Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: Consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology

Abstract

Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied, those more likely associated with MS include certain viruses, smoking, and hypovitaminosis D. This review aimed to determine whether there is evidence to recommend the use of vitamin D as monotherapy or as adjunct therapy in patients with MS. We searched PUBMED, EMBASE, COCHRANNE, and LILACS databases for studies published until September 9 th , 2013, using the keywords "multiple sclerosis", "vitamin D", and "clinical trial". There is no scientific evidence up to the production of this consensus for the use of vitamin D as monotherapy for MS in clinical practice.

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

“…Our data support a role for vitamin D supplementation in reducing depression risk for people with MS, with a halving of odds of screening positive for depression for participants taking more than 5000 IU of vitamin D daily, and a dose-response effect. A dose of at least 5000 IU daily has previously been suggested as an optimal dose for people with MS [ 70 ].…”

Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis

“…Preliminary studies of vitamin D3 as an add-on therapy in MS have shown promising results, but none have yet provided significant evidence of a clinically meaningful effect on disease activity. Until the results of ongoing larger randomized controlled trials help elucidate the role of vitamin D supplementation in MS, the panel recommends to check the serum level of 25-OH-vitamin D3 in all patients with MS, and to consider supplementation on a case-by-case basis, in physiologic doses, i.e., sufficient to achieve serum levels between 40 and 100 ng/mL (100-150 nmol/L) 124 . After starting supplementation, serum levels should be re-checked after three months, to further tailor the dose, as MS patients may have a less robust response to supplementation compared to those without comorbidities 123 .…”

Influence of vitamin D on clinical-pathogenetic curriculum of multiple sclerosis

“…У зв'язку з цим останнім часом існує консенсус у відношенні того, що рівень вітаміну D у крові ≤ 30 нг/мл повинен коригуватися у пацієнтів із клінічним ізольованим синдромом та у хворих з МС на будьякій стадії захворювання (grade D recommendation). Водночас на сьогодні немає науково обґрунтованих рекомендацій щодо використання вітаміну D як монотерапію для лікування МС [9].…”