VitaminD levels do not predict relapse after a baby

Runia TF, Neuteboom RF, de Groot CJ, de Rijke YB, Hintzen RQ.The influence of vitamin D on postpartum relapse and quality of life in pregnant multiple sclerosis patients. Eur J Neurol. 2014 Nov 28. doi: 10.1111/ene.12594. [Epub ahead of print]

BACKGROUND AND PURPOSE: In relapsing-remitting MS
patients, lower serum vitamin D concentrations are associated with
higher relapse risk. In a number of conditions, low vitamin D has been
associated with fatigue. Pregnant women are at particular risk for
vitamin D insufficiency. Our objective was to investigate whether
vitamin D status is associated with postpartum relapse and quality of
life during pregnancy.
METHODS:Forty-three pregnant
relapsing-remitting MS patients and 21 pregnant controls were seen at
regular times before, during and after pregnancy. At every clinical
assessment visit, samples for 25-hydroxyvitamin D (25(OH)D) measurements
and quality of life questionnaires were taken.
concentrations were not associated with postpartum relapse risk.
Pregnancy 25(OH)D levels of patients and controls were not significantly
different. In controls, but not patients, higher 25(OH)D concentrations
were correlated with better general health, social functioning and
mental health, but not with vitality.
CONCLUSION:Low vitamin D levels
are not associated with postpartum relapse. In pregnant MS patients,
vitamin D levels are similar to levels in healthy women and are not
associated with quality of life. Therefore, with regard to quality of
life and postpartum relapse, no arguments were found for advising
pregnant MS patients to take more vitamin D supplements than healthy

This study looks at pregnant women  and finds that potential for developing a relapse is unrelated to their vitamin D level. 
Is this surprising?.

not when other sudies look in to the ability of vitamin D we find a

However the major
question is: What does vitamin D do to the unborn in pregnant women?
Does this limit MS suceptibility.

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  • "Vitamin D was such a fantastic immunomodulator, people taking loads of vitamin D would be immunocompromised". I don't think it is an immunomodulator, it is a shortage of supply that leads to inflammation and increased immune activity. 25(OH)D in the blood is as far as anyone can tell is inert, until very high levels are reached. It is what the cells do with it 25(OH)D that affects the immune system and that is tightly controlled. Vitamin d as taken is not a drug or an active hormone, you are not disrupting a balanced system. The argument is about what is a sensible blood 25(OH)D level, remembering that there are 2 effects controlling the 25(OH)D level in the blood: Supply and consumption. People who cannot 'scrape the bottom of the barrel' will have higher 25(OH)D levels than those who can, but they will be more deficient.

  • I don't even think it is a brake, I think it is the active immune system rising as the innate immune system limits itself to conserve 25(OH)D. I think it was a short term survival mechanism that was supposed to only operate for a month or so a year, but due to modern behaviour operates continuously. We have it the wrong way round, vitamin d does not suppress the active immune system, a lack of vitamin d activates it.

    If the point where the innate immune system limits itself is set by the lowest vitamin d level in pregnancy, and low levels in pregnancy set it higher then more 25(OH)D is conserved for calcium control and the risk of rickets in babies and death to the mother is reduced, but at the cost of higher auto-immunity. The body is programmed to expect long winters if the mother experienced a long winter. If this is true you cannot use 25(OH)D, certainly at low levels, as a measure of sufficiency as each person has a different threshold. Those with higher levels may be more deficient. In the paper are not those who relapsed on average higher than those who do not? I only had a quick look.

  • You may be interested in PLoS One. 2014 Nov 5;9(11):e111265. doi: 10.1371/journal.pone.0111265. eCollection 2014.
    The importance of body weight for the dose response relationship of oral vitamin d supplementation and serum 25-hydroxyvitamin d in healthy volunteers. Ekwaru JP1, Zwicker JD2, Holick MF3, Giovannucci E4, Veugelers PJ1. Note the relationship between vitamin d supply and 25(OH)D it is as though consumption is increasing because vitamin d is not building up. Note also the lack of effect on blood calcium, so fairly large doses do not cause blood calcium problems.

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