Friday, 25 August 2017

Vitamin D supplementation during the Winter may be beneficial

Miclea A, Miclea M, Pistor M, Hoepner A, Chan A, Hoepner R. Vitamin D supplementation differentially affects seasonal multiple sclerosis disease activity. Brain Behav. 2017 Jul 11;7(8):e00761.

OBJECTIVES:Low ultraviolet-B (UVB) radiation causes hypovitaminosis D, which is a known risk factor for multiple sclerosis (MS) and associated with MS disease activity. Our objective is to test whether vitamin D supplementation is most effective in lowering disease activity during the period of the year with low UVB radiation and consequently low serum 25-hydroxyvitamin D3 (25(OH)D3) concentration.
METHODS:Retrospective analysis of medical records from our outpatient department identified 40 MS patients with available data of at least 6 months before and during oral vitamin D supplementation. Serum 25(OH)D3 concentration was analyzed using immunoassay. UVB radiation data were provided by the local government. Annualized and quarterly relapse rates before and during vitamin D supplementation served as outcome parameters.
RESULTS:During vitamin D supplementation (18,950 international units/week (mean, SD 3,397)), serum 25(OH)D3 concentration increased by 51 nmol/L and the UVB-related seasonal variability in 25(OH)D3 levels ceased (rho = -0.13, p > .05). Furthermore, the annualized relapse rate decreased by approximately 50%. This was almost solely driven by the prominent reduction in the quarterly relapse rate in late winter/early spring, when 25(OH)D3 levels of non-supplemented patients were the lowest.
CONCLUSIONS: Our study demonstrated the modulation of seasonal MS disease activity through vitamin D supplementation. Given the prominent reduction in the quarterly relapse rate in late winter/early spring, our data indicate a beneficial effect of supplementing MS patients with vitamin D, especially during this period of the year.

ProfG is an advocate of Vitamin Supplementation is areas where there is insufficient sunlight to make you vitamin d replete. In the UK this means you need to take your pills throughout the winter.  Does this do any good?

The advice we give is this will help maintain bone health and help protect you if you fall, etc.

The next question is whether it affects your immune system, to be beneficial.  I am quite sceptical on this and think the influence of vitamin D is long before diagnosis. But am willing to keep an open mind. In this study they retrospectively looked at the influence of supplementation and they found that supplementation during the winter months was associated with lower relapse rates. Great ProfG wins the argument, but if it were so easy to show this why wouldwe need trials involving hundreds of people. 

Is forty people in a trial  really enough. We will have to wait until it is repeated and repeated.

13 comments:

  1. Could it be that vitamin D reduces the chance of infection, such as respiratory tract infection? This in turn reduces MS relapse rate or progression.

    The following article is quite interesting:

    Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data

    BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.i6583 (Published 15 February 2017)
    Cite this as: BMJ 2017;356:i6583

    " Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit".

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  2. " the annualized relapse rate decreased by approximately 50%"

    There you have it ,this is better than teriflunomine

    "representing relative risk reductions versus placebo of 31.2% and 31.5%, respectively"
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752181/

    Its simple lets all take Vitamin D and 50% reduction in Arr

    Next Barts team gonna put vitamin D in the Essential offlabel therapies for resource-poor settings with such great results

    Azathioprine*
    Cladribine
    Cyclophosphamide*
    Fludarabine*
    Leflunomide
    Methotrexate*
    Mitoxantrone
    Rituximab*
    HSCT/BM
    Vitamin D

    We dont need the ABC drugs anymore
    Long live d 25

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  3. MS three years. First year: 3 relapses. Second and third year taking 30000ui / day VD3: 0 relapses, 0 symptoms. I avoid calcium (dayri products) and drink 2.5 liters of water. Under medical supervision.

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    Replies
    1. Are you also taking a DMT for your MS?

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    2. No. Never. Only this: https://www.coimbraprotocol.com/general-information

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  4. Vitamin d is still being viewed upside down. It is not that high vitamin d stops relapses, it is a lack of sufficient vitamin d that allows them to happen. Low vitamin d in the blood was not a normal state when humans evolved. This is in the same way as a lack of vitamin c causes scurvy, it is not that a high dose of vitamin c stops it.

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  5. The effect of vitamin d on the immune system can be seen in the double blind trial of vitamin d supplementation and sunburn. This showed an effect one hour after supplementation so the effect is not on cell populations.
    https://www.sciencedaily.com/releases/2017/07/170706125020.htm

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    Replies
    1. The main difference with this research is it is not the active hormone that is being given. A lot of medical research in immunity has concentrated on the active form of vitamin known as 1,25(OH)D and the levels of this are carefully controlled in the body, by the body. The use of 1,25(OH)D as a drug disrupts the blood calcium levels and is dangerous. In one hour I would be surprised if there was time for the supplement to convert to the storage form 25(OH)D. It is also often forgotten that increased vitamin d intake raises 25(OH)D in the blood and suppresses 1,25(OH)D in the blood, so the effects on the immune system are not due to raised 1,25(OH)D levels at least in the blood.

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  6. 1,25-Dihydroxyvitamin-D3 induces brain proteomic changes in cuprizone mice during remyelination involving calcium proteins. https://www.ncbi.nlm.nih.gov/pubmed/28818673

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  7. Vitamin D and multiple sclerosis: An update.https://www.ncbi.nlm.nih.gov/pubmed/28619429

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  8. Vitamin D receptor gene is epigenetically altered and transcriptionally up-regulated in multiple sclerosis http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0174726#authcontrib

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  9. Vitamin D could repair nerve damage in multiple sclerosis, study suggests https://www.cam.ac.uk/research/news/vitamin-d-could-repair-nerve-damage-in-multiple-sclerosis-study-suggests

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  10. Huuuummm

    A "follower" of the protocol of Dr. Cícero Coimbra from here the Brazil is already appearing here.

    Be very careful with that.

    He doesn't attempt to do a study if he wants, or head-to-head on such a protocol with high doses of Vitamin D3 that promotes (doses above 20.000 ui/day accompanied by intake of much water and no consumption of calcium).
    I know people who even doing such protocol abandoned their DMTs and had outbreaks yes, and I know people who use the protocol and uses a DMT and even yes they also have outbreaks.

    I prefer to take a daily dose of 10.400 ui my DMT (Copaxone) than to risk only with "paths" that even Science knows where it goes.

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