This article is more than 5 years old. Information may no longer be current.

Vitamin D safe, may benefit people with multiple sclerosis

Daily, high-dosage cholecalciferol, or vitamin D3, supplements of 10,400 IU are safe and tolerable in patients with multiple sclerosis, and have exhibited in vivo pleiotropic immunomodulatory effects, including a reduction in the percentage of inflammatory T cells, according to a study published in Neurology.

“The majority of studies examining the immunologic effects of vitamin D have been conducted either in vitro or in animal models, and human studies have employed differing methods and produced discrepant results,” Elias S. Sotirchos, MD, of the department of neurology at the Johns Hopkins University School of Medicine, Baltimore, and colleagues wrote. “The immunologic effects of high-dose compared to low-dose vitamin D in patients with [multiple sclerosis (MS)] remain unclear.”

To study the safety and immunologic effects of high and low doses of cholecalciferol supplementation in patients with MS, and to confirm that vitamin D3 at 10,000 IU daily is well-tolerated in these patients, the researchers conducted a double-blind, single-center randomized pilot study. Between April 2010 and January 2013, 40 patients aged 18 to 55 years with relapsing-remitting MS were randomly assigned to receive either 10,400 IU or 800 IU cholecalciferol daily for 6 months.

The researchers performed assessments at baseline 3 months and 6 months. Patients were interviewed by telephone monthly between visits to assess compliance, additional vitamin D intake and adverse events.

According to the researchers, there was a higher mean increase of 25-hydroxyvitamin D levels from baseline to final visit in the high-dose group: 34.9 ng/mL compared to 6.9 ng/mL in the low-dose group. In addition, the high-dose group exhibited a reduction in the proportion of interleukin-17+ CD4+ T cells (P = .016), CD161+ CD4+ T cells (P = .03) and effector memory CD4+ T cells (P = .021). There was also an increase in the percentage of central memory CD4+ T cells (P = .018) and native CD4+ T cells (P = .04). The researchers did not observe these effects in the low-dose group. There was no difference between the groups in adverse events. One relapse occurred in each treatment arm.

“We have found that high-dose cholecalciferol supplementation is safe and exerts in vivo pleiotropic immunomodulatory effects in patients with MS,” Sotirchos and colleagues wrote. “Future studies are warranted to further elucidate the molecular mechanisms of these effects and ongoing randomized controlled clinical trials will be instrumental to establish the clinical utility of cholecalciferol as a novel immunomodulatory therapy for MS.” – by Jason Laday

Disclosure: Sotirchos reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.