Full-text evidence summary

Multiple sclerosisVitamin D levels

  • Increased risk of multiple sclerosis is seen amongst people with Epstein Barr virus infection
  • Vitamin D may inhibit the development of multiple sclerosis
Most autoimmune diseases seem to be caused by an overreaction by the body’s immune system in dealing with a viral or bacterial infection.  The virus most commonly associated with risk of MS is EBV1 2

Many people have EBV, but only a few develop diseases linked to it such as infectious mononucleosis, Hodgkin’s lymphoma, and MS.  These diseases have peak incidence rates in spring3 4, a time when the body’s vitamin D levels are at their lowest. 

Evidently, EBV infection and/or reaction to EBV infection is kept to minimal levels by vitamin D as long as levels are high enough.  A recent study found that MS risk is extremely low among individuals not infected with EBV, but it increases sharply in the same individuals following EBV infection5.  Many other childhood infectious diseases appear to be ruled out6.

Page last edited: 03 May 2011


  1. Ascherio, A. Munger, K. L. 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: Epstein-Barr virus and multiple sclerosis: epidemiological evidence. Clin Exp Immunol. 2010 Apr; 160 (1): 120-4.
  2. Ascherio, A. Munger, K. L. Epstein-barr virus infection and multiple sclerosis: a review. J Neuroimmune Pharmacol. 2010 Sep; 5 (3): 271-7.
  3. Douglas, A. S. Brown, T. Reid, D. Infectious mononucleosis and Hodgkin's disease--a similar seasonality. Leuk Lymphoma. 1996 Oct; 23 (3-4): 323-31.
  4. Jin, Y. de Pedro-Cuesta, J. Soderstrom, M. Stawiarz, L. Link, H. Seasonal patterns in optic neuritis and multiple sclerosis: a meta-analysis. J Neurol Sci. 2000 Dec 1; 181 (1-2): 56-64.
  5. Levin, L. I. Munger, K. L. O'Reilly, E. J. Falk, K. I. Ascherio, A. Primary infection with the Epstein-Barr virus and risk of multiple sclerosis. Ann Neurol. 2010 Jun; 67 (6): 824-30.
  6. Ramagopalan, S. V. Valdar, W. Dyment, D. A. DeLuca, G. C. Yee, I. M. Giovannoni, G. Ebers, G. C. Sadovnick, A. D. Association of infectious mononucleosis with multiple sclerosis. A population-based study. Neuroepidemiology. 2009; 32 (4): 257-62.