The association between Multiple Sclerosis and Vitamin D status: a review
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Sevil Babashpour,1,*
1. Department of Medical Genetics, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
- Introduction: Multiple sclerosis (MS) is a complex demyelinating autoimmune disease in which an immune response of the body’s immune system is against the central nervous system (CNS). Vitamin D influence on immune cells has been suggested in numerous investigations. Several observational studies have proposed that there is a positive correlation between serum vitamin D deficiency and the development of MS. This study was aimed to review the role of vitamin D in the treatment of MS and with the hypothesis that high levels of vitamin D could be beneficial for MS.
- Methods: This review was performed within English articles published at PubMed from 2012 to 2020. The keywords were Multiple Sclerosis, Vitamin D, and clinical trials. By searching this database, 53 articles were found and 36 of them by reading abstract were removed.
- Results: Finally 17 articles were included in the study. Many clinical studies and animal models have shown the positive effect of Vitamin D and its metabolites on immune cells that decrease the MS developing by shifting cytokines ratio towards an anti-inflammatory state. Moreover, At least 10 studies have suggested that the cholecalciferol supplements can be used for the treatment of MS, and high vitamin D status reduces the risk of exacerbations and magnetic resonance imaging activity in people with MS, so it makes a significant difference in the patient's quality of life. Although some other studies declare that no strong evidence between positive effects of vitamin D supplements and MS has yet. Also, these studies reported the side effects of high doses of vitamin D supplementation, such as seizures, severe hypercalcemia, kidney failure, gastric symptoms, weakness, and fatigue. Indeed, these side effects develop in patients who intake more than 50,000 IU of cholecalciferol per day over several months.
- Conclusion: While observational reports have indicated that vitamin D may reduce inflammation in MS patients, randomized controlled trials have yet to validate this. However, results from clinical trials suggested that vitamin D doses ranging from 10,000 to 40,000 IU/day appear to be safe as an add-on therapy. The findings highlight the importance of becoming aware of the possible adverse side effects of vitamin D supplementation. Furthermore, no evidence shows vitamin D as a monotherapy for MS prevention.
- Keywords: Multiple Sclerosis, Vitamin D
