age at which people were diagnosed with MS by a small amount. In the study however, scientists did not find any association between using vitamin D or other supplements and the delay of MS onset. The impact of vitamin D on MS requires further study before it can be concluded that it has a beneficial effect on the disease.

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  1. Danny says:

    The `high dose` of vitamin D3 used in this trial per week is a dose obtained by being 20 minutes in the midday sun in shorts and a T-shirt without sunscreen. Therefore, it is no wonder that the results were poor, yet the scientific damage is huge because it discourages further trials on vitamin D3 and MS that may actually use therapeutic doses instead of physiological.

    • Alisa Woods, PhD says:

      According to the methods section “Patients were randomized to once
      weekly oral 20,000 IU vitamin D3 (DekristolTM, Mibe
      GmbH Arzneimittel, Brehna, Germany) or identical placebo
      capsules for 96 weeks.”

  2. Alisa Woods, PhD says:

    Note that only inflammation was studied in this report. As noted in the news report, vitamin D may, however, have other beneficial effects in people with MS which need to be further examined.

    • Marta says:

      I don’t have access to the full paper, but for what I can read, I agree the dose is not that high, only 68 people were studied, and they measure 11 standard markers, at the beginning and at the end of the study. Alisa, can you please tell us if they mention relapse rate in both groups and state of those markers at the time relapse ? thanks 😀

      • Alisa Woods, PhD says:

        No mention of relapse in the original study, which I will email to you Marta. As for explanations of the results, in the conclusions section the authors state “The conflicting results could be explained by different
        outcome measures, application of diverse vitamin D doses
        and supplementation protocols, and important confounding
        factors such as UVR exposure being unevenly distributed
        between studies. One could also speculate that the present
        results may be attributed to vitamin D having only a
        transient effect on systemic inflammation, as serum was
        collected 96 weeks apart and increasing vitamin D levels
        were most likely apparent already after 3 weeks of supplementation
        [29]. However, larger RCTs examining systemic
        inflammation in other disease settings and healthy
        individuals with comparable or higher vitamin D doses and
        follow-up periods between 3 and 12 months also failed to
        show clear effects of intervention [30
        –32]. Another possible
        explanation for our negative results could be that the
        anti-inflammatory effects of vitamin D
        3 supplementation
        are restricted to patients with an initial poor vitamin D
        status [i.e., 25(OH)D levels
        \25 nmol/L], which was only
        the case for 9 % of the patients in the current study.
        However, no such effects were evident in the trials
        reported by Mosayebi et al. or Sokol et al. with baseline
        25(OH)D mean levels of 25 and median levels of
        32.5 nmol/L, respectively [27
        , 31]. Lastly, the discrepancies
        between our previous and current findings could be
        due to differences in study design, as our earlier results
        were solely found in patients without immunomodulatory
        treatment, while less than half of the patients were without
        therapy in the current study.”

        • Alisa Woods, PhD says:

          I am re-printing Marta’s additional comments here, with her permission:

          I think this group just wanted to get an extra paper from their results in their bone density trial; this study was clearly not aimed to find out the effects of vit D on the course of MS, as they say there were not enough relapses, so they can’t really look into what really matters. Well that’s my point of view anyway.
          It is just a shame that so little effort, they are reporting negative data on something that I think it may actually be beneficial. My boyfriend has MS and since he has started VitD, 3 years and a half ago, he hasn’t had any more relapses.
          I think in this study if they wanted to talk about inflammation they should have taken regular blood samples and look at the effect of the treatment more thoroughly but anyway, that’s only my feeling.
          But thank you so much anyway for sending me the paper. That’s really kind of you!

  3. Ian Birchenough says:

    Following a refusal by my wife’s NHS specialist to put her on Beta Interferon despite a recommendation from our private specialist that she was an ideal candidate, I put her on 15,000IU of Vit D3 per day (and told her GP 6 months later). 3 years later she has had no further relapses and was having one about every 12-15 months previously. She is 57 now and maybe the relapses were due to come to an end but it appears that there have been no further episodes, no further loss of any abilities and some slight improvement in her cognitive skills. I just wish I had found out about Vitamin D3 16 years ago. BTW we live in the North of England in one of the wettest places in the country- sunshine is a very infrequent visitor!

    • David Kallman says:

      It is most likely that your wife has transitioned from relapsing remitting MS to secondary progressive MS. In SPMS, there are no more attacks; the MS just continues to progress in the absence of attacks. The key factor is the rate of progression.

      My current rate of progression is small. I had quite a bit 15 years ago and ended up needing to go out on disability and use a wheelchair for all the time I’m awake.

      Since then, my MS is about the same. I do take vitamin D, but just 3,000 IU per day.

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