Multiple sclerosis (MS) is an often disabling unpredictable disease of the brain and spinal cord. The body’s own immune system attacks the myelin sheath, the protective sheath that insulates nerve fibers. When the myelin sheath is damaged or destroyed, nerve impulses are interrupted, and thus, communication issues between the body and the brain occur.
Symptoms can vary significantly from one individual to another. Furthermore, symptoms can widely vary within an individual, potentially changing in severity from year to year, or even day to day.
Common MS symptoms include the following:
- Unusual sensations: “Pins and needles” sensation, itching, numbness, burning or deep pain
- Bladder problems: Frequent urination
- Dizziness: Feeling light headed or dizzy
- Trouble walking: Muscle spasms and balance problems
These symptoms, among others, often result in a reduced quality of life (QOL) for MS patients. Currently, there are no treatments available for MS, leaving patients to seek methods to slow the progression of the disease and manage symptoms.
In recent years, studies have discovered that vitamin D supplementation helps manage these symptoms. Furthermore, research has illustrated that low vitamin D status relates to reduced QOL. Due to these findings, researchers recently conducted a study to determine the effects of high dose vitamin D supplementation on QOL among patients with MS.
The study included 94 relapsing-remitting multiple sclerosis patients. The researchers randomly divided the patients into two groups: one group received 50,000 IU of vitamin D3 every five days for three months, and the other group received a placebo every five days for three months. All patients continued their main treatment, interferon-β, in both groups.
The researchers assessed QOL with a self-reported questionnaire called the Multiple Sclerosis QOL-54 (MSQOL-54). The questionnaire involves both generic components associated with quality of life and MS specific issues. The MSQOL-54 produces a physical health score and a mental health score, with a higher score indicating a higher QOL. The researchers used MSQOL-54 before and after treatment to evaluate whether vitamin D and/or the placebo reduced the physical health or mental health scores.
Expanded Disability Status Scale (EDSS) was used to quantify disability among the MS patients, with higher scores denoting more severe disability.
Ideally, a randomized controlled trial consists of an experimental (i.e. vitamin D) group and a control (i.e. placebo) group with virtually the same characteristics, such as sex, age, education, socioeconomic status, BMI, disease characteristics, etc. In this study, the researchers found that all but one characteristic were the same at baseline; the EDSS scores were significantly lower for patients in the vitamin D group compared to the placebo group (p value = 0.033). Therefore, the researchers adjusted the results to compensate for this difference.
The researchers determined the effects of vitamin D supplementation on QOL. Here is what they found:
- At baseline, average vitamin D levels were 28.22 ng/ml and 39.54 ng/ml in the vitamin D group and placebo group, respectively (p value = 0.412).
- The vitamin D group significantly increased their average vitamin D levels to 84.53 ng/ml after three months of vitamin D supplementation (p value = 0.034). Whereas, the placebo group remained with an average vitamin D status of 28.61 ng/ml (p value = 0.765).
- After three months of treatment, the vitamin D group had significantly higher scores than the placebo group in all QOL categories: physical, mental, sexual satisfaction and health change (p < 0.001).
The researchers concluded,
“Mental QOL improved significantly after taking high dose vitamin D for 3 months in vitamin D group relative to placebo. Also, a positive change in health status was reported by patients receiving high dose vitamin D relative to placebo.”
The researchers pointed out that, at baseline, none of the MS patients were considered vitamin D deficient by most standards. However, the benefits received from obtaining relatively high vitamin D levels, far above the standard value for vitamin D sufficiency of 20 ng/ml, reinforces the Vitamin D Council’s recommendation of maintaining a vitamin D status between 40-80 ng/ml. If one were already truly sufficient in vitamin D, why would their health improve by increasing their vitamin D levels?
The study’s participants in the vitamin D group achieved uniquely high vitamin D levels in comparison to most vitamin D trials. Despite these high levels (exceeding even the Vitamin D Council’s recommended range for sufficiency), the researchers stated, “high dose vitamin D was safe in our patients and patients showed good compliance.” Though, it’s important to note that the study only included MS patients; therefore, this conclusion cannot be made for the general population.
The researchers called for more studies with longer follow-up periods to further evaluate the effects of vitamin D supplementation on QOL among MS patients.
Tovey, A. & Cannell, JJ. High dose vitamin D supplementation improves quality of life among patients with MS. The Vitamin D Council Blog & Newsletter, 2016.
Ashtari, F. et al. High dose Vitamin D intake and quality of life in relapsing-remitting multiple sclerosis: a randomized, double-blind, placebo-controlled clinical trial. Neurological Research, 2016.