Why we should offer routine vitamin D supplements in pregnancy and childhood to prevent multiple sclerosis

Department of Neurology, Institute of Neurological Sciences, 1345 Govan Road, Glasgow G51 4TF, UK.
Medical Hypotheses (Impact Factor: 1.07). 02/2005; 64(3):608-18. DOI: 10.1016/j.mehy.2004.06.022
Source: PubMed


Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that runs a chronic course and disables young people. The disease is more prevalent in the geographic areas that are farthest from the equator. No form of treatment is known to be effective in preventing MS or its disabling complications. A number of epidemiological studies have shown a protective effect of exposure to sunlight during early life and a recent longitudinal study confirmed that vitamin D supplementation reduced life-time prevalence of MS in women. Very little is known regarding the role of vitamin D on the developing brain but experimental data suggest that cerebral white matter is vitamin D responsive and oligodendrocytes in the brain and spinal cord and express vitamin D receptors. It is possible that differentiation and axonal adhesion of oligodendrocytes are influenced by vitamin D level during brain development and a relative lack of vitamin D may increase oligodendroglial apoptosis. The age effect of migration on susceptibility to develop MS could be explained by a role of vitamin D on brain development. In areas of high MS prevalence, dietary supplementation of vitamin D in early life may reduce the incidence of MS. In addition, like folic acid, vitamin D supplementation should also be routinely recommended in pregnancy. Prevention of MS by modifying an important environmental factor (sunlight exposure and vitamin D level) offers a practical and cost-effective way to reduce the burden of the disease in the future generations.

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    • "The risk factors for the onset of MS have not yet been fully defined. Degree of latitude [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16], season of birth [2,3,17–24], vitamin D deficiency [25] [26] [27] and childhood infections [3,23,28–30] are the most studied environmental factors that may be associated with this disease. "
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    ABSTRACT: Risk factors for development of multiple sclerosis (MS) are still a matter of debate. Latitude gradient, vitamin D deficiency and season of birth are among the most investigated environmental factors associated with the disease. Several international studies suggest that birth in spring is a substantial risk factor for MS. We investigated the season of birth as a potential risk for MS in different geographical regions of Brazil. We conducted a cross-sectional retrospective study with 2257 clinically definite MS patients enrolled in 13 Brazilian MS clinics in the south, southeast, and northeast regions of Brazil. Demographic and clinical data relating to date of birth and clinical features of the disease were collected and analysed, and subsequently compared with birth date among the general Brazilian population. The distribution of date of birth of MS patients showed an increase in spring and a decrease in autumn, with no difference being observed in the other seasons. In conclusion, season of birth is a probable risk factor for MS in most parts of Brazil. These findings may be related to the role that vitamin D plays in MS pathogenesis.
    Full-text · Article · Jun 2013 · Journal of the Neurological Sciences
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    • "Interestingly functional MRI (fMRI) studies showed altered patterns of cortical activation and network connectivity in benign MS that may represent a compensatory mechanism through cortical reorganization. The authors explained how these differences may help in understanding benign MS and emphasized the importance of excluding cognitive decline when defining this phenotype, since there was evidence of more gray matter damage shown by magnetization transfer and fMRI in patients with benign MS and cognitive decline [13] "
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    ABSTRACT: For patients with Relapsing Remitting Multiple Scierosis Beta Interfaerons and Glatiramer Acetate were the first to be licensed for treatment. This review deals with one major question: when to initiate therapy? Through exploring the unique characteristics of the disease and treatement we suggest an approach that should be helpful in the process of decision-making.
    Full-text · Article · May 2011
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    • "Results fit well together with another study demonstrating that mean 25(OH)D levels were only 25 nmol/L in cord blood samples of newborns who were born in the winter half-year (from October to March) [22]. Although newborns usually receive vitamin D supplements for preventing rickets, possible adverse effects of deficient vitamin D concentrations during fetal development such as increased susceptibility for type I diabetes and multiple sclerosis have to be considered as well [23] [24] "
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    ABSTRACT: This article gives an overview of the vitamin D status in Germany, provides evidence for an independent association of vitamin D deficiency with various chronic diseases, and discusses preventive measures for improving vitamin D status in Germany. The prevalence of vitamin D insufficiency is 40-45% in the general German population. An additional 15-30% are vitamin D deficient. Vitamin D can prevent falls and osteoporotic fractures in older people. There is also accumulating evidence that vitamin D may prevent excess mortality and may probably prevent some chronic diseases that occur in early life such as type 1 diabetes and multiple sclerosis. Adherence to present sun safety policy (avoidance of the sun between 11 am and 3 pm) and dietary recommendations (5-10 microg daily for adults) would, however, definitively lead to vitamin D deficiency. The estimated cost saving effect of improving vitamin D status in Germany might be up to 37.5 billion euro annually. It should be the goal of nutrition and medical societies to erase vitamin D deficiency in Germany within the next 5-10 years. To achieve this goal, the daily production of at least 25 microg of vitamin D in the skin or an equivalent oral intake should be guaranteed.
    Full-text · Article · Apr 2010 · Molecular Nutrition & Food Research
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