"Posted Tue Nov 17, 2009 4:01pm AEDT
Updated Tue Nov 17, 2009 4:27pm AEDT
Researchers are advising people with MS to take safe levels of vitamin D supplements.
Researchers are advising people with MS to take safe levels of vitamin D supplements. (ABC News: Giulio Saggin, file photo)
* Audio: New research shows Vitamin D may slow the progress of MS (The World Today)
Australian scientists have found that Vitamin D may slow the progression of multiple sclerosis (MS).
Figures showing that people living in Tasmania are seven times more likely to develop MS than Queenslanders had suggested a link between sunlight exposure and the disease. "
High-dose oral vitamin D3 supplementation in the elderly.
Bacon CJ, Gamble GD, Horne AM, Scott MA, Reid IR.
Osteoporos Int. 2009 Aug;20(8):1407-15. Epub 2008 Dec 20.
PMID: 19101755
Sixty-three elderly participants were randomized to three regimens of vitamin D supplementation: a 500,000-IU loading dose; the loading dose plus 50,000 IU/month; or 50,000 IU/month.
CONCLUSIONS: Large loading doses of vitamin D(3) rapidly and safely normalize 25OHD levels in the frail elderly. Monthly dosing is similarly effective and safe, but takes 3-5 months for plateau 25OHD levels to be reached.
Vitamin D and cancer mini-symposium: the risk of additional vitamin D.
Vieth R.
Ann Epidemiol. 2009 Jul;19(7):441-5. Epub 2009 Apr 11. Review.
PMID: 19364661
Conclusion
The results of well-conducted trials of vitamin D lead to the conclusion that the current U.S. National Academy of Sciences-Institute of Medicine upper limit for vitamin D intake of 2000IU per day 1, 37 is excessively conservative. That intake would raise serum 25(OH)D by an average of about 50 nmol/L (20 ng/mL), well within the safe range of serum 25(OH)D concentrations that extends to 500 nmol/L (200 ng/mL). Intake of 4,000IU per day would raise serum 25(OH)D by an average of about 100 nmol/L (40 ng/mL). Even prolonged physiologic-replacement intake of 10,000IU per day of vitamin D3 would pose no known risk of adverse effects in virtually all adults.
"Dr. Jodie Burton is the acting principal investigator (PI) of the dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis with Dr. O'Connor. She started the trial as his fellow, while doing an additional 2 years of training in MS specifically after she received her neurology certification. She completed her fellowship training in 2007. Now she is staff doing clinical research and continuing with the vitamin D trial. As of August 2009, she will be Assistant Professor in Neurology in the Department of Clinical Neuroscience in Calgary and at the University of Calgary. She will be part of the MS team there with Dr. Luanne Metz and the MS group.
Please scroll down for an abstract of the trial:
A Phase I/II dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis."
Conclusions:
High-dose VD3 (~10 000 IU/day, possibly higher) in MS is safe and tolerable, with evidence of clinical improvement."
Benefits of Vitamin D Supplementation
Joel M. Kauffman, Ph.D.
Journal of American Physicians and Surgeons
Volume 14 Number 2 - Summer 2009
Clinical trials show that vitamin D supplementation at higher
levels than previously recommended is beneficial for many
conditions. It decreases the frequency of falls and fractures, helps
prevent cardiovascular disease, and reduces symptoms of colds or
influenza. Benefits are also seen in diabetes mellitus, multiple
sclerosis, Crohn disease, pain, depression, and possibly autism.
Sunlight does not cause an overdose of vitamin D production,
and toxicity from supplementation is rare. Dose recommendations
are increasing, but appear to be lagging the favorable trial results. A
number of common drugs deplete vitamin D levels, and others may
limit its biosynthesis from sunlight.
People with adequate levels from sun exposure will not benefit
from supplementation. While dietary intake is helpful,
supplementation is better able to raise serum 25-hydroxyvitamin D ,
the major circulating metabolite, to the level now thought adequate,
30-50 ng/mL.
Where there is inadequate daily sun exposure, oral doses of
1,000-2,000 IU/d are now considered routine, with much higher
doses (up to 50,000 IU) for rapid repletion now considered safe.
Clinical Responses to a Mega-dose of Vitamin D3 in Infants and Toddlers With Vitamin D Deficiency Rickets.
Soliman AT, El-Dabbagh M, Adel A, Ali MA, Aziz Bedair EM, Elalaily RK.
J Trop Pediatr. 2009 Jun 8. [Epub ahead of print]
PMID: 19506025
doi:10.1093/tropej/fmp040
Conclusion: An IM injection of a mega dose of cholecalciferol is a safe and effective therapy for treatment of VDD rickets in infants and toddlers with normalization of all the biochemical parameters and healing of radiological manifestations. Measurement of serum 25(OH)D level is highly recommended in all short children with a clear need for a general vitamin D supplementation for all infants and young children in Qatar.
Epidemiology of vitamin D insufficiency and cancer mortality.
Pilz S, Tomaschitz A, Obermayer-Pietsch B, Dobnig H, Pieber TR.
Anticancer Res. 2009 Sep;29(9):3699-704. Review.
PMID: 19667167
In conclusion, we still need further studies to evaluate the association of vitamin D insufficiency and cancer incidence and mortality, but the multiple health benefits of vitamin D and the easy, safe and inexpensive way by which vitamin D can be supplemented should already guide current public health strategies to achieve 25(OH)D levels of at least 75 nmol/l (30 ng/ml) in the general population.
Evidence continues to pile up that the sunshine vitamin protects against much more than bone-softening rickets. Vitamin D, also found in milk and oily fish, is becoming king, from fighting colds to preventing cancer. \n\nInvestigators at the Medical University of South Carolina shut down part of a National Institutes of Health study that left nursing mothers and infants deficient, even though the mothers received the maximum safe amount of vitamin D allowed by the Institute of Medicine.\n\nBut here's the kicker. New research suggests we're not getting nearly enough, and recommended levels may be woefully inadequate.
"April 28, 2009 (Seattle) -- High doses of vitamin D dramatically cut the relapse rate in people with multiple sclerosis, a study shows.
Sixteen percent of 25 people with multiple sclerosis (MS) given an average of 14,000 international units (IU) of vitamin D a day for a year suffered relapses, says Jodie Burton, MD, a neurologist at the University of Toronto. In contrast, close to 40% of 24 MS patients who took an average of 1,000 IU a day -- the amount recommended by many MS specialists -- relapsed, she says.
Also, people taking high-dose vitamin D suffered 41% fewer relapses than the year before the study began, compared with 17% of those taking typical doses.
People taking high doses of vitamin D did not suffer any significant side effects, Burton tells WebMD."
"So why is Dr Vieth so frustrated? You might think he'd have cause for celebration. But for him and other vitamin D researchers around the world, the good news comes with a bitter aftertaste. They believe they can prove vitamin D could help millions live longer and be healthier and yet they have not been able to convince their own governments.
In the US and Canada, official vitamin D policy is set by the Institute of Medicine. And in the opinion of Vieth, the current recommendations - 200 International Units per day for people under 50, 400 for people aged 51-70, and 600 for those 71 and older - are outrageously low. Bruce Hollis, professor of paediatrics at the Medical University of South Carolina, calls 400 IU a day "a joke". That's because the best research suggests that to achieve the higher vitamin D blood levels associated with disease prevention, most adults in the US would need to take 1,000-2,000 IU a day: five to 10 times more than the current official recommendation for adult
In 1999, Reinhold Vieth (pictured right) published a review of vitamin D research in response to the IOM conclusions. In it, he argued that there was no evidence that amounts lower than 20,000 IU a day could be toxic. "Throughout my preparation of this review, I was amazed at the lack of evidence supporting statements about the toxicity of moderate doses of vitamin D," Vieth wrote.
Studies have since shown 10,000 IU a day of vitamin D to be safe. While any substance will become toxic in excess, vitamin D researchers today accept that the current vitamin D recommendations could be more than quadrupled with no fear of toxicity.!
"Powerful new evidence about the ability of vitamin D to stem a wide range of diseases has brought the prospect of a nationwide programme to prescribe it in Scotland as a dietary supplement significantly closer.
Reports at the weekend suggested that experts were increasingly convinced that the so-called sunshine drug - whose significance was first revealed in detail by The Times last year - could make a difference to the country's appalling health record.
New research suggests that high doses of vitamin D could dramatically cut the relapse rate in people with multiple sclerosis. According to scientists in Canada, more than a third of sufferers taking high levels of supplement
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