The professor of epidemiology and nutrition at Harvard TH Chan School of Public Health discussed what might be an optimal dose of vitamin D supplementation in MS, and how vitamin D deficiency should be addressed as a modifiable risk factor.
“I think it’s pretty reasonable to think about 3000 IU per day of oral vitamin D3 would probably be sufficient for the large majority of patients. It’s a dose that would increase the level of vitamin D from a median of 50 nmol/L, which is what we’ve found in Europeans with MS, to close to 110 nmol/L, which is the level you find associated with the optimal outcome in MS.”
In 2014, Alberto Ascherio, MD, DrPH, professor, epidemiology and nutrition, Harvard TH Chan School of Public Health, presented data on the use of vitamin D as a predictor of multiple sclerosis (MS) disease activity and progression in patients on interferon ß-1b. That work shows that among MS patients treated with interferon ß-1b, higher serum 25-dihydroxy vitamin D levels were associated with lower rates of MS activity on MRI, but not with brain atrophy or clinical progression.1
This year at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), September 11-13, in Stockholm, Sweden, Ascherio led a hot topic discussion, recommending that patients with MS be advised to take vitamin D to help treat their disease. He noted that while his and others’ findings along with a large body of epidemiological data suggest vitamin D plays a role in MS, establishing that role has been a challenge. Ultimately, clinical trials have been plagued with obstacles including short durations, small sample sizes, and poor patient exclusion, among others.2
Although, under critical examination with regard to vitamin D supplementation’s safety, Ascherio said that the “compelling conclusion” is the risk/benefit ratio for moderate dose vitamin D is favorable, and thus supplementation should be part of the treatment for most MS patients. To find out what that optimal dose might be, NeurologyLive's sister publication AJMC spoke with Ascherio.
For more coverage of ECTRIMS 2019, click here.
1. Ascherio A. Vitamin D as a predictor of multiple sclerosis activity and progression in patients with multiple sclerosis on interferon beta-1b. ECTRIMS Online Library. FC4.4. Published Sep 12, 2014. Accessed September 11, 2019.
2. Ascherio A. MS patients should be advised to take vitamin D for MS. Presented at: ECTRIMS; September 11—13, 2019; Stockholm, Sweden. Abstract 27.