Vitamin D is an essential dietary nutrient and plays many important roles in the body to maintain health and prevent many different diseases – it is also a known risk factor for multiple sclerosis (MS).
Until recently, there was limited evidence on whether supplementation with vitamin D could alter the disease course in people living with MS. Three large clinical trials were undertaken to look at the influence of vitamin D supplementation on the disease course.
One large randomized clinical trial that took place at centres across the United States looked at whether supplementation with high-dose vitamin D (5,000 international units (IU)) compared to low-dose vitamin D (600 IU) reduced the risk of relapse in people with relapsing-remitting MS (RRMS) who were also taking a disease-modifying therapy (glatiramer acetate). At the end of the 2-year study, they found that supplementation with high-dose vitamin D was safe, but it did not reduce the risk of relapses. No other significant differences were found between the vitamin D low- and high-dose groups.
A second large study from Australia and New Zealand explored whether vitamin D supplementation could prevent or delay the development of MS in people with clinically isolated syndrome, who were at high risk of developing MS. They compared different doses of vitamin with up to 10,000 IUs taken over a year. At the end of the study, no differences were found between those who received vitamin D supplementation versus a placebo (no vitamin D).
A third randomized clinical trial that took place in France found that supplementing with high doses of vitamin D (100,000 IUs taken every two weeks for up to two years) was able to significantly delay the development of MS in people with clinically isolated syndrome. They also reported decreases in disease activity and lesions in people who received high-dose vitamin D compared to placebo (no vitamin D).
The findings from these studies and others, while conflicting, have helped us better understand how vitamin D might influence the MS disease course but more research is needed to determine the best dosage. Low vitamin D levels remain a risk factor for developing MS and other chronic diseases. Everyone is encouraged to follow Health Canada’s vitamin D recommendations for overall health.
Learn more about vitamin D.
Reference:
- Sandra D Cassard, Kathryn C Fitzgerald, Peiqing Qian, Susan A Emrich, Christina J Azevedo, Andrew D Goodman, Elizabeth A Sugar, Daniel Pelletier, Emmanuelle Waubant, & Ellen M Mowry. (2023). High-dose vitamin D3 supplementation in relapsing-remitting multiple sclerosis: a randomised clinical trial. EClinicalMedicine. Link to article – here.
- Helmut Butzkueven, Anne-Louise Ponsonby, Mark S Stein, Robyn M Lucas, Deborah Mason, Simon Broadley, Trevor Kilpatrick, Jeannette Lechner-Scott, Michael Barnett, William Carroll, Peter Mitchell, Todd A Hardy, Richard Macdonell, Pamela McCombe, Andrew Lee, Tomas Kalincik, Anneke van der Walt, Chris Lynch, David Abernethy, Ernest Willoughby, Frederik Barkhof, David MacManus, Michael Clarke, Julie Andrew, Julia Morahan, Chao Zhu, Keith Dear, & Bruce V Taylor, (2024). Vitamin D did not reduce multiple sclerosis disease activity after a clinically isolated syndrome. Brain, Link to article – here.
- Eric Thouvenot,David Laplaud,Christine Lebrun-Frenay, Nathalie Derache, Emmanuelle Le Page, Elisabeth Maillart, Caroline Froment, Giovanni Castelnovo, Olivier Casez, Marc Coustans, Anne-Marie Guennoc, Olivier Heinzlef, Laurent Magy, Chantal Nifle, Xavier Ayrignac, Agnes Fromont, Nathalie Caucheteux, Nicolas Gaillard, Ivania Patry, Jérôme De Seze, Romain Deschamps, Pierre Clavelou, Damien Biotti, Gilles Edan, William Camu, Hanane Agherbi, Christophe Demattei, Fabbro-Peray Pascale, Thibault Mura, Manon Rival, on behalf of the D-lay MS Study Group. (2024). High-dose cholecalciferol reduces multiple sclerosis disease activity after a clinically isolated syndrome: results of a 24-month placebo-controlled randomized trial (D-lay MS). Unpublished results presented at ECTRIMS 2024. Link to abstract – here.
Additional Resources:
- William Camu , Philippe Lehert, Charles Pierrot-Deseilligny, Patrick Hautecoeur, Anne Besserve, Anne-Sophie Jean Deleglise, Marianne Payet, Eric Thouvenot, & Jean Claude Souberbielle. (2019). Cholecalciferol in relapsing-remitting MS: A randomized clinical trial (CHOLINE). Neurology: Neuroimmunology & Neuroinflammation. Link to article – here.
- Raymond Hupperts, Joost Smolders, Reinhold Vieth, Trygve Holmøy, Kurt Marhardt, Myriam Schluep, Joep Killestein, Frederik Barkhof, Manolo Beelke, & Luigi M E Grimaldi. (2019). Randomized trial of daily high-dose vitamin D3 in patients with RRMS receiving subcutaneous interferon β-1a. Neurology. Link to article – here.
- Jan Dörr, Priscilla Bäcker-Koduah, Klaus-Dieter Wernecke, Elke Becker, Frank Hoffmann, Jürgen Faiss, Bernd Brockmeier, Olaf Hoffmann, Kerstin Anvari, Jens Wuerfel, Sophie K Piper, Judith Bellmann-Strobl, Alexander U Brandt & Friedemann Paul. (2020). High-dose vitamin D supplementation in multiple sclerosis–results from the randomized EVIDIMS (efficacy of vitamin D supplementation in multiple sclerosis) trial. Multiple Sclerosis Journal–Experimental, Translational and Clinical. Link to article – here.
- Real Talk MS with Jon Strum. Episode 347: Vitamin D and MS with Dr. Ellen Mowry – Listen here.