Iranian MS Hypothesis


Dear Professor Gavin Giovannoni

Significant increase in the incidence of multiple sclerosis in Iran has been always puzzling.

With strong evidence from Danish MS Registry (Nielson et all) early environment rather than ones genetic is the primary etiological agent for Multiple sclerosis. Iran was exposed to this agent much earlier than other Gulf countries. British and Russian troops invaded Iran in the 1940s and left after 1946. Since the USA and late Shah of Iran had a friendly relation, it has been documented 25,000 USA military technicians and up to 850,000 Americans stayed or visited Iran till 1979 and left after the Iranian revolution. This viral agent is the most likely cause of high incidence of MS.

During the Gulf War in 1990, there was a massive movement of Allied troops within the Gulf countries and caused the spread of this MS virus to other Gulf countries. We have documented evidence of increased MS in Kuwait and Saudi Arabia published in 2005 and 2016. We are going to see more MS cases in other Gulf countries like Iran in the coming years and in the Indian Subcontinent and the rest of the world (the article by Zahoor titled MS in India Iceberg or Volcano is interesting to read in the journal of NeuroImmunology 2017 March 22nd).

Yours Sincerely,

Dr. V Santharam

Retired Accident & Emergency Medicine consultant and has been interested in MS over 40 years and support Dr Geoffrey Dean migration theory



1 Iran and United States Relations Wikipedia

2 Epidemiology of MS in Kuwait AF Alshubaili European Neurology 2005:53:125-131

3 Environmental exposure and risk of MS  Osama Al Wutayd BMC Neurology June 2016

About the author

The MS Bloggger


  • I agreed with the virus theory since they begging of my search about MS.

  • If MS killed u quickly and the virus was spread easily we’d be hunting down with urgency. Just leave that thought with you.

  • As I’ve banged on about several times before, much more likely is the fact that since the Iranian revolution, the incidence of women being veiled in Iran has risen dramatically, leading to very low levels of vitamin D in many Iranian women in a country where there is no shortage of sunshine and in normal circumstances would ensure people are replete. The link between low vitamin D and MS is well known. Iranian scientists tiptoe around this subject, for obvious reasons.
    The elephant in the room?

    • How do you explain not insignificant incidence in Israel then? I think there is a stronger genetic component involved than given credit for.

      • Again, there is a large (and growing rapidly) religious community in Israel that dress modestly and where not enough skin is exposed to sunlight.

    • But one thing to consider is that gardens in Iran are sometimes private traditional courtyards, and women do sunbath in these private spaces.

      It would be interesting to know how many Iranian homes have these private courtyards and how many women sunbath in them.

    • Ok and Brasil?

      Introduction: The peculiar geographical distribution of Multiple Sclerosis (MS) suggests the presence of an environmental factor in the genesis of this disease. It has been proposed for decades that vitamin D deficiency could be a possible explanation for the latitudinal gradient of MS
      Objectives: To evaluate vitamin D levels in patients with Multiple Sclerosis in the Fluminense Southern Region of Brazil
      Methodology: This is a cross-sectional case control study of a cohort in follow-up over the last 10 years
      Results and Conclusions: Results:Data from 50 patients and 50 controls were obtained. The female sex was more frequent. The mean age of the two groups is found in the 5th decade of life. In the group of patients the median EDSS was 2, ranging from 0 to 8.5 and the average disease time was 8.7 years (± 7.5 years). There was no significant difference between the mean serum levels of vitamin D between the groups studied. However, the majority of participants in both groups had serum levels of vitamin D below normality. There was also no difference between these two groups when assessing the time of daily exposure to sun, season of birth and vitamin D status. Conclusion: In Brazil there is great availability of solar radiation. Despite this, the majority of study participants had serum levels of vitamin D below those considered normal. Further studies are needed in different populations for greater conclusions.

      Fernanda Ferreira Chaves Costa Pereira1; Ana Beatriz Calmon Pereira1,2; Claudia Cristina Ferreira Vasconcelos1; Regina Maria Papais Alvarenga1; Oscar Fernandez3
      1 – Universidade Federal do Estado do Rio de Janeiro – UNIRIO Brasil; 2 – Universidade de Vassouras; 3 – Hospital Regional Universitario Carlos Haya-Malaga


  • Could the increased incidence of MS be because since the revolution in Iran in the late 70’s there are more women wearing a Burka or Niqab and therefore receive less vitamin D on their skin? Has the increased incidence of MS been the same between men and women?

    • Great minds eh Patrick?
      The incidence of MS has increased at least eightfold (and probably higher) in Tehran since 1979. Increasing female incidence.

  • Countries with the highest prevalence of MS Canada, San Marino, Denmark, Sweden, Hungary etc women there don’t wear Burka. There is three fold rise in the incidence among women over the years, There has been report of increase in the incidence of Paediatric MS in Iran. Rising incidence of MS in other Gulf countries cannot be attributed by women increasingly wearing Burka So it is not acceptable that wearing a Buka has increased the incidence of MS in Iran. More over world wide increase of MS cannot be attributed by low vitamin D.

    • Countries like Canada etc have much lower levels of sunlight compared to Iran, they don’t have to be veiled but if they are without vitamin D supplementation their vitamin D levels year round will be very low. In addition, the widespread inclusion of sunscreen compounds in make-up can be another factor as is the widespread advice to cover up to protect against skin cancer. It is maternal vitamin D in pregnancy that is significant, as is seen in well-known the month of birth.There is obviously more than one factor at play here, in Japan they are suggesting shift to Western diet for example but to suggest that low vitamin D is not a factor is I suggest disingenuous but obviously a sensitive topic in Iran and other countries. It will be interesting to see around the London Hospital, where there is now a much larger proportion of women in the local Bangladeshi community choosing to wear the hijab/niqab, than twenty years ago whether there is a concomitant increase in the incidence of MS in this population. Already there is a rise in osteoporosis cases so the experiment is already underway.

    • vitamin D, westernisation, later infection with EBV, diet obesity, fewer wars. scanners MS nurses, available treatments, etc etc etc etc

      • Agree. There might be few factors i.e. EBV that is changing the Vitamin D receptor (VDR polymorphism as ApaL TC – low vitamin D metabolism) and low Vit D suplementation might be the case.

      • Vitamin D level has been found to be low following viral infection like Hepatitis C ,B Epstein Bar and even HIV. Low level Vitamin D in MS patients are due to a on going viral infection. It is a fluctuation resulting from the disease. It is perfectly possible that MS virus has a long incubation period showing low vitamin D before the clinical symptoms appear. Third Generation of Asian in London are more prone for MS and they are all not female wearing Burka. If Bengladesh women getting more Multiple Sclerosis they are living in an environment where the MS virus is abundant. How come incidence of MS low in Bengladesh which is traditional Muslim community?

        • I understand that the subject of the veiling of women is troublesome for those living in a theocracy so I won’t waste any more time on this.
          If it is a virus, it’s almost certainly EBV which as far as I’m aware is pandemic across the globe.

          • EBV also isn’t that infectious, there’s a reason that glandular fever is called the kissing disease… so the increase in MS in Iran and other Arabic nation is probably not due to the increase in westerners, especially during Gulf war.

          • What is the evidence that EBV was not in Persia before the Gulf War? As on of the seats of civilization I doubt it very much

          • Iranians are certainly not Arabic and would be greatly offended if you said they were and do you honestly think that mothers don’t kiss their children in these countries (which is how most of us get EBV as children)? Figures indicate that EBV infection is just as prevalent in Iran as in the West in fact it may be a co-factor for the development of the immune system and MS is an unfortunate side-effect in some.

        • Dr V Santharam thank you for your careful comments and your scientific clarity.

          There is no study proving that MS is caused by low vit D, so we should be at least more careful before expressing such conflicting opinions (this goes to MD2).

          In my opinion, the connection between MS and Vit D is only explained as a causational effect of EBV infection, and the studies associating the sunniness of a country to MS incidence do not nessecarily relate to Vit D, but rather to the spread of the virus itself.
          A virus is the most probable cause of the general increase of all autoimmune pathologies. Why is there a global increase? Definitely we can’t explain it with burgas or make-up.
          We should take into consideration that viruses evolve and test out different strategies to multiply and spread within the body over time.
          Maybe we are facing a virus evolution that outplays the human one.

          • There is no study proving that MS is caused by low vit D, so we should be at least more careful before expressing such conflicting opinions (this goes to MD2)

            Yet there are numerous studies showing an association between latitude, both North and South are you suggesting that for some reason there is more EBV in these latitudes?

            The most comprehensive review of MS prevalence to date, has confirmed a statistically significant positive association between MS prevalence and latitude globally. Exceptions to the gradient in the Italian region and northern Scandinavia are likely a result of genetic and behavioural-cultural variations. The persistence of a positive gradient in Europe after adjustment for HLA-DRB1 allele frequencies strongly supports a role for environmental factors which vary with latitude, the most prominent candidates being ultraviolet radiation (UVR)/vitamin D.

          • Thank you for your comment. As you rightly commented Why there is a global increase of MS? What Dr Geoffrey Dean has said in his article BMJ 1976 (April 10 861-4) Immunity to MS develops in the childhood in low risk zone. If MS is spreading world wide that immunity has disappeared. So our race is to isolate this antibody and viral antigen. Recent Danish study showing significant rise in MS among immigrants confirms (Nielsen et all) this.

          • Hmmmmm, might work for chickenpox but certainly not smallpox before it was eradicated and won’t work for EBV as that is primarily transmitted by saliva. Now I know there are some that wander round with their mouths permanently open but even so…………… 😉

  • The advent of the contraceptive pill and “moral decline” I suppose you could call it, along with the massive rise in drunken woman falling down drunk in the streets on nights out and snogging anything that has a pulse.
    And the ability of people to travel the world on planes so easy nowadays. Exposure to cultures and people who a hundred years ago would never have ever got to a country in a million years because transport was not like it is now. I think that is helping spread EBV/Herpes virus apace.

    A lot of people these days have multiple partners and those multiple partners have had multiple partners….so going with one person can inadvertently mean exposure to many, many more…..

    • How much of that is going to apply to modern day Iran though?
      Sounds like a Peter Hitchens/Simon Heffer tirade.

      • it’s the movement of people around the world that causes things to spread either where it’s never been seen before, or only in small incidences.

        MS is a symptom of whatever we have ciaught that comes out later….

        like someone says further up:
        “If MS killed u quickly and the virus was spread easily we’d be hunting down with urgency. Just leave that thought with you.”

        This person went to Nigeria and came back with Monkey Pox this year……viruses spread through easier because the world is a much smaller place now.

    • “The advent of the contraceptive pill and “moral decline” I suppose you could call it, along with the massive rise in drunken woman falling down drunk in the streets on nights out and snogging anything that has a pulse.”

      That’s really sexist, insulting and nonsensical. Woman-shaming for the increase in MS? Really? I guess that even if EBV was called a-male-virus, women would still be the ones to be blamed for.
      Of course MD2 didn’t notice because he was too busy with his western world revelation.

      • Oh I noticed Anonymous, which is why I likened the post to Peter Hichens/Simon Heffer (renowned right-wing hate-funneling newspaper columnists) if you were unaware. I’ll add Richard Littlejohn too.

        • Yep, some of us first had symptoms at an early age and no we hadn’t had sex, fallen over drunk or even kissed anyone. Great theory!!

By The MS Bloggger



Recent Posts

Recent Comments