Vitamin D & MS: An interview with Dr. Brenda Banwell During last week’s webcast, Living Well with MS: Lifestyle, Diet and Complementary Therapies, we received a number of questions about vitamin D. We sat down with Dr. Brenda Banwell, MD, following the webcast to get answers to some of the most popular questions you submitted. How much vitamin D should a person with MS be taking? The graph below shows the current recommendations, for the general population, according to the Canadian Food Guide. If you are living with MS, I would recommend that you work with your healthcare provider to obtain your vitamin D blood levels (also called a 25-hydroxy vitamin D), which is a measurement of the circulating vitamin D in the body. vitamin D levels should be around 75 nanomals per liter (Canada) or between 40-80 nanograms per milliliter (United States). Many people with MS will require much higher doses than is recommended for the general population in order to bring their blood levels up, particularly in the winter.
Under the care of a physician, it wouldn’t be unusual for a person with MS to take 3,000 to 5,000 IUs per day. But, if you are taking vitamin D in doses beyond what is recommended, you will want to make sure you are being monitored by a doctor, as vitamin D can potentially be toxic. Aim for an intake of international units (IU)/day Infants 0-6 months old Infants 7-12 months old Children 1-3 years old Children 4-8 years old Children and Adults 9-70 years old Adults over 71 years old Pregnant and Breastfeeding Women *This includes vitamin D from both food and supplements Is it better to get Vitamin D through nutrition or sunlight? The most effective way of obtaining vitamin D nutrition is through sunlight acting on the skin – particularly for people with lighter skin. People with darker skin absorb less vitamin D. If we weren’t worried about the negative effects of sunlight, then it would be a very good way (in the sunnier months) of obtaining vitamin D – but of course we have to balance the risks.
We live in a world where there are harmful effects of ultraviolet (UV) radiation and skin cancer is a very real concern. Therefore, sunblock has become a major health initiative, and if you wear sunblock, you also block vitamin D production pretty dramatically. I advocate for the safer route of wearing sunscreen and taking oral supplements in order to obtain vitamin D. Is it possible to get enough vitamin D from sunlight alone? During certain times of the year, the amount of UV radiation from the sun is so low that no vitamin D is even made. One expert, Dr. Vieth, states that if you’re taller than your shadow, there’s not enough UV radiation to synthesize vitamin D through your skin. Typically in temperate climates, this would be from the end of September through the middle of April. So, during the winter months, we don’t make enough vitamin D on our own, and likely need supplements to keep normal blood levels. Can vitamin D help prevent MS in family members of people with MS?
There haven’t been any primary prevention trials using vitamin D, so it would be very difficult to assume that vitamin D alone would be sufficient to prevent MS. However, the data at this point would suggest that there may be a connection between vitamin D levels and MS risk. One study looked at military recruits in the US who were sampled as part of routine blood screening when they entered the military. This study found a fairly strong relationship between levels of vitamin D and MS. Those who had higher levels of vitamin D at the time of the routine screening were much less likely to be diagnosed with MS in the 5 to 10 years following the screening than those with lower levels. What that suggests is that if you have robust vitamin D during childhood and teenage years, it could be one of the factors that reduces your MS risk. Having healthy vitamin D levels and nutrition during childhood and teenage years is important not only for reduction in MS risk. It is important for bone health, and may also help reduce your risk for other autoimmune diseases.
I would suggest anyone living in places where we get little sunlight during half of the year take steps to maintain their vitamin D nutrition. And, for family members who have an increased risk of MS, I think it would be a really wise investment to have your vitamin D levels tested and take vitamin D supplements if your levels are low. Please tune in to the MS Connection blog tomorrow as Dr. Banwell discusses other supplements that are potentially helpful and harmful for people with MS – and throughout the coming week as we chat with Drs. Allen Bowling, Timothy Coetzee and Albert Lo about the roles of diet, exercise and other holistic approaches to living well with MS. Watch the “Living Well with MS” webcast Explore the current research on vitamin D often called the “sunshine vitamin,” is an important nutrient. called calcitriol, behaves like a hormone in the body. The body can produce 10,000 IU or more of vitamin D with as little as 10 to 15 minutes of exposure
plays a crucial role in supporting and maintaining bone health. natural food sources that contain vitamin D. Food manufacturers began fortifying milk and other products with vitamin D decades ago, aiming to wipe out rickets, a childhood bone disease. for this important hormone are found in virtually every type of cell and tissueReceptors work like locks: The lock turns when the right key is inserted, prompting the cell to act in a certain way. people with higher levels of vitamin D may live longer. Studies also suggest that a majority of Americans have insufficient or deficient levels of vitamin D. of vitamin D receptors throughout the body hints at the importance of theResearch shows that vitamin D plays a crucial role in the health of the immune system, brain, heart, and blood vessels, among other organs and now monitor their patient’s vitamin D levels and prescribe supplemental vitamin D when levels are too low. A lack of vitamin D may increase your risk of
developing numerous diseases and conditions. diseases — such as type 1 diabetes, multiple sclerosis, and rheumatoid arthritis —may be linked to a vitamin D deficiency. when the immune system attacks the body’s own tissues. Too little vitamin D has been linked to poor immune system function. deficiency is also linked to a risk for type 2 diabetes, osteoporosis (a condition that results in brittle bones), heart disease, mood disorders, and even certain types of cancer. This is because the active form of vitamin D helps control chronic inflammation. Ongoing inflammation has been linked to diseases such as hardening of the arteries (atherosclerosis), arthritis (painful, inflamed joints), and even cancer. may be taken as a supplement. Two forms are available: vitamin D-3 and vitaminVitamin D-3 is preferable, as it is better absorbed when taken by mouth. government recommended dietary intakes for vitamin D range from 400 IU
to 800 IU depending on your age, but are based on the needs of healthy individuals, not someone who may already be deficient or battling an illness orMany experts argue that higher daily intakes above what’s recommended, even what may be considered megadosing (up to 50,000 IU per week), are required to achieve better health outcomes. following factors can affect your vitamin D levels: dark skin don’t make vitamin D as easily as light-skinned people when exposed dissolves in fat, and is stored in fat cells. Overweight people tend to have more vitamin D stored in fat rather than circulating in the blood. require higher doses of vitamin D-3 to maintain optimal serum levels. toxicity, resulting from taking too much supplemental vitamin D, is relativelyThe amount of supplemental vitamin D needed to cause vitamin D toxicity is more than 10,000 IU per day, taken every day for months. intake levels published by the U.S. government range from 1,000 IU per day for