Editor’s note: This is the first story in a three-part report examining the question “Should vitamin D supplements be recommended for MS patients?”, which was a topic discussed at this year’s Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Here, we provide a synopsis of the argument.
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While a large body of epidemiological data suggest that low vitamin D levels increase the risk of multiple sclerosis (MS) onset, establishing its benefit for a person who already has the disease remains a challenge.
The question prompted a hot topic discussion at this year’s ECTRIMS, held Sept. 11–13 in Stockholm, where a group of clinicians shared their views and discussed the scientific evidence supporting or rebutting the benefits of vitamin D supplements for people with MS.
Normally, most vitamin D production in our body is triggered by sun exposure (UV radiation), but it also can be obtained from food and dietary supplements, either as vitamin D2 or vitamin D3, also known as cholecalciferol. The recommended dietary intake of vitamin D in healthy children and adults up to age 70 is 600 IU (15 micrograms) daily.
To become biologically active, vitamin D is first converted in the liver to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. This is what is measured in a vitamin D blood test.
According to the National Institutes of Health (NIH), generally a serum concentration of 50 nanomolar per liter (nmol/L) or higher (up to 125 nmol/L) is the reference for adequate levels.
At ECTRIMS, the discussion was led by Alberto Ascherio, MD, researcher and professor at the Harvard T.H. Chan School of Public Health in Boston, who believes MS patients should be advised to take vitamin D. Ellen Mowry, MD, researcher and professor of neurology at Johns Hopkins University in Baltimore, also supports the clinical practice use of vitamin D supplements, in moderate doses, for MS patients.
The “no” side to supplementation was represented by Joost Smolders, MD, PhD, neurologist at the Dutch Canisius Wilhelmina Hospital and a researcher at the Netherlands Institute for Neuroscience (NIN).