Good news for those at high risk for developing multiple sclerosis! A new study out of Iran reports that vitamin D supplementation can prevent or delay the onset of multiple sclerosis.
Often what is called “clinically isolated syndrome” (CIS) is the first neurological manifestation of multiple sclerosis. A patient will have a neurological symptom for the first time and their doctor will call this CIS. They will then order a brain MRI to check if the patient with CIS also has brain-lesions. If they do, the patient is at high risk of developing MS. In fact, in 90% of MS cases, CIS is the first clinical sign.
So what’s CIS? One of the most common types of CIS is optic neuritis. People with optic neuritis experience vision loss, as the optic nerve from the retina becomes inflamed. Twenty-percent of patients with MS have optic neuritis, and vice-versa, 50% of patients with optic neuritis develop MS within 15 years.
When a patient experiences CIS and other tests determine the patient has a high risk for MS, the patient and doctor want to take immediate action to prevent or delay the onset of MS and disease progression.
In this study, researchers out of Isfahan University of Medical Sciences led by Dr Hajar Derakhshandi wanted to know, if a patient presenting with optic neuritis starts taking vitamin D, will they lower their risk or delay the onset of MS?
The researchers designed a randomized controlled trial. They enrolled 30 patients that were recently diagnosed with optic neuritis and were then randomized to either take vitamin D3 50,000 IU/week or placebo/week for duration of 12 months. Thirteen patients in the vitamin D group completed the study and 11 completed it in the placebo group.
After 12 months, the researchers found the following:
- Baseline vitamin D levels of the vitamin D group were 13.7 ng/ml and 16.4 ng/ml in the placebo group. They did not report the vitamin D levels after the trial, but did mention the vitamin D levels were “optimized” in the vitamin D group and not in the placebo group (which would be expected at 50,000 IU/week).
- Zero patients in the vitamin D group experienced a second demyelinating attack, while five of the 11 placebo patients did, and this was highly statistically significant (p=.007). When a patient experiences a second demyelinating attack, MS is diagnosed. Thus, this is another way of saying, zero of the vitamin D group patients were diagnosed with MS in these 12 months, while 5 of the 11 placebo patients were.
- The incidence rates of positive MRI findings, such as black holes, cortical, juxtacortical, corpus callosal, new gadolinium-enhanced, and new T2 lesions were significantly lower in the vitamin D treatment group than in the placebo group. The incidence rate for black holes in the vitamin D group was 84% less than the placebo group.
The researchers conclude:
“Our results indicate that vitamin D3 protects optic neuritis patients developing MS… The immunomodulatory effects of vitamin D3 can delay or prevent future relapses in CIS patients, even after the first demyelinative attack, thus reducing the risk of MS development.”
Furthermore, the researchers recommend:
“We recommend the optimization of serum 25(OH)D status in all patients presenting with optic neuritis who have low serum levels of this vitamin. We also propose that all other CIS patients who are at risk of developing MS should be similarly treated.”
Here, in this study, the researchers found results using 50,000 IU of vitamin D3/week, which is equivalent to 7,000 IU/day.
Derakhshandi H et al. Preventive effect of vitamin D3 supplementation on conversion of optic neuritis to clinically definite multiple sclerosis: a double blind, randomized, placebo-controlled pilot clinical trial. Acta Nerol Belg, 2012