In recent years, testing and supplementation of the ‘sunshine vitamin’ has become of great interest to neurologists and those of us with multiple sclerosis.
It’s easy to see why.
MS has been linked to vitamin D deficiency – both as a risk factor for disease development and following diagnosis. People with MS also have an increased risk of fracture – due to falls. So it seems reasonable people with the disease should be getting enough vitamin D.
Except some are not.
“Our experience is that almost all MS patients who are not supplementing with vitamin D have insufficient, if not deficient, levels,” according to Dr Ruth Dobson, neurologist at Queen Mary University and co-author of a 2017 BMJ article on the vitamin.
Unique
Vitamin D is unique among vitamins because we produce it ourselves – when our bare skin is exposed to the sun’s rays. This worked for our hunter-gatherer ancestors, but is more of a challenge today as many of us work inside.
Another factor is that many of us live in northern latitudes. This means from October-March, the sun’s rays don’t contain enough ultraviolet B (UVB) to allow our bodies to manufacture
vitamin D. And no – using a sunbed is not the answer as many do not use UVB, says Prof Gavin Giovannoni, Professor of Neurology, Queen Mary University.
As for getting vitamin D though our diet? Unfortunately only a few foods – like oily fish and egg yolks – contain it and only in small amounts.
So that leaves taking vitamin D supplements – which thankfully are cheap and have a low risk of toxicity.
But how many should we take every day? And what is the optimal level of vitamin D we should be aiming for?
Fifteen neuros
In hopes of guidance, I asked fifteen MS neurologists from the UK, Canada, US, Europe and Australia a series of questions:
- Do you test your MS patients for vitamin D? If so, on diagnosis – or periodically?
- What is the ideal range you would like to see?
- When would you suggest re supplementation – and how much per day?
- Does this vary if the patient is Black/Hispanic, Asian or First Nation people (Canada) – or if pregnant or looking to become pregnant?
While their answers varied, none suggested a different dose depending on a patient’s race/ethnicity or if pregnant. However Dr. Dobson did suggest women with MS looking to start a family should ensure they start taking vitamin D prior to conception.
Also worth noting it is the measurements for vitamin D levels are in nmol/L – not ng/mL (the measurement used in the US). The dosage is in IU – International Unit and that the type of vitamin D to take – is vitamin D3 (cholecalciferol) – not vitamin D2.
Dr Khaled Abdel-Aziz,St George’s and St Peter’s Hospitals, England -tests on diagnosis and supplements all patients with 4,000 IU daily. Looking for upper end of normal – 75-100 nmol/L.
Dr Aaron Boster, the Boster Center for Multiple Sclerosis, Ohio – tests on diagnosis and once annually during the winter. Aims for a blood level of 50-100 nmol/L. Advises taking 5,000 IU or in some cases 50,000 IUweekly.
Prof Alasdair Coles, Cambridge University- tests on diagnosis and looks for a result greater than 50 nmol/L. If below, suggests a loading dose and then 800 IU a day. Encourages exercise outdoors throughout the year to get sun.
Dr Ruth Dobson, Queen Mary University of London – recommends 4-5,000 IU per day, or 10,000 IU on alternate days. Advises testing for vitamin D several weeks after starting daily supplements. Likes to see a level >75nmol/L but not greater than 200nmol/L.
Prof Gavin Giovannoni, Queen Mary University of London – advises dosing of 5,000 IU per day based on the Vitamin D Council’s advice and likes to see patients on a level above 100 nmol/L all year round, but not greater than 250 nmol/L.
Dr Sharmilee Gnanapavan, Queen Mary University of London – tests at diagnosis. Recommends 4-5,000 IU per day – regardless of vitamin D level as believes it has an anti-inflammatory role to play in MS. Looking for a level greater than 50 nmol/L.
Dr Orla Gray, Ulster Hospital, Northern Ireland – does not routinely test; advises treatment to those who are happy to take. Normally suggests 800 IU per day.
Dr. Niall MacDougall, Queen Elizabeth University, Scotland – “I never test as without supplementation I don’t think I’ve ever seen someone in Scotland with a ‘normal’ level and it’s an expensive test.” Advises patients to take 4-5,000 IU daily.
Prof Ruth Ann Marrie, University of Manitoba, Canada – helped write vitamin D guidance for the MS Society of Canada. Advises patients to take 2-3,000 IU a day and tests four months after supplementation starts. Aims for a level of 50-125 nmol/L.
Dr Joost Smolders, Erasmus University, Rotterdam – tests on diagnosis. Repeats only if patient is at risk of very low vitamin D levels due to very active disease, African/Mediterranean ancestry, limited sun-exposure (clothing/ culture-wise), high level of disability and old age. Looking for level above 50 – closer to 100 nmol/L ideal. Dosage varies from 1-4,000 IU.
Dr Stephen Krieger, Mount Sinai, New York- tests on diagnosis and occasionally after. Likes to see patients in 50-70 nmol/L range. Suggests 3,000 IU per day and then tests to see if it is sufficient.
Dr Emma Tallantyre, Cardiff University, Wales – tests most patients and aims for a range of 30-50 nmol/L – though ideally above 50. Suggests everyone – unless they are on calcium supplements – take 4-5,00 IU a day. If patient is already on 1,000IU per day and levels are adequate – greater than 50 nmol/L – then no dose increase.
Dr Benjamin Turner, Queen Mary University of London – tests on diagnosis but not routinely after. Advises patients to take 2,000 IU a day and likes to see a level no greater than 200 nmol/L.
Dr Anneke van der Walt, Monash University, Australia – tests on diagnosis and then annually due to Australian Medicare constraints – but finds this sufficient. Happy with a range of 75-150 nmol/L and usually recommends 1,000 IU a day.
Dr Wei Yeh, Monash University, Australia – test at entry to clinic or on diagnosis. Suggests dosing at 1-2,000 IU daily, but guided by initial vitamin D level. Aims for a vitamin D level of at least 75 nmol/L.
Remember this is guidance only. It is worth checking with your GP or neurologist first.
If I understood Prof G correctly he was saying Vitamin-D helps prevention of MS but doesn’t help with disease progression?…MD also shared a few articles pointing to the same conclusion… Bit confused now.
The epidemiology supports vD or sunshine exposure as a way to prevent or lower your chances of getting MS. At the moment we don’t know if it is the low vD level itself or lack of sunshine that is the risk factor, which is why we need to do a trial. Please note that both vD and sunshine have immune effects that are potentially independent of each that could explain the epidemiological observations. Some studies suggest the effect is likely to due to vD, but as these were observational studies we can’t be sure.
In established MS the evidence that vD supplements are disease-modifying is weak; the trials have been underpowered and small, which is why we need larger and better-powered studies.
The link between low vD levels and MS disease activity is likely to be reverse causation, i.e. inflammation consumes vD and lowers blood vD levels. All inflammatory diseases including infections lower vD levels.
There is a clear link between low vD levels and poor bone health, which is our main driver for recommending it people with MS. When it comes to recommending it family members is about possible MS prevention.
Thank you.
Epidemiology rules out that it is an inverse relationship.
I went on holiday to the Maldives last month (booked pre-pandemic) and talking about immune effects of sunshine, I’m allergic to it! I have started getting polymorphic light eruption in the past few years. The last two days of my holiday (and two days after I got back) I was covered in an itchy rash.
I get it when I go back home to NZ for Christmas too. Not happening this year of course…
I was always kept out of the sun due to my pale skin, living under an ozone hole and my godmother’s death from melanoma. Here in the UK at least I can spend as much time as possible outside, I can be out running on the trails all day long, it’s a new kind of freedom for me!
Thank profess
5000 iu daily is fine, i ve been on 10000 iu for years.. For some every other day is fine.
I am glade you picked up the results… Honestly.. Healthy living is great but also one needs to excise..
I ll be happy to assist you , i wish you a speedy recovery..
“The link between low vD levels and MS disease activity is likely to be reverse causation, i.e. inflammation consumes vD and lowers blood vD levels. All inflammatory diseases including infections lower vD levels.” This begs two questions, why is the 25(OH)D being consumed (what process is consuming it/to do what) and what happens if you don’t let the blood levels of vitamin d drop because you have supply enough.
What a great post.
Of course it depends where you live among other factors like your genes and your age how much vitamin D3 you should take. So one should test, test, test. It is penny wise pound foolish not to test. Vitamin D prevents 88 health conditions and COVIT-19. GrassrootsHealth recommends a vitamin D level 100 – 150 nmol/L.
I don’t trust population normative data because they are based on generating a mean and setting deficiency at two standard deviations below the mean. The problem with this is a tautology in that a lot of people in theca normative data set will have low levels and hence lower the normative vD range.
I, therefore, prefer an evolutionary medicine approach, i.e. what are vD levels like in populations who live like our ancestors did, for example, hunter-gatherers, farmers, lifeguards, outdoor workers etc. These populations tend to have vD levels above 100nmol/L and not to have the much cyclical seasonal variation in their vD levels we see in populations who live in Northern Europe and North America.
However, I agree that your genes and other factors all affect vD levels an hence in an ideal world personalised dosing would be ideal, albeit expensive to do at a population level.
Not as expensive as a world wide outbreak of for example COVID-19.
So interesting. I’m at Queen Square. Was tested on diagnosis and prescribed 5000 units daily. I did not know it’s an expensive test. I would like to be tested again now I have been supplementing for a few years.
Thanks for responding. It is my understanding – and any neuros/MS nurses please feel free to correct me – that each vit D test costs the NHS about £25 per person I have just looked online – and you can get a self-at home test kit for £29. It was temping to include this in the piece, but I was trying to keep it short.
I did think about paying for a test! I might do that… I know I could ask my GP for one but getting blood test results out of my GP is impossible, the receptionist just says he’ll call me if there’s any cause for concern.
Thanks for this post.
It would be great to know if there is a supplementation regimen that ensures proper level of vD reducing the need for periodical testing. Would it be feasible to develop one based on data already available? people BMI, periodical blood test and intake could be used to obtain an established regimen.
I was a bit shocked that my levels dropped from 40 ng/ml to 30 in barely two months. Now I am supplementing again.
What is your opinion in vD in people taking depleting drugs such as ocrelizumab, alemtuzumab and cladribine? If they work as IRT to me it would make sense to keep high levels for prevention.
Interesting, thankyou. I’ve been taking 10,000 IU D3 for about 5 years now…Neuro is aware. Any thoughts on whether it would be better to drop to 5,000?
How about testing your vitamin D level?
If you have not had any events where your blood calcium levels have been high then why bother changing your supplement level. After 5 years it is safe to say your body is happy with that intake. The only known toxic effect of vitamin d overload is deregulation of the level of calcium in the blood. It appears that so long as you are not deficient and not toxic then in between your body does not care. 10,000IU per day is stated as the amount the body makes from the sun under suitable conditions, so it is a natural intake level. But it is likely that anywhere between 5,000 and 10,000Iu will do.
Thanks for sharing this Rachel. Very interesting and have been curious about this for a while. Seems everyone is recommended different amounts. I think I’ll stick with my dose of 3000 IU a day, which seems in the middle of everyones numbers 🙂
Another question I wondered, what really is too high a dose to be taking daily? Is there any harm we can cause to ourselves?
I take 5,000iu a day and am still deficient (15 nmol/L). Can you be vit d resistant?
Certain medical problems, including Crohn’s disease, cystic fibrosis, and celiac disease, can affect your intestine’s ability to absorb vitamin D from the food you eat and possibly vitamin D tablets.
There is now a new robust blood test for testing celiac disease, so less need for an endoscopy.
https://www.celiac.com/articles.html/one-blood-test-can-now-diagnose-celiac-disease-without-biopsy-r5304/
Even before diagnosed with MS, I fell one winter and broke my arm. Discussion with a Doctor I worked with, we narrowed it down to wearing Sunscreen every single day in Vermont where I worked in Hospital most daylight hours. He said Vermont winter sun doesn’t usually warrant sunscreen.
Interesting discussion
My D3 prescription for coeliac / osteoporosis is 800iu per day. Not as much as many suggest but has kept my blood levels between 70 and 100 so I am happy with that. My MS is’not active’ so maybe less depletion effect? I also try to get some exposure to pale Eng sun (only effective Mar to Sept) every day.
I’m tested every couple of years, so damn the expense. Also cheaper than broken bones. (-;
Good morning.i read this article is a good and I am taking also a vitamin D3 50.000 IU every week 💪😄😍thanks and have a good day 🌹
Very interesting. I was advised 4,000iu per day yet have never been tested since diagnosis. What risks do levels of vitamin d that are ‘too high’ carry?
Í was diagnosed with MS in 2006, a few years ago I heard about vitD levels being a potential problem. I was tested and my D levels were good (500 Ng or so, as I recall, surprising as I’ve never spent much time outdoors). I’ve been a vegetarian who dabbled in veganism for 35 years and read Prof George Jelinek’s “Overcoming MS” book which recommends a vegan diet with daily vitD supplements of 6000+IU. I was taking this high dose for a few months when I developed kidney stones which were incredibly painful. The consultant advised me the vitD was the most likely cause. Since then I spend 20 mins daily in the sun and occasionally take 400IU vitD supplement. I’m horrified at the recent resurgence of vitD as a “harmless” supplement.
Modern trials have shown no link between vitamin d intake and kidney stones. The idea was that higher intakes of vitamin d caused higher calcium levels in the urine and that led to kidney stones, except people with low vitamin d levels have higher blood and urine calcium levels due to the action of the parathyroid. So the opposite is true. If you get to toxic levels then it may be true but at that point your blood calcium levels will make you feel very ill. You were just unlucky.
https://academic.oup.com/ajcn/article-abstract/109/6/1578/5475743?redirectedFrom=fulltext
So, no one really knows!
Those look like bets for the World Cup!
Perhaps a better question would have been how high of D3 intakes before hitting toxicity levels?
15 Neuros and yes ,15 responses 🙂 (almost)
Does these people agreed on anything?
Maybe on the next pharma meeting perhaps 🙂
Vitamin d its a complicated subject
Guess i’m gonna complicated further
Multiple studies have suggested that people with low vitamin D levels are at higher risk for cancer, heart disease, worse COVID-19 infections and other diseases. Yet the largest randomized clinical trial to date, with more than 25,000 adults, concluded that taking vitamin D supplements has no effect on health outcomes, including heart disease, cancer or even bone health
“Our study suggests that might be because these studies measured only the precursor form of vitamin D, rather than active hormone,” said Kado, who is also professor at UC San Diego School of Medicine and Herbert Wertheim School of Public Health. “Measures of vitamin D formation and breakdown may be better indicators of underlying health issues, and who might best respond to vitamin D supplementation.”
This is a nice one
“It seems like it doesn’t matter how much vitamin D you get through sunlight or supplementation, nor how much your body can store,” Kado said. “It matters how well your body is able to metabolize that into active vitamin D, and maybe that’s what clinical trials need to measure in order to get a more accurate picture of the vitamin’s role in health
“We often find in medicine that more is not necessarily better,” Thomas added. “So in this case, maybe it’s not how much vitamin D you supplement with, but how you encourage your body to use it.”
https://medicalxpress.com/news/2020-11-reveals-gut-bacteria-vitamin-d.html
There are already trials planned we keep doing the same trials over and over
Yep
https://medicalxpress.com/news/2020-11-reveals-gut-bacteria-vitamin-d.html
Thanks for this post Rachel.
This study report is interesting in light of what you’ve said + some of the replies from readers.
Might this go some way to explain why some people find their levels remain low despite supplementation?
Does it also indicate the testing needs to be refined?
Either way I maybe appreciated being tested at all; instead of which I was told it’s not something offered on the NHS.
Whoops sorry!
Hadn’t realised Luis has already provided the link to the Medical Xpress article
Excellent article. Thank you for the sharing your findings.
I’m interested to know why the differentiation between D3 and D2 in terms of advice.
The article suggests D2 is not suitable. Is that the case?
You all might be interested in a book by Jeff T Bowles on vitD.
A very interesting read.
It is my understanding that Vitamin D3 appears to be better than D2 at improving vitamin D status – based on many studies. Also worth noting: Prof Ruth Ann Marrie said it is best to take your Vit D dose with your largest meal of the day – (which will likely contain the most fat) as it will be absorbed quicker.
Hopefully this helps – I am no expert – just a messenger!
That’s really useful, thank you.
I’m only take Vitamin D2 because of a plant based diet but was getting ready to make a sacrifice. I’m taking 6,000 IU D2 daily which seems to be in the range in this thread and in your article.
There seems to be a large consensus around vitamin K to be taken in combination, so I will be researching that as a direct result of reading this.
Thanks again!
You can buy vegetarian and vegan vitamin d3, try Amazon. Vitamin D3 is what your body makes on the skin using UVB light. Vitamin D2 is made by fungi. As D3 is the one made by the body it is thought to be better. Most apes cannot use vitamin D2 at all.
How interesting… do you mean because VitD3 is animal-based vs Vit D2 is plant based? I’m afraid I know nothing about Vit K. I do know that Vit D is the only supplement that Barts MS neuros recommend to their MS patients. Not sure what other neuros recommend re Vitamins. That’s a question for another time!
Vitamin D3 should be taken with vitamin K, which helps the body process the D3. Also, several readers have asked about D3 toxicity, which is real and generally manifests itself as increased gastro issues. I test D3 levels every three months and adjust my dosage accordingly. Generally take 5,000 units a day but will increase the level to a maximum of 10,000 units a day depending on test results. I noticed my levels improved when I started adding vitamin K. I was D3 deficient at the time my MS was diagnosed and become deficient if I stop the supplements.
With vitamin D3 you should also take vitamin K2 to help with your bones dencity Also help remove plack from your Arterys
That a big difference from one doctor to another. So I am assuming 4,000 IU
would be safe for most MS patients snd non MS patients.
As a Scotsperson it’s always embarrassing to be the person who mentions cost. In general I remember talking to Gavin years ago about normal ranges for vitamin D and evolution and overall I think it’s a good idea to take some.
We need proper studies to prove the value of taking any (although I do take 4000-5000iu when I remember). I remain unconvinced that testing levels is in any way value without proper scientific work done to tell us what values mean in MS
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613455/
Reference for my previous statement about the need to take Vit K with Vit D3. The article is not related to MS; however, discusses the interactions between the two vitamins (i.e. one helps the other). This also supports FI and Luis article reference, indicating it is not how much Vit D3 you get but rather how you process it in your gut. Vit K resides mostly in the gut. 🧐
My vitamin very low rizwana
What is bottom line confused on how much to take d how many pills
Hi, So a couple of years back I was diagnosed wit osteopenia…
I have also severe neuropathy throughout my brain …encephalitis 3 times.
I’m due to have a extra scan every couple of years….this hasn’t happened.
Over the past 18 months I have fallen twice…I didn’t put to much to do with the fall…10 days later I was told that I’d fractured my elbow.
This May I fell again, I have neuropathy so thanks to my carers they could detect the ‘ow that hurts’. I had again fallen but inverted my right leg….
I walked on my foot for a month, the local minor injuries said it was nothing..The next day I got a call from the orthapeadics…saying that I’d fractured my heel bone…
I have had so many hospital admissions this past year…I need 50,000 units per week & no bloods to see what my level is ? Ten tablets are going to cost me over £25.00 & I’m supposed to be medically excempt ? The healthcare isn’t providing those that cannot absorb nutrients, have been shielding since March… You politicians I would love for you to know just as let down by yourselves.
So if we should all be on vitamin D how come it isn’t prescribed (not in my case anyway!)? Should it be GP or neuro?
Neuro asks if I am on them and I just say yes, but the ones at the dosage of 200 iu so need 2 a day cost £8.19 for a pack of 96 so haven’t taken them for about a year and a half (plus it’s easier to lie to telephone consultations innit cos of covid)…………………Superdrug often does 3 for 2 on them, but that still means pulling out £16.38 every six weeks.
Simply Supplements, fifteen pounds for a years supply, 5000iu tablets, free delivery.
On Amazon, you can purchase 365 x 4,000IU tablets or a year’s supply for £11.97. That is 3.3p per day or about £1 per month.
Prof, any view on whether the vit D3 and K2 is preferable? i had read that the K2 helps with absorption
Thanks
When i was first diagnosed with MS almost 12 yrs ago, they had me taking about 50,000 IU of vitamin D daily. It was working pretty well but then i stopped taking it, but im going to start back taking it because i noticed the effects with my teeth and bone weakness.
I am taking 75 nmul/L daily i feel good .
Can you please tell me taking about the safety of taking 200000IU Vit D every month? I am a medical student my HOD of Orthopaedics department says its completely fine to take single high dose and it has benefit of compliance over daily dose and it’s relatively cheaper too.
My 72 year-old mother has been prescribed a monthly megadose of vitamin D. When I told her I had read that was often done with older patients due to adherence issues she was offended and said she would take it up with her GP! I feel it makes no sense really, older patients usually have other medication they are required to take on a daily basis, for example my mother takes thyroxine – so why not just take vitamin D at the same time? She’s also not the type to forget medication and her GP will know this. Her bone density has recently started to decline, so she is keen to follow whatever dosing regimen is the most effective.
Somewhat related, my partner’s family is advocating Vitamin K2 along with Vitamin D3 for Covid (she does not have MS), and so she has already started to take the Vitamin combo. I am happy that she is now taking vitamin d3, I can’t find out much about vit K other than it may inhibit the effects of some anticoagulants which seems counter intuitive in Covid given the propensity for blood clots. I also did a search of the blog archive and really find only vitamin K mentioned by the commenters. What are the known or hypothetical risks to vitamin K?
Thank you for this very informative article.
I find the controversy about vitamin D very interesting, but I think it is a pity that the fronts are often very hardened. Some people swear on it, others think it is completely overblown. So I find this article very refreshing.
The absurdity of such extreme positions is illustrated very nicely in the COVID19 treatment. Remdesivir received emergency approval despite the unclear data situation and has been and is used in many parts of the world for severe courses of disease. Potentially severe side effects were accepted.
Although there are now a number of well-documented studies of vitamin D having a positive effect on COVID19, there is still a constant debate about whether this is a causal link or just a coincidence.
Even though it would be very cheap and extremely low in side effects it’s still not prophylactically recommended to anyone. The risk of serious side effects in the range of 4000 to 5000 IU daily is virtually non-existent, if one can believe the literature of the last 5 decades.
So it’s quite nice to read that this dose is also chosen by many neurologists.
Agree… re dose. What I also found heartening was that so many neuros test on diagnosis. When I was diagnosed eleven years ago with MS, my neuro (since retired) waved away my request to get my Vit D levels tested.
That said, I know I only asked 15 doctors – and none from resource-poor countries… so I wonder if that made a difference.
I work permanent Nightshifts and have done for 6 years. I take 20,000IU a day. It has totally transformed my mental health. Feel like I have a spring in my step again.
Great post, thanks. But why nobody comments on vit D levels in non-white population? Is this related to no evidence of protective vit D effects in Hispanics and blacks (reporter by Langer-Gould et al.)?
It is more related to no one actually having looked. It is not that there is no evidence of a protective effect, just no good evidence. Most of the trials done have been poorly designed no matter the person’s skin colour, partially because they treat it as a drug, rather than a food. They look for a linear dose relationship, rather than a step between deficient and not deficient and then a plateau, which you would expect from a controlled endocrine system, to which you are providing a precursor not an active compound. That said it would be sensible for everyone to try and match their vitamin d levels to those who live at the equator and get good sun exposure. It’s not as though vitamin d is unnatural, your body goes to a lot of trouble to make it and it makes a lot more than the RDA.
Great question… and I am afraid I don’t have the answer. I would have thought that because non-whites seem to have lower Vit D levels – they would have been told to take more supplements. I did email Dr. Langer-Gould with the Vit D questions – and also Dr. Amezcua who has done work on Hispanic MS populations, but both did not respond. I also contacted Dr Dr. Williams – but she was up against time constraints, so couldn’t answer.
I will keep trying though – because I think it is such an important issue – and shapes the future of personalised medicine.
Vitamin D and COVID-19: Is There a Lack of Risk/Reward Understanding Among Health Authorities?
November 2020
DOI: 10.13140/RG.2.2.13972.12164
Espen Gaarder HaugEspen Gaarder HaugDominic de LalouviereDominic de LalouviereLaeeth IsharcLaeeth Isharc
The COVID-19 (SARS-CoV-2 infection) crisis is affecting the whole world; many people have died, even more have gotten very sick, and people in many regions have been directly affected in their daily lives due to lockdowns of society. A series of studies by various medical researchers strongly indicates that vitamin D supplements can offer preventive effects against COVID-19. Looking at the dichotomy of seasonal variations in COVID-19, patterns of infection seen in countries toward the southern and northern hemispheres seems to give additional compelling support to this hypothesis. The seasonal variations in the northern and southern hemispheres in relation to COVID-19 appear to be in line with previous studies in vitamin D serum levels in those populations. These findings, combined with the knowledge that vitamin D supplements in moderate dosages have minimal to no risk, mean that the risk/reward of taking vitamin D is very good. Yet, while health authorities in numerous countries must be well aware of the potential preventive benefits from taking vitamin D, they seem more focused on finding a definitive answer before taking action. This seems to be a grave mistake based on the information at this point in time. Potentially, hundreds of thousands of people could be saved if health authorities would recommend vitamin D to the population, even with the qualification that studies are still underway to ascertain their efficacy. If a stronger stand were taken on the positive use of vitamin D, authorities could also make sure that particular at-risk groups could obtain such supplements, the elderly in nursing homes and assisted living facilities, for example. At this point, the discussion should not be about whether it is helpful to take vitamin D during the COVID-19 pandemic or not, but rather about what dose to take and how to distribute vitamin D effectively among the population. Even if very promising vaccines are now entering production, it will likely take many months before they are available to all vulnerable groups. Further, one does not need to be an “anti-vaxxer” to understand that there can be considerable risk with a new vaccine. We recommend that health authorities act now and recommend vitamin D supplements based on risk/reward analysis.
Interesting paper (small numbers), I wonder why they did not give 25(OH)D3 so they did not have to wait a number of days for it to convert.
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065
In UK GPs donot routinely check Vit D levels at all fot MS pateints.Should they?
Rachel Horne and Prof. Gavin Giovannoni, I am confused.
Why are neurologists not deferring to the deep experts, endocrinologists, on vitamin D? Please see: https://n.neurology.org/content/vitamin-d-supplementation-ms-community-studying-too-high-dose American Academy of Neurology
Four days after this post and article Prof. Giovannoni wrote a blog post about the need to bring back experts: https://multiple-sclerosis-research.org/2020/12/bring-back-the-experts/
The vagaries and variability in medical care are inexcusable, and it is time that we speak up.
#TOGETHERweCanDoBetter #1MisSion1community
The vD experts in the UK state that the RDA is 400U per day for adults and 800U per day for over 70’s. I have been at many vD meeting with deep vD experts and even then there was no consensus on what dose is adequate. The consensus around 4,000U per day is based on safety, and not efficacy or biology.
Here is our vD/NHS Expert advice: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
A study has come out that says that high dosages of vitamin D are very bad for people with MS. In light of this study what do you think is the correct dose of vitamin D supplements. Thank you very much
This is the Study…
https://academic.oup.com/brain/article/142/9/2737/5532100
We’ve been here before, this study is in mice NOT humans where the authors appeared completely unaware that vitamin D is a rodenticide.
This study is simply rubbish (Harsh I know)…..It shows that the vitamin D doesnt do anything good in the mice and therefore it is not fit for purpose.
so let’s stay on your advice on the most appropriate dosage?
Thanks
Massimo
So this is part of the reason why healthcare experts always advise people to get into the sunlight for some time of the day so that they can absorb vitamin D naturally and prevent multiple sclerosis. Guess that I should do that more often, and also required my children too.
At this time of year, if you live in the UK, you can spend all the time you like outside but you won’t synthesise enough Vitamin D.
Yep