Multiple Sclerosis (MS) is one of the most common neurological diseases, is progressive and affects 2.8 million people worldwide. In addition, MS is the most common disabling neurological (affecting the nerves) disease in young adults (20-40 years old). Shockingly more than 9,000 people live with Multiple Sclerosis in Ireland, and it affects women twice as much as men.
The origin of multiple sclerosis is not clearly understood. Retroviruses, Epstein-Barr Virus (EBV) and Vitamin D are suggested to play a role in the triggering and trajectory of the disease. Data indicates that vitamin D strongly impacts viral infections and positively interferes with EBV infection.
According to research from Harvard University, Epstein-Barr Virus is recognised as the strongest infectious risk factor for the development of multiple sclerosis (MS), along with other genetic, environmental and epigenetic factors. One of these environmental factors is sun exposure and Vitamin D levels.
MS is a debilitating disease of the spinal cord, brain, and central nervous system. Nerves have a protective myelin sheath which aids communication along the nerve fibre. In MS, the immune system attacks and degrades this sheath leading to deterioration and damage. Common symptoms include fatigue, bladder and bowel problems, sexual problems, pain, cognitive and mood changes such as depression, muscular changes and visual changes. While there is no known cure for MS, patients do get periods of remission, and early treatments can slow progression.
Periods of remission have been associated with increased levels of Vitamin D, and higher incidences of MS occur where there is less sunshine. Lower levels of Vitamin D are associated with higher rates of respiratory viruses. Interestingly Vitamin D affects viruses such as herpes simplex, influenza and Epstein Barr. Although there is no definitive cure, MS often develops after an infection with EBV.
Vitamin D has a wide-ranging effect on immunity and is made in three stages:
- UV-B reacts with the cholesterol in your skin (Often vilified, this is one of the reasons we need cholesterol in the body.)
- Vitamin D3 or cholecalciferol 25(OH)D is then produced and ends up in your liver.
- There it is converted through a hydroxylation process into its active form calcidiol, also known as 1,25 hydroxyvitamin D or 1,25(OH)D
Vitamin D is so vital to immune function that it also gets converted in all immune cells and immune organs of the body. These include the thymus, spleen, bone marrow, lymph nodes, tonsils and adenoids. Vitamin D also influences immune cells in the brain, known as microglia cells.
A low Vitamin D status has been associated with several autoimmune diseases, including multiple sclerosis (MS). A Study in 46 patients with PRMS (progressive relapse onset of MS) and 40 controls showed 71.1% deficiency of 25(ОН)D in patients during relapse. (1)
Vitamin D is well known for its regulation of calcium balance and bone health. However, its significance on immune regulation is increasingly apparent. Vitamin D receptors (VDR) are found on immune cells (T cells, B cells, dendritic cells and macrophages).
Association between low serum vitamin D levels and increased risk of developing several immune-related diseases, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19. (2)
In an article published in the Journal of Integrated Neuroscience by Christine Brutting on 30 March 2012, the risk of development and progression of MS is strongly correlated with low vitamin D status.
MS prevalence increases the further away people live from the equator and reaches 100-200 cases per 100 000 people in some northern regions. Vitamin D levels correlate with sun exposure. Observations in patients with MS have determined significantly lower serum levels of 25(OH)D and 1,25(OH)2D in the relapse phase.
Vitamin D is known to be deficient in many parts of the world, especially the northern hemisphere. In Ireland, studies show a higher incidence of MS in the North West of Ireland than in any other part of the country.
Supplementation with Vitamin D is essential to increase blood levels for optimum immune health. At Wild Atlantic Health, we recommend testing your blood levels to know your baseline, how vulnerable you might be, and what you can do to boost your levels with more sunshine and vitamin D supplementation.
In people with the genetic disposition to MS, it is considered that higher intakes of Vitamin D may be required. Higher levels make a positive shift in your immune system as Vitamin D regulates many of our immune genes. Vitamin A is also a cofactor with Vitamin D and is required to enter the cell’s nucleus and access these genes. (3)
Supplements are mostly in the 25 hydroxyvitamin D form, making it freely available to the immune system. This is also the form of Vitamin D in blood that gets measured when you take a test.
If you or a loved one are suffering from MS, please visit the MS Society of Ireland for more information and support https://www.ms-society.ie