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    You are here : Home » MS Research News » Vitamin D

    Vitamin D

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    More news can be found in New Pathways Magazine, our bi-monthly publication, and also check daily at MSRC: Latest MS News.

    Elevated levels Of Vitamin D during pregnancy may prevent MS in mothers

    Vitamin DHigh levels of Vitamin D in the blood could prevent multiple sclerosis (MS) in mothers, more so than in babies, according to a new study published in the journal Neurology.

    Study author Jonatan Salzer, MD and neurologist at Umeå University Hospital says: "In our study, pregnant women and women in general had a lower risk for MS with higher levels of the vitamin, as expected. However, a mother's levels of vitamin D during early pregnancy did not have an effect on MS risk for her baby."

    Previous research has told us that low levels of vitamin D decrease risk for developing diabetes. Low vitamin D levels are associated with clinically isolated syndrome, a precursor to MS, as well as the occurrence of a second episode and higher incidence of relapse.

    Separate research also suggests that MS is not as prominent in sunnier countries, a possible explanation linking high vitamin D levels to less risk of developing MS. Vitamin D, made in the skin, regulates the immune system and therefore can be extremely helpful in easily treating MS, a condition where the immune system attacks the covering that protects nerve fibers because it recognizes it as foreign to the body.

    During the study, a team of researchers analysed data of 291,599 blood samples from 164,000 people gathered in the northern part of Sweden since 1975. One hundred and ninety-two of these people developed MS, on average nine years after their blood sample was taken. In total, 37 blood samples were taken during pregnancy from mothers whose kids developed MS in the future.

    The findings showed that women with high levels of vitamin D in their blood had a risk of developing MS 61 percent lower than those who had low levels of vitamin D in their blood.

    In total, only some had high levels of vitamin D. Just seven of 192 people who had MS, approximately four percent, also had high vitamin D levels, in contrast to 30 out of 384 controls, around 8 percent, who did not have the disease.

    No link was seen between the mother's vitamin D level and her offspring developing MS.

    Salzar said: "Since we found no protective effect on the baby for women with higher levels of vitamin D in early pregnancy, our study suggests the protective effect may start in later pregnancy and beyond. Another interesting finding in our study was that the vitamin D levels became gradually lower with time from 1975 and onward. It is possible that this decline in vitamin D status is linked to the increasing numbers of MS cases seen worldwide."

    Sufficient sources of vitamin D include supplements, sun, and certain foods.

    Source: Medical News Today Copywrite MediLexicon International Ltd © 2004-2012 (21/11/12)

    Analysis backs birth-month effect in MS

    QuestionsBirth month had a significant association with multiple sclerosis (MS), suggesting as much as a 12% swing in risk, probably reflecting ultraviolet (UV) light exposure and maternal vitamin D levels, authors of a meta-analysis concluded.

    Data on more than 150,000 patients with MS showed a 5% excess of cases among patients born in April and 5% to 8% reductions in MS risk associated with birth in October or November.

    A more conservative analysis showed even greater excess risk in April and May and greater reductions in risk in October and November, as reported online in the Journal of Neurology, Neurosurgery, and Psychiatry.

    "This study, which uses the largest number of patients to date, confirms and extends the month of birth effect seen in MS," Ruth Dobson, MRCP, of Queen Mary University of London, and co-authors wrote. "Through the demonstration of an interaction between month of birth effect magnitude and latitude, it supports ambient UV radiation, and hence maternal vitamin D levels, as prenatal environmental modulators of MS risk.

    "This finding, which supports concepts hypothesized some years previously, surely adds weight to the argument for early intervention studies to prevent MS through vitamin D supplementation," they added.

    The outcome of the analysis continues a longstanding discussion about the origin of multiple sclerosis, which some specialists in the field believe occurs as a result of interaction between genes and environment. One hypothesis implicates a deficiency in vitamin D, which forms in the skin in response to UV light, which also figures into several gene/environment theories, according to the article's introduction.

    Vitamin D hypotheses have received support from evidence that people born in the spring have an increased risk of MS and those born in the winter have a lower risk, suggesting a prenatal role for vitamin D in MS risk. Specifically, maternal vitamin D levels might affect the immune status of the developing fetus to increase or decrease MS risk.

    Several studies have examined the month-of-birth effect, but investigations have taken place across a range of latitudes, resulting in substantial interstudy variation in UV light exposure. No large-scale study has investigated the potential variation.

    To address limitations of previous studies, the authors performed a systematic review and meta-analysis.

    "By interrogating the available data for both risk of MS and any interaction between population latitude and the effect of month of birth on MS risk, we hope to more accurately describe the magnitude of this phenomenon, in addition to demonstrating the effect of seasonal UV light variation on the month-of-birth effect," the authors wrote.

    Their review included studies published since 2000 that had MS and control groups and that provided data on month or season of birth for both groups.

    The search of databases yielded 10 studies suitable for inclusion and a total of 151,978 MS births. Nine studies reported data by month, and one by season.

    The authors performed four analyses:

    One that included all of the studies
    One that excluded studies suspected of evaluating duplicate populations (population-conservative)
    One that used a geographically conservative approach limited to studies of populations living in latitudes more than 52° from the equator, areas with greater seasonal variation in UV light exposure
    One that excluded all studies from the other two conservative analyses
    Risk was expressed in observed:expected (O:E) ratios.

    The analysis involving all studies showed a statistically significant 5% lower risk of MS among individuals born in October (O:E=0.95, P=0.04) and an 8% lower risk among those born in November (O:E=0.92, P=0.01). In contrast, a 5% excess of MS births occurred in April (O:E=1.05, P=0.05).

    In the population-conservative analysis, only November was associated with a statistically significant O:E ratio (O:E=0.93, P=0.04).

    The geographically conservative analysis showed an excess of MS births in April (O:E=1.08, P=0.001), May (O:E 1.11, P=0.007), and June (O:E=1.06, P=0.05). Significantly fewer MS births occurred in October (O:E=0.94, P=0.006) and November (O:E=0.89, P=0.004).

    When the authors limited their analysis to populations <52°N, the only month with significant variation was June, which had an excess of MS birth (O:E=1.21, P=0.04).

    The overall-conservative analysis showed a significant excess of MS births in April (O:E=1.08, P=0.004) and May (O:E=1.09, P=0.002) and significantly fewer MS births in October (O:E=0.95, P=0.03) and November (O:E=0.90, P=0.03).

    "Through combining existing datasets for month of birth and subsequent MS risk, this study provides the most robust evidence to date that the month-of-birth effect is a genuine one," the authors wrote of their findings.

    "While these data support the month-of-birth effect being a result of UVB (and hence vitamin D) variation, it could result from any factor that varies in a similar seasonal and latitudinal manner," they added. "It must be noted that there is a large body of evidence supporting the importance of vitamin D in MS, and so maternal vitamin D levels would appear to be the most likely explanation for this effect."

    The study was supported by the MS Society of Great Britain and Northern Ireland, Medical Research Council, and the Roan Charitable Trust.

    Dobson had no disclosures. One or more authors disclosed relationships with Bayer-Schering Healthcare, Biogen-Idec, GW Pharma, Merck Serono, Merz, Novartis, Teva, sanofi-aventis, Eisai, Elan, Fiveprime, Genzyme, Genentech, GlaxoSmithKline, Ironwood, Pfizer, Roche, Synthon BV, UCB Pharma, and Vertex Pharmaceuticals.

    Primary source: Journal of Neurology, Neurosurgery, and Psychiatry
    Source reference:
    Dobson R, et al "The month-of-birth effect in multiple sclerosis: Systematic review, meta-analysis, and effect of latitude" J Neurol Neurosurg Psychiatry 2012; DOI: 10.1136/jnnp-2012-303934.

    Source: MedPage Today © 2012 MedPage Today, LLC (16/11/12)

    Vitamin D in pregnancy may prevent multiple sclerosis

    Pregnancy and MSResearchers said Thursday they have found evidence that Vitamin D supplements for pregnant women in the world's colder, darker countries may stave off multiple sclerosis (MS) in their offspring.

    The finding adds to a growing body of work showing a link between low Vitamin D levels and the debilitating disease, which sees the immune system attacking the body's own nerve fibers.

    Data on more than 150,000 MS patients born in places north of 52 degrees, revealed a heightened risk for those born in April -- a month preceded by a long period without sunlight, said a paper in the Journal of Neurology, Neurosurgery and Psychiatry.

    Of the total, 13,300 were born in April compared to 11,600 in November -- a lower-risk month after summer in the northern hemisphere, British researchers wrote.

    "Month of birth has a significant effect on subsequent MS risk," they said.

    "This is likely to be due to ultraviolet light exposure and maternal Vitamin D levels."

    They added, though, it could also be "any factor that varies in a similar seasonal and latitudinal manner."

    The data was taken from individuals born between 1930 and 1980, from studies done in Britain, the United States, Italy, Israel, Finland, Scotland, Sweden, and Canada -- parts of which see little sunlight between the months of October and March.

    About 100,000 people in Britain and about 400,000 in the United States are believed to suffer from MS, a disease that affects vision, movement, balance, sensation, bladder control, and eventually also memory and thinking. There is no cure.

    Study co-author Sreeram Ramagopalan from the Queen Mary University of London told AFP the findings amounted to an added MS risk of five percent for people born in April -- about five extra births per million.

    "Pregnant mothers need to ensure they are Vitamin D replete at all times," Ramagopalan said in an email exchange.

    "Because Vitamin D deficiency is a massive problem at the moment due to living at high latitudes and lifestyle changes (wearing sunscreen etc), mothers may need to take several thousand international units of Vitamin D3 to become Vitamin D replete."

    Humans need Vitamin D, which our bodies produce from exposure to sunlight or extract from food, for healthy bones

    Suspected links between a lack of vitamin D and an increased risk of death, including from heart disease and certain types of cancer, have been the subject of medical research for several years.

    Researchers have also focused on its possible role in MS.

    "It is thought that maternal Vitamin D levels during pregnancy affect the immune status of the developing fetus, and hence modulates subsequent MS risk," wrote the authors.

    North of 52 degrees latitude lies the northern parts of England, the Scandinavian countries, and most of Russia and Canada.

    No studies from the southern hemisphere were included in the analysis.

    Source: Interaksyon (15/11/12)

    MS trial to explore vitamin D links

    Vitamin DA world-first clinical trial beginning in Hobart today will assess if vitamin D can stall or prevent the development of multiple sclerosis (MS).

    The cause of the condition is not known, but research shows those living further from the equator are at higher risk.

    People who live in Tasmania are 10 times more likely to develop the condition than their counterparts in the Northern Territory.

    It has long been suspected that vitamin D, or a lack of it, has a large part to play in the development of MS.

    Menzies Research Institute professor Bruce Taylor says a placebo-controlled trial to begin at Royal Hobart Hospital today will hopefully give scientific proof to that hypothesis.

    "We know that MS is not evenly distributed around the world," he said.

    "The further you get away from the equator in a genetically susceptible population, the greater your risk of getting MS.

    "That means about 90 per cent of your risk of getting MS can be due to your environment.

    "Our science all points to this, that vitamin D, derived from solar radiation, may be one of the clues," Professor Taylor said.

    MS is an inflammatory disease that affects the brain and spinal chord, but those with MS can have varying symptoms.

    'Major step forward'
    Professor Taylor says MS is one of the most difficult diseases to study.

    "And that's why it's unfortunately been very badly studied in the past, because it has a huge what we call interpersonal and intrapersonal variation," he said.

    "So one can have very bad MS for a period of time and then they can just stop having attacks.

    "We spent a lot of time designing the study, which means that if there is a significant effect of MS, we will be able to pick this is up in this study.

    "And this is unique - no-one else in the world is doing this.

    "This is an Australian and New Zealand first and this is really a major scientific step forward for MS," Professor Taylor said.

    MS Research Australia chief executive Jeremy Wright says the study will provide new hope to those battling MS.

    "We know a lot about the circumstantial evidence that links vitamin D deficiency and MS and we want to take that fact and act on it and see if vitamin D at the earliest stage of MS can really affect the progress of the disease, slow it or stop it," he said.

    Sharlene Brown, 40, is one Tasmanian who hopes that this study will make sense of how she developed the disease.

    She has looked at her lifestyle to see if it may have contributed to MS.

    "I'm a bit of a bookworm, I must say I spend a lot of time inside," she said.

    "I often wonder whether if I'd spent more time out in the playground instead of the library, whether that would have made a difference."

    But despite being in remission from MS for more than nine years, her future health remains uncertain.

    She hopes the results of this study will prevent a similar outcome for people yet to develop the condition.

    "If you can help prevent future generations suffering from this type of illness and it can be done as simply as monitoring your vitamin D levels, then that's really exciting I think for people who have it or for those people who think they might actually be in the early stages of it," she said.

    "I think that's the exciting part of the study.

    "It could be something so simple."

    Source: ABC News © 2012 ABC (17/10/12)

    Low vitamin D levels linked to more severe multiple sclerosis symptoms

    Vitamin D and MSLow blood levels of vitamin D are associated with an increased number of brain lesions and signs of a more active disease state in people with multiple sclerosis (MS), a new study finds, suggesting a potential link between intake of the vitamin and the risk of longer-term disability from the autoimmune disorder.

    But researchers, led by Ellen M. Mowry, M.D., M.C.R., an assistant professor of neurology at the Johns Hopkins University School of Medicine and principal investigator of a multicenter clinical trial of vitamin D supplementation in MS patients, caution that more research is needed to determine if large doses of vitamin D help without harming MS patients.

    Mowry's study, conducted mostly when she worked at the University of California, San Francisco, shows a strong correlation between vitamin D levels in the body (measured through blood samples) and the characteristic brain lesions of MS as measured with MRI images. Results were described in the August issue of Annals of Neurology.

    "Even though lower levels of vitamin D are associated with more inflammation and lesions in the brain, there is no evidence that taking vitamin D supplements will prevent those symptoms," she says "If we are able to prove that through our currently-enrolling trial, it will change the way people with multiple sclerosis are treated."

    In people with MS, the body's immune system attacks the coating of nerve fibers in the brain and spinal cord. The coating, made of a fatty protein called myelin, insulates the nerves and helps them send electrical signals that control movement, speech and other functions. When myelin is attacked, inflammation interferes with message transmission, activity that shows up on an MRI as lesions, which look like white spots.

    In the most common form of MS, called relapsing-remitting MS, patients may at times have no symptoms, but at other times may suffer from "attacks" (or "relapses") of symptoms such as blurred vision, numbness and weakness. There is currently no cure for the disease but there are medications to help reduce the number of attacks and to help reduce symptoms left over if a person hasn't fully recovered from an attack.

    For the study, Mowry and her colleagues used data from a five-year study of 469 people with MS. Each year, beginning in 2004, researchers drew blood from, and performed MRIs on, the brains of study participants, looking for both new lesions and active spots of disease, which lit up when a contrast dye was used. The investigators found that each 10-nanograms-per-milliliter increase in vitamin D levels was associated with a 15 percent lower risk of new lesions and a 32 percent lower risk of spots of active disease, which require treatment with medication to reduce likelihood of permanent nerve damage. Higher vitamin D levels were also associated with lower subsequent disability.

    The impact of vitamin D levels remained even after other factors that can affect disease progress were accounted for, including smoking status, current MS treatment, age and gender. At least early in MS, the more new lesions and active spots of disease, the more likely a patient is to develop longer-term disability, Mowry says. Some people with relapsing-remitting MS progress to a more serious form due to damage of the underlying nerve cells.

    From one year to the next, Mowry says, she and her colleagues were able to predict the appearance of new lesions and active disease spots based on vitamin D levels from the year before.

    Active and new lesions indicate that a patient's MS is not under optimal control. Previous studies have indicated that lower vitamin D levels are associated with increased relapse risk in certain MS patients. Those studies relied on patients to report their attacks, which is sometimes a less reliable assessment than MRI. Some patients already take extra vitamin D because of publicity about earlier studies. However, Mowry says that there is no research proving vitamin D alleviates symptoms or suggesting what dose is best or safest. And nothing is known about whether vitamin D can prevent the autoimmune disorder, she says. "People think vitamin D is available over the counter so it must be safe," Mowry says. "But vitamin D is a hormone, and any medication really does need to be thoroughly tested before we definitely recommend it. That's the main reason why we are now performing a randomized trial of vitamin D supplementation. People with MS should talk with their doctors about the pros and cons of taking vitamin D before starting the supplement."

    Source: Medical Xpress © Medical Xpress 2011-2012 (02/10/12)

    Vitamin D status predicts new brain MRI activity in MS.

    Vitamin DAbstract

    OBJECTIVE:
    We sought to determine whether vitamin D status is associated with developing new T2 lesions or contrast-enhancing lesions on brain magnetic resonance imaging (MRI) in relapsing multiple sclerosis (MS).

    METHODS:
    EPIC is a 5-year longitudinal MS cohort study at the University of California at San Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually. From the overall cohort, we evaluated patients with clinically isolated syndrome or relapsing-remitting MS at baseline. In univariate and multivariate (adjusted for age, sex, ethnicity, smoking, and MS treatments) repeated measures analyses, annual 25-hydroxyvitamin D levels were evaluated for their association with subsequent new T2-weighted and gadolinium-enhancing T1-weighted lesions on brain MRI, clinical relapses, and disability (Expanded Disability Status Scale [EDSS]).

    RESULTS:
    A total of 2,362 3T brain MRI scans were acquired from 469 subjects. In multivariate analyses, each 10ng/ml higher 25-hydroxyvitamin D level was associated with a 15% lower risk of a new T2 lesion (incidence rate ratio [IRR], 0.85; 95% confidence interval [CI], 0.76-0.95; p = 0.004) and a 32% lower risk of a gadolinium-enhancing lesion (IRR, 0.68; 95% CI, 0.53-0.87; p = 0.002). Each 10ng/ml higher vitamin D level was associated with lower subsequent disability (-0.047; 95% CI, -0.091 to -0.003; p = 0.037). Higher vitamin D levels were associated with lower, but not statistically significant, relapse risk. Except for the EDSS model, all associations were stronger when the within-person change in vitamin D level was the predictor.

    INTERPRETATION:
    Vitamin D levels are inversely associated with MS activity on brain MRI. These results provide further support for a randomized trial of vitamin D supplementation. ANN NEUROL 2012;72:234-240.

    Mowry EM, Waubant E, McCulloch CE, Okuda DT, Evangelista AA, Lincoln RR, Gourraud PA, Brenneman D, Owen MC, Qualley P, Bucci M, Hauser SL, Pelletier D.

    Multiple Sclerosis Center, Department of Neurology, University of California at San Francisco, San Francisco, CA.

    Source: Ann Neurol. 2012 Aug;72(2):234-40. doi: 10.1002/ana.23591. Copyright © 2012 American Neurological Association. & Pubmed PMID: 22926855 (30/08/12)

    Low vitamin D & EBV immune activity may be key to MS breakthrough within 2–3 years

    Epstein-Barr VirusAbstract:
    Objective: Vitamin D deficiency and Epstein-Barr virus (EBV) infection may be associated with the development of multiple sclerosis (MS).

    We investigated serum 25-hydroxyvitamin D (25-OH-D) levels and anti-EBV immunoreactivity in 25 individuals before the first clinical manifestation of MS.

    Patients and methods:

    • 56 serum samples of 25 individuals who had donated blood prior to the first clinical MS manifestation (clinically isolated syndrome (CIS))

    • Four male subjects, 21 female subjects,

    • Mean age 31.5 years at time of pre-CIS blood sampling;

    • Mean age at disease onset 33.4 years…

    ….were available, covering an interval of 7.3 years-2 months (mean 31.5 months) before CIS.

    In 18 of 25 patients serum samples were also obtained after established diagnosis of MS.

    Longitudinal age- and gender-matched healthy blood donors (four male subjects, 21 female subjects, 39 samples, mean age 32.5 years) served as controls.

    Serum 25-OH-D was measured by isotope dilution-liquid chromatography-tandem mass spectrometry. 25-OH-D levels were deconvoluted using published seasonal coefficients from a German population.

    Immunoglobulin G (IgG) against Epstein-Barr virus nuclear antigen-1 (EBNA1) were assessed using commercially available ELISA.

    Results:

    • Low 25-OH-D levels were observed during the 24-month pre-CIS interval (47.8 (32.5-77.2) nmol/l, median (IQR); healthy controls: 81.6 (57.7-98.5), p=0.004,

    • However, still higher than after established diagnosis (24.5 (13.7-47.7), p<0 .0001) compared with controls).

    • IgG against EBNA1 during the 36-month pre-CIS interval was increased (185.9 (91.2–460.0) IU/ml, median (IQR); healthy controls 63.7 (29.5–121.6), p=0.002).

    Conclusions: Low vitamin D and remote EBV infection may be associated with clinical MS breakthrough within 2–3 years.

    By Brenard F Decard, Andrew Chan, et al

    Source: Journal of Neurology, Neurosurgery and Psychiatry, Aug 11, 2012. PMID:22888143

    Source: ProHealth Copyright © 2012 ProHealth, Inc (20/08/12)

    European food safety authority ups vitamin D upper limit

    Vitamin DThe European Panel on Dietetic Products, Nutrition and Allergies has recently increased their tolerable upper limit for vitamin D. Following a request from the European Commission, the panel took a look at research to date to re-evaluate if a change in the upper limit was necessary.

    In result, the panel raised the upper limit to 4,000 IU of vitamin D/day for adults and teenagers older than eleven, despite finding no evidence of hypercalcemia or hypercalcuria in supplementation up to 11,000 IU/day. The panel cited that they did not want to raise the upper limit higher for the time being in order to take “into account uncertainties associated with these studies.”

    Children between 1-10 years old, the panel proposed an vitamin D upper limit of 2000 IU/day. For infants under one year old, the upper limit was set at 1,000 IU/day.

    Their scientific opinion can be found in full in the European Food Safety Journal.

    Source: Vitamin D Council © Vitamin D Council 2012 (15/08/12)

    Vitamin D links to MS supported by study

    Vitamin DScientists have moved a step closer to understanding how to better treat multiple sclerosis (MS) after more evidence emerged of a crucial link to vitamin D.

    In the latest study, University of Tasmania researchers discovered that MS sufferers treated with interferon-beta, a common MS drug, had higher vitamin D levels than those not on the treatment.

    Interferon-beta caused patients to become far more efficient at making vitamin D in their skin, senior researcher Professor Bruce Taylor said.

    MS sufferers taking the drug had nearly three times as much vitamin D from the same amounts of sun exposure than those who didn't take interferon-beta, he said.

    The results also shed light on how the therapy works, which has previously been unclear although it was thought to effect the immune system.

    Interferon-beta only reduced the risk of having an MS attack if patients had sufficient levels of vitamin D in their system, Prof Taylor said.

    MS sufferers in Tasmania and other areas of low latitude, where it was impossible to absorb enough vitamin D from sunlight in winter, may need to consider vitamin D supplementation, he said.

    The study analysed around 200 people living with MS in southern Tasmanian between 2002 and 2005.

    The research was instigated by the high rates of MS in the state, Prof Taylor said. The condition is more common in populations living further from the equator.

    Tasmanians are seven times more likely to have MS than people in Northern Queensland and the Northern Territory and rates are three times higher than in NSW, Prof Taylor said.

    He said the findings would need to be tested further in clinical trials.

    However, the discovery will also be examined in an upcoming Australian study investigating the effect of taking vitamin D supplements on people with early MS symptoms.

    That research will be carried out between 2012 and 2016 by MS Research Australia and the Florey Neuroscience Institutes in Melbourne.

    "Hopefully, there will be a major public health initiative in the future about how to treat or prevent MS," Prof Taylor told AAP.

    The study was published in the journal Neurology.

    Source: 9 News © 1997-2012 ninemsn Pty Ltd (27/07/12)

    Scientists claim artificial sunshine may be key to treating MS

    Sunlight Aberdeen scientists have found that artificial sunlight can have a “striking effect” in helping treat sufferers of diseases such as multiple sclerosis.

    Researchers from Aberdeen University studied patients in the north of Scotland – which has the highest rate of MS in the UK - who were being treated during winter with artificial UV (ultraviolet)-B light therapy for skin diseases caused by their immune systems acting inappropriately.

    The research - published in the Journal of Allergy and Clinical Immunology – shows how UV-B light boosts vitamin D, as well as cells in our body that are responsible for regulating or balancing the immune system. Vitamin D is made in our bodies by UV-B light from the sun.

    Some studies have suggested a link between vitamin D deficiency and autoimmune diseases such as MS. This possible link might also explain the increasing prevalence of autoimmune disease among those living far from the equator, where there are lower levels of winter sun.

    Autoimmune diseases - like MS and type 1 diabetes - are diseases where the immune system mistakenly attacks the body’s own tissues or harmless substances that enter the body.

    Dr Anthony Ormerod, clinical reader in dermatology at the university, said: “Our study shows that UV-B light, which mimics sunshine, can have a striking effect on the immune system of patients.

    “We found that UV-B light boosted the production of vitamin D, and of regulatory T cells, which play an important role keeping our immune systems in check.

    “Our findings have important implications for future interventions including the recommendations for healthy lifestyle and a possible role for phototherapy and/or vitamin D supplementation in the prevention or treatment of autoimmune and inflammatory diseases.

    “While too much exposure to sunlight is harmful and increases skin cancer risk, these results suggest that subjects in our study would have some benefits from small amounts equivalent to summer exposure in the winter but more work needs to determine the role of sunlight and the role of supplementing the diet with vitamin D.”

    Dr Helen Macdonald, senior lecturer in nutrition and translational musculoskeletal research at the university and chair of the National Osteoporosis Society Nutrition and Lifestyle forum, said: “There are risks associated with high levels of both therapies, so it is important that we get the balance right.

    “We would also want to stress that we are not advocating sun bed use since this is not the same type of radiation produced by sun beds which already have well-documented health risks.

    “The average dose of UV light that the volunteers received was the equivalent to sunlight exposure in Aberdeen over spring and summer and further work is required to determine if lower doses are effective.”

    Professor Mark Vickers, chair in applied medicine at the university, added: “Ours is the first study to demonstrate in patients a cause and effect between UV light, vitamin D and systemic immune function in people.”

    Source: STV News Copyright © 2007–2012 STV. (18/07/12)

    Link between Multiple Sclerosis, vitamin D to be trialled

    Vitamin D A world-first clinical trial to determine the role vitamin D plays in preventing multiple sclerosis (MS) is about to get underway in Perth.

    The four-year trial is being spearheaded by prominent local neurologist and 2012 Western Australian of the Year in the field of business and professions, Bill Carroll, from Sir Charles Gairdner Hospital.

    The Multiple Sclerosis Society of Western Australia (MSWA), which is contributing almost $1.1 million to the $2.5 million trial, said 290 patients from Australia and New Zealand who had experienced their first episode of MS symptoms would be recruited for the study.

    Professor Carroll said about 80 per cent of people who experienced a first attack of MS-like symptoms would go on to experience a second episode or show further disease activity.

    "In this prevention trial we'll be giving patients three different levels of vitamin D while others will be given a placebo," Prof Carroll said.

    "We want to investigate whether there is a correlation between a patient's vitamin D blood levels and the prevention of further disease activity, which we can monitor using MRI (magnetic resonance imaging) scans."

    He said the link between vitamin D and the inflammatory disease appeared strong, with a 2008 study confirming a significantly higher incidence of MS in places further away from the equator, where there was less sunlight.

    "Variations in genes involved in vitamin D metabolism have also been implicated in susceptibility to MS, and vitamin D deficiency has also been shown to be associated with a higher rate of relapses in people with established MS," Prof Carroll said.

    MSWA chief executive Marcus Stafford said there were currently no evidence-based interventions to prevent the development of MS.

    "That's why this study is so important," he said.

    Source: 9 News © 1997-2012 ninemsn Pty Ltd (05/07/12)

    Multiple Sclerosis risk lower when vitamin D levels are higher

    Vitamin D Vitamin D, the "sunshine vitamin", is vital for health and can be obtained from food, sunlight or supplements. In addition, individuals with high vitamin D levels are less likely to develop multiple sclerosis (MS).

    Now, Iranian researchers have found that vitamin D supplements at levels above the physiologically recommended dose are safe for MS patients.

    Results from the study were presented at the 22nd Meeting of the European Neurological Society (ENS) in Prague.

    A neurological condition called clinically isolated syndrome (CIS) is a common precursor to MS and presents itself as an episode of a vision disorder or affective sensation disorder traceable to damage in certain parts of the central nervous system.

    Doctor Vittorio Martinelli, a neurologist from San Raffaele Hospital in Milan, Italy, and his team examined the medical histories of 107 patients who had been diagnosed with CIS. The team conducted magnetic resonance images (MRIs) of the study participants, examined cerebrospinal fluid test values, the reactions to sensory stimuli in the EEG (known as multimodal Evoked Potentials), as well as the serum concentration of vitamin D3 (known as calcidiol, or 25-hydroxyvitamin D, after its conversion in the liver).

    The researchers found that 21% of study participants developed MS within 1 year, 36% developed the disease within two years, and 44% withing five years. Low vitamin D levels increase the risk of developing MS, say the researchers.

    Dr Martinelli explained: "Vitamin D is even suitable for predicting MS risk in patients with clinically isolated syndrome as long as they have only a few lesions and their cerebrospinal fluid is still free of inflammation."

    According to the researchers, low vitamin D levels are linked to a shorter interval between CIS and the occurrence of a second episode. In addition, it is also associated with a higher annual rate of relapse. The researchers explained:

    "If inflammation occurs in the cerebrospinal fluid (oligoclonal bands), the most important predictive factors for short-term development of MS are the clinical course, multimodal Evoked Potential results and visible lesions in the MRI."

    More studies are demonstrating that vitamin D deficiency is a possible risk factor for MS. Furthermore, studies are also showing that vitamin D3 supplementation is beneficial for MS patients or for patients with other auto-immune diseases.

    Another study presented at the ENS Meeting examined what risk a pharmaceutical dose of vitamin D3 poses to individuals with MS. The study was conducted by Dr Seyed Massood Nabavi from Shahed University in Teheran, Iran.

    The researchers enrolled 44 patients who had been diagnosed with MS no longer than one year before to participate in the study. The patients, who showed slight functional disorders at the start of the action but no disabilities, were given a vitamin D3 dose of 50,000 IUs (international units; 1 IU=0.025 µg) per week - 4 times the daily maximum dose of 2000 IUs the European Commission recommends.

    In this group the researchers found that the concentration of calcidiol in the blood increased from 7.3 ±15 ng/dl, (severe vitamin D deficiency), to the favourable level of 45.6 ± 34.9ng/dl in the sixth month. The team also found no clinical signs of vitamin D poisoning among study participants. In addition, all patients stayed in the normal range of reference values for calcium in the blood, for creatinine, and for 24 hour urinary calcium excretions. None of the participants showed any sign of toxicity.

    The researchers said:

    "The data supported the tolerability of a pharmaceutical dose of vitamin D3, at least 50,000 international units a week. In other words, vitamin D intake is safe for MS patients at levels above the physiologically recommended dose."

    Source: Medical News Today © MediLexicon International Ltd 2004-2012 (13/06/12)

    Autonomic dysfunction: A unifying MS theory, linking CCSVI, vitamin D3, and Epstein-Barr virus

    MS MRIAbstract
    Multiple sclerosis (MS) is a disease with multiple etiologies. The most recent theory of the vascular etiology of MS, Chronic Cerebrospinal Venous Insufficiency (CCSVI), suggests that cerebral venous obstruction could lead to cerebral venous reflux, promoting local inflammatory processes.

    This review article offers strong evidence that the route of the observed narrowing of cerebral veins arises from autonomic nervous system dysfunction, particularly cardiovascular autonomic dysfunction.

    The dysfunction of this system has two major effects: 1) the reduction of mean arterial blood pressure, which has the potential to reduce the cerebral perfusion pressure and the transmural pressure, and 2) the failure of cerebral autoregulation to maintain constant cerebral blood flow in the face of fluctuations in cerebral perfusion pressure. Alterations in cerebral autoregulation could in turn raise the critical closure pressure, indicated to be the cerebral perfusion pressure at which the transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel. These two effects of autonomic nervous system dysfunction (reduction in arterial blood pressure and alterations in cerebral autoregulation), when combined with inflammation-induced high levels of nitric oxide in the brain, will lower transmural pressure sufficiently to the point where the threshold for critical closure pressure is reached, leading to venous closure.

    In addition, cerebral vessels fail to overcome the closure as a result of low central venous pressure, which is also regulated by autonomic nervous system function. Furthermore, through their neuroregulatory effects, infectious agents such as the Epstein-Barr virus and vitamin D3 are able to alter the functions of the autonomic nervous system, influencing the rate of CCSVI occurrence.

    The absence of CCSVI specificity for MS, observed in recent clinical studies, may stem from a high prevalence of autonomic nervous system dysfunction in control groups which were recruited to these studies. Future studies should investigate CCSVI in relation to cardiovascular autonomic function.

    Abbreviations
    ANS, autonomic nervous system; BBB, blood brain barrier; BP, blood pressure; CCSVI, chronic cerebrospinal venous insufficiency; CIS, clinically isolated syndrome; CP, chronic progressive; CrCP, critical closure pressure; EBV, Epstein-Barr virus; EDSS, expanded disability status scale; HR, heart rate; IJV, internal jugular vein; MBP, myelin basic protein; PTA, percutaneous transluminal angioplasty; RR, relapsing remitting; SLE, systemic lupus erythematosus; Vit D, 1,25-dihydroxyvitamin D

    Zohara Sternberg, Department of Neurology, Baird MS center, Jacobs Neurological Institute, 100 High St. Buffalo, NY 14203, USA

    Full Article

    Source: Autoimmunity Reviews Copyright © 2012 Published by Elsevier B.V. (08/05/12)

    A culprit to consider in Multiple Sclerosis?

    Vitamin DStudy Summary

    Vitamin D is a sterol hormone implicated in several immunologic pathways, and therefore it may help to prevent isolated immune-mediated central nervous system attacks from developing into recurrent disease. Low levels of 25-hydroxyvitamin D have been linked to greater risk for multiple sclerosis (MS) and higher relapse rates in patients with MS. The goal of this retrospective analysis was to evaluate the association between low serum levels of vitamin D and recurrent spinal cord disease.

    Investigators at Johns Hopkins Transverse Myelitis Center in Baltimore, Maryland, measured 25-hydroxyvitamin D levels in 77 patients who had monophasic and recurrent inflammatory diseases of the spinal cord. After adjustment for season, age, sex, and race, patients who developed recurrent spinal cord disease had significantly lower vitamin D levels.

    Viewpoint

    Study limitations include retrospective design, small sample size, and failure to account for some covariates of vitamin D. In addition, vitamin D levels were not obtained at the same time in the disease state for each patient. Nonetheless, the findings suggest a possible association between lower total 25-hydroxyvitamin D levels in patients with recurrent inflammatory spinal cord disease compared with patients who have monophasic disease. The findings from this study justify conducting a prospective trial to measure 25-hydroxyvitamin D levels in these patient populations and determine the effect of vitamin D supplementation on the frequency of relapses in patients with recurrent inflammatory spinal cord disease.

    Low serum vitamin d levels and recurrent inflammatory spinal cord disease.
    Arch Neurol. 2012; 69(3):352-6 (ISSN: 1538-3687)

    Mealy MA; Newsome S; Greenberg BM; Wingerchuk D; Calabresi P; Levy M
    Department of Neurology, Johns Hopkins University, 600 N Wolfe St, Pathology 509, Baltimore, MD 21287.

    BACKGROUND: Low 25-hydroxyvitamin D levels have been associated with a higher risk of developing multiple sclerosis and increased relapse rates in patients with multiple sclerosis. As a sterol hormone involved in multiple immunologic pathways, vitamin D may play a role in preventing monophasic immune-mediated central nervous system attacks from developing into recurrent disease.

    OBJECTIVE: To investigate the association between low serum vitamin D levels and recurrent spinal cord disease. Design, Setting, and Patients We performed a retrospective analysis at Johns Hopkins Transverse Myelitis Center, Baltimore, Maryland, evaluating 25-hydroxyvitamin D levels in 77 patients with monophasic and recurrent inflammatory diseases of the spinal cord. Main Outcome Measure Levels of 25-hydroxyvitamin D.

    RESULTS: Vitamin D levels are significantly lower in patients who developed recurrent spinal cord disease, adjusting for season, age, sex, and race.

    CONCLUSIONS: This study provides a basis for a prospective trial of measuring 25-hydroxyvitamin D levels in these patient populations and assessing the influence of vitamin D supplementation on the frequency of relapses in those with recurrent inflammatory spinal cord disease.

    Source: Medscape News Copyright © 1994-2012 by WebMD LLC (17/04/12)

    Effect of vitamin D3 supplementation on relapses, disease progression and measures of function in persons with MS

    Vitamin DExploratory outcomes from a double-blind randomised controlled trial.

    Summary: The authors report data from a 96-week randomised controlled treatment trial of vitamin D(3) supplementation on annualised relapse rate (ARR), EDSS, multiple sclerosis functional composite (MSFC) components, grip strength, and fatigue.

    In patients with multiple sclerosis supplemented with 20,000 IU vitamin D(3) weekly there was no significant difference in ARR, EDSS, MSFC components, grip strength, or fatigue. Although the study was not powered to address clinical outcomes, none of the results were suggestive of a clinically meaningful effect of vitamin D(3) in this unselected population of fully ambulatory persons with multiple sclerosis.

    Abstract
    Background: High vitamin D levels may reduce the risk of relapses and disease progression in multiple sclerosis.

    Methods: This 96-week randomised controlled trial was designed to assess the effect of vitamin D(3) supplementation on bone mineral density in persons with multiple sclerosis.

    Supplementation with 20,000 IU vitamin D(3) weekly raised median serum 25-hydroxy vitamin D (25[OH]D) to 121 nmol/L. The modified intention to treat analysis included 35 persons in the vitamin D(3) group and 33 in the placebo group.

    Participants were age 21 to 50 years and fully ambulatory (median Expanded Disability Status Scale (EDSS) 2.5). We studied the effect of supplementing vitamin D(3) on the exploratory outcomes annualised relapse rate (ARR), EDSS, multiple sclerosis functional composite (MSFC) components, grip strength, and fatigue.

    Results: After 96 weeks, there was no significant difference between groups in ARR (absolute difference 0.10, 95% CI -0.07 to 0.27; p = 0.25), EDSS (absolute difference -0.01, 95% CI -0.35 to 0.35; p = 0.97), MSFC components, grip strength, or fatigue.

    Conclusion: Supplementation with 20,000 IU vitamin D(3) weekly did not result in beneficial effects on the measured multiple sclerosis-related outcomes. This study was not powered to address clinical outcomes, but none of the results were suggestive of an effect in this unselected population of fully ambulatory persons with multiple sclerosis.

    Full Text

    Kampman MT, Steffensen LH, Mellgren SI, Jørgensen L.

    Source: Mult Scler. 2012 Feb 21 Copyright © 2012 by SAGE Publications & Pubmed PMID: 22354743 (01/03/12)

    Vitamin D could be weapon against Multiple Sclerosis

    Vitamin DA Clinical trial will test whether Vitamin D can help fight multiple sclerosis (MS).

    If successful, researchers say the trial could open the door to a treatment which is 100 times cheaper than other drugs available.

    The $2 million trial, announced today by MS Research Australia, will begin recruiting in Victoria, NSW, Tasmania and New Zealand from April.

    Researchers hope to find 150 people with early or suspected symptoms of MS and put them on varying doses of Vitamin D.

    "If we can ... watch to see if that actually slows the progress or stops the progress, and they don't actually get MS, then we know Vitamin D is having an effect," MS Research Australia CEO Jeremy Wright said.

    The vitamin, which can be sourced from sunlight and some foods, is gaining credence as an effective treatment in preventing MS.

    But all the evidence so far has been circumstantial, Mr Wright said.

    "If we can prove the efficacy we are going to come up with a treatment which, would you believe, is about 100 times cheaper than the current treatments," Mr Wright said.

    "But it won't be a solo treatment. It will join the other treatments and add impacts, is what we expect."

    He said it was hoped the study would show some results in five years.

    Some 20,000 Australians are diagnosed with MS, an incurable disease which attacks the central nervous system and can cause bladder dysfunction, spasticity, depression and cognitive problems.

    Source: The Australian © 2012 The Australian (23/02/12)

    Son's Multiple Sclerosis crusade in danger as funds run dry

    Shine On Scotland LogoA campaign launched by a schoolboy to help stop the spread of multiple sclerosis after his mother contracted the disease has run out of money and is in danger of being wound up.

    The Shine On campaign was started by Ryan McLaughlin when he was 14 to raise awareness of the role vitamin D supplements can play in preventing the spread of MS.

    Ryan was inspired after his mother Kirsten, a former taekwondo champion, fell ill with the disease.

    However, after three years of fighting to change official thinking and get the Scottish Government to provide free vitamin D to schoolchildren and pregnant women, funds have now run dry.

    The campaign's website was briefly taken down this week as they could no longer afford internet charges, and much of the data they had collected on the importance of vitamin D was lost.

    The campaign's manager, Alan McLaughlin, Ryan's father, said: "We ran out of everything a couple of weeks ago and the website had to be taken down. We lost everything – about 700 pages of information and links we had collected to help the appeal and tell people about vitamin D.

    "We've been running the campaign from home and speaking to people in Australia, the US and Canada, and that has meant our phone bills have been high day-to-day.

    "So, with those costs and the website, our funds have just dried up. We'd hoped to get help from other charities but it's not been forthcoming."

    Mr McLaughlin and his son scored noticeable successes when they led a march of hundreds of Saltire-waving children down the Royal Mile in Edinburgh to deliver a petition to the Scottish Parliament.

    Pressure from the campaign also encouraged Health Secretary Nicola Sturgeon to agree to a summit to raise awareness of the impact of vitamin D on MS, and to issue fresh information based on the research they had collated.

    The McLaughlins' campaign saw Ryan nominated for The Herald's Campaigner of the Year and also honoured by the Multiple Sclerosis Society.

    Many scientists believe that MS is directly linked to vitamin D deficiency. The neurological disease has no cure and affects 12,500 Scots, the highest rate of any country in the world.

    Vitamin D is known as the "sunlight vitamin" as it comes from sunshine, and one theory about why MS is so prevalent in Scotland is that it is linked to dark winters north of the Border.

    Mr McLaughlin said they had been struggling to keep the campaign going for a while after his wife's condition worsened and she began to require more care. Ryan, who is now 16, is also studying for his exams.

    However, his father said they intend to keep going as long as they can, and have set a new fundraising target of £3000 to keep the effort going.

    He said: "We considered calling it a day when the website went down, but we got lots of emails from people supporting us, and we don't want to let people down.

    "People have been urging us to fight on, so that's what we're going to do."

    Source: Herald Scotland © Copyright 2012 Herald & Times Group (08/02/12)

    New standard for vitamin D testing to ensure accurate test results

    Vitamin DAt a time of increasing concern about low vitamin D levels in the world's population and increased use of blood tests for the vitamin, scientists are reporting development of a much-needed reference material to assure that measurements of vitamin D levels are accurate. The report appears in ACS' journal Analytical Chemistry.

    Karen Phinney and colleagues explain that medical research suggests vitamin D deficiency or insufficiency may be even more common than previously thought and a risk factor for more than just bone diseases. An estimated 50-75 percent of people in the U.S. may not have enough vitamin D in their bodies.

    Low levels of vitamin D have been linked to the development of several conditions, including rickets (soft and deformed bones), osteoporosis, some cancers, multiple sclerosis and Parkinson's disease. People can make their own vitamin D simply by rolling up their shirt sleeves and exposing their skin to sunlight. But for those cooped up in offices all day long, food and dietary supplements also can provide vitamin D.

    With this renewed interest in vitamin D, scientists need an accurate way to measure its levels in the blood. Measuring vitamin D itself doesn't work because it is rapidly changed into another form in the liver. That's why current methods detect levels of a vitamin D metabolite called 25(OH)D.

    However, the test methods don't always agree and produce different results. To help laboratories come up with consistent and accurate methods, the researchers developed a Standard Reference Material called SRM 972, the first certified reference material for the determination of the metabolite in human serum (a component of blood).

    The researchers developed four versions of the standard, with different levels of the vitamin D metabolites 25(OH)D2 and 25(OH)D3 in human serum. They also determined the levels of 3-epi-25(OH)D in the adult human serum samples. Surprisingly, they found that this metabolite - previously thought to only exist in the blood of infants - was present in adult serum. "This reference material provides a mechanism to ensure measurement accuracy and comparability and represents a first step toward standardization of 25(OH)D measurements," say the researchers.

    Source: Medical News Today © MediLexicon International Ltd 2004-2012 (27/01/12)

    Experts review vitamin D advice

    Vitamin DThe chief medical officer for England, Dame Sally Davies, is to contact medical staff about concerns young children and some adults are not getting enough vitamin D.

    Government guidelines recommend some groups, including the under-fives, should take a daily supplement.

    However, recent research found that many parents and health professionals were unaware of the advice.

    There has been an increase in childhood rickets over the past 15 years.

    According to Dr Benjamin Jacobs, from the Royal National Orthopaedic Hospital, links to heart disease and some cancers are also being investigated.

    The consultant paediatrician told BBC Breakfast that the hospital saw about one severe case a month of rickets - softening of bones through lack of vitamin D in childhood.

    He said: "There are many other children who have less severe problems - muscle weakness, delay in walking, bone pains - and research indicates that in many parts of the country the majority of children have a low level of vitamin D."

    The Feeding for Life Foundation report, published in October last year, suggested one in four toddlers in the UK is vitamin D deficient.

    However, this may be an underestimate as only vitamin D from food was included, and not any vitamin D obtained through sun exposure.

    Vitamin D supplements are recommended for all people at risk of a deficiency, including all pregnant and breastfeeding women, children under five years old, people aged over 65, and people at risk of not getting enough exposure to sunlight.

    Vitamin D is mainly obtained from sunlight. However, too much sun exposure increases the risk of skin cancer.

    According to one recent study, nearly three-quarters of parents and more than half of health professionals are unaware of the recommendations.

    The Department of Health has asked the Scientific Advisory Committee on Nutrition to review the issue of current dietary recommendations on vitamin D.

    Dame Sally Davies: "We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements."

    Free supplements
    "Our experts are clear - low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.

    "Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

    "It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups."

    It has long been known that vitamin D prevents rickets and children were once given food supplements like cod liver oil.

    However, this practice was stopped in the 1950s because it was thought unnecessary.

    In the last 10 years, doctors have been seeing more cases of vitamin D deficiency, leading to a debate over the use of food supplements and concern that many medical staff are unaware of the problem.

    Source: BBC News © British Broadcasting Corporation 2012 (25/01/12)

    Call for vitamin D supplements to tackle Scots MS rates

    Vitamin DRates of multiple sclerosis are so "dire" in Scotland that essential foods should be fortified with vitamin D, according to an Oxford academic.

    Professor of clinical neurology, George Ebers, has published a study showing a strong link between the condition and vitamin D deficiency.

    He says the Scottish government could face legal action from people who go on to develop MS in future.

    Scotland's chief medical officer said trials of supplements were needed.

    Scotland has the highest levels of MS in the world and the lowest levels of vitamin D, due to a lack of sunshine and a diet low in oily fish.

    Prof Ebers has published the latest study to show a link between the vitamin and multiple sclerosis, but he says efforts to convince the Scottish government and its top health advisor, Sir Harry Burns, that the whole population needs to take vitamin D have come to nothing.

    World experts
    He said: "I went to see Harry burns six years ago and I said, 'Look Harry, it's looking like it's going to be vitamin D and you've got a serious MS problem up here, we should keep in touch.'

    "Then I saw him three years ago and said the same thing - that more information was coming along. It's been puzzling that it hasn't led to too much action."

    Fifteen months ago the advice to the Scottish government was even stronger.

    It came not only from Prof Ebers but from a group of world experts in multiple sclerosis and vitamin D who met in Glasgow.

    They recommended that the Scottish government consider supplementing the population.

    Ministers responded by issuing advice for "at risk" groups such as pregnant women and people with darker skin. Most of these groups remain unaware that they should be taking vitamin D and the Scottish government issued no advice for the general population.

    When asked whether people who go on to develop MS in future will be able to accuse the government of inaction, Prof Ebers said: "Absolutely. In fact I think that is going to happen in the future. Inevitably, it's going to happen."

    'Important issue'
    He said the evidence that low levels of vitamin D can lead to increased risk of multiple sclerosis is now "awfully strong".

    Sir Harry Burns said he welcomed contributions to the debate about this "important issue" but that trials of vitamin D supplements in large populations were needed before the Scottish government could act.

    He added: "Mass medication of the Scottish population without such evidence would be considered irresponsible by the public health community."

    Sir Harry added that he would be guided by the Scientific Advisory Committee on Nutrition which was due to issue new advice on vitamin D in 2014.

    But Prof Ebers said 2014 was too long to wait.

    He added; "Public health authorities have got to be conservative, that's their nature...but these are equations. You have to compare the cost of action against the cost of inaction.

    "Scotland can't afford to look after its existing MS patients. This is an equation which has to be reviewed on a regular basis to see when the right time is and, for many of us, the time has long passed."

    Source: BBC News © British Broadcasting Corporation 2011 (20/12/11)

    Rare gene links vitamin D and multiple sclerosis

    MS And GeneticsA rare genetic variant which causes reduced levels of vitamin D appears to be directly linked to multiple sclerosis, says an Oxford University study.

    UK and Canadian scientists identified the mutated gene in 35 parents of a child with MS and, in each case, the child inherited it.

    Researchers say this adds weight to suggestions of a link between vitamin D deficiency and MS.

    The study is in Annals of Neurology.

    Multiple sclerosis is an inflammatory disease of the central nervous system (the brain and spinal cord).

    Although the cause of MS is not yet conclusively known, both genetic and environmental factors and their interactions are known to be important.

    Oxford University researchers, along with Canadian colleagues at the University of Ottawa, University of British Columbia and McGill University, set out to look for rare genetic changes that could explain strong clustering of MS cases in some families in an existing Canadian study.

    They sequenced all the gene-coding regions in the genomes of 43 individuals selected from families with four or more members with MS.

    The team compared the DNA changes they found against existing databases, and identified a change in the gene CYP27B1 as being important.

    When people inherit two copies of this gene they develop a genetic form of rickets - a disease caused by vitamin D deficiency.

    Just one copy of the mutated CYP27B1 gene affects a key enzyme which leads people with it to have lower levels of vitamin D.

    Overwhelming odds
    The researchers then looked for the rare gene variant in over 3,000 families of unaffected parents with a child with MS.

    They found 35 parents who carried one copy of this variant along with one normal copy.

    In every one of these 35 cases, the child with MS had inherited the mutated version of the gene.

    The likelihood of this gene's transmission being unconnected to the MS is billions to one against, say the researchers.

    Prof George Ebers, lead study author at Oxford University, says the odds are overwhelming.

    "All 35 children inheriting the variant is like flipping a coin 35 times and getting 35 heads, entailing odds of 32 billion to one against."

    He added: "This type of finding has not been seen in any complex disease. The uniform transmission of a variant to offspring with MS is without precedent but there will have been interaction with other factors."

    Prof Ebers believes that this new evidence adds to previous observational studies which have suggested that sunshine levels around the globe - the body needs sunshine to generate vitamin D - are linked to MS.

    He maintained that there was now enough evidence to carry out large-scale studies of vitamin D supplements for preventing multiple sclerosis.

    "It would be important particularly in countries like Scotland and the rest of the UK where sunshine levels are low for large parts of the year. Scotland has the greatest incidence of multiple sclerosis of any country in the world."

    Dr Doug Brown, head of biomedical research at the MS Society, called it an important development.

    "This shines more light on the potential role of vitamin D deficiency on increasing the risk of developing MS.

    "This research is gathering momentum and will be the subject of discussion at an international expert meeting in the USA this month, the outcomes of which will shape future research that will give us the answers we so desperately need about the potential risks and benefit of vitamin D supplementation."

    Paul Comer, from the charity MS Trust, said the research strengthened the case for vitamin D being one potential contributory cause of MS.

    "Current opinion suggests that a combination of genetic predisposition, environmental factors such as exposure to sunlight and possibly some sort of trigger, such as a viral infection, interact in some way to start the development of MS.

    "We welcome any research that clarifies the interplay between these factors. This is another step towards finding ways to reduce the risk of developing MS, but it is likely to be some years yet before we can gauge the significance of vitamin D deficiency to MS."

    Source: BBC News © British Broadcasting Corporation 2011 (09/12/11)

    Vitamin D benefits: hope or hype?

    Vitamin DVitamin D is good for what ails you. Or at least that's what patients and doctors might conclude if they read only the headlines.

    In the past few months, deficiency in the substance has been linked to chronic obstructive pulmonary disease, tuberculosis, spinal inflammatory diseases, age-related macular degeneration ... and the list goes on.

    On the other hand, taking high doses of vitamin D didn't help patients with multiple sclerosis, MedPage Today reported, and it was of no benefit in reducing left ventricular mass in patients with chronic kidney disease.

    But overall, vitamin D gets pretty good press. The trouble is that hard evidence to back up the vitamin's benefits is lacking, according to Clifford Rosen, MD, of the Maine Medical Center Research Institute in Scarborough. "There's no data," Rosen told MedPage Today. "It's all weak association studies."

    Benefit Beyond the Bones

    At the American Heart Association meeting earlier this month, several studies suggested associations between low vitamin D and various aspects of heart disease.

    But as one observer said at the time, there are no clinical trials yet that show improving vitamin D status does anything to reduce cardiovascular risk.

    One study, the Vitamin D and Omega-3 (VITAL) trial, may shed some light on the issue. It is a randomized trial that is enrolling some 20,000 patients to see if daily vitamin D supplements prevent cancer and cardiovascular disease.

    It will be one of the few randomized trials -- if not the only one -- to look at the issue directly, according to JoAnn Manson, MD, of Brigham and Women's Hospital in Boston, who is the principal investigator.

    Although other randomized trials have produced evidence for a vitamin D benefit in several important clinical categories, Manson told MedPage Today it was mostly as an afterthought.

    "Many of the randomized trials people have heard about were trials designed to look at the effect of vitamin D on fractures and falls," she said, with other effects as secondary outcomes.

    It's in the nature of statistics, she pointed out, that if researchers look at enough outcomes, some will be significant just on the basis of chance.

    The vast mass of the evidence for any kind of nonskeletal benefit is observational, and therefore suspect until confirmed by a properly designed, randomized trial, Manson said.

    Among other things, a host of confounding factors -- obesity, poor nutrition, lack of exercise -- might play a role. No matter how carefully an observational study is done, she said, confounding is always possible. "Correlation does not prove causation," Manson reminded.

    She noted that randomized trials have demolished observational evidence many times in the past, notably in the cases of such former fads as beta-carotene and selenium.

    According to Rosen, there is reasonable evidence that improved vitamin D status leads to better bone health and some evidence that supplements reduce all-cause mortality in elderly women.

    For almost everything else, he said, hard evidence is missing.

    Biologically Active D

    Measuring exposure to vitamin D is relatively easy -- it's a simple matter of serum levels of a compound called 25-hydroxyvitamin D, or 25(OH)D, Rosen said.

    But the relationship between circulating 25(OH)D and the active form of the vitamin, 1,25-dihydroxycholecalciferol, is not clear. It's entirely possible, he said, to have low levels of 25(OH)D and yet have a perfectly adequate amount of the hormonally active form.

    Indeed, Manson said, the Institute of Medicine (IOM) recently estimated that the average requirement of 25(OH)D is really only 16 nanograms per milliliter -- a level that would in most cases ensure adequate amounts of the active vitamin.

    "It's extremely variable," she noted, "and there is much that isn't known about vitamin D and metabolism."

    "So the tissues and cells may be seeing adequate amounts of biological active vitamin D and adequate stimulation of the vitamin D receptor even in those who have lower blood levels," she said.

    So the question of how much vitamin D is enough is a vexing one. But doctors and their patients still want an answer.

    The IOM last year released new guidelines for vitamin D, which say that healthy people should aim to have at least 20 nanograms of 25(OH)D per milliliter of serum.

    That can be achieved, the IOM said, by taking 600 IU a day of a vitamin D supplement if people are between ages 1 and 70, and 800 a day if they are 70 or older.

    Manson, who along with Rosen was part of the IOM panel, said that "relatively modest amount" of vitamin D will keep 97.5% of the general population in good bone health.

    And, she noted, the IOM really was only concerned about bone health, because there's such a dearth of evidence for benefits in other areas.

    But even if there's no evidence for a benefit, is there any harm in taking a bit extra? Well, possibly.

    One of the functions of vitamin D is to regulate calcium and phosphorus; too much can lead to hypercalcemia. The IOM set the tolerable upper limit at between 2,500 and 4,000 IU per day, depending on age.

    The institute also cautioned, Manson said, that there is some evidence of a U-shaped curve for vitamin D -- too little is bad and so is too much.

    In particular, the IOM reported that, although the evidence is weak, more than 4,000 IU a day of the vitamin might increase the risk of cardiovascular disease, some cancers, and all-cause mortality.

    "There's no evidence that more is better, so why use more?" Rosen asked.

    On a day to day basis, most people can ensure they have enough vitamin D by eating certain foods – fatty fish like salmon, for example – and taking a multivitamin, Manson said.

    But there's no need to screen the healthy population for vitamin D levels at least until there's more evidence that it matters, the IOM concluded.

    On the other hand, the Endocrine Society has called for regular screening for groups at risk for vitamin D deficiency such as the obese, African Americans, and pregnant women.

    Source: MedPage Today © 2011 Everyday Health, Inc.(29/11/11)

    Non-MS spine disease linked to low vitamin D

    Vitamin DA retrospective study has found low 25-hydroxyvitamin D levels in people who developed recurrent non–multiple sclerosis (MS) spinal cord diseases, including transverse myelitis, neuromyelitis optica, and neuromyelitis optica spectrum disorders.

    In contrast, vitamin D levels were normal in people with monophasic spinal cord disease such as idiopathic transverse myelitis.

    "There is a well-recognized link between low vitamin D levels and risk of development of MS," study author Michael Levy, MD, PhD, assistant professor, Johns Hopkins University School of Medicine, and medical director of Inpatient General Neurology, Johns Hopkins Hospital, Baltimore, Maryland, told Medscape Medical News.

    "We wanted to see if that link was present in transverse myelitis and neuromyelitis optica — diseases that may share immunopathogenic mechanisms with MS," he explained.

    "Our result," Dr. Levy said, "is in line with expectations of the impact of vitamin D on the immune system. In patients with recurrent disease, the vitamin D levels were low, and in those with monophasic conditions that do not recur, the vitamin D level was within normal limits."

    The study was published online November 14 in the Archives of Neurology.

    The authors say it "provides a basis for a prospective trial of measuring 25-hydroxyvitamin D levels in these patient populations and assessing the influence of vitamin D supplementation on the frequency of relapses in those with recurrent inflammatory spinal cord disease."

    Observations Not Unexpected

    In this report, the researchers evaluated total 25-hydroxyvitamin D levels in 77 adults seen at the Johns Hopkins Transverse Myelitis Center within the past 6 years. Patients taking more than 800 IU supplemental vitamin D daily at the time their blood was drawn were excluded.

    The analysis included 33 adults with recurrent transverse myelitis and 44 adults with monophasic idiopathic transverse myelitis. The monophasic group included only patients with at least 1 year of follow-up from the time of the inflammatory event who were disease-free without immunomodulatory or immunosuppressive treatment during this time.

    The researchers report that total 25-hydroxyvitamin D levels were significantly lower in the recurrent transverse myelitis group relative to the monophasic group. Before adjusting for demographic differences, mean vitamin D levels were 18 ng/mL (range, 4 - 54 ng/mL) in the recurrent transverse myelitis group vs 33 ng/mL (range, 8 - 60 ng/mL) in the monophasic idiopathic transverse myelitis group.

    The Johns Hopkins Hospital laboratory defines vitamin D deficiency as a level lower than 20 ng/mL, and optimal levels as higher than 30 ng/mL, the authors note.

    After adjusting for age, race, sex, and season, vitamin D levels were 10 ng/mL lower, on average, in patients with recurrent transverse myelitis, neuromyelitis optica, and neuromyelitis optica spectrum disorders relative to patients with monophasic idiopathic transverse myelitis (P = .002; 95% confidence interval [CI], 3.9 - 16.3).

    The authors note that race is a well-known confounding factor affecting vitamin D levels, and that the recurrent transverse myelitis group had a markedly disproportionate number of black patients. The researchers therefore conducted a separate analysis that excluded black patients from each group to determine whether race alone could account for the differences in vitamin D levels. It did not.

    Even when black patients were excluded, there was a significant difference between vitamin D levels of the recurrent and monophasic groups; the vitamin D level was an average of 9 ng/mL lower in the recurrent transverse myelitis group than it was in the monophasic idiopathic transverse myelitis group (P = .01; 95% CI, 1.9 - 15.9).

    "Given that vitamin D deficiency may play a role in the development of MS and risk of relapses in those with known MS, this study adds to a growing body of evidence that inadequate vitamin D levels may affect the development and recurrence of other immune-mediated [central nervous system] disorders like recurrent [transverse myelitis and neuromyelitis optica]," the authors write.

    "Exploratory" Study

    Reached for comment, Alberto Ascherio, MD, DrPH, professor of epidemiology and nutrition, Harvard School of Public Health, Boston, Massachusetts, who was not involved in the study, cautioned that this is an "exploratory study with several methodological limitations."

    "For example, some patients had vitamin D levels measured at time of first symptoms, and others over 20 years later. Further, vitamin D levels were measured in different laboratories, using different methods. For comparison, it is difficult to get consistent results even within same lab and using [the] same method," he noted in an email to Medscape Medical News.

    "Basically, the authors did their best rescuing old data from medical records. Nothing wrong with this, and because of lack of better data, this paper may be of some interest for those in the field, but not for a broader public," Dr. Ascherio commented.

    The study was supported by the Guthy Jackson Charitable Foundation. Dr. Levy has received commercial research support and honoraria from ApoPharma Inc, travel funding from Amplimmune, academic research support from Guthy Jackson Charitable Foundation, book royalties from Lippincott, and legal fees for expert witness services. A complete list of author disclosures is listed with the study. Dr. Ascherio has no relevant financial disclosures.

    Source: Medscape Today Copyright © 1994-2011 by WebMD LLC & Arch Neurol. 2011. Published online November 14, 2011. (23/11/11)

    High dose vitamin D pills 'can double heart condition risk'

    Vitamin DTaking high doses of vitamin D could more than double the chance of having a type of serious heart complaint, according to results of a large-scale survey.

    Those with "excess" levels of the vitamin in their blood were 2.5 times more likely than those with normal levels to have atrial fibrillation (AF), a type of heart flutter common in old age which can lead to stroke.

    More than a million people in Britain are thought to have AF, the vast majority over 70.

    The results, presented this week at a meeting of the American Heart Association, are perhaps most concerning for post-menopausal women, who commonly take supplements of the vitamin with calcium to help fend off osteoporosis.

    Vitamin D is essential for bone growth and cellular health. The body naturally manufactures it when the skin is exposed to strong sunlight. However, in winter reserves can drop due to lack of sunlight, so many people take supplements.

    However, baseline levels vary considerably, both between people and over the seasons, meaning some could unnecessarily be topping up.

    Researchers at the Intermountain Medical Centre in Utah looked at blood tests from 132,000 of their patients.

    They found those with vitamin D levels above 100 nanograms per 100ml, were 2.5 times more likely to have AF as those with normal levels (41-80ng/100ml).

    Dr T Jared Bunch, a heart rhythm specialist, said patients should always tell their doctors what vitamins they were taking.

    He said: "Patients don't think of vitamins and supplements as drugs. But any vitamin or supplement that is touted as 'healing' or 'natural' is a drug and will have effects that are both beneficial and harmful.

    "Just like any therapy, vitamins need to be taken for the right reasons and at the right doses."

    Doctors have increasingly recognised vitamin D's crucial importance to overall health, helping to fend off not only osteoporosis but also multiple sclerosis, heart disease, diabetes and certain cancers.

    They have also realised that many people in Britain now suffer from vitamin D deficiency, due in part to increasingly indoor lifestyles, with GPs seeing more children with rickets.

    Doctors now advise that all people over 65 should take regular supplements, as should children up to five, pregnant and breastfeeding women, those who do not get enough sun and people with darker skin.

    Source: The Daily Telegraph © Copyright of Telegraph Media Group Limited 2011 (17/11/11)

    High dose vitamin D has no impact on MS study suggests

    Vitamin DHigh dose vitamin D does not appear any better than low doses for people with multiple sclerosis, according to an Australian study.

    The preliminary study, which found supplements ineffective at reducing brain lesions, paves the way for a larger trial seeking definitive answers on whether high doses are beneficial, harmful or neutral.

    The findings appear today in the journal Neurology.

    The trial involved 23 participants who had clinically active relapsing remitting multiple sclerosis (MS) - the most common type. Researchers gave patients low dose vitamin D2 (1000 international units) daily, while 11 people also received a high dose supplement to mimic blood levels found in people from sunny climates. They also underwent MRI scans at athe start of the study and again at four, five and six months.

    The scans revealed no significant difference in the volume or number of new brain abnormalities during the six month trial - 14 lesions in high dose group compared with 11 in the low dose group, meaning there was no difference in brain inflammation or nervous system scarring regardless of dose.

    "We did not find added benefit from high-dose vitamin D over and above ongoing low-dose supplementation but these results need to be confirmed with larger studies," says study lead author, Dr Mark Stein from the Royal Melbourne Hospital and Walter and Eliza Hall Institute of Medical Research .

    "Previously there was no data comparing doses so findings provide a solid foundation for a larger study to confirm one way or another."

    "We are not saying vitamin D doesn't work, but if it does, there appears no benefit of high over low. Although we found no evidence of benefit, it doesn't mean there isn't a benefit."

    The researchers downplay the finding that some of the high dose participants had relapses (there were no relapses in the low dose group), or that high dose patients were more likely to score poorly on a disability scale at the study's end.

    "I wouldn't say high dose is harmful because these findings were of borderline statistical significance as there were only 23 participants, but high dose was unlikely to have favourable effects," says Stein.

    More research needed
    According to Stein, the participants had MS for an average six years, adding that it may be possible that earlier high dose supplementation may lead to different results.

    Research shows there is more MS in places with less sunshine and a strong association between vitamin D levels and chances of getting MS and relapse.

    "There is tremendous interest about vitamin D among patients and the medical community because it is a cheap, oral treatment whereas MS drugs are expensive injections but it's best to stick to proven therapies and wait for hard evidence on vitamin D," he says.

    The group is hoping to fund a larger study in Australia and New Zealand expected to start soon.

    An MS Australia spokesperson said: "We are excited about the possible link between vitamin D and multiple sclerosis. We are encouraged by the ongoing inquiry into this area and eagerly await results of further studies."

    The study was funded by The Myer Foundation.

    Source: ABC Science © 2011 ABC (25/10/11)

    MS patients to be given vitamin D to test sun's effect on the condition

    Vitamin DPatients with early-stage multiple sclerosis are to be given vitamin D supplements as part of a trial to determine if a lack of sunshine may contribute to the illness.

    It has long been noted that incidences of MS increase the further away from the equator people are, although doctors are not sure whether the reasons are environmental or genetic, or a combination of both.

    A previous study examined discrepancies between MS rates in Donegal, which has some of the lowest sunshine levels in Ireland and has high rates of MS, and Wexford, which is the sunniest part of the country and has lower levels of the disease. The study concluded that sunshine may play a role, but it may also be down to genetics.

    Consultant neurologist Dr Chris McGuigan, who works in St Vincent’s Hospital, said the study, which is scheduled to begin before the end of the year, will be carried out to see if vitamin D supplementation can stop the next “event” or seizure.

    “There have been international studies which suggest a role for it in MS. Low vitamin D is implicated in other auto-immune conditions,” he said.

    MS is one of the most common forms of auto-immune disease. Some 7,000 families are affected by the chronic illness, according to MS Ireland.

    A survey carried out by Biogen Idec and MS Ireland found 54 per cent of patients in this country are very, or extremely, affected by decreased mobility and a similar amount by decreased sexual function.

    Only 22 per cent are in full-time employment and the same amount are unemployed.

    Both organisations have launched a Mobility Matters in MS website which provides advice and encouragement to people with the disease on how to maintain their mobility.

    Dr McGuigan said outcomes for MS sufferers have improved dramatically in recent years and “huge progress” had been made.

    He cited the introduction of injectable drugs such as Copaxone and Tysabri, with some oral drugs coming on stream, as giving real hope to patients.

    “There have been huge advances, but I suspect in the next five years that the landscape of treatment is going to change again for the better,” he predicted.

    Source: IrishTimes.com © 2011 irishtimes.com (18/10/11)

    Sunlight exposure and sun sensitivity associated with disability progression in MS

    Sunlight and MSAbstract

    Background: Sunlight and vitamin D have been inversely associated with the risk of multiple sclerosis (MS).

    Objective: We investigated sunlight exposure and sun sensitivity in relation to disability progression in MS.

    Methods: We conducted a survey among persons with MS, registered by the Flemish MS society, Belgium, and stratified data according to relapsing-onset and progressive-onset MS. We used Kaplan–Meier survival and Cox proportional hazard regression analyses with time to Expanded Disability Status Scale (EDSS) 6 as outcome measure. Hazard ratios for the time from onset and from birth were calculated for the potentially predictive variables, adjusting for age at onset, gender and immunomodulatory treatment.

    Results: 704 (51.3%) of the 1372 respondents had reached EDSS 6. In relapsing-onset MS, respondents reporting equal or higher levels of sun exposure than persons of the same age in the last 10 years had a decreased risk of reaching EDSS 6. In progressive-onset MS, increased sun sensitivity was associated with an increased hazard of reaching EDSS 6.

    Conclusion: The association of higher sun exposure with a better outcome in relapsing-onset MS may be explained by either a protective effect or reverse causality. Mechanisms underlying sun sensitivity might influence progression in progressive-onset MS.

    MB D'hooghe National Centre For Multiple Sclerosis, Melsbroek, Belgium, P Haentjens Center for Outcomes Research and Laboratory for Experimental Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium, G Nagels National Centre For MS, Melsbroek/Service d’orthopédagogie Clinique, Faculty of Psychology and Education Sciences, University of Mons, Belgium, M Garmyn Department of Dermatology, Universitaire Ziekenhuizen, Leuven, Belgium, J De Keyser Dpt of Neurology UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium/Dpt of Neurology Uni. Med. Center Groningen, Groningen, The Netherlands

    Full Article

    Source: Mult Scler September 27, 2011 1352458511423778 & Sage Journals Online Copyright © 2011 by SAGE Publications (28/09/11)

    MS breakthrough: Vitamin D directly terminates production of disease-causing protein

    Vitamin DMechanism suggests a potential new path toward pharmaceutical treatment of MS, as well as therapies for other autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, eczema and psoriasis.

    For years scientists have noted an association between levels of vitamin D in a person’s body and the person’s ability to resist or minimize the effects of multiple sclerosis (MS) but didn’t understood the mechanism involved. Until now.

    New breakthrough research by a collaborative team at UMDNJ-New Jersey Medical School and Stanford indicates that vitamin D directly terminates the production of a disease-causing protein.

    As the investigators outline in their report, published in the September issue of Molecular and Cellular Biology (“1,25-Dihydroxyvitamin D3 ameliorates Th17 autoimmunity via transcriptional modulation of interleukin-17A” ):

    • During MS (“EAE” in mice), a damaging protein called interleukin-17 (IL-17) is produced by immune cells in the brain.

    • The research team found that after vitamin D binds to its receptor, the receptor parks itself on the gene that encodes IL-17.

    • By doing so, the vitamin D receptor occupies a site normally reserved for a protein called NFAT, which is required to turn the IL-17 gene on.

    • The gene stays off and IL-17 levels plummet.

    • At the same time, the vitamin D receptor turns on another gene, whose product generates suppressive T cells that combat the destructive action of their IL-17-producing counterparts.

    According to the researchers, led by UMDNJ Prof. Sylvia Christakos, PhD, the mechanism they identified suggests what might be a new path toward pharmaceutical treatment of MS, as well as therapies for other autoimmune diseases that might include rheumatoid arthritis, type 1 diabetes, eczema and psoriasis.

    Source: ProHealth Copyright © 2011 ProHealth, Inc. (17/08/11)

    High levels of vitamin D linked to skin cancer, study

    Vitamin DHigher levels of vitamin D, still within the normal range, are associated with an increased risk of nonmelanoma skin cancer, researchers reported.

    In a cohort study, people with higher serum 25-hydroxyvitamin D (25(OH)D) were more likely to develop squamous cell or basal cell carcinoma, according to Melody Eide, MD, and colleagues at Henry Ford Hospital in Detroit.

    But other factors – such as increased exposure to sunlight – probably complicate the relationship, Eide and colleagues reported online in Archives of Dermatology. Ultraviolet B light is known to cause skin cancer, but it also increases cutaneous vitamin D synthesis, the researchers noted, adding that the relationship between vitamin D and skin cancer is complex and studies have yielded conflicting results.

    Indeed, some research suggests that vitamin D might reduce the risk of basal cell carcinoma, but other studies have had the opposite outcome.

    To help clarify the situation, Eide and colleagues analyzed data, over an average of 9.8 years of follow-up, from 3,223 white members of a health maintenance organization who had a high probability of developing nonmelanoma skin cancer.

    The participants had sought counseling for osteoporosis or low bone density between January 1997 and December 2001, and their assessment included levels of serum 25(OH)D, a marker for vitamin D intake and storage.

    The researchers used the HMO's claims database to track incident cases of basal cell and squamous cell carcinoma.

    When they were assessed, 2,257 participants did not have a sufficient vitamin D level, where sufficient was defined as at least 30 nanograms of 25(OH)D per milliliter of serum.

    All told, the researchers found, 240 patients developed nonmelanoma skin cancer, including 49 with squamous cell carcinoma, 163 with basal cell carcinoma, and 28 with both. Most cases -- some 80% -- occurred in sites frequently exposed to the sun.

    When patients were divided into four groups according to their 25(OH)D levels, there was a trend linking the higher levels and skin cancer risk that was significant at P=0.02.

    Compared with the lowest quartile, the highest (less than 19 nanograms per milliliter versus 31 or higher) had an odds ratio for cancer of 1.6 (95% CI 1.1 to 2.3), Eide and colleagues found. Intermediate quartiles also had elevated risks, but they did not reach significance compared with the lowest quartile.

    Logistic regression analysis found that having a vitamin D level that was just above the cutoff for deficiency – less than 15 nanograms of 25(OH)D per mL of serum – was associated with an increased risk of nonmelanoma skin cancer. Specifically:

    For both types combined, the adjusted odds ratio was 1.8 (95% CI 1.1 to 2.9, P<0.05).

    For squamous cell carcinoma alone, the odds ratio was 1.7, but it did not reach significance with a 95% confidence interval from 0.7 to 4.0.
    For basal cell carcinoma, the odds ratio was also 1.7 but reached significance at P<0.05 (95% CI 1.00 to 2.9).

    The findings add "to the limited and conflicting epidemiological investigation regarding the relationship between vitamin D and [nonmelanoma skin cancer]," Eide and colleagues concluded.

    They added that, aside from UVB light, the finding might also be confounded by such things as participants' vitamin D levels over a lifetime and consumption of vitamin D supplements, which they were unable to investigate.

    Eide and colleagues also cautioned that the study was conducted at a single institution and that people who seek counseling for osteoporosis risk represent a self-selected group that may not be a representative population.

    The study was supported by a Dermatology Foundation Career Development Award in Health Care Policy.

    The journal said the authors did not report any conflicts.

    Source: MedPage Today © 2011 Everyday Health, Inc.(17/08/11)

    Why sunshine could ease Multiple Sclerosis symptoms

    Sunshine, Vitamin D and MSSun exposure may help ease the symptoms of multiple sclerosis.

    New research has found a link between hospital emergency admissions among MS patients and low Vitamin D levels. The findings, based on a study of some 70,000 admissions over more than a decade, suggest that the vitamin – which is produced by the skin in response to sunlight – plays an important role in the disease.

    Seasonality is also thought to be a key feature of the complex neurological disorder: other research has shown that a person born in the spring – and therefore with mother and baby exposed to low levels of sunshine during the pregnancy – has a significantly higher risk of MS later in life.

    Further studies have shown that fewer people with MS are born in November and more in May, again implicating a lack of sunshine during pregnancy.

    ‘Our work strongly suggests that low Vitamin D levels are associated with the risk of MS relapse,’ says Dr Sreeram Ramagopalan, who led the Oxford University study.

    ‘Due to a lack of sunshine in the UK, a large proportion of the population is Vitamin D deficient.

    ‘Being deficient in Vitamin D affects your immune system. This study is another reason to make sure you are Vitamin D replete.’

    An autoimmune disease of the central nervous system, MS is the most common disabling neurological condition, affecting 100,000 Britons.

    It is the result of damage to myelin, the protective sheath which surrounds nerve fibres, and leads to the disruption of messages between the brain and other parts of the body.

    Symptoms vary and range from dizziness, tremor and blurred vision, to bladder problems, memory difficulties and muscle stiffness. The cause is not known.

    In the new study, researchers looked at Vitamin D levels in the blood of MS patients who were admitted to hospital in Scotland, that has some of the lowest sunlight levels in the UK.

    Dr Ramagopalan said that when patients were admitted, blood tests revealed what their Vitamin D level was likely to have been in the months beforehand – and those with the lowest levels were more likely to be hospitalised.

    Source: Mail Online © Associated Newspapers Ltd 2011 (15/08/11)

    Sun exposure, Vitamin D intake and progression to disability in progressive MS

    Vitamin D and the sunSummary: This study assessed vitamin D-related exposures from childhood to disease onset and their associations with MS progression among war veterans in the MS Surveillance Registry, based on self-reporting of sun-exposure and age at disability milestones.

    Low average sun exposure in the fall/winter before disease onset was associated with an increased risk of progressing more quickly, whereas use of cod liver oil during childhood and adolescence was associated with a reduced risk. The authors propose that exposure to vitamin D before MS onset might slow disease-related neurodegeneration and thus delay progression to disability among patients with the progressive subtype.

    Abstract
    Background: Early life events have been suggested to influence multiple sclerosis (MS) susceptibility, and to potentially modulate its clinical course. We assessed vitamin D-related exposures from childhood to disease onset and their associations with MS progression.

    Methods: Among veterans in the Multiple Sclerosis Surveillance Registry, 219 reported having the progressive form and met the inclusion criteria. Participants reported their past sun exposure, vitamin D-related intake and age at disability milestones using the Patient-Determined Disease Steps (PDDS). The Cox proportional hazards model was used to examine the association between vitamin D-related exposures and time (years) to disability.

    Results: Low average sun exposure in the fall/winter before disease onset was associated with an increased risk of progressing to a PDDS score of 8 (hazard ratio, HR: 2.13, 95% confidence interval, CI: 1.20-3.78), whereas use of cod liver oil during childhood and adolescence was associated with a reduced risk (HR: 0.44, 95% CI: 0.20-0.96).

    Conclusions: These results suggest that exposure to vitamin D before MS onset might slow disease-related neurodegeneration and thus delay progression to disability among patients with the progressive subtype.

    Authors: McDowell TY, Amr S, Culpepper WJ, Langenberg P, Royal W, Bever C, Bradham DD.

    Source: Pubmed 21822026 & Neuroepidemiology. 2011 Aug 5;37(1):52-57. Copyright © 2011 S. Karger AG, Basel. (10/08/11)

    Further evidence for the role of Vitamin D levels in MS

    Vitamin DAn Australian MS researcher based in Oxford (UK), Dr Julia Morahan, has recently co-authored a commentary about Vitamin D and its relationship to hospital admissions for MS in Scotland. The data presented in the QJM: An International Journal of Medicine provide further evidence for the important preventive role of Vitamin D, not only in reducing the risk of MS, but also the severity and relapse rate for those living with MS.

    In a previous study the authors demonstrated that emergency hospital admissions for MS in Scotland fluctuated with the seasons. They found that the risk for an emergency admission was reduced during Spring and Autumn (in the northern hemisphere the two lowest risk months were March and October). In this further analysis of data, the researchers found that the level of Vitamin D three months prior to the admission to hospital was the strongest predictor of risk.

    ‘These results indicate that low Vitamin D levels may be triggering the onset of relapses manifesting even 3 months later,’ the authors stated. They went on to say, ‘These considerations are extremely relevant as they highlight the need for well-powered randomized placebo-controlled clinical trials which would firmly prove or disprove the potential therapeutic effect of vitamin D in MS.’

    MS Research Australia, in conjunction with a group of highly experienced Australian and New Zealand MS clinical researchers, is keen to initiate a major Clinical Trial to provide this much needed evidence. Generous funding from The Trish MS Research Foundation and the MS Society of WA has been secured, however the full cost of this exciting, world-first project will run to over $3 million and additional funds are still required.

    Dr Julia Morahan is based at the University of Oxford Wellcome Trust Centre for Excellence and is funded by MS Research Australia and The Macquarie Group Foundation on a UK MS Society Exchange Fellowship.

    You can read more about Dr Morahan’s research here.

    Reference
    Vitamin D and multiple sclerosis hospital admissions in Scotland
    Disanto, A.E. Handel, J.M. Morahan, G.C. Deluca, S.M. Kimball, E. Hypponen, G. Giovannoni, G.C. Ebers and S.V. Ramagopalan
    Q J Med doi:10.1093 /qjmed/hcr101G, EPub 26 June 2011

    Source: MS Research Australia © 2011 Multiple Sclerosis Research Australia (MSRA ABN: 34 008 581 431).(06/07/11)

    Vitamin D levels low in African-Americans with multiple sclerosis

    Vitamin DAfrican-Americans who have multiple sclerosis (MS) have lower vitamin D levels than African-Americans who don't have the disease, according to a study published in the May 24, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. However, most of the difference in vitamin D levels was due to differences in climate and geography.

    "MS is not as common in African-Americans as it is in whites, although the disease tends to be more severe in African-Americans," said study author Ari J. Green, MD, of the University of California San Francisco and a member of the American Academy of Neurology. "We have known that vitamin D levels are associated with MS and that African-Americans are at increased risk for having low vitamin D levels, but little research has been done to look at vitamin D levels in African-Americans with MS."

    Melanin, which determines the level of pigment in the skin, acts as a filter of UV light, which limits the amount of vitamin D that can be produced by the body in response to sunlight.

    The study involved 339 people with MS and 342 people who did not have the disease. Researchers looked at vitamin D levels in the blood, the severity of the disease, the amount of UV exposure for participants based on where they lived and the proportion of European genetic ancestry participants had.

    A total of 77 percent of the people with MS were vitamin D deficient, compared to 71 percent of those without the disease. The people with MS were exposed to a lower monthly UV index (average of 3.8) than those without the disease (average of 4.8). They also lived an average of about one degree of latitude farther north than those without the disease. The link between low vitamin D levels and MS was weaker, but still present after adjusting for the differences in UV exposure and geography.

    People with a higher proportion of European ancestry in their genes were less likely to have low vitamin D levels than people with a lower proportion of European ancestry, but European ancestry was not associated with MS.

    There was no association between vitamin D levels and how severe the disease was.

    People should talk to their physicians about blood testing for vitamin D levels, whether they should take supplements and how much UV exposure they should get, Green said. "These findings may provide a mechanism to help explain how genes and the environment interact to produce MS," he said.

    Source: Science Codex (24/05/11)

    Pregnancy and Vitamin D may protect against MS - studies

    Vitamin D and MSTasmanian researchers have found that delaying pregnancy may increase the likelihood of women getting multiple sclerosis.

    A yet to be published study looking at MS over the last 60 years has found the frequency of the disease has risen dramatically and it's largely been driven by women.

    The Menzies Research Institute's Associate Professor, Bruce Taylor, says delaying pregnancy could be having an impact.

    "We think that having children is protective for having MS, He said.

    "In fact in another study we've done we've shown the more children you have the lower chance you have of developing MS and because women are having their children later in their 30s rather than their 20s or even in their late teens they don't get that neuro-protective or neuro-immunological affect of carrying a child."

    A comparatively cheap vitamin D supplement could change the way sufferers of multiple sclerosis are treated for the disease.

    Research has long established that increased vitamin D levels reduce the risk of getting MS.

    Another new study has shown that vitamin D levels are not only associated with the onset but also with the frequency of attacks.

    The Menzies Research Institute looked at vitamin D levels in nearly 200 people with MS and found the higher the levels of the vitamin, the lower the number of attacks.

    Dr Taylor says the research has worldwide implications.

    "Currently our treatments for MS which are effective are hugely expensive," he said.

    "They are drugs that cost the Pharmaceutical Benefit Scheme $25,000 a year, vitamin D is about $300 per year."

    Dr Taylor says relapses add to the level of disability experienced by the sufferer.

    "They can be devastating, relapses can be fatal to people."

    "If you get it in the wrong part of the brain it can stop you breathing.

    "So that's incredibly rare and I don't want to scare people, they also can be extremely mild, but what they indicate is the disease is active."

    Source: ABC News © 2011 ABC (20/05/11)

    Medical Journal Of Australia calls for routine vitamin D testing in pregnancy

    Pregnancy And MSMany individuals have been calling for increased recognition of the vitamin D deficiency epidemic in Western countries due to sun avoidance, but have not been heeded by mainstream health authorities.

    This editorial in Australia's premier medical journal brings to the fore the issue of vitamin D deficiency during pregnancy, a critical issue for the development of autoimmune diseases like type 1 diabetes and multiple sclerosis, among other diseases.

    Prominent Australian endocrinologist Professor Peter Ebeling, in commenting on a paper published in this week's issue of the MJA showing that 41% of pregnant women screened were deficient in vitamin D (at the very conservative level of 50nmol/L or less), called for routing screening for vitamin D in pregnancy.

    More importantly he argued that Australian authorities may need to alter the regulations that currently do not allow higher dose cheap supplements of vitamin D such as those available freely in the US and Europe via the internet.

    Women with MS who are pregnant or planning pregnancy should not stop their vitamin D supplementation during pregnancy as is sometimes mistakenly advised.

    Original Article

    Source: Overcoming Multiple Sclerosis © 2011 Overcoming Multiple Sclerosis (12/04/11)

    Worldwide vitamin D call to action

    Vitamin DAn international consortium of vitamin D experts published a new call to action to address the worldwide vitamin D deficiency in the latest journal of Public Health Nutrition due to their observations that the recent IOM (Institute of Medicine) report was ‘deficient’.

    Ten members of the GrassrootsHealth Call to Action Panel wrote letters indicating their points of view. “The potential benefits of vitamin D were underemphasized while overstating the evidence for potential harm” from Edward Giovannucci, Harvard; “People consistently take a supplement, first and foremost, because that supplement makes them feel better. They will continue to take vitamin D.” from John Cannell, Vitamin D Council; “The IOM’s latest recommendations are largely inconsequential. The IOM committee ignored the consensus of hundreds of vitamin D research scientists and nutritionists from at least twenty-five countries” wrote Anthony W. Norman, Emeritus Professor, University of California Riverside.

    Added data from Dr. Cedric Garland, one of the authors of the latest paper published in the AntiCancer Journal said “We found that daily intakes of vitamin D by adults in the range of 4000-8000 IU are needed to maintain blood levels of vitamin D metabolites in the range needed to reduce by about half the risk of several diseases – breast cancer, colon cancer, multiple sclerosis, and type 1 diabetes.” It is suggested that this level is in the range of 40-60 ng/ml or higher. Dr. Garland is professor of family and preventive medicine at UC San Diego Moores Cancer Center. “I was surprised to find that the intakes required to maintain vitamin D status for disease prevention were so high – much higher than the minimal intake of vitamin D of 400 IU/day that was needed to defeat rickets in the 20th century.”

    One of the key findings in the AntiCancer study was that the vitamin D blood levels rose in a curvilinear fashion, with no intakes of 10,000 IU/d or lower producing vitamin D values above the lower-bound of the zone of potential toxicity (200 ng/ml). The fact that the higher intakes do not increase the blood levels in a linear fashion is a major contributor to the fact that it is hard to get to a potentially toxic level.

    In addition to the GrassrootsHealth contingent, there is another consortium of ingredient suppliers, food manufacturers and public health groups which has issued a ‘call to action’ to raise awareness about micronutrient deficiencies among European governments, with an accent on vitamin D.

    The action plan for individuals and clinicians according to the vitamin D experts is to do vitamin D testing as necessary to establish a baseline serum level and get the serum levels to 40-60 ng/ml (100-150 nmol/L). The intakes will vary considerably and are not useful as guides to vitamin D levels.

    More information on the vitamin D experts and the current GrassrootsHealth vitamin D population study can be found on http://www.grassrootshealth.net

    Source: Shine On Scotland (01/04/11)

    MS 'link' to vitamin D deficiency may be studied

    Vitamin DThe MS Society is considering carrying out research in Scotland on a possible link between vitamin D deficiency and Multiple Sclerosis.

    A report has called for more research on the role of vitamin D, and highlighted that Scotland is an ideal candidate country for the study.

    Scotland has high levels of both vitamin D deficiency and MS.

    The MS society wants to establish an international group of experts to carry out the research.

    Last year, the MS Society hosted a summit in Glasgow on vitamin D and MS.

    Unanswered questions

    Scientists from across the world presented the latest research on the issue and debated ways of tackling vitamin D deficiency.

    The report acknowledged that questions remain to be answered but proposed that a working group be set up to investigate links between vitamin D deficiency and MS further.

    The report also stated that the centralised system for collecting health data that exists in Scotland would be beneficial to researchers.

    The MS Society hopes that further research will help policy makers in addressing vitamin D deficiency and in gaining a better understanding of MS as a condition.

    David McNiven, director of MS Society Scotland, said: "Research into the potential links between vitamin D deficiency and MS has really gathered pace in recent years and looks very exciting.

    "I was delighted that we were able to convince so many world class scientists to come to Scotland last year to explore this issue.

    "The report summaries the very interesting debate that was had in Glasgow and proposes to build on this work by bringing an international group together to tackle some of the outstanding questions."

    Mr McNiven added: "The MS Society helped to bring researchers and policy makers together and we will continue to do so to contribute towards evidence-based policy making and to benefit people affected by MS."

    Source: BBC News © British Broadcasting Corporation 2011 (25/03/11)

    MS prevalence in Ireland: relationship to vitamin D status and HLA genotype

    Vitamin DAbstract
    Background: The relationship between prevalence of multiple sclerosis (MS) and latitude may be due to both genetic and environmental factors. The hypothesis that, in Ireland, MS prevalence is increasing and that north–south differences relate to variation in serum 25-hydroxyvitamin D (25(OH)D) levels was tested in this study.

    Patients and methods: Patients and matched control subjects were identified in counties Donegal, Wexford and South Dublin through multiple sources. Prevalence was determined. Blood samples were taken for serum 25(OH)D and serum intact parathyroid hormone measurement, and DNA was extracted.

    Results: Prevalence in 2007 was significantly greater in Donegal (northwest) (290.3/105, 95% CI 262.3 to 321.7) compared with 2001 (184.6/105; 162 to 209.5). In Wexford (southeast), there was a non-significant increase in prevalence in 2007 compared with 2001. Prevalence was significantly higher in Donegal than in Wexford (144.8/105; 126.7 to 167.8, p<0.0001) and South Dublin (127.8/105; 111.3 to 148.2, p<0.0001). Overall, mean 25(OH)D levels were low and did not differ between patients (38.6 nmol/l) and controls (36.4 nmol/l) However, significantly more patients than controls had 25(OH)D levels <25 nmol/l (deficiency) (p=0.004). Levels of 25(OH)D (mean 50.74 nmol/l) were significantly higher in South Dublin (area with lowest prevalence) (p<0.0001) than in Donegal or Wexford. HLA DRB1*15 occurred most frequently in Donegal (greatest MS prevalence) and least frequently in South Dublin.

    Conclusion: Vitamin D deficiency is common in Ireland. Latitudinal variation in MS probably relates to an interaction between genetic factors and environment (25(OH)D levels), and MS risk may be modified by vitamin D in genetically susceptible individuals.

    Lay Summary - http://jnnp.bmj.com/content/suppl/2011/02/24/jnnp.2010.220988.DC1/PatientchoiceMarch2011.pdf

    R Lonergan1, K Kinsella1, P Fitzpatrick2, J Brady3, B Murray3, C Dunne4, R Hagan4, M Duggan1, S Jordan1, M McKenna3, M Hutchinson1, N Tubridy1

    1Department of Neurology, St Vincent's University Hospital and University College Dublin, Ireland
    2School of Public Health and Population Science, University College Dublin, Ireland
    3Department of Metabolism, St Vincent's University Hospital, Dublin, Ireland
    4National Histocompatibility and Immunogenetics Reference Laboratory, National Blood Centre, Dublin, Ireland

    Source: J Neurol Neurosurg Psychiatry 2011;82:317-322 doi:10.1136/jnnp.2010.220988 Copyright © 2011 by the BMJ Publishing Group Ltd (17/03/11)

    Vitamin D, pregnancy, breastfeeding, and postpartum MS relapses

    Pregnancy And MSAbstract
    Objective:  To determine whether low levels of 25-hydroxyvitamin D (25[OH]D) contribute to the increased risk of postpartum multiple sclerosis (MS) relapses.

    Design:  Prospective cohort study.

    Setting:  Outpatients identified through membership records of Kaiser Permanente Northern California or Stanford University outpatient neurology clinics.

    Patients:  Twenty-eight pregnant women with MS.

    Interventions:  We prospectively followed up patients through the postpartum year and assessed exposures and symptoms through structured interviews. Total serum 25(OH)D levels were measured using the DiaSorin Liaison Assay during the third trimester and 2, 4, and 6 months after giving birth. The data were analyzed using longitudinal multivariable methods.

    Main Outcome Measures:  Levels of 25(OH)D and relapse rate.

    Results:  Fourteen (50%) women breastfed exclusively, and 12 women (43%) relapsed within 6 months after giving birth. During pregnancy, the average 25(OH)D levels were 25.4 ng/mL (range, 13.7-42.6) and were affected only by season (P = .009). In contrast, in the postpartum period, 25(OH)D levels were significantly affected by breastfeeding and relapse status. Levels of 25(OH)D remained low in the exclusive breastfeeding group, yet rose significantly in the nonexclusive breastfeeding group regardless of season (P = .007, unadjusted; P = .02, adjusted for season). By 4 and 6 months after childbirth, 25(OH)D levels were, on average, 5 ng/mL lower in the women who breastfed exclusively compared with the nonbreastfeeding group (P = .001).

    Conclusions:  Pregnancy and exclusive breastfeeding are strongly associated with low 25(OH)D levels in women with MS. However, these lower vitamin D levels were not associated with an increased risk of postpartum MS relapses. These data suggest that low vitamin D in isolation is not an important risk factor for postpartum MS relapses.

    Annette Langer-Gould, MD, PhD; Stella Huang, MS, DO; Stephen K. Van Den Eeden, PhD; Rohit Gupta, BS; Amethyst D. Leimpeter, MS; Kathleen B. Albers, MPH; Ron Horst, PhD; Bruce Hollis, PhD; Lawrence Steinman, MD; Lorene M. Nelson, PhD

    Author Affiliations: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (Dr Langer-Gould); Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California (Drs Langer-Gould, Huang, Steinman, and Nelson and Mr Gupta); Division of Research, Kaiser Permanente Northern California, Oakland (Drs Van Den Eeden and Leimpeter and Ms Albers); Heartland Assays Inc, Ames, Iowa (Dr Horst); and Medical University of South Carolina, Charleston (Dr Hollis). Dr Huang is now with Loyola University Medical Center, Maywood, Illinois.

    Source: Arch Neurol. 2011;68(3):310-313. doi:10.1001/archneurol.2010.291 © 2011 American Medical Association. (15/03/11)

    Insight into link between sunlight, vitamin D3, MS risk and severity

    Sunlight and Vitamin DNew research into the neurodegenerative disease, Multiple Sclerosis (MS) offers new insight into the link between sunlight, vitamin D3, and MS risk and severity. The research, published in the European Journal of Immunology, studies the relationship between the sunlight-dependent vitamin D3 hormone, immune cells, and the risk and severity of autoimmunity in an experimental model.

    Expensive first-line treatments for MS modestly reduce the frequency of autoimmune attacks but do not slow disease progression, when the patient's immune system operates against the body's own tissues. More expensive second-line treatments slow disease progression but carry high risks.

    The origin of MS attacks remains unknown. However, new research indicates that a patient's vitamin D3 supply (derived mainly from sunlight exposure) is strongly related to disease activity; the fewest attacks and slowest progression occurred in patients with the highest vitamin D3 supplies. This research suggests that increasing vitamin D3 supplies might be a safe, effective and inexpensive therapy for MS.

    "MS is a genetically and immunologically complex disease," said lead author Dr. Colleen Hayes from the University of Wisconsin-Madison. "It is currently incurable, but environmental factors, such as vitamin D3, may hold the key to preventing MS and reducing the impact of the disease in MS patients."

    Dr Hayes' team originally suggested that the sunlight dependent hormone D3 (1,25-dihydroxyvitamin D3) may restrain the autoimmune attacks that cause MS based on the strong negative correlation between sunlight exposure and MS prevalence, the need for UV light to catalyze vitamin D3 formation, and the presence of receptors for the vitamin D3 hormone in T lymphocytes. They proposed that the vitamin D3 hormone might act on these receptors to control the T lymphocytes responsible for autoimmunity.

    "Our new study investigated the protective effects of the vitamin D3 hormone in an experimental model of MS when the hormone receptor was either present or absent in T lymphocytes. We found that the hormone's protective effects were only evident when these receptors were present in autoimmune T lymphocytes. Our new data suggest that an action of the vitamin D3 hormone directly on pathogenic T cells leads to elimination of these cells," said Hayes. Actions of the vitamin D3 hormone on other immune cells have not been ruled out, but such actions were not sufficient for protection from autoimmunity if the hormone could not act on the pathogenic T cells.

    "This information is important because it provides a plausible biological explanation for the negative correlation between UV light exposure and MS disease risk and severity," concluded Hayes. "My research group and others around the world are building the scientific knowledge base needed to devise vitamin D-based strategies to prevent and treat MS" she adds. "There are many uncertainties and unanswered questions. However, understanding how sunlight and vitamin D3 may be working at the molecular level contributes greatly to our knowledge base and brings us closer to the goal of preventing this debilitating disease."

    Source: The Medical News (c) News-Medical.Net 2011 (04/03/11)

    Sun exposure, vitamin D may lower risk of multiple sclerosis

    Sunshine and Vitamin DPeople who spend more time in the sun and those with higher vitamin D levels may be less likely to develop multiple sclerosis (MS), according to a study published in the February 8, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. MS is a chronic disease of the brain and spinal cord, usually with recurrent flare-ups of symptoms. It is often preceded by a first episode (or event) of similar symptoms lasting days to weeks.

    “Previous studies have found similar results, but this is the first study to look at people who have just had the first symptoms of MS and haven’t even been diagnosed with the disease yet,” said study author Robyn Lucas, PhD, of Australian National University in Canberra. “Other studies have looked at people who already have MS — then it’s hard to know whether having the disease led them to change their habits in the sun or in their diet.”

    The multi-site study involved 216 people age 18 to 59 who had a first event with symptoms of the type seen in MS. Those people were matched with 395 people with no symptoms of possible MS who were of similar ages, of the same sex and from the same regions of Australia.

    The participants reported how much sun they were exposed to during different periods of their lives, and researchers also measured the amount of skin damage participants had from sun exposure and the amount of melanin in their skin. Vitamin D levels (from sun exposure, diet and supplement use) were measured by blood tests.

    The risk of having a first event, diagnosed by a doctor, ranged from approximately two to nine new cases for every 100,000 people per year in this study. The reported UV light exposure of participants ranged from about 500 to over 6,000 kilojoules per meter squared. The researchers found that the risk of having a diagnosed first event decreased by 30 percent for each UV increase of 1,000 kilojoules. They also found that people with most evidence of skin damage from sun exposure were 60 percent less likely to develop a first event than the people with the least damage. People with the highest levels of vitamin D also were less likely to have a diagnosed first event than people with the lowest levels.

    Studies have shown that MS is more common in latitudes further away from the equator, and this has been confirmed in Australia.

    “Added together, the differences in sun exposure, vitamin D levels and skin type accounted for a 32-percent increase in a diagnosed first event from the low to the high latitude regions of Australia,” Lucas said.

    Lucas noted that the effects of sun exposure and vitamin D acted independently of each other on the risk of first event. “Further research should evaluate both sun exposure and vitamin D for the prevention of MS,” Lucas said.

    Lucas also stated that people should continue to limit their sun exposure due to skin cancer risks. She also noted that the risks of tanning beds far outweigh any possible protective effect against MS. Exposure to the sun has not been shown to benefit people who already have MS.

    The study was supported by the U.S. National Multiple Sclerosis Society, the National Health and Medical Research Council of Australia, the ANZ William Buckland Foundation and Multiple Sclerosis Research Australia.

    R. M. Lucas, A.- L. Ponsonby, K. Dear, P. C. Valery, M. P. Pender, B. V. Taylor, T. J. Kilpatrick, T. Dwyer, A. Coulthard, C. Chapman, I. van der Mei, D. Williams, A. J. McMichael. Sun exposure and vitamin D are independent risk factors for CNS demyelination. - http://www.neurology.org/content/76/6/540.full 

    Source: Neurology, 2011; 76 (6): 540 DOI: 10.1212/WNL.0b013e31820af93d Copyright (c) American Academy of Neurology (08/02/11)

    Researchers to probe vitamin D disease link

    Sunshine and Vitamin DFurther work is to be carried out on Orkney to establish the links between a lack of sunlight and serious health conditions.

    Researchers at Edinburgh University will test whether levels of vitamin D, which is made by the body when it is exposed to sunlight, have an effect on the development of conditions such as diabetes, multiple sclerosis and heart disease.

    The study could also determine whether people with these conditions have lower levels of the vitamin.

    Orkney has the world’s highest rate of multiple sclerosis and researchers believe that lack of vitamin D may be an important factor.

    The study furthers work carried out by Dr Jim Wilson, Royal Society University Research Fellow, who started investigating potential health links in 2008.

    Funding of £50,000 from the chief scientist office will take the research forward.

    He said: “This study will investigate how vitamin D deficiency varies with the seasons, how diet and time spent outside affect vitamin levels, and whether there is a relationship between sunlight and diseases such as diabetes and MS.”

    Source: heraldscotland ©Copyright 2010 Herald & Times Group (20/01/11)

    Vitamin D metabolites associated with clinical and MRI outcomes in MS patients

    Vitamin DSummary: This interesting imaging study recruited 193 patients with MS and aimed to explore the relationship between blood levels of vitamin D metabolites and clinical disability and changes on brain MRI.

    The authors found a statistically significant relationship between low levels of Vitamin D metabolites and degree of disability measured using the MS severity scale. A similar trend was found when disability was measured using the Expanded Disability Status Scale (EDSS), but this did not reach statistical significance. Higher values of the 25(OH)VD(3) to 24, 25(OH)(2)VD(3) ratio were associated with higher MSSS (p=0.041) and lower brain parenchymal fraction (p=0.008)

    The authors conclude that Vitamin D metabolites have protective associations with disability and brain atrophy in MS. In particular, they feel the results indicate strong associations for the 24, 25(OH)(2)VD(3) metabolite, which has not been extensively investigated in MS patients.

    Abstract
    Purpose: The associations between vitamin D and MRI measures of brain tissue injury have not been previously investigated in multiple sclerosis (MS). This research evaluates the significance of vitamin D and its active metabolites in brain tissue injury and clinical disability in MS patients.

    Methods: The study population consisted of 193 MS patients (152 women and 41 men; mean age 46.1 (SD 8.4)&emsp14;years; disease duration 13.8 (SD 8.4)&emsp14;years). Serum levels of 25-hydroxyvitamin D(3) (25(OH)VD(3)), 25-hydroxyvitamin D(2) (25(OH)VD(2)), 1α, 25-dihydroxyvitamin D(3) (1, 25(OH)(2)VD(3)) and 24(R), 25-dihydroxyvitamin D(3) (24, 25(OH)(2)VD(3)) were measured using a novel capillary liquid-chromatography-mass spectrometry method. Disability was assessed with the Expanded Disability Status Scale (EDSS) and the MS Severity Scale (MSSS). MRI measures included T2 lesion volume (LV), T1-LV and brain parenchymal fraction. The associations between deseasonalised levels of vitamin D metabolites and clinical and MRI measurements were assessed using regression analyses.

    Results: Lower deseasonalised levels of total 25(OH)VD (p=0.029), 25(OH)VD(3) (p=0.032) and 24, 25(OH)(2)VD(3) (p=0.005) were associated with higher MSSS. Similarly, lower deseasonalised levels of 24, 25(OH)(2)VD(3) (p=0.012) were associated with higher EDSS. Higher values of the 25(OH)VD(3) to 24, 25(OH)(2)VD(3) ratio were associated with higher MSSS (p=0.041) and lower brain parenchymal fraction (p=0.008).

    Conclusions: Vitamin D metabolites have protective associations with disability and brain atrophy in MS. In particular, the results indicate strong associations for the 24, 25(OH)(2)VD(3) metabolite, which has not been extensively investigated in MS patients.

    Weinstock-Guttman B, Zivadinov R, Qu J, Cookfair D, Duan X, Bang E, Bergsland N, Hussein S, Cherneva M, Willis L, Heininen-Brown M, Ramanathan M.

    427 Cooke Hall, Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY 14260, USA

    Sources: J Neurol Neurosurg Psychiatry. 2011 Feb;82(2):189-95. & Pubmed PMID: 21047880 (19/01/11)

    Vitamin D has a direct immunomodulatory effect in MS

    Vitamin DVitamin D has a direct immunomodulatory effect on CD8+ T cells of patients with early multiple sclerosis and healthy control subjects

    summary
    There is increasing interest in the role of vitamin D in the pathogenesis and potentially in the treatment of multiple sclerosis (MS). The active form of vitamin D has been shown to have an immunomodulatory effect on CD4+ T cells. In this study its effect on CD8+ T cells from ten patients was examined.
    It was found that the addition of the active form of vitamin D to CD8+ T cells resulted in a reduced secretion of pro-inflammatory cytokines and an enhanced secretion of anti-inflammatory cytokines. This effect was independent of the effect on CD4+ T cells.

    As there is growing interest in the potential therapeutic effects of vitamin D CD8+ T cells could be used in conjunction with CD4+ T cells as potential markers in future trials of vitamin D in MS.

    Abstract
    Little is known on a putative effect of vitamin D on CD8+ T cells. Yet, these cells are involved in the immmunopathogenesis of MS. We assessed the cytokine profile of EBV-specific CD8+ T cells of 10 early MS patients and 10 healthy control subjects with or without 1,25(OH)(2)D(3) and found that, with 1,25(OH)(2)D(3), these cells secreted less IFN-γ and TNF-α and more IL-5 and TGF-β. CD4+ T cell depletion or even culture with CD8+ T cells only did not abolish the immunomodulatory effect of 1,25(OH)(2)D(3) on CD8+ T cells, suggesting that 1,25(OH)(2)D(3) can act directly on CD8+ T cells.

    Lysandropoulos AP, Jaquiéry E, Jilek S, Pantaleo G, Schluep M, Du Pasquier RA.
    Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

    sources: J Neuroimmunol. 2010 Dec 24 Copyright (c) 2010 Elsevier B.V. & Pubmed PMID: 21186064 (05/01/11)

    Consensus vitamin D position statement issued by charities

    Sunshine & Vitamin DThis consensus statement represents the unified views of the British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society.


    Vitamin D is essential for good bone health and for most people sunlight is the most important source of vitamin D. The time required to make sufficient vitamin D varies according to a number of environmental, physical and personal factors, but is typically short and less than the amount of time needed for skin to redden and burn. Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without unduly raising the risk of skin cancer.

    Vitamin D supplements and specific foods can help to maintain sufficient levels of vitamin D, particularly in people at risk of deficiency. However, there is still a lot of uncertainty around what levels qualify as “optimal” or “sufficient”, how much sunlight different people need to achieve a given level of vitamin D, whether vitamin D protects against chronic diseases such as cancer, heart disease and diabetes, and the benefits and risks of widespread supplementation.

    You can download and read the full document here.

    Vitamin D and MS – Australian researchers say its time for evidence
    Vitamin DMany people believe that vitamin D supplements can reduce the activity of MS, and different websites recommend that MS patients use vitamin D supplementation. Vitamin D is naturally made in sun-exposed skin, especially in summer, but our increasingly indoor lifestyle and public health campaigns to reduce skin cancer have meant that less of our skin is exposed to the sun, and low vitamin D levels are common, even in this sundrenched country.

    As vitamin D is readily available in 1000IU capsules, and is generally safe (with few exceptions).

    Many people with MS take it. It also  helps the New Zealand economy as the most common product is made from sheep fat.

    However, we don’t actually know whether taking vitamin D supplements reduces MS relapses and brain inflammation, and we certainly don’t know if the very large doses recommended by some authorities (up to 10,000 IU / day) are in fact any better than lower doses.

    In order to address this huge need for evidence, Multiple Sclerosis Research Australia (MSRA) has convened a committee, “PrevANZ”, to explore funding and to run a trial of vitamin D supplementation. It involves providing different doses to people with the earliest signs of relapsing-remitting MS, ie people who have just suffered their first MS-like attack.

    The PrevANZ committee are also exploring international collaborations. As a delegate of this committee, A/Prof Helmut Butzkueven said “I was invited to present to a Scottish summit on vitamin D in MS, held in September this year. Pleasingly, I discovered that a similar trial is planned in the UK and is also awaiting funding decisions. We agreed in principle to share protocols and information, and sincerely hope both projects will be funded.”

    The Scottish summit on vitamin D in MS was brought about by Ryan McLaughlin, aged 15, from Glasgow. Ryan’s mother has MS and he has highlighted the urgent need for improving vitamin D supplementation in Scotland, given the extremely low levels in Scottish people.

    The next step is to finalise the resources needed for a comprehensive study. MSRA and PrevANZ is hopeful that this will allow us to generate the evidence required to prove vitamin D is a relevant treatment and a preventive measure for MS.

    Source: Shine On Scotland (02/12/10)

    US triples intake advice on levels of vitamin D

    Vitamin DIOM report sets new dietary intake levels for calcium and vitamin D to maintain health and avoid risks associated with excess.

    Most Americans and Canadians up to age 70 need no more than 600 international units (IUs) of vitamin D per day to maintain health, and those 71 and older may need as much as 800 IUs, says a new report from the Institute of Medicine.  The amount of calcium needed ranges, based on age, from 700 to 1,300 milligrams per day, according to the report, which updates the nutritional reference values known as Dietary Reference Intakes (DRIs) for these interrelated nutrients.

    The report’s recommendations take into account nearly 1,000 published studies as well as testimony from scientists and stakeholders.  A large amount of evidence, which formed the basis of the new intake values, confirms the roles of calcium and vitamin D in promoting skeletal growth and maintenance and the amounts needed to avoid poor bone health.  The committee that wrote the report also reviewed hundreds of studies and reports on other possible health effects of vitamin D, such as protection against cancer, heart disease, autoimmune diseases, and diabetes.

    While these studies point to possibilities that warrant further investigation, they have yielded conflicting and mixed results and do not offer the evidence needed to confirm that vitamin D has these effects.  Rigorous trials that yield consistent results are vital for reaching conclusions, as past experiences have shown.  Vitamin E, for example, was believed to protect against heart disease before further studies disproved it.

    “There is abundant science to confidently state how much vitamin D and calcium people need,” said committee chair Catharine Ross, professor and Dorothy Foehr Huck Chair, department of nutritional sciences, Pennsylvania State University, University Park.  “We scrutinized the evidence, looking for indications of beneficial effects at all levels of intake.  Amounts higher than those specified in this report are not necessary to maintain bone health.”

    The science on calcium’s role in bone health shows that 700 milligrams per day meets the needs of almost all children ages 1 through 3, and 1,000 milligrams daily is appropriate for almost all children ages 4 through 8.  Adolescents ages 9 through 18 require no more than 1,300 milligrams per day.  For practically all adults ages 19 through 50 and for men until age 71, 1,000 milligrams covers daily calcium needs.

    Women starting at age 51 and both men and women age 71 and older need no more than 1,200 milligrams per day.

    As for vitamin D, 600 IUs daily meets the needs of almost everyone in the United States and Canada, although people 71 and older may require as much as 800 IUs per day because of potential physical and behavioral changes related to aging.

    The majority of Americans and Canadians are getting enough vitamin D and calcium, the committee determined from reviewing national surveys of blood levels.  Some adolescent girls may not get quite enough calcium, and there is a greater chance that elderly individuals may fall short of the necessary amounts of calcium and vitamin D.  These individuals should increase their intake of foods containing these nutrients and possibly take a supplement.

    Confusion about the amount of vitamin D necessary to ward off deficiency has arisen in recent years as tests that measure levels in patients’ blood have become widely used.  The measurements of sufficiency and deficiency — the cutpoints — that clinical laboratories use to report test results have not been based on rigorous scientific studies and are not standardized.  This lack of agreement means the same individual could be declared deficient or sufficient depending on which laboratory reads the test.  There may be an overestimation of the number of people with vitamin D deficiency because many labs appear to be using cutpoints that are higher than the evidence indicates are appropriate.  Based on available data, almost all individuals get sufficient vitamin D when their blood levels are at or above 20 nanograms per milliliter as it is measured in America, or 50 nanomoles per liter as measured in Canada.

    Although sunlight triggers the natural production of vitamin D in skin and contributes to people’s vitamin D levels, individuals’ sun exposure varies greatly and many people are told to minimize their exposure, so the committee assumed minimal sun exposure to establish the DRIs.  The new intake levels for vitamin D cover the needs of US individuals who get little sun.

    Greater amounts of food fortification and rising rates of supplement use have increased the chances that people consume high amounts of these nutrients.  Getting too much calcium from dietary supplements has been associated with kidney stones, while excessive vitamin D can damage the kidneys and heart.  Evidence about other possible risks associated with routine vitamin D supplementation is still tentative, and most studies have focused on very high doses taken short term rather than on routine, long-term consumption of large amounts.  However, some signals suggest there are greater risks of death and chronic disease associated with long-term high vitamin D intake, which informed the committee’s conclusions about levels that consumers should not exceed.

    Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume.  The upper intake levels for vitamin D are 2,500 IUs per day for children ages 1 through 3; 3,000 IUs daily for children 4 through 8 years old; and 4,000 IUs daily for all others.

    The upper intake levels for calcium are 2,500 milligrams per day from age 1 through 8; 3,000 milligrams daily from age 9 through 18; 2,500 milligrams daily from age 19 through 50; and 2,000 milligrams per day for all other age groups.

    “While it is too early to make definitive statements about the risks associated with routine high doses of vitamin D and calcium, people don’t need more than the amounts established in this report,” Ross said.  “Past cases such as hormone replacement therapy and high doses of beta carotene remind us that some therapies that seemed to show promise for treating or preventing health problems ultimately did not work out and even caused harm.  This is why it is appropriate to approach emerging evidence about an intervention cautiously, but with an open mind.”

    The new DRIs are based on much more information and higher-quality study results than were available when the DRIs for these nutrients were first set in 1997.  At that time, limitations in the evidence resulted in intake levels called Adequate Intakes, which are rougher estimations of people’s requirements than the new values.  The old and new DRIs reflect different calculations and are not directly comparable.

    The study was sponsored by the U.S. Department of Health and Human Services, U.S. Department of Agriculture, U.S. Department of Defense, and Health Canada.  Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

    Source: PA International Foundation & Shine On Scotland (01/12/10)

    New Study shows UK vitamin D divide

    Sunlight & Vitamin DScientists found 40% of women living in the north-east of Scotland had less than the minimum recommended amount of the vitamin in their bodies during the winter months.

    But only 10% of those in the south-east of England were below the Department of Health threshold of 25 nanomoles per litre.

    Vitamin D helps the body absorb calcium and is important for healthy bones. It is created naturally in the body by exposure to the sun, but women in Scotland were not exposed to enough sunlight of the right UVB wavelength to create vitamin D, the study suggested.

    The research, published in the Osteoporosis International journal, was conducted jointly by the universities of Aberdeen and Surrey. It also found that 9% of women north of the border still lacked vitamin D in the summer.

    Scientists compared the amount of sunlight women in Aberdeen and Surrey were exposed to throughout the year. They found those in Scotland received half as much sun as their southern counterparts and were “significantly” more deprived of UVB rays.

    A total of 500 women between the ages of 55 and 70 in Aberdeen and Surrey were asked to wear a badge with a film that detected the amount of UVB rays they were exposed to daily.

    The researchers said their findings highlight the need for better public advice on ways to boost vitamin D levels in the winter months. Low levels of vitamin D can lead to rickets – a rare disease that causes the softening and weakening of bones in children – and has been linked to multiple sclerosis.

    Dr Helen Macdonald, from the University of Aberdeen’s Institute of Medical Sciences, said: “Vitamin D is highly important in the prevention of bone diseases such as osteoporosis, helping our bodies absorb more calcium through our diet.

    “We cannot assume that winter requirements of vitamin D are met by the stores accumulated over summer if people do not get enough sunlight to make sufficient vitamin D. Dietary sources of vitamin D are important but the vitamin D status in the current diet of women in the UK is unlikely to be adequate."

    Earlier this year, Glasgow schoolboy Ryan McLaughlin took a petition to the Scottish Parliament which called on ministers to produce new guidelines on vitamin D supplements for children and pregnant women, along with an awareness campaign about the issue. Ryan took up the cause after watching his mother Kirsten suffering from MS.

    Source: Press Association Copyright (c) Press Association Ltd. 2010 (22/11/10)

    Low vitamin D not causal in postpartum MS relapses

    Vitamin DThe elevated risk of multiple sclerosis relapse for new mothers doesn't appear to be related to low vitamin D, results of a small prospective study showed.

    Among women with MS, vitamin D insufficiency was common during pregnancy -- at 71%, Annette Langer-Gould, MD, PhD, of Kaiser Permanente Southern California in Pasadena, and colleagues found.

    However, relapses were no more common at lower serum 25-hydroxyvitamin D (25[OH]D) levels and by six months postpartum were actually associated with marginally higher levels (P=0.04), the group reported online in the Archives of Neurology.

    "These data suggest that low vitamin D in isolation is not an important risk factor for postpartum multiple sclerosis relapses," the researchers concluded in the paper.

    Rather, the results imply other factors associated with pregnancy and breast feeding, such as sex hormones, may be mediating the link, they speculated.

    Prior research had suggested that low levels of vitamin D -- "a potent immunomodulator" -- are linked to increased relapse risk in nonpregnant patients, Langer-Gould's group noted.

    Many thus hoped that extra vitamin D supplementation could ward off the particularly high relapse risk for women after pregnancy and nursing -- 43% within six months and 71% within one year in Langer-Gould's study -- but that is unlikely based on the new findings, the investigators cautioned.

    "Our findings imply that the recommended dose of vitamin D supplementation for women with multiple sclerosis during pregnancy and lactation should be the same as for women who are not," Langer-Gould and colleagues wrote in the paper.

    The researchers prospectively followed 28 pregnant women with MS identified as members of Kaiser Permanente or through Stanford University outpatient neurology clinics.

    The women's average serum 25(OH)D level was 25.4 ng/mL -- in the insufficient range defined as less than 30 ng/mL -- during the third trimester of pregnancy.

    Levels rose after childbirth but remained lower for the half of women who exclusively breast fed their infants with a difference of 5 ng/mL on average by four and six months after childbirth compared with women who didn't breast feed (P=0.001 unadjusted, P=0.38 adjusted for season).

    During pregnancy, serum 25(OH)D levels correlated only with season (P=0.009), whereas they were significantly affected in the postpartum period by breast feeding and relapse status.

    Postpartum multiple sclerosis relapses were not associated with low vitamin D overall in the cohort.

    The somewhat higher 25(OH)D levels seen between three and six months after delivery among the women who had a relapse by six months "was of marginal statistical significance after accounting for season" at P=0.04, the researchers noted.

    Also, this rise didn't appear to occur before the onset of symptoms, as the average 4 ng/mL increase occurred around the time of relapse, they pointed out in explaining why they didn't believe the effect was real.

    "Instead, we think this apparent inverse association is a reflection of the fact that most of the women who relapsed in this study also did not breast feed or did so only briefly," they wrote in the paper.

    They cautioned that the study was limited by the small sample size and inability to account for sun exposure.

    And because most of the women had insufficient vitamin D levels, the study couldn't exclude a protective effect of much higher vitamin D levels, the group added. "Thus, our findings should be confirmed in a larger study."

    Source: Medpage Today © 2004-2010 MedPage Today, LLC. (09/11/10)

    Funnyman Brand's Holyrood mistake

    Darren & Ryan McLaughlinRussell Brand burst in to the Scottish parliament to tell a teenage fan he had won a Pride Of Britain award - but got the wrong person.

    The comedian sneaked in as campaigner Ryan McLaughlin, 15, was making a speech.

    But Brand mistook Ryan's brother Darren for him and was halfway through telling him he had a big surprise before an aide pointed out his mistake.

    As MSPs roared with laughter, Brand was guided to Ryan and had to start his congratulations speech all over again.

    Ryan & Russell Brand

    When the funnyman realised his error, he told Ryan: "The reason I didn't come to you initially is because your oratory and rhetoric was so skillful, I thought it was the Scottish Prime Minister."

    The hilarious scenes will be screened at the Daily Mirror's star-studded Pride Of Britain Awards, in front of guests including Prince Charles, Cheryl Cole and Simon Cowell, on Wednesday on ITV1.

    Ryan, of Glasgow, whose mum Kirsten has Multiple Sclerosis, was selected for the award for his high-profile campaign to raise awareness of the disease.

    Brand said: "What a wonderful person you are and what a wonderful example of how things that are difficult and challenging in life can be turned around if you have a beautiful spirit like you obviously do have."

    A shocked Ryan said: "I was speaking in parliament and they cut me off. The next thing I know is there's a commotion and I see a big scraggly guy who looks like Russell Brand talking to my brother.

    "Then I realised it was Russell Brand. I was gobsmacked. I'm a really big fan, I couldn't really believe he was there. Then it sank in that I'd won a Pride of Britain award and, well, I just thought, 'Wow!'

    Ryan, Russell Brand and Kirsten McLauglin

    "I just thought of all those amazing people who win. I still don't really believe I belong in their ranks. I feel humbled."

    Ryan started his Shine On Scotland campaign to highlight the importance of vitamin D in combating autoimmune diseases after his mum was struck down by MS.

    He successfully lobbied the Holyrood to launch an awareness campaign.

    The Daily Mirror's Pride Of Britain Awards, sponsored by Littlewoods.com is on Wednesday, November 10 at 8pm on ITV1

    Source: Daily Record © 2010 owned by or licensed to Scottish Daily Record and Sunday Mail Ltd. (05/11/10)

    Relationship between vitamin D during perinatal development and health

    Vitamin DVitamin D deficiency is a highly prevalent condition that is present in 40% to 80% of pregnant women.

    There is emerging evidence that vitamin D deficiency may be a risk modifying factor for many chronic diseases, including osteomalacia, rickets, multiple sclerosis, schizophrenia, heart disease, type 1 diabetes, and cancer.

    Heightened susceptibility to these diseases may originate in early life during the development of tissue structure and function.

    It is suspected that biologic mechanisms can “memorize” the metabolic effects of early nutritional environment through fetal and neonatal imprinting. Inadequate vitamin D nutrition during perinatal life may establish a poor foundation that may produce long-term threats to human health.

    This review summarizes the risks of vitamin D deficiency for human health and provides the current vitamin D recommendations for mothers and their newborns.

    Jovana Kaludjerovic, MSc, Reinhold Vieth, PhD

    Source: Journal Of Midwifery & Women's Health Volume 55, Issue 6, Pages 550-560 (November 2010) © 2010 American College of Nurse-Midwives. Published by Elsevier Inc (27/10/10)

    Dietary intake of vitamin D during adolescence and risk of MS
    Vitamin DAbstract
    Adolescence may be an important etiological period in the development of multiple sclerosis (MS), and studies suggest that adequate vitamin D nutrition is protective.

    Here, the authors examined whether dietary intake of vitamin D during adolescence decreases the risk of MS in adulthood. In 1986 in the Nurses' Health Study and in 1998 in the Nurses' Health Study II (NHSII), women completed a food frequency questionnaire regarding their dietary intake during adolescence. From this, daily intake of vitamin D was calculated.

    Adolescent diet was available for 379 incident MS cases confirmed over the combined 44 years of follow-up in both cohorts, and for 67 prevalent cases in the NHSII who had MS at baseline (1989). Cox proportional hazards models were used to calculate relative risk estimates and 95% confidence intervals.

    Total vitamin D intake during adolescence was not associated with MS risk. Intake of ≥400 IU/day of vitamin D from multivitamins was associated with a non-statistically significant reduced risk (RR compared to no intake = 0.73, 95% CI: 0.50-1.07, P = 0.11), whereas intake of whole milk, an important source of dietary vitamin D, was associated with an increased risk.

    The possibility of opposite effects of vitamin D and milk intake on MS risk should be considered in future studies.

    Munger KL, Chitnis T, Frazier AL, Giovannucci E, Spiegelman D, Ascherio A.

    Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Bldg. 2, 3rd Fl., Boston, MA, 02115, USA,

    Source: J Neurol. 2010 Oct 14 & Pubmed PMID: 20945071 (20/10/10)

    Low vitamin D levels increases risk of Paediatric MS

    Sunlight and Vitamin DLow serum vitamin D at the time of a first demyelinating event increases the risk of subsequent multiple sclerosis (MS) in children, according to a new study.

    Of 208 children under age 16 who experienced an acute demyelinating episode, 41 subsequently received a diagnosis of MS an average of eight months following their first symptom. Those with MS had an average serum vitamin D level of 52 nmol/L, versus 66 nmol/L for those remaining without an MS diagnosis, according to Heather Hanwell, MSc, a PhD candidate in the Department of Nutritional Science at the University of Toronto.

    The result extends the well-known connection between vitamin D and MS to pediatric MS cases, and, by placing deficiency so close to onset, strengthens the argument that vitamin deficiency plays a causal role in MS. The study was presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting.

    MS risk was also influenced by the HLA-DRB1*15 allele, previously shown to increase MS risk in adults, but there was no interaction detected between the gene and the vitamin, Hanwell said.

    The data came from a longitudinal study by the Canadian National Pediatric Demyelinating Diseases Network, a collaborative effort to understand pediatric multiple sclerosis and other demyelinating diseases.

    The network enrolls children who have developed an acquired demyelinating syndrome (ADS), "very similar to the CIS [clinically isolated syndrome] that we talk about in adults," Hanwell said. "At least a quarter of children with ADS go on to develop MS."

    "Several lines of evidence point to a window of susceptibility early in life," from the prenatal period to as late as age 15, she said, during which environmental risk factors may act to increase subsequent risk of MS. In this study, "we are able to capture factors at or near the time those factors are acting."

    The children in the study were enrolled from 23 sites across Canada. Blood samples were taken within 40 days of the demyelinating episode, and patients were followed regularly afterward for occurrence of a second episode and potential diagnosis of MS.

    While MS patients were older than non-MS patients, and older children have lower vitamin D levels, the difference in vitamin D levels between the groups remained significant even after correcting for age.

    Both groups had less vitamin D than they should, Hanwell noted. "Seventy-five nanomoles per liter is considered a conservative cutoff for vitamin D deficiency. These children are, on average, insufficient." One hundred nmol/L "is considered a possible therapeutic target for MS," she said.

    There was also a dose response. Those in the highest quartile, above 81 nmol/L, had one quarter of the risk of subsequent MS outcome, compared to those in the lowest quartile.

    The hazard ratio per nanomole was small, only 0.98, but, Hanwell said, "that 2% risk is actually quite meaningful," because it adds up. An increase of 10 nmol/L, for instance, would amount to a 20% risk reduction.

    Alberto Ascherio, MD, DrPH, of Harvard School of Public Health, commented, "I think this is interesting and important, because it is a look at vitamin D levels shortly after the acute episode. These data do support an effect from vitamin D, even though they are not fully prospective."

    "If vitamin D is, in fact, causal, it would be pretty dramatic, since over 80% of young adults have serum levels of under 100," he said. The risk of toxicity from supplementation is low, and the established benefits on other conditions are high. "Two hundred units per day would possibly be sufficient in most patients."

    Vitamin D can't explain everything in MS, he said. "But it is time to consider a very large randomized trial," involving hundreds of thousands of young people over several years, he suggested.

    Source: Medpage Today © 2004-2010 MedPage Today, LLC (16/10/10)

    Low vitamin D levels linked to depression

    Vitamin DVitamin D status in patients with MS is negatively correlated with depression, but not with fatigue.

    Abstract
    Background -  Depressive symptoms and fatigue are frequent and disabling symptoms of multiple sclerosis (MS). Depression and fatigue have been associated with a poor vitamin D status, and a poor vitamin D status is often found in MS.

    Aim - Assess whether vitamin D status contributes to depressive symptoms and fatigue in MS.

    Methods - Patients with MS that participated in previous studies in which depression and fatigue were assessed and of whom serum 25-hydroxyvitamin D (25(OH)D) levels were available within a timeframe of less than one half-life of 25(OH)D were included. Depression and fatigue were assessed with the Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory.

    Results - Fifty-nine patients were included. Mean scores of fatigue and depression were 14.6 (SD 4.2) and 6.2 (SD 4.4), respectively. The mean vitamin D status was 62.3nm (SD 27.8). Vitamin D status correlated negatively with depression (r=-0.326, P=0.006). No significant correlation was found between vitamin D status and fatigue. In a multiple regression model, vitamin D status was not a significant contributor to depression, after controlling for age Expanded Disability Status Scale score and fatigue (P = 0.078). Alternatively, depression and fatigue did not contribute to vitamin D status.

    Discussion - This study shows a negative correlation between vitamin D status and depressive symptoms in patients with MS. Although multiple confounders exist, we observed an indication that vitamin D status might contribute to the presence of depressive symptoms in MS. Therefore, further studies on vitamin D in MS should include depressive symptoms as outcome measures to confirm these findings.

    Knippenberg S, Bol Y, Damoiseaux J, Hupperts R, Smolders J.

    School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht Academic MS Center Limburg, Orbis Medical Center, Sittard Division of Clinical and Experimental Immunology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht Department of Medical Psychology and Psychiatry, Orbis Medical Center, Sittard Laboratory for Clinical Immunology, Maastricht University Medical Center, Maastricht, The Netherlands.

    Source: Acta Neurol Scand. 2010 Sep 29. doi: 10.1111/j.1600-0404.2010.01447.x. © 2010 John Wiley & Sons A/S & Pubmed PMID: 20880265

    International Summit on Vitamin D and MS – A Summary

    Shine On Scotland LogoThe summit brought together researchers and policy makers to discuss the vital issue of vitamin D and public health in Scotland.

    Cabinet Secretary Nicola Sturgeon delivered the keynote address and highlighted the government’s awareness campaign on vitamin D. Moreover, she assured the summit that the government was listening.

    Key findings:

    • Scotland leads the world in the prevalence/incidence of MS. The MS register will provide valuable additional data on these rates. Scotland also leads the world in vitamin D deficiency.

    • Research suggests that the risk of MS is high where UV light is low. The risk of MS is low where the vitamin D status is high in childhood and adolescence.

    • Some research has found that MS relapses are most frequent in people who have low vitamin D levels.

    • Vitamin D supplementation in childhood and adolescence may eliminate autoimmune t-cells before they can cause MS.

    Weight of the evidence for vitamin D

    • The evidence on the links between vitamin D and MS is circumstantially strong.

    • Most researchers agreed that the status quo is unattractive and taking no action is unacceptable.

    • The implications of inaction are great given the high rates of MS in Scotland. In addition, most agreed that the risks associated with vitamin D are minimal or none (see recommendation on dosage).

    • The benefits of higher vitamin D status are only potential but are potentially great.

    • The evidence on the benefits of vitamin D is inevitably incomplete but this has been the case for many previous public health interventions from the introduction of hydroelectric power to folate in neural tube defects – something which has been a major public health triumph of the twentieth century.

    Estimated cost:

    • Research and treatment will no doubt incur costs. However, the high levels of MS in Scotland incur a significant cost to the public purse; this will increase as new cases are diagnosed. We cannot, of course, ignore the huge human cost of MS.

    • In contrast to treatments for MS, vitamin D is relatively cheap and supplementation per person per year is estimated to cost £5 – £10.

    • The cost of any national supplementation programme, therefore, is dwarfed by the cost of MS to individuals, families, the public sector and wider society. Vitamin D also has a number of other health benefits.

    Recommendation on dosage:

    • Most agreed that vitamin D supplementation has a wide safety margin. Implicit evidence shows that up to 10,000 international units/day is safe because it matches the potential effect of UV light exposure.

    • It was suggested that current UK vitamin D dietary guidelines beyond infancy are of minimal effect. Aside from those relating to the prevention of rickets, recommendations are not evidence based.

    • In the light of this, higher dosages should be recommended. These should at least be in line with those currently recommended in North America (which are higher). It was noted that the current recommendations in North America are very likely to be revised upwards this autumn.

    Delegates conclusions

    Inaction seems unacceptable. Supplementation of is feasible, low-risk and would provide valuable evidence on the health outcomes of vitamin D. The Scottish health system is well-placed to monitor effects of vitamin D. Dosage should be increased to match that of North American countries as a matter of urgency.

    Source: Shine On Scotland (04/10/10)

    Young campaigner makes an emotional call to Scottish Parliament to help him prevent MS

    Shine On Scotland LogoRyan McLauglin, the 15 year old Scottish boy campaigning for Vitamin D to be made available to all Scots, made a speech to members of the Scottish Parliament on the 28th October.

    "I would like to thank the Scottish Government, which has been fantastic with the campaign; in helping it reach some of its goals; by raising the awareness of Vitamin D deficiency in Scotland and making sure all GP’s and medical professionals have been given this important information and are now able to advise women who are pregnant or breastfeeding and also people who have children under the age of 5 that they are at risk. This has been one of the main goals of the campaign.

    However, evidence strongly suggests that the levels of vitamin D intake on your leaflet are simply not high enough to protect the future generations of this country, which would lead to a healthier Scotland.  And I’m not just talking about protecting people from MS but from other diseases like Diabetes, Lupus, and some types of cancers to name a few.

    I can think of nothing more important than taking swift and decisive action to protect our children and to improve maternal health in Scotland.

    More can be done! More must be done and we must do it quickly.

    We have waited 60 years for a glimmer of hope for preventing MS so now let’s send out a message around the world that Scotland will look after its own people and that Scotland is leading the charge in the battle against MS.

    We are at one of those big moments in history. We have been given the opportunity to change our country’s health for the better. Experts from around the world and the MS community believe that we can prevent multiple sclerosis for future generations by opting for a national supplementation programme of vitamin D.

    I believe we can prevent Multiple Sclerosis in Scotland. And at this point in time the world is watching us.

    The fight back against this horrible disease starts right here at the Scottish Parliament. And it starts with you our MSP’s.

    I want to finish by saying thank you for all your support and well wishes, and I will continue to do my best in making you all proud! I will continue with my campaign and make sure one day this country will be a healthier one."

    Ryan McLaughlin

    Source: Shine On Scotland (30/09/10)

    Scottish government short-sightedly ignores essential facts on Vitamin D and MS

    Sunlight and Vitamin DThe Scottish Government yesterday ruled out a move to provide Vitamin D supplements on the NHS to make up for a lack of sunlight and to help combat chronic disorders such as multiple sclerosis.

    Experts recommended that Scotland should become the first to fund the free Vitamin D supplement for everyone – which could cost up to £15 million.

    Professor George Ebers, Professor of Clinical Neurology at Oxford University, was one of those who made the call during a one-day summit examining the possible link between multiple sclerosis and vitamin D deficiency.

    The meeting in Clydebank was inspired by campaigning Glasgow schoolboy Ryan McLaughlin, whose 35-year-old mother Kirsten, a former European Taekwondo champion, was diagnosed with multiple sclerosis three years ago.

    The vitamin is naturally created in the body by exposure to the sun but in Scotland there is only enough sunlight of the necessary UVB wavelength for about half the year.

    The Scottish Government said yesterday: “We take our advice from the Scientific Advisory Committee on Nutrition and as far as they are concerned there isn’t enough evidence to justify giving everyone free Vitamin D.”

    Mr Ebers, who works in clinical neurology, said that, although not proven, the evidence was strong enough for all Scots to gain the benefit from the supplement.

    He said: “Scotland has the highest prevalence of MS in the world.

    “We know that if Scots moved to places where it is sunny such as Queensland their MS risk drops sixfold or even higher.”

    Source: hearaldscotland Copyright © 2010 Herald & Times Group (23/09/10)

    Vitamin D could be tested as Multiple Sclerosis aid in Scotland

    Vitamin DVitamin D supplements should be introduced in Scotland to see if they can help combat multiple sclerosis (MS), an expert has said.

    Professor George Ebers, from Oxford University, made the suggestion at a one-day summit examining the possible link between MS and vitamin D deficiency.

    The vitamin is naturally created in the body by exposure to the sun but in Scotland there is only enough sunlight of the necessary UVB wavelength for about half the year.

    The conference in Clydebank, West Dunbartonshire, was organised as part of the Shine on Scotland campaign.

    Teenager Ryan McLaughlin started the initiative after he watched his mother Kirsten struggle with MS.

    Prof Ebers, who works in clinical neurology, said that, although not proven, the evidence was strong enough to see an introduction of the supplement.

    He estimated the supplements could cost under £5 per person a year.

    Prof Ebers said: "MS has the highest frequency here in Scotland. The frequency of vitamin D deficiency is very high here in Scotland and we know that if Scots move to places where it is sunny, their MS risk drops very substantially.

    "It's clear that vitamin D and sunshine are very strong candidates for being responsible for the difference in the risk from staying here to going somewhere else. There is a lot of thinking that has gone into this.

    "I think that we are at the point now where the evidence is sufficiently strong, but not proven, that supplementing Scottish diet, if you like, with vitamin D will have some health benefits, particularly in the case of MS, where it may be protective."

    The Press Association Copyright (c) Press Association Ltd. 2010, All Rights Reserved. (22/09/10)

    Scottish warning over vitamin D levels

    Sunshine and Vitamin DNew leaflets are to be handed out urging people to make sure they get enough vitamin D.

    Doctors are concerned people in Scotland are not getting enough of the vitamin from sunlight and are not topping up their levels with a healthy diet.

    There is increasing evidence that a lack of vitamin D could be linked to cancer and multiple sclerosis.

    Doctors are also concerned about a rise in the bone disease rickets.

    Rickets is a rare condition which causes the softening and weakening of bones in children.

    Pregnant and breastfeeding women are particularly at risk of vitamin D deficiency, along with children under five, the elderly, the housebound and people with darker skin.

    About 10 to 15 minutes a day of sunshine is considered safe.

    But in Scotland the sun is only strong enough to provide vitamin D between April and September.

    If the body's reserves of vitamin D run out during the winter, they need to be topped up from oily fish, eggs, meat or a supplement.

    Health Secretary Nicola Sturgeon said: "We know that in Scotland the winter sun is not strong enough to provide the minimum vitamin D needed for health - especially for those with darker skin.

    "A significant proportion of the UK population has low vitamin D levels. This leaflet aims to ensure that those at risk are aware of the implications of vitamin D deficiency and know what they can do to prevent it."

    She added: "Vitamin D is key to maintaining healthy bones. Young children have a high risk of deficiency and we are seeing an increase in reported cases of rickets in Scotland.

    "These conditions are easily prevented by improving diet and taking a supplement if you are at risk.

    "Recent research suggests that vitamin D deficiency may also contribute to a range of other medical conditions. The Scottish government are keen to continue to monitor this evidence."

    The health secretary is due to speak at the Shine on Scotland conference on Tuesday, which will bring together academics from across the world to consider the possible links between vitamin D deficiency and various health problems.

    The event is taking place after schoolboy Ryan McLaughlin took a petition to the Scottish Parliament which called on ministers to produce new guidelines on vitamin D supplements for children and pregnant women, along with an awareness campaign about the issue.

    Ryan took up the cause after watching his mother Kirsten suffering from MS.

    He said: "It's amazing that I only launched Shine on Scotland early last year and so much has happened since.

    "The petition lodged at the Scottish Parliament got great support and I'm really grateful to the Scottish government for being prepared to look at this issue.

    "I hope the summit is a great success and that something positive can be done for people with MS and to prevent future generations from developing it."

    Source: BBC News © British Broadcasting Corporation 2010 (20/09/10)

    International Vitamin D summit comes to Scotland

    Vitamin DResearchers will present the latest evidence on the ‘sunshine vitamin’ and the implications for Scottish health policy.

    Researchers from around the world will gather in Glasgow next week to discuss links between vitamin D deficiency and multiple sclerosis. 

    The Scottish Summit on Vitamin D and MS will be opened by Nicola Sturgeon, Cabinet Secretary for Health and Wellbeing, and is the next step in the incredible Shine on Scotland campaign led by Glasgow schoolboy Ryan McLaughlin.  Ryan’s Mum has MS and he’s campaigned for well over a year now for changes to public health policy on vitamin D.

    The summit is being hosted in conjunction with the MS Society Scotland and the Scottish Government and will feature speakers from Australia, Canada, and the U.S. as well as the United Kingdom. 

    Researchers will present the latest evidence on the ‘sunshine vitamin’ and the implications for Scottish health policy. 

    The Scottish Government have already pledged to undertake an awareness raising campaign on vitamin D and this has been welcomed by campaigners.  Speaking ahead of the summit Ryan McLaughlin reflected on just how far his campaign has come in a short period of time:

    “It’s amazing that I only launched Shine on Scotland early last year and so much has happened since.  The petition lodged at the Scottish Parliament got great support and I’m really grateful to the Scottish Government for being prepared to look at this issue.  I hope the summit is a great success and that something positive can be done for people with MS and to prevent future generations form developing it”.

    David McNiven, Director of MS Society Scotland, welcomed the fact that policy makers and researchers had this opportunity to discuss such an important matter:

    “I’m hugely looking forward to the summit next week and I’m very pleased that the Society has helped provide this platform for a crucial discussion on an issue which is very significant for Scotland.  Recent evidence is very compelling on the links between vitamin D and MS and it’s great that this is being considered at the highest levels of government”.

    The summit will take place at the Beardmore Hotel in Clydebank on Tuesday 21 September.  It had originally been scheduled for April but had to be rearranged due to the travel disruption caused by the volcanic ash.

    About Shine on Scotland
    A campaign by Ryan Mclaughlin to get vitamin D for every child and pregnant mother as a preventative measure against Multiple Sclerosis http://www.shineonscotland.org.uk

    Source: Shine On Scotland (17/09/10)

    Vitamin D - health perspectives & deficiencies

    Sunlight and Vitamin DAbstract

    Vitamin D, the sunshine vitamin, has been important not only for the evolution of a healthy calcified vertebrate skeleton but it also evolved into a hormone that has a wide diversity of biologic effects.

    During exposure to sunlight the ultraviolet B radiation converts 7-dehydrocholesterol to previtamin D(3) which in turn rapidly isomerizes to vitamin D(3).

    Once formed, vitamin D(3) is metabolized in the liver to 25-hydroxyvitamin D(3) and in the kidneys to its active form 1,25-dihydroxyvitamin D(3). 1,25-dihydroxyvitamin D(3) interacts with its vitamin D receptor in calcium regulating tissues to regulate calcium metabolism and bone health.

    It is now recognized that most cells in the body have a vitamin D receptor and they also have the capability of producing 1,25-dihydroxyvitamin D(3) which in turn is capable of regulating a wide variety of genes that have important functions in regulating cell growth, modulating immune function and cardiovascular health.

    Epidemiologic evidence and prospective studies have linked vitamin D deficiency with increased risk of many chronic diseases including autoimmune diseases, cardiovascular disease, deadly cancers, type II diabetes and infectious diseases.

    Vitamin D deficiency and insufficiency have been defined as a 25-hydroxyvitamin D <20 ng/ml and 21-29 ng/ml respectively. For every 100 IU of vitamin D ingested the blood level of 25-hydroxyvitamin D, the measure vitamin D status, increases by 1 ng/ml.

    It is estimated that children need at least 400-1000 IU of vitamin D a day while teenagers and adults need at least 2000 IU of vitamin D a day to satisfy their body’s vitamin D requirement.

    It is estimated that 1 billion people worldwide are vitamin D deficient or insufficient. Correcting and preventing this deficiency could have an enormous impact on reducing health costs worldwide.

    Holick MF.

    Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, MA, USA.

    Source: Pubmed 20795941 (08/09/10)

    MS and arthritis may be linked to lack of sun, say scientists
    MilkInsufficient exposure to sunshine, resulting in low levels of vitamin D, could play a part in a wide-range of diseases, from multiple sclerosis to rheumatoid arthritis, type 1 diabetes, some cancers and even dementia, scientists say today.

    A study funded by the Medical Research Council, the Wellcome Trust and others, has succeeded in mapping the points at which vitamin D interacts with DNA. Scientists from Oxford University found that the vitamin exerts a direct influence over 229 genes that are known to be involved with certain diseases. Many of the diseases that are implicated are more common in the northern hemisphere than in sunnier, southern climes.

    Scotland, for instance, has one of the highest rates of multiple sclerosis in the world. The disease is virtually unknown in Africa. The study, published in the journal Genome Research, lends substantial support to the hypothesis that the migration of humankind, hundreds of thousands of years ago, to the colder and darker parts of the world had an effect both on skin colour and on susceptibility to certain sorts of disease.

    Research has previously suggested that the need to make more vitamin D resulted in the lightening of skin and hair of people who migrated to the north.

    A lack of vitamin D has long been known to have an effect on bones. The theory runs that women who were unable to make enough vitamin D suffered from contracting pelvises, with the result that they and their unborn babies died in labour.

    "Over a very long period of time, there has been a systematic selection for individuals that can cope with diminished sunshine," said Prof George Ebers, Action Medical Research professor of clinical neurology and one of the senior authors of the paper. He added: "It may be we have not had enough time to make all the adaptations we have needed to cope with our northern circumstances."

    The good news is that – if the scientists are right – diseases such as MS are not genetically predetermined but a mixture of nature and nurture, says Ebers. The

    work will increase calls for changes in the advice on taking vitamin D supplements, which is not expected to help those already suffering from the disease, but could help future generations.

    At the moment, authorities such as the Food Standards Agency say that most of us should be able to get all we need from a healthy diet, including oily fish and eggs, and "by getting a little sun". Pregnant women and older people might benefit from a small daily dose of vitamin D.

    France already gives pregnant women a large supplementary dose of vitamin D, which is fat-soluble, so it stays in the body for some time.

    The Scottish government has now agreed to a meeting in September with scientists to review the evidence, largely as a result of the Shine on Scotland campaign launched by 15 year-old Ryan McLaughlin, whose mother has MS, which wants vitamin D supplements for every pregnant woman and child.

    Susan Polson, 60, who lives in Fife, was diagnosed with MS at the relatively late age of 46, causing her to have to give up her job as head secretary in a big independent school. She is on the committee of the research network of the MS Society in Scotland and takes vitamin D every day even though, she says, she is not expecting a cure.

    "It is too late for me, but my grand-daughter Catriona is two. I don't want to think that because we didn't do anything about vitamin D, she has more risk factors," she said.

    Source: The Guardian (23/08/10)

    Call for Vitamin D in milk to help beat cancer, MS & other illnesses

    MilkMilk could be fortified with vitamin D to strengthen bones and prevent heart disease, cancer & MS.

    The vitamin is credited with a host of benefits but because the body's stores of it are mainly formed by exposure to sunlight many Britons do not have enough of it.

    In England, half of the population is low in the 'sunshine vitamin' when winter ends – in Scotland, it is two-thirds.

    Dr Ann Prentice, chairman of the scientific advisory committee on nutrition, said: 'It is widely recognised within Government circles that we have a problem now that needs to be addressed. Milk is one of the potential vehicles that could be used.'

    The vitamin is vital for calcium absorption and bone health and may help to prevent Alzheimer's.

    Recent research has shown that vitamin D supplements are as good as some drugs at keeping prostate cancer under control – and it is said that taking supplements of the vitamin in pregnancy and childhood could wipe out 80 per cent of cases of multiple sclerosis.

    Low levels of vitamin D are linked to a higher risk of dying from cancer, heart disease and diabetes.

    Dr Susan Lanham-New, a SACN member and a Surrey University nutritionist, said that a study of 14,000 pregnant women in Bristol during the 1990s found that more than 90 per cent of them were not getting enough of the vitamin.

    She said: 'Vitamin D is known to be vital for a wide range of body functions. A lot of us are very worried about [deficiencies] and think it needs looking at.'

    Vitamin D-rich foods include oily fish and eggs but with 90 per cent coming from the action of sunlight on the skin there are concerns that advice on abstaining from sunbathing is unnecessarily restrictive.

    Finland became the first country to add vitamin D to milk supplies in 2003. Fortification is carried out – but not mandatory – in Canada, Israel and Jordan.

    Opinions on the success of the Finnish initiative are mixed. A 2006 study of young men found that fortification led to a ' substantial' rise in vitamin D of more than 50 per cent. But a similar study the following year concluded that fortification only slightly boosted vitamin D levels.

    Any plans for compulsory fortification of milk in the UK could lead to criticisms that consumers were being stripped of choice, although the vitamin has been added to margarine for many years by law.

    The Department of Health said the SACN's report into fortification would take at least three years to complete.

    The Food Standards Agency says most people should be able to get all the vitamin D they need from their diet and sun exposure but recommends ten micrograms per day for over-65s and pregnant and breastfeeding women.

    It warns that high doses can weaken bones but says that taking up to 25 micrograms in supplements a day is unlikely to cause any harm. 

    Source: MailOnline © Associated Newspapers Ltd 2010 (16/08/10)

    Study confirms raising vitamin D level by 50nmol/L could reduce MS relapses by 50%

    Vitamin DHigher 25-hydroxyvitamin D is associated with lower relapse risk in multiple sclerosis.

    Abstract

    OBJECTIVE: A protective association between higher vitamin D levels and the onset of multiple sclerosis (MS) has been demonstrated; however, its role in modulating MS clinical course has been little studied. We investigated whether higher levels of serum 25-hydroxyvitamin D (25-OH-D) were associated with a lower risk of relapses in people with MS.

    METHODS: We conducted a prospective cohort study of 145 participants with relapsing-remitting MS from 2002 to 2005. Serum 25-OH-D levels were measured biannually, and the hazard of relapse was assessed using survival analysis.

    RESULTS: There was an inverse linear relationship between 25-OH-D levels and the hazard of relapse over the subsequent 6 months, with hazard ratio (HR) 0.91 (95% confidence interval [CI]: 0.85-0.97) per 10nmol/l increase in 25-OH-D level (p = 0.006). When variation due to timing of blood collection was removed by estimating 25-OH-D at the start of each season, this association persisted, with HR 0.90 (95% CI, 0.83-0.98) per 10nmol/l increase (p = 0.016). Taking into account the biological half-life of 25-OH-D, we estimated 25-OH-D at monthly intervals, resulting in a slightly enhanced association, with HR 0.88 (95% CI, 0.82-0.95) per 10nmol/l increase (p = 0.001). Adjusting for potential confounders did not alter these findings.

    INTERPRETATION: In this prospective population-based cohort study, in a cohort largely on immunomodulatory therapy, higher 25-OH-D levels were associated with a reduced hazard of relapse. This occurred in a dose-dependent linear fashion, with each 10nmol/l increase in 25-OH-D resulting in up to a 12% reduction in risk of relapse. Clinically, raising 25-OH-D levels by 50nmol/l could halve the hazard of a relapse. ANN NEUROL 2010;68:193-203.

    Simpson S Jr, Taylor B, Blizzard L, Ponsonby AL, Pittas F, Tremlett H, Dwyer T, Gies P, van der Mei I.

    Menzies Research Institute

    Sources: Ann Neurol. 2010 Aug;68(2):193-203. & Pubmed PMID: 20695012 (11/08/10)

    Confirmation of association between MS, CYP27B1 & Vitamin D
    The sunMultiple sclerosis is a complex inflammatory disease that is characterized by lesions in the central nervous system.

    Both genes and other environmental factors influence disease susceptibility. One of the environmental factors that has been implicated in MS and autoimmune disease, such as type 1 diabetes, is vitamin D deficiency, in which patients have lower levels of 25-hydroxyvitamin D3 (25-OHD3) in blood than do controls.

    Previtamin D3 is produced in the skin, and turned into 25-OHD3 in the liver. In the kidney, skin and immune cells, 25-OHD3 is turned into bioactive 1,25(OH)2D3 by the enzyme coded by CYP27B1 (cytochrome P450 family 27 subfamily B peptide 1) on chromosome 12q13.1–3. 1,25(OH)2D3 binds to the vitamin D receptor, expressed in T cells and antigen-presenting cells. 1,25(OH)2D3 has a suppressive role in the adaptive immune system, decreasing T-cell and dendritic cell maturation, proliferation and differentiation, shifting the balance between T-helper 1 (Th1) and Th2 cells in favor of Th2 cells and increasing the suppressive function of regulatory T cells. Rs703842 in the 12q13–14 region was associated with MS in a recent study by the Australian and New Zealand Multiple Sclerosis Genetics Consortium (ANZgene).

    We show associations with three SNPs in this region in our Swedish materials (2158 cases, 1759 controls) rs4646536, rs10877012 and rs10877015 (P=0.01, 0.01 and 3.5 × 10−3, respectively). We imputed rs703842 SNP and performed a joint analysis with the ANZgene results, reaching a significant association for rs703842 (P=5.1 × 10−11; odds ratio 0.83; 95% confidence interval 0.79–0.88).

    Owing to its close association with 25-OHD3, our results lend further support to the role of vitamin D in MS pathology.

    Emilie Sundqvist1, Maria Bäärnhielm2, Lars Alfredsson2, Jan Hillert3, Tomas Olsson1 and Ingrid Kockum1

    1Neuroimmunology Unit, Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
    2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
    3Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

    Source: European Society of Human Genetics © 2010 European Society of Human Genetics (26/07/10)

    Scottish vitamin D summit captures international attention

    Shine On Scotland LogoShine on Scotland campaigners held productive talks with the Scottish Government yesterday as planning continues for the Scottish Summit on Vitamin D and MS which will take place in Glasgow in September.

    Cabinet Secretary for Health and Wellbeing Nicola Sturgeon will open the event at which international researchers and scientists will be present to discuss the latest research on vitamin D and the implications for public health policy in Scotland.

    In recent weeks more researchers from as far afield as Australia have confirmed their attendance at the summit.  International media organisations have also expressed an interest in the event which looks set to be high profile.

    Looking ahead to September, Ryan McLaughlin said:

    “It’s incredibly exciting that it’s now so close.  A lot of work has gone into the campaign and hopefully this summit will make a real difference.  The Scottish Government and Parliament have been very supportive of the campaign and it’s great to have reached this stage”.

    Craig Wilkie, Head of Policy and Communications at MS Society Scotland also attended the meeting at St Andrews House:

    “The Summit is a great opportunity to bring internationally renowned researchers to Scotland to discuss a hugely important public health issue.  The focus will be a practical one in terms of public health policy and we have the chance to learn lessons from other countries and make a significant contribution to the health of the nation”.

    Source: Shine On Scotland (22/07/10)

    Is hypovitaminosis D one of the environmental risk factors for multiple sclerosis?

    Vitamin DThe role of hypovitaminosis D as a possible risk factor for multiple sclerosis is reviewed.

    First, it is emphasized that hypovitaminosis D could be only one of the risk factors for multiple sclerosis and that numerous other environmental and genetic risk factors appear to interact and combine to trigger the disease.

    Secondly, the classical physiological notions about vitamin D have recently been challenged and the main new findings are summarized.

    This vitamin could have an important immunological role involving a number of organs and pathologies, including autoimmune diseases and multiple sclerosis. Furthermore, human requirements for this vitamin are much higher than previously thought, and in medium- or high-latitude countries, they might not be met in the majority of the general population due to a lack of sunshine and an increasingly urbanized lifestyle. Thereafter, the different types of studies that have helped to implicate hypovitaminosis D as a risk factor for multiple sclerosis are reviewed.

    In experimental autoimmune encephalomyelitis, vitamin D has been shown to play a significant immunological role.

    Diverse epidemiological studies suggest that a direct chain of causality exists in the general population between latitude, exposure to the sun, vitamin D status and the risk of multiple sclerosis. New epidemiological analyses from France support the existence of this chain of links.

    Recently reported immunological findings in patients with multiple sclerosis have consistently shown that vitamin D significantly influences regulatory T lymphocyte cells, whose role is well known in the pathogenesis of the disease.

    Lastly, in a number of studies on serum levels of vitamin D in multiple sclerosis, an insufficiency was observed in the great majority of patients, including at the earliest stages of the disease.
    The questionable specificity and significance of such results is detailed here.

    Based on a final global analysis of the cumulative significance of these different types of findings, it would appear likely that hypovitaminosis D is one of the risk factors for multiple sclerosis.

    Charles Pierrot-Deseilligny1 and Jean-Claude Souberbielle2

    1 Service de Neurologie 1, Hoˆ pital de la Salpeˆ trie` re, Assistance Publique Hoˆ pitaux de Paris, Universite´ Pierre et Marie Curie (Paris VI), Paris, France
    2 Service d’explorations fonctionnelles, Hoˆ pital Necker-Enfants-Malades, Assistance Publique Hoˆ pitaux de Paris, Universite´ Rene´ Descartes (Paris V),
    Paris, France

    Source: Brain © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain.(12/07/10)

    Expert questions outdated view on staying out of the sun

    Vitamin D and the SunLack of sunshine and the vitamin it makes in our skin is probably the most serious single cause of disease in the UK today.

    Vitamin D deficiency is well known as the classic cause of rickets and serious bone diseases, but in the last 10 years it has also been identified as a major risk factor for diabetes, heart disease, arthritis, infections, some cancers and other ills.

    The cost of all this disease to the UK has been put at an astounding £27bn annually, which compares with only £5bn for the cost of disease caused by smoking.

    Small amounts of vitamin D can be obtained from food but you can't obtain more than about 10 per cent of the optimal amount this way unless you eat oily fish – skin and all – three times a day.

    We depend on the sun for our vitamin D. Since our weather is so unreliable, British people suffer more than almost any other from vitamin D deficiency.

    Many years of bad advice has also been a factor.

    The British Isles are located far north so the winter sun is not strong enough to make any vitamin D. The prevailing westerly wind bringing cloud in from the Atlantic is also against us. The Scots are worst off because there is nothing to the west to protect them. Their vitamin D levels are lower and they have the highest incidence of multiple sclerosis in the world.

    Scientists studying MS now believe that it may be prevented if women take vitamin D in pregnancy and children take regular supplements. Another devastating disease, diabetes type 1 – affecting mostly children who must inject themselves with insulin – could be prevented by the same vitamin D supplements.

    Indeed it is possible that these two diseases could now be eradicated if Government had the will.

    However a recommendation that pregnant women take vitamin D has been ignored over many years by obstetricians.

    Standard advice is that babies are not given vitamin D until they are six months old. Nobody any longer remembers the reason for this, which is implemented nowhere else.

    Everybody thinks that breast milk is a complete food – and so it might be if mothers sunbathed as often as they can. As it is, breast milk in the UK is deficient in vitamin D while artificial milk is supplemented.

    This need not be a problem if mothers give vitamin D drops to their babies. Melanoma, the worst form of skin cancer, has dramatically increased during some 20 years of advice to avoid the sun and use suncream. This is quite possibly because the advice has been wrong. Suncream blocks the action of UVB (shortwave ultraviolet radiation from the sun) – so blocking synthesis of vitamin D with loss of protection against cancer – while UVA (longwave radiation), which seems to carry the main risk of melanoma, is not blocked by many creams.

    We could do much, much more. The Irish Republic has already fortified semi-skimmed milk with vitamin D, Finland has fortified milk and Israel is making milk fortification mandatory. Jordan is bringing in fortification of bread.

    The UK the Food Standards Agency has hummed and hawed. The United States has had fortification for 80 years. What are the English and Scots waiting for?

    The one simple action open to us all is to sunbathe, carefully without burning. The sun is natural, free, and safe if you are sensible. It's also good to take a vitamin D supplement of at least 1000 to 2000 IUs [international units of measurement] per day.

    Oliver Gillie is a health writer and vitamin D campaigner.

    Source: The Independent ©independent.co.uk 2010 (07/07/10)

    Pregnant women 'must take vitamin D supplements'

    Vitamin DPregnant women in the UK should be told to routinely take vitamin D supplements, researchers say.

    The team at University College London Institute of Child Health says official bodies currently offer conflicting advice.

    Writing in the British Journal of Nutrition, they say there is a "strong case" for a daily dose of vitamin D in pregnancy.

    But one leading expert said more evidence was needed.

    The Department of Health advises pregnant women to ensure they receive a certain level of vitamin D - 10 micrograms per day. The researchers say this in effect endorses use of supplements, because diet and the sun provide too little.

    But the National Institute of health and Clinical Excellence (NICE) said in its guidance that it did not support supplements.

    It has instead said that women should simply "be informed" about the importance of having adequate vitamin D levels during their pregnancy and while breastfeeding - adding that some women may choose to do this via supplements.

    Additionally, pregnant women on low incomes are entitled to a range of nutrients - including vitamin D - as part of the Healthy Start Scheme.

    'Unacceptably high'
     
    The paper said the UK was the only one of 31 countries examined which did not recommend that women of reproductive age took a vitamin D supplement, and that it also fails to endorse a daily supplement for expectant mothers.

    Dr Elina Hypponen, co-author of the paper, said: "The incidence of vitamin D deficiency in pregnant women in Britain is unacceptably high, especially during winter and spring.

    "This is compounded by a lack of exposure to sunlight and the limitations of an average diet to meet the optimal need.

    "In the most severe cases, maternal vitamin D deficiency can be life threatening to a newborn.

    "We believe that the routine provision of a daily supplement throughout pregnancy would significantly decrease the number of mothers who are clearly vitamin D deficient, reducing related serious risks to their babies."

    Dr Hypponen said past evidence showed a proactive approach to supplements coincided with a much lower incidence of deficiency linked diseases such as infantile hypocalcaemia [also known as William's syndrome, which affects development], and rickets [which weakens bones].

    One in four

    The authors say women from some ethnic minorities are recognised to be at greater risk because their darker skin means they do not absorb as much sunlight.

    But they add that the problem is also common among white women, even when they live in southern England.

    Women are more likely to be vitamin D deficient than men, and a previous study found one in four pregnant mothers has been found to be vitamin D deficient during winter and spring

    The Royal College of Obstetricians and Gynaecologists recommends only women at risk of vitamin D deficiency should take a supplement.

    Patrick O'Brien, a spokesman for the college, said: "There is gradually accumulating evidence that universal vitamin D supplementation in the UK might be beneficial for the whole population.

    "But more research is needed on the balance of risks and benefits in women at low risk of vitamin D deficiency, and on the correct dosage to use."

    Source: BBC News © British Broadcasting Corporation 2010 (05/07/10)

    Vitamin D linked to poor learning performance in patients With MS

    Vitamin DA new study shows that serum vitamin D deficiency is associated with poor learning performance among patients with multiple sclerosis (MS).

    The research was presented at the Consortium of Multiple Sclerosis Centers 24th Annual Conference and the Third Joint Meeting of Americas Committee for Treatment and Research in Multiple Sclerosis.

    There is some evidence that vitamin D suppresses proinflammatory cytokines, and that low levels of these cytokines could contribute to MS. Other evidence suggests that vitamin D plays a role in cognitive function in older adults. Cognitive impairment is very common in MS, but few studies have examined the relationship between serum vitamin D and cognitive deficits in this population.

    The researchers enrolled 23 patients with relapsing-remitting MS and secondary progressive MS. After laboratory work to determine serum vitamin D levels, patients underwent a comprehensive neuropsychological evaluation to assess emotional functioning, memory, executive functioning, processing speed, attention, and visuospatial abilities.

    Low vitamin D levels and poor performance were correlated on a verbal learning test (r = .49; P < .05). The effect was stronger in single-trial learning (r = .65; P < .001). No correlation was observed during later learning trials.

    "These findings suggest the importance of determining vitamin D levels in order to maximize cognitive potential among MS patients. Future randomized trials should examine whether vitamin D supplementation may improve learning in MS," the researchers wrote in the abstract.

    The work was prompted by several recent studies that showed a relationship between cognitive function and vitamin D levels in the elderly, Todd Feaster, PsyD, a neuropsychologist at the MidAmerica Neuroscience Institute in Lenexa, Kansas, told Medscape Neurology. Dr. Feaster also works with patients with Alzheimer's disease, so those findings struck a chord in him, he said.

    The study suggests that cognitive impairment might not be caused by MS alone but could be caused or exacerbated by vitamin D deficiency, and supplementation might improve symptoms.

    "When you have a winter like we've had in the Midwest, you're stuck inside all day. So is vitamin D deficiency exacerbating cognitive issues? And if we get those levels up, will we get improvement?" Dr. Feaster posited.

    The study was relatively small, cautioned Helen Tremlett, PhD, assistant professor of neurology at the University of British Columbia in Vancouver, Canada. "It does need to be reproduced," she told Medscape Neurology.

    "He didn't factor in seasonality, which could be [important]. But if the findings are true, we might be able to supplement vitamin D and bring up cognitive levels" in these patients, Dr. Tremlett suggested.

    However, the study isn't robust enough to change clinical practice just yet. "We can't do an intervention based on what he's presented, but it gives us real food for thought. A longitudinal study would be nice to see," she remarked.

    Source: Medscape Today © 1994-2010 by WebMD LLC (10/06/10)

    Low sunlight linked to MS onset age

    Sunshine and MSAge of onset of multiple sclerosis was more than two years earlier in patients who lived in northern latitudes -- with reduced exposure to the sun in fall and winter -- during childhood, researchers found.

    Low intake of vitamin D supplements was also associated with earlier onset, according to Joel Culpepper, MD, of the University of Maryland School of Medicine in Baltimore and colleagues.

    "This is the first evidence that low sun exposure may be related to early onset of of MS symptoms," Culpepper told attendees at the meeting of the Joint Consortium of Multiple Sclerosis Centers and America's Committee on Treatment and Research in Multiple Sclerosis.

    Low sun exposure has long been linked to the risk of MS, based on geographic and ethnic patterns in differential MS incidence. To determine if the same was true for age of onset, Culpepper and colleagues recruited 1,167 men and women drawn from the Veterans Administration's Multiple Sclerosis Surveillance Registry for an extensive interview to determine how much time they spent out in the sun during the fall and winter between the ages of 6 and 15.

    Combined with their ZIP code and altitude, this information allowed the researchers to determine the total UV-B exposure during those months.

    Vitamin D supplement intake was determined by participants' recollection of milk, fish, and cod liver oil consumption.

    The group of participants was about half women, and included 948 patients with relapsing-remitting MS and 219 with primary progressive form of the disease.

    No effect of sun exposure or vitamin D intake was seen in those with primary progressive disease, and no effect was seen in patients with either form who lived in areas of the country that got a lot of sunlight in the winter months. "If you live in a high solar radiation area, such as the deep South, you are probably getting enough exposure even in the deep winter," Culpepper said.

    But in those with relapsing-remitting MS who lived in more northern areas, those in the lowest quartile of exposure, with less than 16 weeks of cool-season exposure, had an age of onset 2.3 years before those in the highest three quartiles (P=0.01).

    Age at onset was delayed by three years for regular users of cod liver oil (P=0.01), a potent source of readily available vitamin D. In a multiple regression model, that effect was more pronounced in low-solar radiation areas.

    "The link between age of onset and sun exposure is likely through the effect of sun on vitamin D," Culpepper said.

    Childhood through puberty is a critical period of MS risk, he noted. "We believe there is a window of susceptibility" up to the early or mid-teens.

    "We need to be able to identify the at-risk individuals, and then intervene in childhood," he said, but noted that risk is likely to be a combination of genetic, in utero, and childhood effects.

    "This is a big challenge for epidemiologists to work out."

    Intervention would be another challenge, he pointed out, since increasing sun exposure without protecting against sun burn increases risk of melanoma. Vitamin D supplementation would be an alternative, Culpepper suggested.

    Source: MedPage Today © 2004-2010 MedPage Today, LLC (07/06/10)

    Should Scotland introduce a Vitamin D supplementation programme?

    Vitamin DWhen Ryan McLaughlin was 14 he found himself displaying symptoms of Multiple Sclerosis.

    Acutely aware of the condition as a result of his mother’s diagnosis two years previously, he was referred to Yorkhill hospital for tests.

    Hoping to learn of a cure, he sought answers on the internet and came across research from Oxford University, highlighting the link between Vitamin D deficiency and MS.

    “To be honest with you, I kind of discounted it at first, thinking it was a wee bit too simple,” says dad, Alan. “He went back upstairs and had another good read of the research and came back down and said would it not be just as easy to put the vitamins straight into the milk and then every child has protection. We thought that was a brilliant idea and that is really when we took notice.”

    With the help of the MS Society Scotland, Ryan, whose suffering turned out to be stress causing his body to mimic the symptoms of his mother’s condition, formed the Shine on Scotland campaign and took his proposals to the Scottish Parliament. His petition attracted over 1500 signatures and since then the Scottish Government has agreed to run an awareness campaign highlighting the links between Vitamin D, the so-called sunshine vitamin, and MS.

    However, his long-term aim remains that Vitamin D supplements be offered to every child and pregnant women.

    This goal was given a significant boost last week following the publication of an article in the Lancet Neurology journal.

    In addition to casting a spotlight on Scotland, the article also references the Shine on Scotland campaign and argues that as Vitamin D is an inexpensive supplement, the potential cost savings of such a programme are enormous.

    It continues: “In Europe, if the predicted effects of raising serum Vitamin D concentrations to 100 nmol/L are realised, the potential savings have been estimated to be €187 billion [c £160bn] per year from the direct and indirect burden of disease, set against an expenditure of €10 billion on testing and public education.” While it makes clear that trials are still needed to address questions about dosage levels and long-term implications, it nevertheless argues that given the high prevalence and incidence of MS in Scotland, as well as other diseases related to Vitamin D deficiency such as many types of cancer, cardiovascular disease and diabetes, “the benefits of supplementation are likely to outweigh any potential side-effects” and so should not be seen as an impediment to beginning a supplementation programme in the near future.

    The McLaughlin family are understandably delighted with the news and argue that a supplementation programme should be introduced without delay.

    “I think there has got to be some movement on it, one way or another now,” says Alan.

    “To go to a cohort study will take five years.

    To go to a randomised control study will probably be a ten-year process and we would be looking at probably another 15 years on top before we see a result and get proper data from it and that is too long. Children are suffering. The numbers are growing for MS for children vastly and obviously, people are being diagnosed a lot younger and that means folk are suffering now. So we can’t wait 15 to 20 years to get a result and then take action.” He continues: “A large study would cost between £10-25m. Whereas the Government literally could say we go and allow fortification for certain products at a higher dosage and share some of the burden and cost of that with the food industry and what you will have is healthier kids with a built up immune system at very little cost to the Government to implement it and hopefully, you will see an instant improvement in people’s health.” Certainly, the food industry is not waiting on the Government to make up its mind, he argues.

    “There are plans afoot already by several brands on the market to start putting Vitamin D into all sorts of foods. We’ve already seen it with powdered milk - SMA and Cow & Gate have already started putting it in. Nestle have started putting it into some of their products abroad but not in the UK. They have already brought out Vitamin D in Australia in Kit Kat bars. That will happen here as well, with the right encouragement.” There is growing international recognition of the issue, says Alan, pointing out that US President Barack Obama has recently launched a task force to look at Vitamin D deficiency and Ryan has already written to First Lady Michelle Obama, who is spearheading the ‘Let’s move’ campaign to end childhood obesity to tell her about his campaign in Scotland.

    “American groups are up in arms,” Alan says, “they really want it. North America, especially.

    Australia started campaigning last week.

    Germany kicks one off in a week’s time.

    “So it has caught on and the research is there to prove the theory.”

    “I think we are way by the point where people don’t believe it anymore, it is now just about taking action and seeing how much it will help.” And there is a sense that Scotland is leading the field on this issue, argues Craig Wilkie, head of policy and communications, MS Society Scotland.

    “Partly that is because some of the most significant research has been done in the UK and has been taken up in a Scottish context throughout this campaign,” he says, “and from our perspective, the Scottish Government has been very receptive to looking at that, considering that and working with us to see what some of the implications might be.” There is certainly much to consider. In March a group of international experts, health professionals, politicians and patient representatives met in Brussels to call for action to address widespread deficiency of Vitamin D in Europe.

    “Most of the experts and health professionals there were very much of the view that this is quite a significant challenge and it was described by one of the participants as the low-lying fruit of public health - the next stage that governments could and should consider,” explains Wilkie, who attended the meeting.

    Unfortunately, the meeting tended to be a little bit focused on the academic research itself rather than some of the policies that politicians and governments might look at, he says. However, he is hopeful that the summit that is being hosted by MS Society Scotland with support from the Scottish Government later this year will provide a forum for such debate.

    The summit, which had been scheduled for April but was postponed due to the volcanic ash cloud, will now be held in Scotland in September.

    “It is quite exciting for us to be able to bring these people into the same room to look at a potentially important issue,” he says.

    “One of the things that is interesting, at least to me, about Vitamin D is that even though the research and the evidence is still emerging, and some of it is still at a reasonably early stage, I think, especially in the current climate, that it is important that the options we are looking at are relatively low cost. And even if the benefit as yet is not absolutely definitive, the potential benefit is actually quite big and at the same time, the risks seem to be very low.

    “So the combination of all those factors make it potentially quite a significant area to look at in relation to public health and one that might bring a lot of benefit for not very much investment.” Backing the Lancet article’s calls for action now on supplementation, Wilkie says he would like to see the Government giving serious consideration to a programme of supplementation for at-risk groups, such as young children, pregnant women, and certain ethnic minority groups who may tend to cover up and so do not receive the same exposure to the sun.

    However, alongside this he would also like to see more co-ordination of public health messages around how to boost levels of Vitamin D naturally.

    “By and large, the message on sunscreen and so on has been quite a successful one in public health terms. But one of the implications of that in a country like Scotland is that people are actually denying themselves the opportunity to get Vitamin D from the sun, which is the most obvious and plentiful source of it. Even ten, 15 minutes in the sun prior to putting on sunscreen can make a difference. So one of the things that we’ve been talking about with the Government is how you can try and coordinate some of those messages and look at some of the unintended consequences of certain health messages around sunscreen, for example.” While he says there is still a long way to go, he says it is remarkable what the Shine on Scotland campaign has managed to achieve in a relatively short time, which he credits in no small part to Ryan’s unstinting “enthusiasm and commitment”.

    “He is always looking for new opportunities to expand the campaign or add different dimensions to it. He is quite an extraordinary young man. So it is no surprise that he is getting things done,” Wilkie says.

    Alan is also proud of what his son has achieved. “He’s done a fantastic job with it.

    He’s got his own wee style in the way he speaks to the Government and to manage to get the whole government on side, he has done really well.

    “For the last year he has just been stuck in his room, apart from when he is doing his Taekwondo, researching and annoying politicians until they give in.” And he has been right to do so, Alan says.

    “It is not as if they are giving in for any reason other than that he’s right. The research is 40 years old now. It was only last year that Oxford University found that specific gene which proved the theory, but the Vitamin D hypothesis has been there for nearly going on 40 years. So it is about time something is done about it.”

    Source: Holyrood Magazine (c) Holyrood.com (01/06/10)

    Vitamin D: hope on the horizon for MS prevention?

    Vitamin DThe worldwide prevalence and incidence of multiple sclerosis (MS) are on the increase.

    The need for strategies to prevent this devastating disease is therefore greater than ever.

    As highlighted in a Review in this issue of The Lancet Neurology, vitamin D deficiency might be an important modifiable risk factor for MS. This raises the question of whether population-wide supplementation programmes might be a reasonable prevention strategy.

    Vitamin D deficiency is especially common in high latitude regions, such as northern USA, Canada, northern Europe, and New Zealand, where weaker ultraviolet B rays during winter months are insufficient for people to produce enough vitamin D. Vitamin D deficiency has traditionally been linked to bone diseases such as rickets; in addition to MS, links with other diseases such as type 1 diabetes, heart disease, infectious diseases, and some types of cancer are now emerging. Pregnant women, young children, and the elderly are at the greatest risk. Vitamin D deficiency might also adversely affect disease course in many disorders, including MS, although evidence for this is less robust.

    The main sources of vitamin D are sunlight and diet, but many people do not get sufficient amounts, so dietary supplements are required. The current recommended daily intake of vitamin D is typically 200—400 IU/day in Europe, and in the USA and Canada, where some foods are fortified with vitamin D, the recommendation is for 200—600 IU/day. The US National Academy of Sciences' Institute of Medicine is currently reviewing the dietary reference intakes for vitamin D and calcium and is due to report its recommendations at the end of summer 2010.

    Expert recommendations for optimum serum vitamin D concentrations range from 50 nmol/L to 100 nmol/L; the total daily need for vitamin D, from sunshine, diet, and supplementation, to achieve this concentration is thought to be 1000—4000 IU/day, depending on factors such as age, geographical region, and health status. The risks of taking high doses of vitamin D are thought to be low, and the main concern of overdose is hypercalcaemia. However, given that an adult who spends 20 min in summer sunshine can produce an oral intake equivalent of about 10 000 IU/day, the suggested dose of 1000—4000 IU/day is unlikely to be toxic. Recent evidence suggests that prolonged intake of 10 000 IU/day (and even up to 40 000 IU/day) poses no risk for adults.

    So far, the evidence for a protective effect of vitamin D on MS largely comes from ecological and observational studies, although evidence is accumulating on possible mechanisms linking vitamin D deficiency and autoimmunity. Large-scale, long-term randomised controlled trials on high-dose vitamin D supplementation would be needed to definitively establish a protective effect and to identify any unexpected long-term complications. But it could take decades before data on MS prevention become available.

    In the meantime, because the risks seem to be low, is there already a case for widespread vitamin D supplementation? Scotland is one such region where the prevalence and incidence of MS, and other diseases related to vitamin D deficiency, are already so high that the benefits of supplementation are likely to outweigh any potential side-effects. During an upcoming summit in Scotland, hosted by MS Society Scotland and resulting from the Shine on Scotland campaign, researchers will present the case to Scottish government officials for vitamin D supplements to be made freely available for all young children and pregnant women.

    As vitamin D is an inexpensive supplement, the potential cost savings of such a programme are enormous, and in addition to MS, might have implications for numerous diseases linked to vitamin D deficiency. In Europe, if the predicted effects of raising serum vitamin D concentrations to 100 nmol/L are realised, the potential savings have been estimated to be €187 billion per year from the direct and indirect burden of disease, set against an expenditure of €10 billion on testing and public education. As well as the possible health benefits, such a supplementation programme might provide important research opportunities to understand the long-term effects of vitamin D.

    Trials are needed to address the numerous questions that remain to be answered about dosing levels, potential long-term complications, and causal mechanisms, among others. In the meantime, given the low costs, low toxicity, and possible beneficial effects of supplementation programmes, steps to tackle vitamin D deficiency in high-risk populations seem warranted. Because any benefits for MS in particular will take decades to emerge, a long-term outlook is needed from policy makers, but future health and financial benefits have the potential to make this investment highly rewarding.

    Source: The Lancet Neurology Copyright © 2010 Elsevier Limited. (25/05/10)

    MS Gene Expression Regulated By Vitamin D
    MS Genetics

    Expression of the Multiple Sclerosis-Associated MHC Class II Allele HLA-DRB1*1501 Is Regulated by Vitamin D

    Abstract Top
    Multiple sclerosis (MS) is a complex trait in which allelic variation in the MHC class II region exerts the single strongest effect on genetic risk.

    Epidemiological data in MS provide strong evidence that environmental factors act at a population level to influence the unusual geographical distribution of this disease.

    Growing evidence implicates sunlight or vitamin D as a key environmental factor in aetiology.

    We hypothesised that this environmental candidate might interact with inherited factors and sought responsive regulatory elements in the MHC class II region.

    Sequence analysis localised a single MHC vitamin D response element (VDRE) to the promoter region of HLA-DRB1. Sequencing of this promoter in greater than 1,000 chromosomes from HLA-DRB1 homozygotes showed absolute conservation of this putative VDRE on HLA-DRB1*15 haplotypes. In contrast, there was striking variation among non–MS-associated haplotypes.

    Electrophoretic mobility shift assays showed specific recruitment of vitamin D receptor to the VDRE in the HLA-DRB1*15 promoter, confirmed by chromatin immunoprecipitation experiments using lymphoblastoid cells homozygous for HLA-DRB1*15. Transient transfection using a luciferase reporter assay showed a functional role for this VDRE. B cells transiently transfected with the HLA-DRB1*15 gene promoter showed increased expression on stimulation with 1,25-dihydroxyvitamin D3 (P = 0.002) that was lost both on deletion of the VDRE or with the homologous “VDRE” sequence found in non–MS-associated HLA-DRB1 haplotypes. Flow cytometric analysis showed a specific increase in the cell surface expression of HLA-DRB1 upon addition of vitamin D only in HLA-DRB1*15 bearing lymphoblastoid cells.

    This study further implicates vitamin D as a strong environmental candidate in MS by demonstrating direct functional interaction with the major locus determining genetic susceptibility. These findings support a connection between the main epidemiological and genetic features of this disease with major practical implications for studies of disease mechanism and prevention.

    Author Summary Top
    Multiple Sclerosis (MS) is a complex neurological disease with a strong genetic component. The Major Histocompatibility Complex (MHC) on chromosome 6 exerts the strongest genetic effect on disease risk. A region at or near the HLA-DRB1 locus in the MHC influences the risk of MS. HLA-DRB1 has over 400 different alleles. The dominant haplotype of Northern Europe, marked by the presence of DRB1*1501, increases risk of MS by 3-fold. The environment also plays a key role in MS. The most striking illustration of this is the geographical distribution of the disease in populations matched for ethnicity. This has led to the proposal that sunshine, and in particular, vitamin D, is an environmental factor influencing the risk of MS. Circumstantial evidence supporting this comes from studies showing the involvement of vitamin D in immune and nervous system function. The current investigation sought to uncover any relationship between vitamin D and HLA-DRB1. It was found that vitamin D specifically interacts with HLA-DRB1*1501 to influence its expression. This study therefore provides more direct support for the already strong epidemiological evidence implicating sunlight and vitamin D in the determination of MS risk, and implies that vitamin D supplementation at critical time periods may be key to disease prevention.

    Sreeram V. Ramagopalan 1,2#, Narelle J. Maugeri1#, Lahiru Handunnetthi1,2, Matthew R. Lincoln1,2, Sarah-Michelle Orton1,2, David A. Dyment1,2, Gabriele C. DeLuca1,2, Blanca M. Herrera1,2, Michael J. Chao1,2, A. Dessa Sadovnick3,4, George C. Ebers1,2*, Julian C. Knight1*

    1 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom, 2 Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom, 3 Department of Medical Genetics, Division of Neurology, University of British Columbia, UBC Hospital, Vancouver, British Columbia, Canada, 4 Faculty of Medicine, Division of Neurology, University of British Columbia, UBC Hospital, Vancouver, British Columbia, Canada

    Source: Public Library of Science Genetics (20/05/10)

    MS & solar exposure before the age of 15 years

    Sunshine & MSAbstract
    Few studies report a protective role of childhood solar exposure to multiple sclerosis.

    Our objective was to confirm the protective role of childhood solar exposure in multiple sclerosis in Cuba, Martinique and Sicily.

    This was a matched case-control study, and cases met Poser criteria for clinically, laboratory (definite, probable) multiple sclerosis.

    Controls were resident population, without neurological disorder, living close to cases (within 100 km), matched for sex, age (+/-5 years), residence before age 15. We recruited 551 subjects during a 1-year period (193 cases, Cuba n = 95, Sicily n = 50, Martinique n = 48; 358 controls). Some (89%) met definite clinical multiple sclerosis criteria (relapsing-remitting form (with and without sequel) (74%), secondary progressive (21%), primary progressive (5%)).

    Odds ratios in a univariate analysis were: family history of multiple sclerosis (5.1) and autoimmune disorder (4.0); wearing shirt (3.5), hat (2.7), pants (2.4); sun exposure causing sunburn (1.8); sun exposure duration (1 h more/day; weekends 0.91, weekdays 0.86); bare-chested (0.6); water sports (0.2).

    Independent factors in the multivariate analysis were family history of multiple sclerosis (4.8 (1.50-15.10)), wearing pants under sunlight (1.9 (1.10-3.20)), sun exposure duration (1 h more/day, weekdays 0.90 (0.85-0.98), weekends 0.93 (0.87-0.99)), water sports (0.23 (0.13-0.40)).

    We conclude that outdoor leisure activities in addition to sun exposure reports are associated with a reduced multiple sclerosis risk, with evidence of dose response.

    Dalmay F, Bhalla D, Nicoletti A, Cabrera-Gomez J, Cabre P, Ruiz F, Druet-Cabanac M, Dumas M, Preux P.

    Université de Limoges, IFR 145 GEIST, Institut de Neurologie Tropicale; EA 3174 NeuroEpidémiologie Tropicale et Comparée, Faculté de Médecine, Limoges, France

    Source: Pubmed PMID: 20463038 (19/05/10)

    Majority of pregnant women not getting enough Vitamin D

    Preganacy and Vitamin DA majority of pregnant women are not getting enough Vitamin D according to a study published in the May issue of the American Journal of Obstetrics and Gynecology.

    While prenatal vitamins do raise Vitamin D levels during pregnancy, the study shows that higher doses may be needed for many women.

    Adit Ginde, MD, MPH, from University of Colorado Denver School of Medicine, lead author of the study said, "We already know Vitamin D is important for bone health of the mother and infant, but we are just starting to scratch the surface about the many potential health benefits of Vitamin D during pregnancy."

    The latest study shows that many pregnant women in the United States have insufficient vitamin D levels. For those women, prenatal vitamins do not provide enough vitamin D, and higher doses are needed to raise levels. Women with darker skin, those who cover their skin for religious or cultural reasons and those living further north during winter months are at particularly high risk for lower Vitamin D levels.

    "Prenatal vitamins do help raise vitamin D levels, but many women start taking them after becoming pregnant. Although research is ongoing, I think it's best for women to start a few months before becoming pregnant to maximize the likely health benefits," said Ginde.

    There is a growing body of evidence that Vitamin D levels have fallen below what's considered healthy in the overall population -- likely from decreased outdoor activity. And vitamin D has reemerged as an important nutritional factor in maternal and infant health. Vitamin D deficiency early in life has been linked to increased risk of respiratory infections and childhood wheezing. Lower levels in adults have been linked to cardiovascular disease and specific types of cancer.

    The study did find that some women have enough Vitamin D. Study co-author Carlos Camargo, MD, DrPH, from Massachusetts General Hospital cautioned that there may be risks from excessive Vitamin D intake. "We need more data from clinical trials of Vitamin D supplementation in pregnant women. If the ongoing trials continue to show benefit, the best strategy will likely be measuring Vitamin D levels through a simple blood test and choosing supplementation doses according to those levels."

    Ginde added, "This tailored approach is common in preventive care for people with high cholesterol, and safer and more effective than a one-size-fits-all solution."

    The study team from University of Colorado School of Medicine, Massachusetts General Hospital and Children's Hospital Boston analyzed nationally representative data from 928 pregnant and 5,173 non-pregnant women of childbearing age collected by the Centers for Disease Control and Prevention. This research was supported by the National Institutes of Health.

    Source: Science Daily © 1995-2009 ScienceDaily LLC (12/05/10)

    Vitamin D status is associated with relapse rate in paediatric-onset multiple sclerosis

    Vitamin DAbstract
    OBJECTIVE:
    We sought to determine if vitamin D status, a risk factor for multiple sclerosis, is associated with the rate of subsequent clinical relapses in paediatric-onset multiple sclerosis.

    METHODS: This is a retrospective study of patients with paediatric-onset multiple sclerosis or clinically isolated syndrome who were consecutively recruited into a prospective cohort at their clinical visit at the paediatric multiple sclerosis center of University of California, San Francisco or State University of New York at Stony Brook.

    Of 171 eligible patients, 134 (78%) with multiple sclerosis/clinically isolated syndrome were included in the cohort; a further 24 were excluded from this analysis due to lack of available serum (n = 7) or lack of follow-up (n = 17). Serum 25-hydroxyvitamin D(3) levels were measured and were adjusted to reflect a deseasonalized value. The adjusted serum 25-hydroxyvitamin D(3) level was the primary predictor in a multivariate negative binomial regression model in which the main outcome measure was the number of subsequent relapses.

    RESULTS: Among the 110 subjects, the mean unadjusted 25-hydroxyvitamin D(3) level was 22 +/- 9 ng/ml. After adjustment for age, gender, race, ethnicity, disease duration, disease-modifying therapy, and length of follow-up, every 10 ng/ml increase in the adjusted 25-hydroxyvitamin D(3) level was associated with a 34% decrease in the rate of subsequent relapses (incidence rate ratio, 0.66; 95% confidence interval, 0.46-0.95; p = 0.024).

    INTERPRETATION: Lower serum 25-hydroxyvitamin D(3) levels are associated with a substantially increased subsequent relapse rate in paediatric-onset multiple sclerosis or clinically isolated syndrome, providing rationale for a randomized controlled trial of vitamin D supplementation.

    Mowry EM, Krupp LB, Milazzo M, Chabas D, Strober JB, Belman AL, McDonald JC, Oksenberg JR, Bacchetti P, Waubant E.

    MS Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94117, USA.

    Source: Pubmed PMID: 20437559 (05/05/10)

    Low vitamin D levels are related to MS brain atrophy, cognitive function, studies show

    Vitamin DLow vitamin D levels may be associated with more advanced physical disability and cognitive impairment in persons with multiple sclerosis, studies conducted by neurologists at the University at Buffalo have shown.

    Their results, reported at the American Academy of Neurology meeting, held earlier this month, indicated that:

    • The majority of MS patients and healthy controls had insufficient vitamin D levels.

    • Clinical evaluation and magnetic resonance imaging (MRI) images show low blood levels of total vitamin D and certain active vitamin D byproducts are associated with increased disability, brain atrophy and brain lesion load in MS patients.

    • A potential association exists between cognitive impairment in MS patients and low vitamin D levels.

    The MRI study involved 236 MS patients -- 208 diagnosed with the relapsing-remitting type and 28 with secondary progressive, a more destructive form of MS -- and 22 persons without MS.

    All participants provided blood serum samples, which were analyzed for total vitamin D (D2 and D3) levels as well as levels of active vitamin D byproducts. MRI scans performed within three months of blood sampling were available for 163 of the MS patients.

    Results showed that only seven percent of persons with secondary-progressive MS showed sufficient vitamin D, compared to 18.3 percent of patients with the less severe relapsing-remitting type.

    Higher levels of vitamin D3 and vitamin D3 metabolism byproducts (analyzed as a ratio) also were associated with better scores on disability tests, results showed, and with less brain atrophy and fewer lesions on MRI scans.

    Bianca Weinstock-Guttman, MD, UB associate professor of neurology/Jacobs Neurological Institute and director of the Baird Multiple Sclerosis Center, is first author on the study. Commenting on these results, Weinstock-Guttman said: "Clinical studies are necessary to assess vitamin D supplementation and the underlying mechanism that contributes to MS disease progression."

    While lower-than-normal vitamin D status is known to be associated with a higher risk of developing MS, little is known about its relationship to cognitive impairment.

    Sarah A. Morrow, MD, UB assistant research professor of neurology/Jacobs Neurological Institute and lead author on the cognitive-impairment study, compared vitamin D levels in blood samples of 136 MS patients with the results of their neuropsychological assessments that tested multiple types of cognition affected by MS.

    "Results showed that MS patients who were impaired on tests of executive function --critical reasoning and abstract thinking -- and the ability to plan and organize, were more likely to be deficient in vitamin D," said Morrow.

    "This relationship held true when controlling for the season during which vitamin D was measured, as well as depression, which is known to be associated with lower vitamin D levels." Morrow noted there also was a suggestion that verbal fluency (word generation) and visual-spatial memory (learning and memory of shapes and figures) is more likely to be affected when vitamin D levels are not sufficient.

    Morrow is continuing her research to clarify these relationships.

    Contributors to the studies, all from UB, were: Robert Zivadinov, MD, PhD; Murali Ramanathan, PhD; Ralph Benedict, PhD; Jun Qu, PhD; Xiaotao Duan, PhD; Barbara E. Teter, PhD; David Hojnacki, MD; Eunjin Bang, Niels Bergsland, Sara Hussein, Mariya Cherneva and Laura Willis.

    Source: University of Buffalo © 2010 University at Buffalo (30/04/10)

    Sunlight may play role in Multiple Sclerosis risk

    SunshineWhen and where people are born may affect their odds of developing multiple sclerosis, according to researchers who found that children born in the early summer months in the Southern Hemisphere are more likely to develop multiple sclerosis than those born in early winter.

    A similar pattern has been found in the Northern Hemisphere, where the summer and winter months are the reverse of those in the Southern Hemisphere. The researchers think the higher disease rates may have something to do with the children's mothers getting less exposure to sunlight during pregnancy.

    Scientists have linked low vitamin D levels to higher rates of multiple sclerosis, and sunlight boosts vitamin D levels.

    In the new study, published online April 29 in BMJ, Anne-Louise Ponsonby, of the Murdoch Children's Research Institute at Royal Children's Hospital in Melbourne, and her colleagues analyzed data on children with multiple sclerosis born in Australia from 1920 to 1950. They tried to find links to the levels of sunlight in the regions in which the mothers lived.

    The risk was about 30 percent higher for those born in November and December, which are early summer months in the Southern Hemisphere, compared with those born in the early winter months of May and June, the study found. Babies were more likely to have multiple sclerosis if their mothers had low exposure to sunlight from five to nine months before giving birth.

    The study authors wrote that researchers need to analyze the idea of giving vitamin D supplements to pregnant mothers to help prevent multiple sclerosis.

    Source: Yahoo! News © 2010 Yahoo! Inc (30/04/10)

    Study explores link between sunlight, multiple sclerosis

    SunshineFor more than 30 years, scientists have known that multiple sclerosis (MS) is much more common in higher latitudes than in the tropics.

    Because sunlight is more abundant near the equator, many researchers have wondered if the high levels of vitamin D engendered by sunlight could explain this unusual pattern of prevalence.

    Vitamin D may reduce the symptoms of MS, says Hector DeLuca, Steenbock Research Professor of Biochemistry at University of Wisconsin-Madison, but in a study published in PNAS this week, he and first author Bryan Becklund suggest that the ultraviolet portion of sunlight may play a bigger role than vitamin D in controlling MS.

    Multiple sclerosis is a painful neurological disease caused by a deterioration in the nerve's electrical conduction; an estimated 400,000 people have the disabling condition in the United States. In recent years, it's become clear the patients' immune systems are destroying the electrical insulation on the nerve fibers.

    The ultraviolet (UV) portion of sunlight stimulates the body to produce vitamin D, and both vitamin D and UV can regulate the immune system and perhaps slow MS. But does the immune regulation result directly from the UV, indirectly from the creation of vitamin D, or both?

    The study was designed to distinguish the role of vitamin D and UV light in explaining the high rate of MS away from the equator, says DeLuca, a world authority on vitamin D.

    "Since the 1970s, a lot of people have believed that sunlight worked through vitamin D to reduce MS," says DeLuca. "It's true that large doses of the active form of vitamin D can block the disease in the animal model. That causes an unacceptably high level of calcium in the blood, but we know that people at the equator don't have this high blood calcium, even though they have a low incidence of MS. So it seems that something other than vitamin D could explain this geographic relationship."

    Using mice that are genetically susceptible to MS-like disease, the researchers triggered the disease by injecting a protein from nerve fibers. The researchers then exposed the mice to moderate levels of UV radiation for a week. After they initiated disease by injecting the protein, they irradiated the mice every second or third day.

    The UV exposure (equivalent to two hours of direct summer sun) did not change how many mice got the MS-like disease, but it did reduce the symptoms of MS, especially in the animals that were treated with UV every other day, DeLuca says.

    The research group also found that although the UV exposure did increase the level of vitamin D, that effect, by itself, could not explain the reduced MS symptoms.

    In some situations, radiation does reduce immune reactions, but it's not clear what role that might play in the current study. "We are looking to identify what compounds are produced in the skin that might play a role, but we honestly don't know what is going on," DeLuca says. "Somehow it makes the animal either tolerate what's going on, or have some reactive mechanism that blocks the autoimmune damage."

    MS is a progressive neurological disease with few effective treatments, but DeLuca stresses that the study, however hopeful, may or may not lead to a new mode of treatment. "There are several ways this could go. If we can find out what the UV is producing, maybe we could give that as a medicine. In the short term, if we can define a specific wavelength of light that is active, and it does not overlap with the wavelengths that cause cancer, we could expose patients who have been diagnosed with MS to that wavelength."

    Does this information change the common prescription to avoid excessive sun exposure? "If you have an early bout with MS, then you have to think about your options," says DeLuca. "Remember, this is just experimental work at this stage. Whether it can be translated into practical applications on MS remains to be seen."

    Source: EurekaAlert! (23/03/10)

    Vitamin D 'triggers and arms' the immune system

    Vitamin DThe so-called sunshine vitamin, which can be obtained from food or manufactured by human skin exposed to the sun, plays a key role in boosting the immune system, researchers believe.

    In particular it triggers and arms the body's T cells, the cells in the body that seek out and destroy any invading bacteria and viruses.

    Scientists at the University of Copenhagen have discovered that Vitamin D is crucial to activating our immune defences and that without sufficient intake of the vitamin, the killer cells of the immune system – T cells – will not be able to react to and fight off serious infections in the body.

    For T cells to detect and kill foreign pathogens such as clumps of bacteria or viruses, the cells must first be ‘triggered’ into action and "transform" from inactive and harmless immune cells into killer cells that are primed to seek out and destroy all traces of invaders.

    The researchers found that the T cells rely on vitamin D in order activate and they would remain dormant, ‘naïve’ to the possibility of threat if vitamin D is lacking in the blood.

    Professor Carsten Geisler from the Department of International Health, Immunology and Microbiology, said: "When a T cell is exposed to a foreign pathogen, it extends a signalling device or ‘antenna’ known as a vitamin D receptor, with which it searches for vitamin D.

    "This means that the T cell must have vitamin D or activation of the cell will cease. If the T cells cannot find enough vitamin D in the blood, they won’t even begin to mobilise. ”

    The discovery, the scientists believe, provides much needed information about the immune system and will help them regulate the immune response.

    This is important not only in fighting disease but also in dealing with anti-immune reactions of the body and the rejection of transplanted organs.

    Active T cells multiply at an explosive rate and can create an inflammatory environment with serious consequences for the body.

    After organ transplants, T cells can attack the donor organ as a ‘foreign invader’. In autoimmune diseases, like arthritis or Crohns Disease, T cells mistake fragments of the body’s own cells for foreign invaders, leading to the body launching an attack upon itself.

    For the research team, identifying the role of vitamin D in the activation of T cells has been a major breakthrough.

    “Scientists have known for a long time that vitamin D is important for calcium absorption and the vitamin has also been implicated in diseases such as cancer and multiple sclerosis, but what we didn’t realise is how crucial vitamin D is for actually activating the immune system – which we know now, ” said the researchers.

    The findings, continues Professor Geisler, “could help us to contain infectious diseases and global epidemics.

    They will be of particular use when developing new vaccines, which work precisely on the basis of both training our immune systems to react and suppressing the body’s natural defences in situations where this is important – as is the case with organ transplants and autoimmune disease.”

    Most Vitamin D is produced as a natural by-product of the skin’s exposure to sunlight. It can also be found in fish liver oil, eggs and fatty fish such as salmon, herring and mackerel or taken as a dietary supplement.

    The findings are published in the latest edition of Nature Immunology.

    Source: Telegraph.co.uk © Copyright of Telegraph Media Group Limited 2010 (08/03/10)

    Drinking milk during pregnancy lowers risk of multiple sclerosis in children

    MilkDrinking milk during pregnancy reduces the chances of development of multiple sclerosis in children in their later life, says a new research study presented at the American Academy of Neurology’s annual meeting in Toronto, Canada.

    The researchers from the Harvard School of Public Health in Boston, US found that children born to pregnant mothers who drank milk were at lower risk of having multiple sclerosis. This was similar in cases where the mothers took vitamin D during pregnancy as well.

    Multiple sclerosis is a medical condition where the brain nerves are damaged and fails to communicate with the spinal cord. It may be seen relapsing in some cases and also show accumulation of the myelin sheaths over time. The common symptoms of this disease are weakness in muscles, spasms and difficulty in movement.

    A study of 35,794 female nurses whose their mothers provided information about their diet pattern during pregnancy established the link between multiple sclerosis and pregnancy. Out of those nurses who took part in the study, 199 were found to develop multiple sclerosis after a span of 16 years.

    The risk of multiple sclerosis was seen to be lower by 56 percent in daughters whose mothers drank milk (four glasses everyday) during pregnancy compared to those mothers who drank less than three glasses.

    The mothers who consumed vitamin D during pregnancy gave birth to daughters with 45 percent lower risk than those whose vitamin D intake was less.

    The findings of the study can help the mothers start having vitamin D and more milk during pregnancy to avoid their children suffer from multiple sclerosis when they grow up.

    Source: Bolo Health © 2009 Bolohealth.com (10/02/10)

    Schoolboy’s petition prompts move on Multiple Sclerosis link to vitamin D

    Ryan McLaughlinAn international conference is to be held in Scotland to discuss the health effects of vitamin D — thanks to the efforts of a 14-year-old schoolboy.

    Ryan McLaughlin, from Glasgow, petitioned the Scottish Parliament questioning possible links between vitamin D and multiple sclerosis after discovering that the disease — from which his mother suffers — could be prevalent in Scotland because of vitamin D deficiency caused by a lack of sunlight.

    The petition called on ministers to produce guidelines on vitamin D supplements for children and pregnant women, and launch an awareness campaign. As a result of his efforts, the Scottish government recognised “an urgent need” to provide information to health professionals and mothers, and is to launch a campaign.

    Ministers also agreed to host a conference on April 27 to discuss the role of vitamin D. The event, to take place in Glasgow, will be opened by Nicola Sturgeon, the Health Secretary. Leading researchers into links between vitamin D deficiency and multiple sclerosis are expected to attend.

    Yesterday, as the Public Petitions Committee agreed to close Ryan’s petition, members congratulated him for his achievement. Bill Butler, Ryan’s local MSP, hailed the schoolboy’s effort, saying that “a very great deal of progress” had been made.

    The Glasgow Anniesland representative praised the way “Ryan and the McLaughlin family have persuaded the government; and the government has listened to the very sensible suggestions contained in the petition.

    “The government has agreed to a co-ordinated programme of action with NHS Scotland to produce guidance on vitamin D, to educate women on its importance, to consider different messages for different groups of people, and to ensure that health professionals are giving correct and consistent advice to pregnant women and new mothers. Not only should the McLaughlin family be congratulated, but also the government for listening.”

    He described that as a significant success. An image of Ryan is now featured on promotional literature for the petitions committee. Speaking about the campaign, Ryan said: “After an amazing year in raising both vitamin D and MS awareness, I now have the commitments that I wanted from the Scottish government.

    “I applaud the positive action taken by the Scottish government and the support from Deputy First Minister Nicola Sturgeon and Shona Robison, Health and Sports Minister.”

    A spokeswoman for the Scottish government said: “We’re keen to learn all we can about any possible links between vitamin D and multiple sclerosis and are keeping a very close eye on all the emerging evidence.”

    • Breast cancer is diagnosed more often in the spring and autumn, and less often in the summer, leading researchers to suggest that its season-ality may be connected to vitamin D deficiency. Researchers at the University of South Carolina, who examined 2,921,714 breast cancer cases, also found that the seasonality was increasingly prominent the further away from the equator that the women lived. This implies that lack of sunshine, and therefore vitamin D, was a factor.

    Source: Times Online Copyright 2010 Times Newspapers Ltd.(10/02/10)

    Low Vitamin D levels are associated with greater risk of MS relapse

    Vitamin DLow vitamin D blood levels are associated with a significantly higher risk of relapse attacks in patients with multiple sclerosis (MS) who develop the disease during childhood, according to a study conducted by researchers from the University of California, San Francisco.

    “We have known for some time that vitamin D insufficiency is a risk factor for developing MS, but this is the first study to assess whether vitamin D levels influence the disease course of those who already have MS,” said lead author Ellen Mowry, MD, MCR, a clinical instructor of neurology at the UCSF Multiple Sclerosis Center.

    The study, which is now published online by the “Annals of Neurology” and is available at http://www3.interscience.wiley.com/journal/123246501/abstract , demonstrates that an increase in vitamin D levels by 10 nanograms per milliliter of blood (ng/mL) corresponds with a 34 percent decrease in the rate of subsequent relapses.

    In other words, raising the vitamin D level of a person with MS by 15 ng/mL, which requires about 2,000 international units of vitamin D supplementation a day, could theoretically cut a patient’s relapse rate in half, explained Mowry.

    “Although we do not yet know if vitamin D supplementation will be beneficial for MS patients, the fact that there is a clear association between vitamin D levels and relapse rate provides strong rationale for conducting a clinical trial to measure the potential impact of supplementation,” she said.

    “This is an exciting finding because it indicates that it is very possible for vitamin D supplementation to have a profound impact on the course of this disease,” said senior author Emmanuelle Waubant, MD, PhD, an associate professor of neurology at UCSF and director of the Regional Pediatric MS Center at UCSF Children’s Hospital. Waubant said she expects similar findings in adult patients with MS.

    Multiple sclerosis is a chronic and often disabling disease that affects the central nervous system, which comprises the brain, spinal cord and optic nerves. A type of autoimmune disorder, MS causes the body’s own defense system to break down a substance called myelin, which surrounds and protects nerve fibers.

    Although MS occurs most commonly in adults, a small proportion of cases are diagnosed in children and adolescents. According to the National MS Society, two to five percent of all people with MS experience their first symptoms before the age of 18.

    The researchers measured vitamin D levels through blood samples from 110 patients whose MS symptoms began at age 18 or younger. The patients were seen at either UCSF Children’s Hospital or the State University of New York Stony Brook’s Regional Pediatric MS Center of Excellence – two of six multidisciplinary referral centers in the United States sponsored by the National MS Society.

    After providing the initial blood sample, patients were followed for an average of 1.7 years, during which the researchers recorded the total number of relapses each patient experienced. According to Mowry, a relapse or flare-up of MS causes new neurologic symptoms or the worsening of old ones, such as impaired vision, problems with balance, or numbness. Relapses can be very mild or severe enough to interfere with a person’s ability to function.

    During the follow-up period, the researchers assessed the patients’ relapse rates and vitamin D levels after controlling for such factors as age, gender, race, ethnicity, use of MS treatments and the duration of follow-up care.

    “If we are able to confirm that vitamin D supplementation is an effective treatment, my hope is that it will help improve the quality of life for all MS patients,” Mowry said.

    In addition to a randomized clinical trial of vitamin D supplementation in MS patients, Mowry said further studies are also needed to determine the mechanism by which vitamin D affects inflammatory processes and, in turn, eases symptoms of MS.

    Additional co-authors from UCSF include Dorothee Chabas, MD, PhD; Jonathan Strober, MD; Jamie McDonald, BS; Jorge Oksenberg, PhD, and Peter Bacchetti, PhD. Co-authors from other institutions are Lauren Krupp, MD; Maria Milazzo, MS, CPNP, and Anita Belman, MD, all of the Pediatric MS Center, State University of New York at Stony Brook.

    The study was supported by a National MS Society Sylvia Lawry Fellowship Award and an additional grant from the National MS Society.

    Source: PRWEB (21/01/10)

    Babies born in April may have increased risk of developing Multiple Sclerosis

    Vitamin D

    Babies born in April face an increased risk of suffering from multiple sclerosis in later life, possibly as a result of their mothers' lack of exposure to sunlight, according to research.

    Scientists found mothers who were pregnant during the autumn and winter were most likely to give birth to those who would suffer from the debilitating neurological disease.

    The researchers, based at Glasgow university and the city's Southern General Hospital, believe the spike in cases among children born in the spring may be due to a shortage of vitamin D because duing a vital developmental stage their mothers are exposed to less sunshine.

    Vitamin D, which is largely gained through sunlight and food, is known to regulate a gene that can predispose individuals to MS. If the gene is passed on to the unborn child, without being regulated by a sufficient amount of vitamin D, it could "hard wire" them to develop the disease in later life.

    The new study, published in the European Journal of Neurology, is the biggest yet carried out in Scotland, which has the highest rate of MS in the world.

    MS affects about 100,000 people in the UK and 10,500 in Scotland. While the cause is not known, experts believe a combination of genetic and environmental factors are responsible for the condition.

    The Glasgow researchers examined data on about 1,300 MS patients born in the west of Scotland between 1922 and 1992. They found that about 400 people born in March, April and May went on to develop MS, 22per cent higher than expected. Almost half of all male and a quarter of female sufferers were born in April.

    By comparison, there were about 16 per cent fewer MS births in the autumn months. Those born in November had the lowest incidence of the disease.

    Dr Colin O'Leary of the institute of neurological sciences at the Southern General and co-author of the study, said several theories about the condition were being explored.

    "It's a very interesting observation and springtime seems to be a period of relatively high risk," he said.

    "Seasonal risk may be a reflection of adverse events that occurred at the time of birth, in utero in the preceding nine months, or during the months following birth, when the central nervous system continues to undergo rapid development.

    "There could be an association between reduced sun exposure and vitamin D levels." O'Leary now plans to carry out a UK-wide study with scientists in Oxford.

    Professor George Ebers, from Oxford University's department of clinical neurology at the John Radcliffe Hospital, said: "The difference [in developing MS in Scotland] between being born in April versus November is an astounding 50per cent. This is real, there's no doubt of a seasonal link. There are different theories, but I think the April excess of births could be linked to a sunlight deficiency.

    "The focus is on trying to prove what the environmental effect is and, pending conclusive demonstration of that effect, some people might view it as prudent to conceive at certain times of the year to lower their child's MS risk if there is a history of the disease in the family."

    Ryan McLaughlin, 14, from Glasgow, whose mother has MS, launched a campaign for all pregnant women and young children in Scotland to be given Vitamin D supplements.

    A spokeswoman for the Scottish government, said: "Much of the evidence of a link between vitamin D and MS is still at a very early stage. We will continue to review all well-conducted research across the world. If the recommendations on vitamin D change we'll make the appropriate arrangements."

    Source: The Daily Telegraph © Copyright of Telegraph Media Group Limited 2010 (04/01/10)

    Shine On Scotland now campaign to fortify school milk with Vitamin D

    Ryan Mclaughlin
    When 14 year old Ryan Mclaughlin started his Shine on Scotland campaign he had set a goal to get vitamin D into our school milk, a simple idea to protect every child in scotland from Multiple Sclerosis,  but he quickly became aware that far more diseases would benefit from vitamin D supplementation not just MS.

    Now the country's largest private health care provider BUPA agree’s and says we should all be taking between 1,500 to 2,000 IUs per day to beat cancer. This is 5 times the current UK RDA and exactly what Ryan has campaigned tirelessly for almost 9 months.

    Dr Virginia Warren, assistant medical director for Bupa, commented: “There has been a lot of research over the last few years about the health benefits of taking a vitamin D supplement. Based on this evidence, we would recommend taking between 37.5 and 50 micrograms of vitamin D on a daily basis to help reduce your risk of certain cancers. Spending time outside in summer will also increase your vitamin D levels, but is a risk for skin cancer.

    "Ensuring you get enough vitamin D is a simple and effective way to reduce your risk of developing certain cancers. Alongside this, it’s important to ensure you eat a healthy balanced diet, exercise regularly, only drink in moderation and do not smoke."

    It was again reinforced today when the Israeli Health Ministry announced that all 3% milk is to be fortified with vitamin D in the next 3 months and Ryan McLaughlin wants the Scottish Government to look to follow suit.

    Last week on a STV news interview with Ryan McLaughlin in relation to his win for vitamin D campaign he said ‘that fortification of school milk was still at the top of his priorities’ as he still thinks its the best way to protect future generations of Scots from many diseases not just MS, this announcement by the Israeli Government only goes to further back his case and show that it can be done on a national basis and with the worst health record in western world and the highest rates of MS in the world – Scotland must take the lead.

    Dr Sareeram Ramagopalan of Oxford University and Ryan’s family all gave evidence at the Scottish Parliaments petitions committee back in June and told the committee that Israel was looking at fortification of both Milk and flour and we heard that France was also looking at it, now its been confirmed in Israel we need to really start considering moving towards fortification of the school milk program now in scotland.

    There are many problems associated with just offering supplementation, simply try getting a child to take a supplement every day for their young life seems doomed for failure, Ryan says he has forgotten a few times to take his and he is running the vitamin D camapign!

    How many adults get a course of antibiotics which state finish the course and don’t.  Ryan says ‘I am sure almost every adult can say that take them till they feel better and the rest is left in a medical cabinet’.

    Furthermore do we really want kids popping tablets everyday?

    Can we ask our teachers to dish out supplements he doesn't think so.

    We would need to ask the questions from the Education Dept, teachers and of course get the teachers unions to agree to it, teachers have a big work load already, Ryan points out that many parents will be able to relate to the following point? How many times as a parent have you been called home and had to take a day off work when a paracetamol would sorted a sore head or a slightly high temperature and the child could have stayed in school getting educated – It would all take too long, too many problems to overcome.

    We could spend millions of pounds trying to educate parents and expectant mothers to take vitamin D supplements everyday, but  I believe we should lead from the front from the start , we owe it to the kids and we must protect each and every child in Scotland.

    If parents don’t want it for their kids – let them simply opt out!

    Ryan believes we need to think much much bigger!  He think we should educate parents to the idea of  the benefits of vitamin D everyday and proposing putting vitamin D into the school milk programme so kids get it every day, start debating it with the public and informing parents immediately.

    Vitamin D boosts your immune system to help fights off cold and bugs and it would improve the school attendence records on wasted days of school due to simple sniffles, as well as save parents the loss of earnings by taking time off work with sick kids that could be in school learning.

    Add his very valid points to the figures compiled for national supplementation of vitamin D in Scotland in relation to just MS alone and you have very good case – Scientists believe it could prevent 2000 cases over 10 years in Scotland alone and could save the UK economy some £4.5 billion surely children’s health must be the priority and a penny onto the cost of a pint of milk is well justified and we should start talking to the dairies immediately!

    Source: Shine On Scotland (30/12/09)

    Welsh government called upon to follow Scottish in vitamin D deficiency awareness

    Vitamin D
    The Welsh Assembly Government has been called upon to fund a campaign about vitamin D deficiency and multiple sclerosis.

    The MS Society Cymru is calling for ministers to follow Scotland’s lead and raise awareness about the links between the two.

    Such a campaign would encourage pregnant women and children under four to take a regular vitamin D supplement.

    Scientists recently discovered that MS could be prevented through daily vitamin D supplements.There is a clear link between vitamin D – known as the sunshine vitamin – and a gene that increases the risk of MS, raising the possibility that the debilitating auto-immune condition could be eradicated.

    The prevalence of MS is far higher in typically wet and cold countries such as Wales, where 110 people in every 100,000 are living with the condition.

    In a country with lots of sunshine – such as Brazil – only 18 people in every 100,000 have MS.

    The NHS in Scotland said it would raise awareness about the links between vitamin D deficiency and MS this month, after being spurred into acting by Glasgow teenager Ryan McLaughlin.

    Ryan’s mother, Kirsten, has had MS for three years, and Ryan, 14, has shown some symptoms of the disease but the family only discovered the link earlier this year after a family holiday.

    The teenager said: “I was shocked there had not been publicity around this before. We wanted there to be more awareness of the link and more research into how much of a problem it is in Scotland.“These actions will make a big difference – it will go a long way to giving children some protection against the disease and give parents proper advice.”

    Joseph Carter, spokesperson for MS Society Cymru, said: “We are delighted by this announcement by the Scottish Government and are now calling on the Welsh Assembly Government to do the same.“You are 10 times more likely to develop MS in Rhyl than you are Rio de Janeiro, and new research suggests this is due to vitamin D deficiency.”

    Vitamin D, obtained from foods and through the action of sunlight on skin, is essential for maintaining healthy bones.It is unclear exactly what causes MS but it has become increasingly evident that environmental and genetic factors play a role.

    Previous research has shown that populations from Northern Europe have an increased MS risk if they live in areas receiving less sunshine.This supports a direct link between deficiency in vitamin D, which is produced in the body through the action of sunlight, and increased risk of developing the condition.

    Researchers at the University of Oxford and the University of British Columbia this year discovered a direct relationship between the genetic variant DRB1*1501, which is associated with MS, and vitamin D.

    Dr Julian Knight, a co-author of the research, said: “In people with the DRB1 variant associated with MS, it seems that vitamin D may play a critical role.“If too little of the vitamin is available, the gene may not function properly.”

    And the study’s lead author Dr Sreeram Ramagopalan said: “Our study implies that taking vitamin D supplements during pregnancy and the early years may reduce the risk of a child developing MS in later life.”

    A spokeswoman for the Welsh Assembly Government said: “We are working closely with the MS Society to raise awareness of multiple sclerosis.“Earlier this year, we produced a leaflet, Multiple Sclerosis – living with a long term condition. This includes information on the condition, its symptoms and the people affected.”

    Source: Shine On Scotland (22/12/09)

    Schoolboy Ryan McLaughlin wins Multiple Sclerosis vitamin D campaign

    Ryan MvLaughlinPregnant women in Scotland are to be educated about the importance of taking vitamin D supplements thanks to a campaign by a 14-year-old Glasgow schoolboy.

    Ryan McLaughlin, whose mother Kirsten has Multiple Sclerosis, took his case to the Scottish Parliament's petitions committee earlier this year.

    He believes taking vitamin D can help prevent the condition.

    In a written response, the Scottish government said it would put in place an action plan to increase awareness.

    It said recent research had found there was an "urgent need" to provide information to all health professionals who work with pregnant women and young children about current guidance on vitamin D.

    "There is also a need to educate women about the importance of taking vitamin D supplement when pregnant and the importance of giving their children a vitamin D supplement until the age of four," the response added.

    The Scottish government will now agree a co-ordinated programme of action with NHS Health Scotland, and has pledged to keep the McLaughlins informed of developments.

    Mrs McLaughlin, a former European Taekwondo champion, was diagnosed with MS two years ago.

    Ryan, from Drumchapel, said: "I am so happy to hear that the Scottish government are being so proactive and really getting behind my campaign.

    "These actions will make a big difference to the health of generations of Scots, and it will go a long way to giving Scots children some protection against disease caused by vitamin D deficiency and gives parents proper advice.

    "I am now looking forward to the summit next year when we'll hopefully be able to tackle the recommended levels but this is such great news."

    Fortified milk

    Ryan became the face of a YouTube campaign to publicise the use of vitamin D, and led hundreds of supporters down Edinburgh's Royal Mile to Holyrood before he put his proposals to the petitions committee in June.

    He told MSPs research into the genetic effect of vitamin D deficiency showed a link to the development of MS. Vitamin D, which the body needs for healthy, strong bones is largely gained through sunlight and food.

    The Scottish government has already ruled out free vitamin D supplements for all pregnant and breastfeeding women, and said there were no plans to introduce the supplements in the form of fortified milk or other drinks at school.

    Scotland is thought to have the highest rate of MS in the world.

    Source: BBC News Scotland © British Broadcasting Corporation 2009 (05/12/09)

    Vitamin D - the missing link for multiple sclerosis sufferers

    Vitamin DScientists have uncovered increasing evidence of the significance of Vitamin D in the development of multiple sclerosis. Now, Australian researchers have found that Vitamin D may actually reduce its symptoms.

    Professor Bruce Taylor, a principal research fellow at the Menzies Institute in Hobart, studied 145 patients in southern Tasmania and tracked their seasonal susceptibility to the disease. He looked at how Vitamin D levels influenced their risk of having an attack of MS.

    'We found that the higher your Vitamin D level, the lower your chance of relapse, and for each ten nanomole [a standard measure of concentration of Vitamin D in the blood] increase in Vitamin D, you can reduce your risk of having an attack of MS by about ten per cent. Doubling your Vitamin D will reduce your risk by up to 50 per cent - a major result.'

    Helen Yates, the Multiple Sclerosis Resource Centre's chief executive, says: 'It has long been believed that Vitamin D has a role to play in the risk of developing MS but this new research opens up the strong possibility that this vitamin could impact on relapse rates.'

    The MS Society's research communications officer, Dr Susan Kohlhaas, says: 'These results are very early-stage and need to be reviewed and validated before we draw any firm conclusions.'

    It has been known for many years that the further you live from the Equator, the more likely you are to develop MS. For example, Malaysia has hardly any sufferers but in Scotland and Scandinavia MS is relatively common.

    It is believed this is due to a shortage of Vitamin D; countries far from the Equator, such as those in Northern Europe, enjoy less sunshine, the main source of Vitamin D.

    Research has shown that babies born in May - who developed in the womb during the Vitamin D-scarce winter months - are the most likely to get MS in later life, while those born in November are at much lower risk.

    Another study this year found evidence that Vitamin D deficiency during pregnancy and infancy could increase a child's risk of developing MS in later life. The researchers concluded that taking Vitamin D supplements during these times could reduce the risk, although this has yet to be proven.

    Source The Mail Online © 2009 Associated Newspapers Ltd (22/11/09)

    Vitamin D could ease symptoms for Multiple Sclerosis patients

    Vitamin DAustralian 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.

    Researchers at the Menzies Institute have now found that taking more vitamin D may also reduce the symptoms of the disease.

    They presented their paper at a national scientific conference for medical research in Hobart.

    Sydney-born soprano Toni Powell was singing with Opera Australia when she was diagnosed with multiple sclerosis in her late 20s.

    "I was at rehearsals and in performances and the tingles were coming up and down my arms and legs and my balance was getting worse," she said.

    "During one performance of a very energetic dance show, I just went flat over and my partner just picked me up so I didn't disturb the line. When you can't stand up and when you can't walk elegantly out onto an operatic stage or judge all the obstacles, it becomes very difficult to keep working in that field."

    Now Ms Powell is 44, teaches singing and uses a walking stick.

    She says the symptoms of the disease come in waves or attacks where she can lose the entire feeling in her hands or legs.

    "The majority of my lesions - which is where there have been attacks on my central nervous system - are actually in my spine so my biggest problem is with walking and my balance. So I find myself falling over a little more than I would like to," she said.

    The autoimmune disease affects the central nervous system and occurs more often in regions furthest from the equator.

    Tasmania has the highest rate of MS in the country.

    The link between vitamin D, which the body produces when exposed to sunlight, and the risk of developing the disease has been well established.

    But until now there's been little research on whether vitamin D can ease the symptoms.

    Professor Bruce Taylor is a principle research fellow at the Menzies Institute in Hobart.

    Professor Taylor says that symptoms vary depending on the time of year.

    "Multiple sclerosis attacks happen seasonally. They are more common in spring than they are in autumn and spring is when you have your lowest vitamin D levels," he said.

    Professor Taylor studied 145 patients in southern Tasmania and tracked their seasonal susceptibility to the disease.

    "In the study we did in Tasmania, we looked at people who had MS and we looked at how their own vitamin D levels influenced their risk of having an attack of MS, which is referred to as a relapse," he said.

    "What we found was that the higher your vitamin D, the lower your chance of relapse and we found that for each 10 nanomole increase in vitamin D which is a standard measure of concentration of vitamin D in the blood, you can reduce your risk of having an attack of MS by about 10 per cent and therefore doubling your vitamin D will reduce your risk by up to 50 per cent which is really a very, very major result."

    Dr Bill Carroll is the head of neurology at the Charles Gardner Hospital in Perth and the chairman of MS Research Australia.

    Dr Carroll says it's a significant finding.

    "Previously we thought vitamin D levels were important in susceptibility that is the risk of contracting MS," he said.

    "Now it does look as though vitamin D might have a role in how MS actually behaves and if this finding can be reproduced in a larger trial, that you can actually reduce the relapse rate and that is the accumulation of disability with high levels of vitamin D, then that is very exciting."

    The findings will be tested in a larger clinical trial throughout Australia over the next few years.

    But Professor Taylor says he's already advising people with MS to take safe levels of vitamin D supplements.

    He says before people take extra vitamin D, they need to check with their doctor to make sure the level of calcium in their bloodstream is normal, and their kidneys are normal.

    "Because if you take extra vitamin D and you don't have normal calcium or you don't have normal kidney function, that can actually cause problems," he said.

    Commenting on the study, Helen Yates, Multiple Sclerosis Resource Centre Chief Executive said, “It has long been believed in many quarters that Vitamin D has a role to play in the risk of developing MS but this new research opens up the strong possibility that this readily available Vitamin could impact on relapse rate.  MSRC welcomes any further research to underpin this work and help to validate the efficacy of Vitamin D in both prevention and reduction of relapses”

    Source: ABC News © 2009 ABC and MSRC (17/11/09)

    Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis

    Vitamin D
    BACKGROUND: In several autoimmune diseases, including multiple sclerosis (MS), a compromised regulatory T cell (Treg) function is believed to be critically involved in the disease process. In vitro, the biologically active metabolite of vitamin D has been shown to promote Treg development. A poor vitamin D status has been linked with MS incidence and MS disease activity. In the present study, we assess a potential in vivo correlation between vitamin D status and Treg function in relapsing-remitting MS (RRMS) patients.

    METHODOLOGY/PRINCIPAL FINDINGS: Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured in 29 RRMS patients. The number of circulating Tregs was assessed by flow-cytometry, and their functionality was tested in vitro in a CFSE-based proliferation suppression assay. Additionally, the intracellular cytokine profile of T helper cells was determined directly ex-vivo by flow-cytometry. Serum levels of 25(OH)D correlated positively with the ability of Tregs to suppress T cell proliferation (R = 0.590, P = 0.002). No correlation between 25(OH)D levels and the number of Tregs was found. The IFN-gamma/IL-4 ratio (Th1/Th2-balance) was more directed towards IL-4 in patients with favourable 25(OH)D levels (R = -0.435, P = 0.023).

    CONCLUSIONS/SIGNIFICANCE: These results show an association of high 25(OH)D levels with an improved Treg function, and with skewing of the Th1/Th2 balance towards Th2. These findings suggest that vitamin D is an important promoter of T cell regulation in vivo in MS patients.

    It is tempting to speculate that our results may not only hold for MS, but also for other autoimmune diseases. Future intervention studies will show whether modulation of vitamin D status results in modulation of the T cell response and subsequent amelioration of disease activity.

    Source: Pubmed PMID: 19675671 (12/11/09)

    Multiple Sclerosis researchers to meet in Boston to design largest-ever Vitamin D study

    Vitamin DOn Saturday, October 17, leading MS researchers from around the US will meet at the Hyatt Regency, Boston to evaluate the feasibility of conducting what would be the largest clinical study ever undertaken to explore the role that Vitamin D may play in Multiple Sclerosis.

    The meeting will be led by Dr. Benjamin Greenberg, deputy director of the MS program and director of the new Transverse Myelitis and Neuromyelitis Optica Program at University of Texas Southwestern Medical Center, and is being organized under the auspices of the nonprofit organization Accelerated Cure Project for Multiple Sclerosis.

    Vitamin D is of particular interest to MS physicians and researchers, since previous epidemiological and laboratory studies have produced strong evidence that low vitamin D levels may play a role in causing MS. The purpose of this meeting is to discuss the feasibility of designing a large-scale study around vitamin D supplementation to evaluate its potential effects early in the course of the disease. This study would also result in the banking of thousands of additional blood samples into the Accelerated Cure Project's MS sample and data repository for future use in understanding the causes and disease mechanisms of MS.

    The Accelerated Cure Project for MS has spent the past three years building the world's largest shared multidisciplinary collection of biological samples and data from people with MS and other demyelinating diseases, as well as control subjects. In addition to supporting individual research efforts around the world with these samples, the Accelerated Cure Project is committed to orchestrating studies such as this one that it believes can "accelerate the cure by determining the cause."

    Source: Medical News Today © 2009 MediLexicon International Ltd (16/10/09)

    Vitamin D status is positively correlated with regulatory T cell function in patients with Multiple Sclerosis

    Vitamin D

    Abstract

    Background

    In several autoimmune diseases, including multiple sclerosis (MS), a compromised regulatory T cell (Treg) function is believed to be critically involved in the disease process. In vitro, the biologically active metabolite of vitamin D has been shown to promote Treg development. A poor vitamin D status has been linked with MS incidence and MS disease activity. In the present study, we assess a potential in vivo correlation between vitamin D status and Treg function in relapsing-remitting MS (RRMS) patients.

    Methodology/Principal Findings

    Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured in 29 RRMS patients. The number of circulating Tregs was assessed by flow-cytometry, and their functionality was tested in vitro in a CFSE-based proliferation suppression assay. Additionally, the intracellular cytokine profile of T helper cells was determined directly ex-vivo by flow-cytometry. Serum levels of 25(OH)D correlated positively with the ability of Tregs to suppress T cell proliferation (R = 0.590, P = 0.002). No correlation between 25(OH)D levels and the number of Tregs was found. The IFN-γ/IL-4 ratio (Th1/Th2-balance) was more directed towards IL-4 in patients with favourable 25(OH)D levels (R = −0.435, P = 0.023).

    Conclusions/Significance

    These results show an association of high 25(OH)D levels with an improved Treg function, and with skewing of the Th1/Th2 balance towards Th2. These findings suggest that vitamin D is an important promoter of T cell regulation in vivo in MS patients. It is tempting to speculate that our results may not only hold for MS, but also for other autoimmune diseases. Future intervention studies will show whether modulation of vitamin D status results in modulation of the T cell response and subsequent amelioration of disease activity.


    For the full article visit: PLoS One

    Joost Smolders1,2*, Mariëlle Thewissen2, Evelyn Peelen1,2, Paul Menheere3, Jan Willem Cohen Tervaert1,2, Jan Damoiseaux2, Raymond Hupperts1,4

    1 School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands, 2 Department of Internal Medicine, Division of Clinical and Experimental Immunology, Maastricht University Medical Center, Maastricht, The Netherlands, 3 Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, The Netherlands, 4 Department of Neurology, Orbis Medical Center, Sittard, The Netherlands

    Source: PloS One (13/07/09)

    Sun exposure cancer warnings 'lead to Vitamin D deficiencies'

    Sunshine and Vitamin D


    Public health warnings about skin cancer have led to a rise in Vitamin D deficiency through lack of sunlight, according to a controversial study into the effects of ultraviolet exposure.

    But now, a controversial new study has blamed the same public health messages for causing growing numbers of people to suffer from vitamin D deficiency, because they are failing to get enough sunlight on their skin.

    Vitamin D is produced by the body in response to exposure from ultraviolet radiation from natural sunlight. It helps protect against cancer and is also thought to be important in helping to prevent bone disease such as osteoporosis, as well as autoimmune diseases, asthma, diabetes, high blood pressure, depression, Parkinson's disease and Multiple Sclerosis.

    The researchers are now calling for guidelines on sunlight exposure to be reviewed to ensure people receive enough vitamin D.

    Dr Veronique Bataille, who led the study, said: "There has been so much effort put into telling people about the damaging effects of ultraviolet light from sunshine, many now take extreme measures to ensure they don't get exposure by wearing moisturisers with factor 15 all year round.

    "We don't want to say that sunbathing is healthy as there is clearly a risk, but people do need a bit of sunshine to stay healthy."

    Dr Bataille and her colleagues measured vitamin D levels in the blood of 1,414 white women in the UK and compared this to their skin type and details about the number of foreign holidays, sunbed use and the number of times they had been sunburnt.

    They found that those with the fairest skin, who usually have red or blonde hair, had the lowest levels of vitamin D.

    Conventional scientific thinking suggests this should not be the case.

    People with greater levels of melanin – which is the pigment which causes darker colour in skin – make less vitamin D and there is evidence to show that those with Asian and Afro-Caribbean backgrounds have trouble producing the vitamin.

    Dr Bataille, a consultant dermatologist at Hemel Hempstead General Hospital and a researcher at Kings College London, also found that those with fair skin also had the lowest levels of sun exposure through the number of holidays they had abroad and sunbed use.

    The researchers concluded that people with fair skin actively avoided sun exposure more, due to their increased sensitivity and so produced less vitamin D. They added, however, there may also be a genetic element that means people with fair skin metabolise vitamin D differently.

    The findings come after another study by Dr Bataille's group that showed sunlight may not be the main cause of melanoma, the most dangerous form of skin cancer. Instead they concluded that the number of moles on the skin was a better indicator of risk.

    "The advice on sun exposure needs to be reviewed," said Dr Bataille. "It is potentially harmful if people are getting the message that they should completely avoid the sun. The advice needs to be better tailored to the differences in skin type and sun levels around the country."

    Experts claim that excessive avoidance of the sun has stemmed from confusing official guidance on sun exposure which has unduly raised fears about the risk of being outside in the sunshine.

    Advice on the Health Protection Agency's website states that people should limit unprotected personal exposure to solar radiation, particularly during the four hours around midday, even in the UK. It even warns that sunburn can occur when in the shade or when cloudy.

    Cancer Research UK used to advice that people stayed in the shade between 11am and 3pm, the time when the sun is at its hottest and the best time for making vitamin D according to experts. They recently changed their advice to "spend time in the shade between 11am and 3pm" and "aim to cover up".

    Vitamin D can be obtained from food, including oily fish and eggs, but it is harder for the body to obtain enough from these sources and consumption of these products in the UK has dramatically declined.

    Dr Bataille believes people can make enough vitamin D from just 15 minutes exposure to sunlight while wearing a T-shirt, but added that this would need to be increased for those with dark skin or during the winter months when sunlight is lower.

    According to a separate recent study at University College London, 20 per cent of women and 12 per cent of men are now classed as being clinically vitamin D deficient, while levels of the vitamin in nearly two thirds of women and 57 per cent of men are "insufficient".

    Dr Vasant Hirani, who led the study, added: "The advice on sun exposure does need to be clarified."

    The British Association of Dermatologists has recently issued guidance with the National Osteoporosis Society that recommends people get 15 to 20 minutes of sun exposure a day.

    Nina Goad, from the Association, said she doubted public health messages were responsible for causing vitamin D deficiency.

    "Vitamin D deficiency is likely to be due to our lifestyles meaning we spend a lot of time indoors, to a lack of vitamin D in our diets, and to our climate meaning we have limited sun exposure for much of the year," she added.

    A spokesman for the Health Protection Agency said: "We are not saying that people should avoid all sunlight. Indeed a small amount can help to maintain vitamin D levels.

    "Sunbathing incurs the potential hazard without adding to vitamin D levels."

    Source: Telegraph.co.uk © Copyright of Telegraph Media Group Limited 2009 (10/08/09)

    New studies show Vitamin D deficiency could cause Multiple Sclerosis in children

    Vitamin D

    Children who develop multiple sclerosis have substantially lower levels of vitamin D than children who do not develop the disease, according to a series of studies presented at an international conference on multiple sclerosis in Montreal.

    Multiple sclerosis is a degenerative disease of the nervous system in which the myelin sheath that insulates nerve cells breaks down, leading to problems in the transmission of nervous signals. Symptoms can range from tingling and numbness to tremors, paralysis or blindness. An estimated 2.5 million people around the world suffer from the disease, which is rarely diagnosed before the age of 15.

    In one study, researchers from the University of Toronto tested the vitamin D blood levels of 125 children who had exhibited symptoms indicating some form of damage to the myelin sheath.

    "Three-quarters of our subjects were below the optimal levels for vitamin D," lead researcher Heather Hanwell said.

    After a year, the researchers compared the data from the 20 children who had since been diagnosed with multiple sclerosis with those who had not exhibited any further demyelinating symptoms. They found that the average vitamin D levels of children who had been diagnosed with multiple sclerosis were substantially lower than those of the other children. Among the diagnosed children, 68 percent of children were actually deficient in the vitamin.

    A similar study was conducted by researchers from Toronto's Hospital for Sick Children.

    "Seventeen of 19 children who had been diagnosed with MS had vitamin D levels below the target level," researcher Brenda Banwell said.

    Researchers have suspected a connection between vitamin D and multiple sclerosis for many years, ever since discovering that the disease is more common at more northern latitudes. Because the body synthesizes vitamin D upon exposure to sunlight, deficiency is much more common in places where the sun is weaker, especially during the winter.

    "There is a very consistent pattern of latitude and multiple sclerosis," said epidemiologist and multiple sclerosis researcher Cedric Garland of the University of California-San Diego.

    Hanwell directly linked Canada's northern latitude to its high rates of multiple sclerosis.

    "In Canada for six months of the year the sun is not intense enough for us to manufacture vitamin D in our skin," she said.

    Canada has one of the highest multiple sclerosis rates in the world. One of the few countries with a higher rate is Scotland, which has regions reached by only a quarter of all available sunlight. Recent research has confirmed a strong connection in Scotland between vitamin D deficiency and poor health status.

    "People have been looking for things in the environment that might account for why Canada has such a high MS risk, and this is one of those factors," Banwell said.

    It remains unclear exactly how vitamin D might influence multiple sclerosis risk, but researchers believe it may have to do with the immune system. New research continues to illuminate the role that vitamin D plays in the immune system, providing protection against cancer, tuberculosis and autoimmune diseases.

    Many health researchers believe that multiple sclerosis is an autoimmune disease.

    "Vitamin D acts as an immune modulator," Banwell said. "On our immune cells there are what are known as receptors, a docking mechanism, for vitamin D. In MS, there are many lines of evidence that immune cells are not regulated properly."

    Researchers called vitamin D research one of the most promising areas of research into causes and potential cures for multiple sclerosis.

    "The Canadian findings are very exciting and raise the possibility of targeting children at risk of MS and preventing some of the disease," said vitamin D researcher Oliver Gillie.

    To prove that vitamin D is effective as a multiple sclerosis treatment or preventive - as well as to figure out what dose would be needed - researchers would first have to conduct large-scale clinical trials.

    Source: Natural News.com © 2009 Natural News Network. All Rights Reserved (08/06/09)

    High doses of vitamin D cut Multiple Sclerosis relapses

    Vitamin D

    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.

    The findings were presented at the annual meeting of the American Academy of Neurology.

    In contrast to many vitamins, no recommended dietary allowance (RDA) has been established for vitamin D. Instead, the Institute of Medicine has set a so-called adequate intake level; the recommendations are 200 IU daily for people under 50, 400 IU daily for people 50 to 70, and 600 IU for those over 70.

    John Hooge, MD, an MS specialist at the University of British Columbia in Vancouver who was not involved with the research, says he recommends MS patients take at least 1,000 IU and "probably 2,000 IU" day.

    "This is an impressive study that shows that even higher doses are probably safe and even more effective. Maybe next year, I'll be recommending higher doses," he tells WebMD.

    Vitamin D vs. Relapsing MS
    Most of the people in the study had the relapsing form of MS, characterised by repeated relapses with periods of recovery in between. They suffered from the disease for an average of eight years.

    "They had very mild disease, with an average score of 1.25 on the Extended Disability Status Scale, where zero corresponds to normal and 10 to death," Burton says. Participants suffered one relapse every other year, an average.

    People in the high-dose group were given escalating doses of vitamin D in the form of a concentrate that could be added to juice for six months, to a maximum of 40,000 IU daily. Then doses were gradually lowered over the next six months, averaging out to 14,000 IU daily for the year.

    The rest of the participants were allowed to take as much vitamin D as they and their doctors thought was warranted, but it averaged out to only 1,000 IU daily.

    Everyone also took 1,200 milligrams of calcium a day. Vitamin D is essential for promoting calcium absorption in the gut and together with calcium, helps promote bone health.

    Vitamin D appears to suppress the autoimmune responses thought to cause MS, Burton says. In MS, haywire T lymphocytes -- the cellular "generals" of the immune system -- order attacks on the myelin sheaths that surround and protect the brain cells.

    In people given high-dose vitamin D in the study, T cell activity dropped significantly. That didn't happen in people who took lower doses.

    The researchers also measured the concentration of 25-hydroxyvitamin D [25(OH)D], also known as calcidiol, in the blood. The Institute of Medicine says that is the best indicator of a person's vitamin D status.

    There's no ideal level, although concentrations of less than 50 nanomoles per liter of blood are considered inadequate for good health. In the study, it appeared MS patients did best if levels reached 100 nanomoles per liter, Burton says.

    People with MS should talk to their doctors about whether they might benefit from vitamin D supplements, she says.

    "Too much vitamin D can be harmful for people with certain medical conditions such as kidney disease," Burton says. "Also doctors can monitor your blood levels of 25(OH)D."

    Source: WebMD © 2005-2009 WebMD (29/04/09)

    Vitamin D may exacerbate autoimmune disease

    Deficiency in vitamin D has been widely regarded as contributing to autoimmune disease, but a review appearing in Autoimmunity Reviews explains that low levels of vitamin D in patients with autoimmune disease may be a result rather than a cause of disease and that supplementing with vitamin D may actually exacerbate autoimmune disease.

    Authored by a team of researchers at the California-based non-profit Autoimmunity Research Foundation, the paper goes on to point out that molecular biologists have long known that the form of vitamin D derived from food and supplements, 25-hydroxyvitamin D (25-D), is a secosteroid rather than a vitamin. Like corticosteroid medications, vitamin D may provide short-term relief by lowering inflammation but may exacerbate disease symptoms over the long-term.

    The insights are based on molecular research showing that 25-D inactivates rather than activates its native receptor - the Vitamin D nuclear receptor or VDR. Once associated solely with calcium metabolism, the VDR is now known to transcribe at least 913 genes and largely control the innate immune response by expressing the bulk of the body's antimicrobial peptides, natural antimicrobials that target bacteria.

    Written under the guidance of professor Trevor Marshall of Murdoch University, Western Australia, the paper contends that 25-D's actions must be considered in light of recent research on the Human Microbiome. Such research shows that bacteria are far more pervasive than previously thought - 90% of cells in the body are estimated to be non-human - increasing the likelihood that autoimmune diseases are caused by persistent pathogens, many of which have yet to be named or have their DNA characterized.

    Marshall and team explain that by deactivating the VDR and subsequently the immune response, 25-D lowers the inflammation caused by many of these bacteria but allows them to spread more easily in the long-run. They outline how long-term harm caused by high levels of 25-D has been missed because the bacteria implicated in autoimmune disease grow very slowly. For example, a higher incidence in brain lesions, allergies, and atopy in response to vitamin D supplementation have been noted only after decades of supplementation with the secosteroid.

    Furthermore, low levels of 25-D are frequently noted in patients with autoimmune disease, leading to a current consensus that a deficiency of the secosteroid may contribute to the autoimmune disease process. However, Marshall and team explain that these low levels of 25-D are a result, rather than a cause, of the disease process. Indeed, Marshall's research shows that in autoimmune disease, 25-D levels are naturally down-regulated in response to VDR dysregulation by chronic pathogens. Under such circumstances, supplementation with extra vitamin D is not only counterproductive but harmful, as it slows the ability of the immune system to deal with such bacteria.

    The team points out the importance of examining alternate models of vitamin D metabolism. "Vitamin D is currently being recommended at historically unprecedented doses," states Amy Proal, one of the paper's co-authors. "Yet at the same time, the rate of nearly every autoimmune disease continues to escalate."

    Source: Autoimmunity Research Foundation (10/04/09)

    Other sources disagree with the Marshall team :

    http://www.msrc.co.uk/index.cfm?fuseaction=show&pageid=2421

    http://www.imminst.org/forum/index.php?s=a0732c938651d5c40cc70a19b6e17e08&showtopic=20104&pid=221424&st=0&#entry221424

    http://www.bmj.com/cgi/eletters/329/7457/112-b

    http://stuff.mit.edu/people/london/universe.htm 

    http://stuff.mit.edu/people/london/universe.htm

    Researchers explore the benefits of supersized doses of Vitamin D for Multiple Sclerosis and other diseases

    Vitamin D

    Researchers are taking a fresh look at vitamin D - the over-the-counter supplement much-ballyhooed as a way to prevent diseases - to determine whether it could be effective as a medical treatment for those who already have chronic illnesses such as cancer.

    Although the investigations are in their early stages, any successful outcomes could be a major health breakthrough, giving patients an inexpensive treatment option that's as close as the nearest pharmacy.

    Already the so-called sunshine vitamin is glowing brightly in medical circles, with recent studies showing its efficacy in preventing everything from cancer to the flu. Typical of the recent investigations was one conducted at St. Michael's Hospital in Toronto, where multiple sclerosis patients received one of the largest vitamin D doses ever dispensed in a clinical setting.

    It yielded some tantalizing evidence that supersizing the nutrient helps calm symptoms of the neurological disease.

    The MS patients took up to 40,000 IU daily, or the amount in 50 multivitamins or 400 cups of fortified milk.

    (The Canadian Cancer Society recommends taking 1,000 international units daily.)

    "We definitely had fewer episodes in the treated group," said Jodie Burton, the principal investigator.

    Because no one knows the dose most helpful for MS, Dr. Burton's group wanted to establish first that it was safe to take a lot of the vitamin. Although overdoses are rare, it is possible to take too much, with symptoms including excess calcium in the urine and blood, cardiac rhythm disturbances and kidney damage.

    The researchers didn't find these problems. "We saw absolutely no evidence of any issues," Dr. Burton said. "What evidence there is suggests that you can go quite high with this before people start to report side effects."

    Many scientists have been wondering whether a lack of vitamin D causes MS because the disease is far more common in countries, such as Canada, where people have low levels of the nutrient in fall and winter because of the seasonal drop in sunlight.

    Although vitamin D is available in supplements and is found naturally in some foods, such as oily coldwater fish, most of what people have in their bodies they make themselves, through a chemical reaction that starts when cholesterol in skin is exposed to intense summertime light.

    "There is a lot of evidence that suggests if your vitamin D status is really quite good, the risk of getting MS is low," Dr. Burton said. "The natural question after that is, 'Well, what happens after the fact, if you already have MS? Is there any benefit to vitamin D intervention?' "

    The researchers gave the vitamin in escalating doses for a year, starting with amounts under 10,000 IU and gradually increasing intakes to peak at 40,000 IU a day. They then reversed the process and slowly lowered the doses to zero.

    Averaged out, the patients received 14,000 IU a day, not far off the estimated 10,000 IU a day that people make in their skin if they live year-round in a sunny climate and spend time outdoors. A separate group of MS patients, known as a control group, was able to take up to 4,000 IU a day, the amount Dr. Burton says is the standard recommendation at her clinic.

    Those in the trial took the vitamin as a concentrated liquid. The doses had about the same volume as a teaspoon, saving patients from swallowing hundreds of pills.

    The amounts were far above Health Canada's recommendations of 200 IU to 600 IU a day, depending on age. The agency also pegs at 2,000 IU daily the safe upper intake by those not under medical supervision - although the MS research suggests the government's limit may be far too conservative.

    MS researchers aren't the only ones speculating on the therapeutic benefits of the vitamin: Some cancer researchers also hypothesize that upping intake of the vitamin might be beneficial.

    A number of cancer treatment centres have begun looking at large doses, hoping to give their patients a survival edge. The approach is considered experimental because no research has yet established that an existing tumour will shrink or grow more slowly in response to having more of the vitamin.

    The notion of positive effects against cancer rests partly on suggestive recent research. Studies have found that rates of some cancers, particularly colon and breast, are higher where people are unable to make the vitamin year-round in their skin. Other studies have found that those diagnosed with cancer in the summer, when vitamin levels are generally higher, have the best outcomes.

    The risk of developing cancer "may be associated with vitamin D deficiency," said Donald Trump, president of the Roswell Park Cancer Institute in Buffalo. "That would suggest that giving vitamin D might slow the growth or reduce the recurrence rate of a cancer."

    Dr. Trump said that while routinely having patients take vitamin D is not part of a standard treatment protocol at Roswell, it is "increasingly being adopted" by many of its physicians. The institute is running formal trials to assess the safety of longer-term supplementation with doses up to 10,000 IU a day.

    But Dr. Trump has given some prostate cancer patients presenting with very low levels of vitamin D up to 20,000 IU for short periods to make sure they're not suffering from insufficiency. "What I do in my patients with cancer is try to restore their levels to the high normal range," Dr. Trump said of the approach. "I think there is a good prospect that optimizing vitamin D intake might favourably affect the outcome in cancer patients, and it vitally needs to be studied."

    Another physician hot on the trail of vitamin D is Ira Cantor, at the Steiner Medical and Therapeutic Centre in Phoenixville, Pa.

    Dr. Cantor became interested in the vitamin after seeing the studies on how those diagnosed with cancer seemed to do better if their malignancies were discovered in summer. Medical treatments, such as chemotherapy and surgery, don't vary by season, raising the possibility that the higher summertime levels of vitamin D play a role.

    This prompted Dr. Cantor to devise a way of jolting patients up to high, summertime readings of vitamin D in a matter of weeks. To this end, he gives one-time doses ranging from 50,000 IU to 300,000 IU, depending on how low a person's levels are initially, followed by 4,000 IU a day.

    Dr. Cantor has been trying this regimen for a year, treating about 100 patients. He said it is too early to say if the step is helping, but he is encouraged. "You have a certain anecdotal impression if your patients are doing better than you would expect," he said. "I have that impression individually, but I wouldn't scientifically state that."

    As a safety precaution, Dr. Cantor monitors patients for calcium and parathyroid hormone levels, another marker of excessive vitamin D intake, but has found nothing abnormal. "There was absolutely no toxicity," he said.

    Further evidence on the safety of high doses is coming from two recently conducted clinical trials in the United States on perhaps the most sensitive people of all, pregnant and lactating women. The latter were given high doses - 6,000 IU a day - to find what amount of vitamin D ensured that mother's milk had adequate levels of the nutrient.

    "We never saw one single adverse event that would have been related to anything remotely due to vitamin D," said Bruce Hollis, one of the researchers and professor of pediatrics at the Medical University of South Carolina.

    One of the problems with conventional drugs is that they often have nasty side effects and compliance can be an issue. But Dr. Burton at St. Michael's says taking vitamin D is a big hit among her patients.

    "People are looking for something natural, so it's very helpful," she said. "It's inexpensive. It's got multiple health benefits. Unless there is a contraindication there is really no downside."

    A role in other illnesses

    Scientists have long known that rickets, a debilitating childhood bone disease, and osteoporosis among the elderly are caused by low levels of vitamin D. But there is evidence the vitamin plays a role in many other conditions, among them:

    Multiple sclerosis

    The neurological disease has a marked global distribution, with the odds of having it increasing the farther further people live away from the equator. This implicates vitamin D because we make most of the nutrient circulating in our bodies ourselves, when skin is exposed to ultraviolet summer light. A study in the Journal of the American Medical Association in 2006 found that Caucasian U.S. military personnel had a 41-per-cent decrease in MS risk for every 50 nanomole/litre increase in vitamin D levels in their blood.

    Prostate cancer

    The season in which a man is diagnosed affects the outcome of the disease, raising the possibility of a vitamin D connection. A study of Norwegian men published in 2007 found that those diagnosed in summer and autumn had the best prognosis. The authors speculated the seasonal increase in vitamin D was the cause.

    Colorectal cancer There is a growing body of research linking low vitamin D to this often deadly cancer. An analysis of blood levels of vitamin D found a 50-per-cent reduction in risk for those with the highest amounts, according to a study published in 2007 in the American Journal of Preventative Medicine.

    Breast cancer

    A review from 2007 found a 50-per-cent decrease in breast-cancer risk for those with the highest level of the vitamin in their blood. The authors of the study, published in the Journal of Steroid Biochemistry and Molecular Biology, said women could attain the blood levels associated with low breast-cancer risk by taking 2,000 IU a day and, when weather permits, 10 to 15 minutes in the sun.

    Vitamin D in the body

    Vitamin D may have drug-like qualities because our bodies convert it into a powerful steroid hormone.

    1. Sunlight We make vitamin D in our bodies when cholesterol in skin is exposed to strong, summertime ultraviolet light. This produces a substance scientists have dubbed D3, the same compound found in vitamin pills. The more sun exposure people receive, or the more supplements they take, the higher the levels of vitamin D they will have.

    2. In the Liver After it's made in skin or taken as a pill, D3 is converted in the liver into another form, called 25 D, which is what is measured when people have tests for blood levels of the vitamin.

    3. In the Kidneys 25D is convertedby enzymes into a steroid hormone known as 1,25 D.

    Hormones are some of the most powerful compounds in our bodies. Scientists believe that the production of this hormone is why vitamin D may have drug-like qualities in the prevention and treatment of cancer and many other conditions.

    Source: The Globe and Mail © Copyright 2009 CTVglobemedia Publishing Inc.(16/03/09)

    Vitamin D could help prevent Multiple Sclerosis

    Multiple sclerosis could be prevented through daily vitamin D supplements, scientists told The Times last night.

    The first causal link has been established between the “sunshine vitamin” and a gene that increases the risk of MS, raising the possibility that the debilitating auto-immune disease could be eradicated.

    George Ebers, Professor of Clinical Neurology at the University of Oxford, claimed that there was hard evidence directly relating both genes and the environment to the origins of MS.

    His work suggests that vitamin D deficiency during pregnancy and childhood may increase the risk of a child developing the disease

    He has also established the possibility that genetic vulnerability to MS, apparently initiated by lack of vitamin D, may be passed through families.

    These risks might plausibly be reduced by giving vitamin D supplements to pregnant woman and young children.

    “I think it offers the potential for treatment which might prevent MS in the future,” Professor Ebers said.

    “Our research has married two key pieces of the puzzle. The interaction of vitamin D with the gene is very specific and it seems most unlikely to be a coincidence of any kind.”

    Warnings over sun exposure could now also be called into question – sunlight allows the body to produce the vitamin.

    Professor Ebers said: “Serious questions now arise over the wisdom of current advice to limit sun exposure and avoid sunbathing. We also need to give better advice and help to the public on vitamin D supplements, particularly pregnant and nursing mothers.”

    The news has momentous implications for Scotland and other northern countries, where the incidence of multiple sclerosis is the highest in the world. It will give added urgency to recent moves by Scotland’s Chief Medical Officer to consider recommending vitamin D supplements.

    Deficiency in vitamin D, caused by lack of exposure to sunshine, has been increasingly linked to the cloudier climate in Scotland and other northern latitudes. The deficiency is twice as common among the Scots as it is amongst the English – and Orkney and Shetland have among the highest rates.

    Studies have also shown that fewer people with MS are born in November and more in May, implicating a lack of sunshine during pregnancy.

    The breakthrough comes after a groundswell of expert belief in the importance of vitamin D. Last November, at a conference organised by the Scottish Government, international experts urged vitamin D supplements for Scots to be tested “sooner rather than later” to find whether they could improve the nation’s health.

    Researchers for the World Health Organisation said there should be large, randomised trials as there was strong evidence that increased daily intake of vitamin D could significantly improve health.

    The seminar followed evidence, revealed in The Times, that Scotland’s poor health record has close links to vitamin D deficiency. Last September this newspaper reported evidence from scientists in Canada that children with early symptoms of multiple sclerosis have low levels of vitamin D.

    Until now there has been no scientific proof of the links. However, Professor Ebers and his team have shown that vitamin D affects a particular genetic variant, identified as the one that increases the risk of developing MS threefold.

    They suggest that a shortage of the vitamin alters this variant, thus preventing the immune system from functioning normally.

    Professor Ebers said: “Whether it’s at the core of MS is going to take some further work, but it does look like a reasonably good chance.”

    Last October Professor Ebers, in an article in The Times, backed the idea of distributing vitamin D supplements in Scotland to guard against conditions that may be linked to a deficiency, including MS.

    “It is plausible that some 200 cases a year of MS might be prevented in Scotland alone by giving vitamin D to mothers and children,” he wrote.

    “Over a trial duration of 25 years, 5,000 cases of this disease might be otherwise prevented.

    “The economic impact of each person with MS is at least an extra million pounds during a lifetime.

    “Over 25 years £5 billion is at issue in this disease without factoring in the human cost, the increasing rate of MS or inflation. A large-scale programme providing vitamin D could provide scientific evidence.”

    Disease of the North: MS rates per 100,000 of the population

    Canada 240

    Scotland 150 - 200

    Norway 110

    England and Wales 90 - 110

    Australia 78

    Spain 59

    Brazil 18

    Sources: Atlas of Multiple Sclerosis; bandolier.com

    Source: Times Online Copyright 2009 Times Newspapers Ltd. (05/02/09)

    Vitamin D story compels experts to act

    There is a sound rationale for supplying supplements of vitamin D to the Scottish population. The case that deficiency contributes to their relative health deficit has recently been outlined in The Times and deserves timely consideration. I wish to add some additional perspective.

    Human beings have spent most of their evolutionary history in tropical and sub-tropical regions where dark skin provides useful protection against intense sun. As man migrated north into Europe thousands of years ago, white skin became a necessary adaptation because it allows for more vitamin D production, and vitamin D is essential for good health.

    The sun is too weak in Northern Europe to enable vitamin D to be made for several months of the year, but white skin enables people to make use of the thin spring or autumn sunlight of the kind we may get at these times of year and so extend the season when vitamin D can be made. There is increasing circumstantial evidence for an important role of vitamin D deficiency in “juvenile onset” diabetes, multiple sclerosis and in the onset of some cancers.

    Scientists yearn for proof that these diseases are influenced by insufficient vitamin D. But such proof will be hard to come by. We know from laboratory evidence that many genes are regulated by vitamin D. A thousand genes (one in 30) have vitamin D response elements, stretches of DNA to which vitamin D complexes bind to exert this effect. This makes D-related genes one of the largest gene families in the genome. Most of these genes are unrelated to bone and calcium, the familiar context for this vitamin-hormone. The way most of these genes work and relate to vitamin D is not yet understood in detail, but there will be many more functions yet to be identified.

    Vitamin D is important for foetal and child development and the evidence is increasing that deficiency early on will have later consequences. We know that the majority of Scots have sub-optimal levels in their blood and most, at winter's end, are deficient in it. The epidemiology of multiple sclerosis (MS) has been studied extensively and the best correlates of prevalence are with latitude and sunshine. Those with the same origins differ markedly for MS risk by geographical location.

    Tasmanians have five to six times as much MS as do Queenslanders, but half as much as Scots, who have the highest rate in the world. Sunlight via an effect on vitamin D production remains the best candidate for this effect. The responsible factor appears to operate early in life.

    We all would like definitive proof to support supplementation on a population level, meaning a trial to see what happens when some people are given the vitamin and others are not. It has been possible to carry out cancer prevention trials, but a trial to see if vitamin D will prevent MS and other later onset diseases might take some 25 years or more to complete.

    It is plausible that some 200 cases a year of MS might be prevented in Scotland alone by giving vitamin D to mothers and children. Over a trial duration of 25 years, 5,000 cases of this disease might be otherwise prevented. The economic impact of each person with MS is at least an extra million pounds during a lifetime. Over 25 years, £5billion is at issue in this disease without factoring in the human cost, the increasing rate of MS or inflation. A large-scale programme providing vitamin D could provide scientific evidence.

    Vitamin D is cheap and the organisation needed to provide it to mothers and babies already exists. There remains room for debate, but if D deficiency accounts for even some of Scotland's health deficit, timely action is needed.

    Experts familiar with the vitamin D story are taking the vitamin and exposing themselves more to the sun as well. There is a large safety margin for vitamin D intake and concerns about amounts under consideration here have proven unfounded. It would make as much or more sense to ban holidays in Portugal as to fear increasing the low amounts of vitamin D that are recommended at present in the UK. Increased intake is now recommended by the Canadian Cancer Society, the National Academy of Sciences (USA), and the dietary committee of the European Union.

    In another era it was said in jest that the reason fundamentalists in the southern US banned sex before marriage was because they were afraid it might lead to dancing. Are we worried about the sex or the dancing here?

    George Ebers - Action Research Professor of Clinical Neurology at the University of Oxford

    Source: The Times Online Copyright 2008 Times Newspapers Ltd.(07/10/08)

    Vitamin D Linked to Genetic, Environmental Risk for Multiple Sclerosis

    Vitamin D

    Results from a new study unite the genetic and environmental risks of multiple sclerosis in a disease-specific and gene-environment interaction. Presenting at the American Neurological Association 133rd Annual Meeting, researchers described a link between vitamin D and the pathogenesis of MS.

    "There's a connection between the 2 — no question about it," lead investigator George Ebers, MD, from the University of Oxford, in the United Kingdom, told Medscape Neurology & Neurosurgery. "But exactly how it works is not clear yet."

    Asked to comment on the work, Emmanuelle Waubant, MD, from the University of California, San Francisco said, "MS is a very heterogeneous disease, and this is an interesting way to look at the factors that predispose people."

    She noted, "This study looks at the bigger picture and is the way things should be done. The data provide decent traction and it is an interesting result."

    Dr. Ebers and his team examined the major histocompatibility complex (MHC) for deoxyribonucleic acid (DNA) sequences predicted to respond to vitamin-D complexes.

    They identified a single sequence, which appeared to be functionally active because it transfected the segment into cell lines and measured functional expression in response to added vitamin D.

    Unexpectedly, they found this sequence is haplotype-specific and perhaps evolving in response to selective pressures characterizing the northern migration of European populations.

    This solitary MHC vitamin-D–responsive element is strategically located in the promoter region of the class II complex specific to a haplotype associated with MS risk, Dr. Ebers told the meeting.

    "These findings further implicate vitamin D in environmentally mediated MS risk," he said.

    Sequence Haplotype-Specific

    During an interview after the session, Dr. Ebers said his group was surprised by what it found. "Most times you don't find exactly what you are looking for, but in this case, that is exactly what we found. It was as plain as day."

    The data suggesting vitamin D is deficient in MS are strong, Dr. Waubant added. "What is unclear is whether or not it also affects the severity of disease."

    "Everyone who has examined this from the National Academy of Sciences to the dietary committee of the European Union to a variety of professional organizations all agree pretty much that the amount of vitamin D that people are getting is too low," Dr. Ebers pointed out.

    "I know all the experts in the field, and they've sort of voted with their feet," he said. "They're all on vitamin D and their family is on it too. As far as anyone can tell, the amounts in question are harmless, and it's dirt cheap."

    Some experts are advocating that given the potential benefit, vitamin D should be widely administered. But others have reservations and are recommending a more cautious approach.

    "I'm reluctant to say there's absolutely no risk, because people have been wrong on these things," Dr. Ebers told Medscape Neurology & Neurosurgery. "But I think in this particular case, the evidence has been so strong that it's safe, and all the experts who examine this are comfortable. Plus, many are giving 2000 units a day to pregnant women, so that should be as reassuring as anything."

    This study was funded by the Scientific Foundation of the Canadian MS Society and the UK MS Society.

    Source: MedScape Medical News (28/09/08)

    Scientists link low vitamin D to Multiple Sclerosis risk in children

    Vitamin D

    Canadian researchers say they have found new links between low levels of vitamin D in children and an increased risk that they may develop multiple sclerosis.

    Speaking at an international meeting of MS specialists in Montreal, Dr. Brenda Banwell said that low levels of vitamin D in some children may explain why doctors are seeing more kids developing MS in Canada and other parts of the world.

    "What we found is the children with the lowest vitamin D levels were far more likely to be diagnosed with multiple sclerosis than were children who had healthier levels of Vitamin D," she said.

    Banwell and a team of scientists measured vitamin D levels from more than 100 children suffering what could be a first attack of MS.

    Of those with the highest blood levels of the so-called "sunshine vitamin," only six percent went on to develop full-blown MS within the next two years. Twenty-seven percent developed MS among those with the lowest levels of the vitamin.

    Multiple sclerosis is a chronic disease that attacks the central nervous system. Past studies have linked the disease, which affects about 55,000 Canadians, to environmental and genetic factors.

    Researchers say low vitamin D levels are epidemic among children, and people without enough vitamin D are at risk for bone problems.

    Doctors also believe that vitamin D may help keep the immune system functioning normally.

    Researchers say too many Canadian children are not getting enough of the vitamin, which may be obtained naturally from sunshine.

    "Children are indoors more they are on computers more, they play outdoors far less, but the consequence is, of course, they are getting little sunlight and little vitamin D," Banwell said.

    Researchers are now trying to see if boosting vitamin D levels in kids with MS could help treat the disease and put it into remission. They're also trying to see if vitamin D can prevent the onset of the disease.

    Source: Bernama.com © 2008 BERNAMA (21/09/08)

    Scotland's poor health 'caused by lack of sunshine'

    A national campaign to persuade every Scot to take daily supplements of vitamin D is needed if the country’s appalling health record is to be reversed, leading scientists believe.

    A report, published this week, links poor weather to the lack of the “sunshine vitamin” in Scotland, and urges the Scottish government to launch a nationwide vitamin D programme to lower the incidence of devastating illnesses, such as heart disease, cancer and multiple sclerosis.

    The research points to the country’s damp, cloudy climate as a significant contributor to its bleak record of ill health and disease.

    Vitamin D deficiency – caused by lack of exposure to sunshine – is twice as common among the Scots as it is among the English. The average Scot has a vitamin D level four times lower than their neighbour south of the Border.

    Oliver Gillie has researched vitamin D deficiency in Scotland

    A five-year research project by Oliver Gillie, a scientist and writer, demonstrates extensive and remarkable parallels between Scotland’s dull weather and indices of disease.

    It suggests that the “Scottish effect”, the country’s hitherto unexplained high mortality rate compared with other industrial countries, is in large part down to lack of sun. Crucially, a shortage of the “sunshine vitamin” is established as a factor in higher rates of multiple sclerosis (MS), diabetes, hypertension, arthritis, several types of cancer, cardiovascular disease and other ailments that together give Scotland one of the worst health records and highest premature mortality rates in Western Europe.

    Dr Gillie’s study – Scotland’s Health Deficit: An Explanation and a Plan – echoes world-wide research on vitamin D deficiency but goes further, showing how the higher rates of disease in Scotland mirror closely the lower amount of available sunlight.

    A lack of sunshine in Glasgow and the West of Scotland reflects levels of chronic illness that which cannot be explained by deprivation alone. A lack of sunshine on Orkney and Shetland – only 24 per cent of the maximum number of hours possible – corresponds to the highest prevalence of MS in the world.

    By contrast, the South Coast of England, where such diseases are much less common, receives 400 more hours of sunshine a year than Scotland.

    Dr Gillie says that successive reports on the state of Scotland’s health have failed to recognise that insufficient sunlight and vitamin D are important risk factors, and calls for firm action from the Scottish government on supplementation and the fortification of food.

    Last week The Times convened a panel of experts who studied the report and endorsed unanimously the importance of vitamin D as an important ingredient in creating a healthy Scottish population.

    Dr Harry Burns, the Chief Medical Officer for Scotland, said: “It is important that attempts to improve health in Scotland remain focused on action on the social, economic, behavioural and psychological determinants of health. If vitamin D supplements can be shown to contribute to that agenda then we will make the appropriate recommendations.”

    Dr Adrian Martineau from Queen Mary’s School of Medicine, London, who is working on evidence that vitamin D can reduce cold and flu symptoms, said: “This is a very important initiative. What [Dr Gillie] has highlighted is that 85 per cent of us have lower Vitamin D levels than we should have and 85 per cent of our cells need vitamin D to function properly. It’s highly plausible that supplementation would be of great benefit.”

    Source: The Times Copyright 2008 Times Newspapers Ltd. (15/09/08)

    Vitamin D may benefit Multiple Sclerosis

    Vitamin D

    Vitamin D, the principal regulator of calcium in the body, may prevent the production of malignant cells such as breast and prostate cancer cells and protect against specific autoimmune disorders, including multiple sclerosis (MS) according to an article by Sylvia Christakos, Ph.D., of the New Jersey Medical School.

    In the article, Christakos reports that research shows that the incidence of MS decreases as the amount of vitamin D available to the body increases, either through sunlight exposure or diet. The article noted MS is “for the most part, unknown in equatorial regions” and the prevalence of the disease is lower in areas where fish consumption is high. The study is available online in the Journal of Cellular Biochemistry.

    “Since vitamin D is produced in the skin through solar or UV irradiation and high serum levels have been shown to correlate with a reduced risk of MS, this suggests that vitamin D may regulate the immune response and may promote a host’s reaction to a pathogen,” Christakos said.

    Christakos’ report focuses on the immunosuppressive actions of the active form of vitamin D, which may inhibit the induction of MS, and emphasizes the importance of maintaining a sufficient vitamin D level.

    “Evidence has shown that the maintenance of an adequate vitamin D level may have a protective effect in individuals predisposed to MS,” Christakos said. “One device of vitamin D action may be to preserve balance in the T-cell reaction and thus avoid autoimmunity.”

    Despite the significant evidence of the benefits of vitamin D relative to MS and other autoimmune diseases, Christakos cautions that further studies are needed to determine whether vitamin D alone or combined with other treatments is effective in individuals with active MS.

    Source: University of Medicine and Dentistry of New Jersey (UMDNJ) (26/08/08)

    Vitamin D, hope for a new disease fighter for Multiple Sclerosis
    In a Newark laboratory, researchers watch as mice stricken with multiple sclerosis suddenly walk. They peer into microscopes and see the growth of breast cancer cells dramatically slowed.

    They are examining, up close, the power of vitamin D.

    "We're believers," said Sylvia Christakos, a longtime vitamin researcher at UMDNJ-New Jersey Medical School.

    Many others are following. A spate of provocative studies shows the potential health benefits of vitamin D on everything from breast, prostate and colon cancer to auto- immune disorders such as Type I diabetes, rheumatoid arthritis, lupus and multiple sclerosis.

    The so-called "sunshine vitamin" may even protect the heart.

    Some researchers, citing widespread vitamin D deficiencies among Americans, call current federal guidelines outdated and argue most people need far more of the nutrient than they get from food, multi-vitamins and the sun.

    Others say more research is needed before Americans start downing supplements or exposing unprotected skin to height-of-the- day sun, whose ultraviolet rays help create the vitamin.

    Few researchers, however, have studied the nutrient more closely than Christakos.

    "There is finally more of a recognition of the value of vitamin D to prevent various diseases," she said. "But it's cheap and over-the-counter so you won't turn on the television and see commercials pushing vitamin D."

    In a review scheduled for publi cation this week in the online Journal of Cellular Biochemistry, Christakos and her team conclude proper blood levels of vitamin D can protect people from multiple sclerosis. The review said the nutrient may help maintain balance in the immune system.

    The team looked at MS in mice, and found those treated early with an active form of vitamin D improved dramatically. The stricken mice, once paralyzed, were able to walk, though Christakos said that does not mean the same will happen for people with MS.

    The lab has gone a step further to show how vitamin D may work on a genetic level. Working with researchers from Stanford University, they showed how vitamin D likely inhibits a key inflammatory response involved in MS.

    The data on vitamin D is accumulating. For example:

  • A Canadian study found women with breast cancer were nearly twice as likely to see their cancer spread, and far more likely to die, if deficient in the vitamin.

  • A 2007 study in the American Journal of Clinical Nutrition concluded improving calcium and vita min D levels substantially reduces all cancer risk in post-menopausal women.

  • In last year's New England Journal of Medicine, researcher Michael F. Holick of Boston University School of Medicine cited a study that found elderly French women given 1,200 mg of calcium and 800 international units (IU) of vitamin D daily for three years reduced their risk of hip fracture by 43 percent.

    Holick cited another study that found women who took more than 400 IU of vitamin D had a 42 percent reduced risk of developing multiple sclerosis. Another study found that 10,366 Finnish children who were given 2,000 IU of vitamin D per day during their first year of life and were followed for 31 years had their risk of developing Type I diabetes reduced by 80 percent.

    Holick said Americans should take at least 1,000 IU of vitamin D daily as well as a multivitamin with another 400 IU. Christakos said vi tamin D supplements are especially important for those at risk of immune disorders, such as siblings of people with Type I diabetes or MS.

    Government guidelines, however, recommend just 200 IU for those under 50; 400 for those 51-70; and 600 for those over 70.

    Jennifer Koentop, a spokeswoman for the U.S. Department of Health and Human Services, said the government is negotiating with the Institute of Medicine, a national advisory organization, to review the vitamin D guidelines.

  • Humans once routinely absorbed vitamin D from the sun, but when jobs and society moved in doors exposure to sunlight dropped. Holick estimates half of all Americans are vitamin D deficient. Deficiency rates among African-Americans may be higher.

    Reinhold Veith, a researcher at the University of Toronto, said people can safely put on a bathing suit and expose much of their skin, without sunscreen, for as little as five minutes several times a week to obtain vitamin D.

    Most dermatologists disagree, however. The American Academy of Dermatology, on its website, said people who want additional vita min D should use supplements to prevent skin cancer and damage.

    Debate continues over supplements, too. Laura Byham-Gray, associate professor of nutritional sciences at the UMDNJ-School of Health Related Professions, does not recommend higher doses.

    "What we consider a vitamin D deficiency is still under debate," she said. She cites the hype that once surrounded vitamin E, which researchers later learned actually increased mortality.

    Vitamin D proponents said as much as 10,000 IU daily will not cause toxicity.

    "Policy makers want a high level of evidence before committing themselves," Veith said. "But all the accumulating evidence on vitamin D has been like a slow rising sun. When do you call it daytime?"

    Source: nj.com © 2008 The Star-Ledger (14/07/08)

    Vitamin D deficiency linked to breast cancer in new study

    Women deficient in vitamin D at the time of a breast cancer diagnosis are more likely to die or see the tumor spread, a Canadian study published in the United States has shown.

    Patients low in vitamin D were 94 percent more likely to see their cancer metastasize and 73 percent more likely to die from it, compared to women with normal levels of vitamin D in their blood, researchers found.

    And many of the 512 breast cancer patients participating in the research, published Thursday in the American Society of Clinical Oncology, had inadequate vitamin D to begin with.

    Some 37.5 percent of the women were "deficient" in vitamin D and 38.5 percent had "insufficient" levels of the vitamin, which is considered key to bone health.

    But investigators stopped short of recommending taking vitamin D supplements to reduce the risk of developing breast cancer or dying from it, saying more research needs to be done.

    "We were concerned to find that vitamin D deficiency was so common in women diagnosed with breast cancer and that very low vitamin D levels adversely affected patient outcome," said Pamela Goodwin of the University of Toronto, lead author of the study.

    "Our results need to be replicated in other clinical studies," she cautioned. "These data indicate an association between vitamin D and breast cancer outcome, but we can't say at this time if it is causal."

    Researchers studied 512 women with a median age of 50 diagnosed with breast cancer in Toronto between 1989 and 1995. The women were followed until 2006, over a median period of 11.6 years.

    Just 24 percent had adequate blood levels of vitamin D at the time of their diagnosis.

    According to Goodwin, a normal level of vitamin D is 80 to 120 nanomoles per liter (nmol/L) of blood. Less than 50 nmol/L is considered deficient.

    In the group studied, 83 percent of those with adequate levels of vitamin D had not experienced metastases 10 years on, and 85 percent were still alive.

    By contrast, 69 percent of women with low levels of vitamin D had not seen their cancer recur, and 74 percent were still alive, 10 years later.

    Women deficient in vitamin D were more likely to develop breast cancer before the onset of menopause, to be overweight and to have high levels of insulin in their blood, the researchers said.

    Their cancers were also more likely to be aggressive, they said.

    Previous studies have shown a link between vitamin D and other types of cancer, notably prostate and colon cancer, as well as cardiovascular disease, Goodwin noted.

    The chief source for vitamin D is sun exposure, since the ultraviolet rays of the sun trigger vitamin D synthesis within the human body.

    Considered key to bone health, it is naturally present in very few foods, fish, beef liver and egg yolks among them.

    But it is added to many foods in the United States, including milk and breakfast cereals, according to the National Institutes of Health.

    Source: American Society of Clinical Oncology

    Children: More Sun Less Multiple Sclerosis

    People who spent more time in the sun as children may have a lower risk of developing multiple sclerosis (MS) than people who had less sun exposure during childhood, according to a study published in the July 24, 2007, issue of Neurology®.

    For the study, researchers surveyed 79 pairs of identical twins with the same genetic risk for MS in which only one twin had MS. The twins were asked to specify whether they or their twin spent more time outdoors during hot days, cold days, and summer, and which one spent more time sun tanning, going to the beach and playing team sports as a child.

    The study found the twin with MS spent less time in the sun as a child than the twin who did not have MS. Depending on the activity, the twin who spent more hours outdoors had a 25 to 57 percent reduced risk of developing MS. For example, the risk of developing MS was 49 percent lower for twins who spent more time sun tanning than their siblings.

    Sun exposure appears to have a protective effect against MS,” said study authors Talat Islam, MBBS, PhD, and Thomas Mack, MD, MPH, with the Keck School of Medicine of the University of Southern California in Los Angeles. “Exposure to ultra violet rays may induce protection against MS by alternative mechanisms, either directly by altering the cellular immune response or indirectly by producing immunoactive vitamin D.”

    The study also found the protective effect of sun exposure was seen only among female twin pairs, but Mack says this novel finding must be viewed with caution since only a few male twins were involved in the study.

    “Our findings note the importance of sun exposure among people with identical genetic risk for MS,” said Mack. “High priority should be given to research into how sun exposure reduces MS risk if we are to unravel the mystery of what causes MS.”

    Source: American Academy of Neurology (24/07/07)

    Study shines light on possible MS cause
    SLIP, slop, slapping to avoid skin cancer could be exposing people to increased risk of multiple sclerosis.

    Researchers believe rising rates of MS could be linked to reduced levels of vitamin D, which is produced in the body by sunlight.

    About 18,000 Australians are thought to have MS, where the body's killer T cells attack the protective myelin sheath around nerve fibres in the brain.

    The disease usually strikes people aged in the 20s and 30s, progressively breaking down functions like mobility and eyesight or hitting in unpredictable bursts punctuated by temporary remissions.

    MS Research Australia executive director Jeremy Wright said the number of MS cases was jumping by about six or seven per cent each year.

    "We're seeing up to 1000 new cases every year, and that is now outpacing the rate of population growth," he said.

    Mr Wright said it was unclear what was behind the rise, but there was growing evidence of a link to sunlight and vitamin D.

    He said research showed the further people lived from the equator, the greater the rate of MS.

    Mr Wright said Victoria's MS rate was four to five times higher than that of Queensland.

    He said Victorians needed 10 to 15 minutes of sunlight exposure two to three days a week to give them adequate vitamin D levels.

    "One theory is maybe we've gone a bit over the top with the slip, slop, slap campaign," Mr Wright said.

    He said another favoured theory was that our increasingly hygienic environments meant our immune systems did not develop properly.

    "Our children have less exposure to nasty things that might give them diseases and excite the immune system into action early in life," Mr Wright said.

    "If you don't use your immune system early, it doesn't learn how to become strong against other diseases later."

    Mr Wright said research promised major breakthroughs in MS.

    He said new drugs that could dramatically reduce the number of attacks suffered by people with the relapse-remitting form of the disease were being tested and could be on the market within five years.

    Other researchers, including at Melbourne and Monash universities, were making advances in the repair of damaged cells that made up the myelin sheath.

    Source: News.com.au Copyright 2007 News Limited. (15/06/07)

    Study Finds Vitamin D May Lower MS Risk
    Got vitamin D? Unless you're taking supplements, drinking fortified milk, or eating a lot of fish, you're probably not getting enough. Ultraviolet rays from the sun trigger vitamin D synthesis, but at higher latitudes, away from the equator, vitamin D production is often insufficient, especially in winter months.

    Growing evidence linking higher vitamin D levels and a lowered risk of MS may explain why people who live further away from the equator are more likely to get the disease.

    The new study
    Researchers from Harvard School of Public Health, led by Alberto Ascherio, MD, DrPH, focused on 257 people who'd had at least two blood samples drawn before they were diagnosed with MS. In these stored samples, levels of 25-hydroxyvitaniin D, a form of the vitamin that reflects recent exposure to sunlight, were compared to samples from people who did not develop the disease. In the white population in this study, the average level of this form of vitamin D was 75.2 nmol/I. (nanomoles per liter). In blacks it averaged 45.5 nmol/L, and in Hispanics it was 66.6 nmol/L. These averages reflect levels found by race in the general population-darker skin produces less vitamin D when exposed to sunlight than lighter skin.

    In the white population in this study, there was a 41% decrease in MS risk for every 50nmol/L increase in vitamin D levels. MS risk was lowest among those with the highest levels of vitamin D and highest among those with the lowest levels of vitamin D. There were not enough black or Hispanic people with MS in the study group to determine what effect vitamin D had on their risk. Dr. Ascherio's study was published in the December 20, 2006, issue of the Journal of the American Medical Association.

    Further studies are needed to confirm these findings and then to determine whether this vitamin could reduce the MS risk. This study did not ask if vitamin D can affect the course of MS once it has begun.

    It is known that too much vitamin D can have toxic effects on the body, including excessive calcium levels in the blood, high blood pressure, nausea, poor appetite, weakness, constipation, impaired kidney function, and kidney damage. The Institute of Medicine recommends 200 International Units (IUs) daily for children and 200-600 IUs for adults, with older adults needing more. Talk with your health-care provider before taking this or any other supplement.

    Source: Inside MS Copyright National Multiple Sclerosis Society Apr/May 2007

    It's official: fun in the sunshine can be good for you
    Sunlight could help prevent diseases including cancer, multiple sclerosis and diabetes, according to Capital-based scientists.

    Experts from Edinburgh University believe wearing sunscreen at all times can starve the body of vitamin D, which they say protects against various diseases.

    Their findings contrast with the common perception that sunlight is a health hazard due to the skin damage caused by ultraviolet rays.

    But Cancer Research UK today said there is no definitive proof about some of vitamin D's health benefits and the charity stressed that excessive exposure to sunlight is linked to skin cancer.

    Skin cancer figures have reached around 65,000 in the UK, and around 7000 people annually contract a deadly malignant melanoma which results in 1600 deaths every year.

    But in the Royal Society of Chemistry journal, Professor Mary Norval, who led the team from the University of Edinburgh Medical School, said: "Vitamin D is now implicated in the prevention of an increasing number of non-skeletal disorders.

    "These include internal cancers, such as colon, breast, prostate and ovarian cancers, and autoimmune diseases, like multiple sclerosis and insulin-dependent diabetes."

    The research supports the public campaigns encouraging people to protect themselves from the sun, but also highlights the beneficial effects of sunlight, which is needed for the skin to synthesise vitamin D.

    Prof Norval said: "Sunscreens shield the body from the type of UV light needed to make vitamin D, so covering any exposed skin with sunscreen at all times is not advisable."

    She added: "Despite the distinct possibility that the ozone layer will repair itself in the coming decades, the take home message from the research so far is that we should strike a balance between the positive effects of vitamin D formation and the serious negative effects of too much sun exposure."

    John Toy, medical director of Cancer Research UK, said he did not want people to "lock themselves away in a darkened cellar".

    But he added: " Casual exposure to the sun is sufficient to get your vitamin D. My concern is that the mixed messages will produce confusion in people's minds."

    Source: News.Scotsman.com ©2007 Scotsman.com

    Study Suggests Vitamin D Protects Against Multiple Sclerosis
    An abundance of vitamin D seems to help prevent multiple sclerosis, according to a study in more than 7 million people that offers some of the strongest evidence yet of the power of the "sunshine vitamin" against MS.

    The research found that white members of the U.S. military with the highest blood levels of vitamin D were 62 percent less likely to develop multiple sclerosis than people with low levels.

    There was no such connection in blacks or Hispanics, possibly because there were so few in the group studied. Also, the body makes vitamin D from sunlight, and the pigmented skin of blacks and other dark-skinned ethnic groups doesn't absorb sunlight as easily as pale skin.

    The new research echoes findings in smaller studies that examined why the nerve-damaging disease historically has been more common in people who live in regions farther from the equator where there is less intense year-round sunlight. "This is the first large prospective study where blood levels are measured in young adults and compared to their future risk. It's definitely different and much stronger evidence," said Dr. Alberto Ascherio, the senior author and an associate professor of nutrition at Harvard's School of Public Health.

    The study appears in Wednesday's Journal of the American Medical Association. "If confirmed, this finding suggests that many cases of MS could be prevented by increasing vitamin D levels," Ascherio said.

    Still, he said the findings don't prove that a lack of vitamin D can cause MS, so it's too preliminary to recommend that people take vitamin D pills to avoid the disease.

    Vitamin D also is found in fortified milk and oily fish, but it's hard to get enough just from diet. Sunlight is the biggest source of vitamin D, which is needed for strong bones. Other studies have linked high levels of vitamin D in the blood to lower risks of a variety of cancers.

    The MS researchers worked with the Army and Navy in analysing blood samples of military personnel stored by the Department of Defense.

    Military databases showed that 257 service men and women were diagnosed with MS between 1992 and 2004. The increased MS risk was especially strong in people who were younger than 20 when they entered the study. The researchers said that finding suggests that vitamin D exposure before adulthood could be particularly important.

    Using blood samples to measure vitamin D levels "tends to nail it down in a much more reliable way" than studies that have relied on people's memories of vitamin D exposure, said Dr. Nicholas LaRocca of the National Multiple Sclerosis Society.

    MS is among the most common nerve disorders affecting young adults, mostly women. About 350,000 people in the United States and 2 million worldwide have MS, a chronic autoimmune disease in which the body attacks the fatty insulation that surrounds nerve fibres.

    Ascherio said there's some evidence that its incidence is increasing in sunny regions including the South and West, possibly because people are avoiding the sun or using sunscreen to protect against skin cancer.

    Some doctors think those practices also have contributed to vitamin D deficiencies in adolescents and young adults.

    "There's no question that vitamin D deficiency is an epidemic in the United States," said Dr. William Finn, a vitamin D expert at the University of North Carolina at Chapel Hill. The MS study "is just one more reason to pay attention to it."

    MS symptoms vary but can be disabling and can include tingling pain in the arms and legs, fatigue and vision problems.

    Doctors believe it is genetic and perhaps triggered in susceptible people by environmental causes, including possibly some viruses. Vitamin D deficiency could be another trigger.

    It's unclear how lack of vitamin D might contribute. In mouse experiments, the vitamin stimulated production of chemicals that fight an MS-like disease.

    Source: My Fox NewYork Copyright 2006 Associated Press. All rights reserved.

    MS diagnosis rate soaring for Canadian women
    A new study has pinpointed an alarming trend that suggests women with multiple sclerosis now outnumber men in Canada by a ratio of more than three to one.

    The researchers, led by Dr. George Ebers of Oxford University, examined Canadian data on multiple sclerosis patients. They also found that this gender ratio has been rising for at least 50 years.

    More than 1,000 new cases of the disease will be diagnosed this year in Canada, and an estimated 55,000 to 75,000 people are currently living with the disease.

    The Canadian research shows:

    In 1931, for every one man diagnosed with MS, 1.8 women received the diagnosis.

    Around 1940, the picture starts to change. The rate of MS cases in men stays relatively the same, but in women, it rises.

    And by 1980, for every one man diagnosed, more than three women develop MS. The team that conducted the research into the Canadian multiple sclerosis data is speculating that an unknown contributing factor has emerged in the last half century to make MS a female-dominated disease. The findings will appear in the November edition of the Lancet's neurology journal.

    "Since there is no indication that multiple sclerosis in men has decreased, it seems that the sex ratio change is determined by a preferential increase in affected women," the study says.

    Canada has among the highest rates in the world, as do many nations in northern Europe, prompting speculation genetics and geography may increase the risk for people who live in countries far from the equator.

    There is growing acceptance of the theory that a vitamin D deficiency due to low sun exposure may be a contributing factor in the development of the often-disabling disease.

    If there is a link between vitamin and multiple sclerosis, this could suggest it is a result of less time spent outdoors.

    Other possible factors that could be contributing to the trend include the changing role of women in the work force, dietary habits, increase in smoking among women, use of oral contraceptives, and changes in the timing of childbearing years.

    Given that the trend in the sex ratio of immigrant patients was similar to that of Canadian-born patients, the researchers believe that this trend is mirrored worldwide.

    Previous research found that having an older brother or sister with MS does not protect younger siblings from developing the disease, suggesting that a genetic predisposition and other factors are likely behind the onset of multiple sclerosis.

    This findings cast into doubt the theory that children whose immune systems are exposed to infections introduced by older siblings are less likely to develop the potentially debilitating disease.

    The study found that babies concieved during the summers, when their mothers have higher levels of vitamin D in their blood are less likely to develop MS later in life.

    "Some of the risk appears to be gestational, and very early in life," Dr. Ebers said.

    This suggests MS may be preventable, if scientists can figure out what's going on, and if it's as simple as a woman having adequate levels of Vitamin D before or during pregnancy or early childhood.

    Multiple sclerosis is an unpredictable disease caused by inflammation and patchy destruction of the protective myelin covering the central nervous system. Those with the progressive disease tend to go through sporadic periods of attack followed by recovery.

    The cause of MS is not known, but most researchers believe it is an autoimmune disease, according to the Multiple Sclerosis Society of Canada. Age of onset among patients is usually between 20 and 40, but MS has also been diagnosed in children.

    Multiple sclerosis initially may cause numbness and tingling in the extremities and temporary loss of vision in one eye. As the disease develops, patients may experience a range of symptoms, including extreme fatigue, balance and co-ordination problems, muscle stiffness and weakness, and speech and cognitive difficulties.

    Source: CTV.ca © 2006 CTV Inc. All Rights Reserved.

    Vitamin D, Wonder pill. Really.
    As Vitamin D's benefits become clearer, we're urged to get more -- much more -- of it.

    EVEN the most brazen snake-oil salesman might blush at trying to sell the public on a pill to ease aches and pains, strengthen bones, slow down cancer and prevent diseases as varied as Type 1 diabetes, multiple sclerosis and schizophrenia.

    But these claims aren't the frothy hyperbole of a sideshow huckster. A growing number of serious scientists are quite willing to speculate that a single compound may be able to accomplish all of these feats — and possibly more. They're not talking about a new miracle drug, but a common nutrient: vitamin D, "the sunshine vitamin."

    Once seen as merely a defense against rickets, vitamin D has in recent years gained recognition as a major force that acts throughout the body. It improves absorption of calcium, controls the growth of cells (both healthy and cancerous), strengthens the immune system and seems to rein in overzealous immune system cells that cause diseases such as rheumatoid arthritis and multiple sclerosis.

    Much of vitamin D's potential is still just that: potential. But at this moment, to some scientists the potential looks huge. "Even if two-thirds of these things don't pan out, it's still a blockbuster," says Dr. Robert Heaney, a professor of medicine at Creighton University in Omaha, who specialises in osteoporosis.

    As excitement about vitamin D grows, so does the concern that many people may not be getting enough. In March, an article in the journal Mayo Clinic Proceedings called vitamin D deficiency "a largely unrecognised epidemic in many populations worldwide."

    Heaney and many other researchers believe the Food and Drug Administration should consider radically increasing the suggested daily dietary intake of the vitamin, which is currently set at 200 international units (IU) for anyone younger than 51, 400 IU for people 51 to 70, and 600 IU for those 71 and older.

    They cite studies such as one published earlier this year that found that cancer deaths were especially common in men with low levels of vitamin D, and a series of studies showing that high levels of vitamin D improved strength and prevented falls in elderly people.

    "The daily allowances for vitamin D are outdated," says Anthony Norman, a professor of biochemistry at UC Riverside. "I would recommend 1,000 IU per day for all ages, with a maximum of 2,000 IU. I'm considering taking 2,000 IU myself." And, he adds, current evidence suggests that even 10,000 IU — overkill by anyone's standards — would probably be safe.

    "I'm 99% sure that vitamin D deficiency is becoming more common," says Dr. Walter Willett, a professor of epidemiology and nutrition at Harvard University who has conducted several studies on the health effects of vitamin D. In one of them, he and his colleagues estimated that an extra 1,500 IU of vitamin D each day could reduce the risk of deadly cancers of the digestive system by 45%.

    Willett believes that more than 1 billion people on the planet — including about two-thirds of whites and almost all blacks in America — don't have enough for optimal health. In recent years, shortages of the compound have even led to a resurgence of rickets, a childhood bone deformity, especially among dark-skinned babies who are exclusively breast-fed.

    Growing body of research

    Vitamin D is the only vitamin that the human body can make on its own, with a little help from rays of ultraviolet B light. On a sunny day, a fair-skinned person can make 10,000 to 20,000 IU in 15 minutes or less. Vitamin D is also available in fatty fishes such as salmon and mackerel and in fortified foods such as milk, orange juice and cereals.

    The vitamin was discovered about 80 years ago, when doctors realised that both cod liver oil and sunlight could cure the rickets plaguing many poor children in northern cities. The race was on to find the common thread. The German organic chemist Adolf Windaus won that race — and the Nobel Prize — by isolating the vitamin in 1926.

    For decades, nobody suspected that vitamin D could do anything other than strengthen bones. But today it's clear that D is a powerful agent with wide-ranging effects. Unlike other vitamins, which act like cogs to aid specific enzymes in the body, vitamin D cycles through the liver and kidneys to turn into a potent steroid hormone in the same chemical class as estrogen and cortisol.

    Whatever messages vitamin D carries, the whole body seems to listen. Scientists have found receptors that respond to it in just about every type of human cell, from brain to bones. The hormone can also switch at least 200 genes on and off.

    Researchers aren't even close to understanding all of its effects, but what they've seen so far has them buzzing. At a vitamin D scientific workshop in April, 37 speakers from around the world talked of their work, and "everybody there was excited," Norman says.

    Much of that excitement is centered around cancer research. Just like nearly all healthy cells, cancer cells have vitamin D receptors too — and when D binds, it tells those cells to stop growing, a potentially life-saving command. In fact, a 2005 article in the Southern Medical Journal called vitamin D "one of the most potent inhibitors of both normal and cancer cell growth."

    This potential cancer-fighting power may help explain why cancers of the breast, colon or prostate tend to be more common, or more aggressive, in dark-skinned people, Norman says. It may also, he adds, help explain why people in northern states such as Maine or Minnesota — where summers are short and sleeves, for most of the year, are long — are more prone to these cancers than people in the sunny South.

    Other quirks of geography offer compelling evidence for the importance of vitamin D, says Dr. Michael Holick, a professor of medicine, physiology and biophysics at Boston University School of Medicine and one of the most vocal proponents of the compound. People in sun-deprived regions are especially prone to schizophrenia, multiple sclerosis and Type 1 diabetes, he says.

    In some cases, taking vitamin D supplements to compensate for a shortage of sunlight may stop such diseases before they start. A 2001 study found that giving Finnish children 2,000 IU of vitamin D each day starting at age 1 reduced the risk of Type 1 diabetes by 80%.

    Generous amounts of D also seem to strengthen bones and prevent fractures. A 2005 study in the Journal of the American Medical Assn. found that an extra 700 to 800 IU of vitamin D, taken with or without calcium, reduced the risk of hip fractures in post-menopausal women by 26%.

    Willett says that boosting levels of vitamin D can build bone density, strengthen muscles and, in some cases, help relieve unexplained aches and pains. A recent Mayo Clinic survey found that 93% of adults and children with unexplained pain were vitamin D deficient. Anecdotally, some people with pain report relief when they take vitamin D.

    A simple experiment reported in March strongly suggests that vitamin D may help fend off dangerous infections. UCLA researchers mixed the bacterium that causes tuberculosis with blood samples from African Americans, a group that is especially vulnerable to the disease.

    The blood was low in vitamin D, as it almost always is with dark-skinned people. When the researchers added a little vitamin D to the mix, disease-fighting cells that had previously sat dormant suddenly roared to life and started attacking the infection.

    A call for caution

    Nobody could blame the general public for rolling their eyes ever so slightly at the current fizz about vitamin D. Many vitamins and supplements have been over-hyped in the past. Vitamin E, for example, was once touted as a potent antioxidant that could prevent heart disease — until a 2000 study found that vitamin E supplements didn't offer any protection to patients at high risk for a heart attack or stroke.

    And beta carotene once enjoyed a reputation as a cancer fighter — until a study of more than 29,000 male smokers found that supplements of the vitamin actually increased the risk of lung cancer.

    In fact, even vitamin D, along with calcium, failed to live up to expectations in the highly publicized Women's Health Initiative, a long-term study of more than 160,000 women. As reported in February, supplements containing 1,000 milligrams of calcium and 400 IU of vitamin D (a modest dose, to be sure) didn't significantly increase bone density or prevent fractures in post-menopausal women.

    For these and other reasons, some scientists argue for circumspection.

    Connie Weaver, a professor of food and nutrition at Purdue University who helped craft the current dietary guidelines for vitamin D, believes some researchers may be asking too much from the nutrient. "Too many people expect nutrients to work like drugs," she says. "That kind of approach is likely to lead to disappointment."

    The guidelines for vitamin D may well have to be bumped upward, she says, but only after careful scientific consideration and more studies. "There's a lot of good data that optimal vitamin D status may have many health benefits, but we don't know what those optimal levels are," she says.

    Hector DeLuca, a professor of biochemistry at the University of Wisconsin at Madison and a prominent vitamin D researcher, says he's open to the possibility that vitamin D can prevent cancer or autoimmune diseases, but he's not yet convinced. He believes that the FDA should eventually raise the recommended dietary intake, perhaps to 2,000 IU a day. ("I see no risks, and it might well help," he says.) But he's concerned about possible toxicity if people take more than that.

    At this time, it's not especially easy for consumers to add large amounts of vitamin D to their diets. A cup of fortified milk contains less than 100 IU of vitamin D and a nice hunk of salmon can provide up to 400 IU. Typical multivitamins contain just 400 IU.

    Vitamin companies have been slow to recognise the potential value — and marketability — of D. In fact, supplements that contain nothing but vitamin D have only recently hit the market. "I saw vitamin D on the shelf for the first time last week," Heaney says.

    Last week, the Institute of Medicine (which advises the government on medical matters) held a workshop to discuss vitamin D and a few other nutrients. Such meetings are often the first step toward new guidelines.

    In the meantime, if people want to supplement their diet with D, scientists suggest aiming for between 1,000 and 2,000 IU a day from a combination of fish and fortified food and supplements, choosing the more common, animal-derived D3 form of the vitamin over another form, vitamin D2. (D2, made by plants, is less than one-third as potent as D3.)

    Doctors can now measure a patient's level of vitamin D with a simple blood test, but Heaney, for one, believes the tests are often unnecessary. At his osteoporosis clinic, he says, "we just assume that every patient is deficient."

    Source: Sun-Sentinel.com Copyright 2006, Sun-Sentinel Co. & South Florida Interactive Inc.

    Avoid too much sun, but a little boosts beneficial vitamin D: advisory group
    Sunlight may be the easiest and most natural way to get a health-enhancing dose of vitamin D, but Canadians should know that a little sun goes a long way, says a Canada-U.S. consensus group formed to determine the risks and benefits of exposure to ultraviolet rays.

    In what has turned out to be a delicate balancing act, the group is advising that while too much time in the sun raises the risk of skin cancer, avoiding it entirely can lead to a deficiency in vitamin D - and that may elevate the risk of other types of cancers and diseases.

    Many Canadians and Americans from northern states may not have optimal levels of vitamin D, a nutrient produced by the body through the skin's exposure to sunlight. Much of that deficiency likely results from lack of sunlight during winter months. But some experts concede that confusion over conflicting messages about the blessings and perils of UV exposure in recent years may also have contributed to inadequate levels in the population.

    "Our messaging at the time said avoid being out in the sun - and in the media they're hearing that there's benefits to being in the sun," said Heather Logan, director of cancer control policy for the Canadian Cancer Society, one of the organizations involved in the consensus group that released its findings and recommendations Thursday.

    "We now have new information (on the health effects from sunlight) and we're revising our messages in accordance with that new scientific evidence."

    However, she cautioned that Canadians still need to carefully weigh the risks and benefits of catching some rays.

    "So while sunlight is important for a person's health, we know that you don't need to get a tan in order to get the benefits," Logan said. "Just a little bit of sun goes a long way."

    The advisory group, a coalition of health-related associations from Canada and the United States, has reiterated the long-standing caution that too much UV radiation from the sun or tanning lights is potentially dangerous: it can cause skin cancer (including the deadliest form, malignant melanoma) and cataracts.

    Experts agree that sun protection is needed when the UV index is three or higher, usually between 11 a.m. and 4 p.m. during warm-weather months.

    But at the same time, adequate levels of vitamin D can promote health by helping to build strong bones in children and maintaining them into old age, as well as possibly preventing certain malignancies, in particular colorectal cancer.

    Vitamin D deficiency has also been linked to multiple sclerosis, a disease that tends to occur more frequently among populations in northern or extreme southern climes.

    "It might be possible for some people to get enough sun to produce adequate vitamin D levels through a five-minute walk, perhaps early in the morning," said Logan. "Five minutes a day is an example, but it's going to vary depending" on the individual.

    "Unfortunately, we need more research to be able to be more crisp in telling people exactly how long to be out in the sun . . . There's no simple answer."

    How much sun someone can safely tolerate to produce enough vitamin D depends on their age, where they live and their complexion. Darker-skinned people take longer to absorb UV rays compared with lighter-skinned individuals because they have higher melanin levels. While that may mean dark-skinned Canadians can safely stay out in the summer sun a bit longer, the downside is that they have more difficulty making vitamin D during winter months when sunshine is low.

    Because few foods contain vitamin D - it is found naturally in such oily fish as salmon, tuna and sardines and is added to milk, soy beverages and margarine - the Dietitians of Canada is recommending for the first time that Canadians take supplements.

    "The amount that we think people need now is a lot more than you could possibly get from diet unless you ate fish every day, and not just fish but the right kind of fish," said Susan Whiting of the Dietitians of Canada, one of the organizations that helped formulate the recommendations.

    That means Canadians will need to meet their daily vitamin D requirements by taking supplements, "in order to compensate for not getting as much sun exposure," Whiting, a professor of nutrition at the University of Saskatchewan, said from Saskatoon.

    Current recommended daily allowances for vitamin D - which experts say are woefully outdated and inadequate - advise that breastfed infants should be given 400 international units (IUs) a day; children and adults up to age 50 need 200 IUs; adults 50 to 70 require 400 IUs; and those over 70, 600 IUs.

    But Whiting said 1,000 IUs of vitamin D daily is a far more realistic amount for all ages, up to a maximum of 2,000 IUs, depending on the individual.

    Reinhold Vieth, director of the Bone and Mineral Laboratory at Mount Sinai Hospital in Toronto, said the recommendations break new ground because they endorse supplementation of a vitamin for the first time.

    "Supplementation means 'Take more vitamin pills.' To me that's new," said Vieth, an internationally recognized expert on vitamin D.

    He's also pleased to see a subtle shift in the message about sun safety, which he called an evolution in thinking.

    "What they're recognizing in regards to the UV message is that it does not apply to everybody. They've accepted the fact that some Canadians don't have white skin, and that they're at particular risk for vitamin D deficiency."

    Source: Canadian Press Copyright © 2006 Canadian Press

    Role of Vitamin D in Prevention of Chronic Diseases and Maintaining Health
    Novel and important benefits of vitamin D and the problems associated with vitamin D deficiency will be discussed at the American Association of Clinical Endocrinologists (AACE) Fifteenth Annual Meeting and Clinical Congress, April 26-30, at the Hyatt Regency Chicago.

    Originally known as a vitamin that aids the body’s absorption of calcium, current studies have drawn attention to the role it plays in maintaining good health and preventing disease. Some evidence suggests that a deficiency of vitamin D may be associated with many chronic diseases, including common cancers, autoimmune diseases such as type 1 diabetes and multiple sclerosis as well as cardiovascular heart disease.

    Michael Holick, MD, Professor of Medicine, Physiology and Dermatology at Boston University School of Medicine and author of The UV Advantage will present his findings to the nations’ endocrinologists at their yearly meeting. Dr. Holick, a leading investigator of the functions of vitamin D, will provide members of the audience with an in-depth discussion on the signs of vitamin D deficiency; a condition which often goes unrecognized in some patients.

    • Topics include:
      The important role of sunlight and diet in receiving adequate amounts of vitamin D.
    • The definition of vitamin D deficiency and how to provide an approach for the prevention and treatment of vitamin D deficiency.
    • Information about the various assays for vitamin D metabolites and how they should be used for the clinical assessment of vitamin D status.
    • The definition of vitamin D intoxication and how to treat it.

    According to the AACE Medical Guidelines for Clinical Practice of the Prevention and Treatment of Postmenopausal Osteoporosis: 2001 Edition, with Selected Updates for 2003, general principles for all individuals, particularly children and adolescents, include a diet with adequate calcium content, good general nutrition, adequate vitamin D intake (at least 400 IU/day; as much as 800 IU/day in the elderly, regular weight-bearing exercise and no tobacco use. Vitamin D is not widely available in natural food sources. It is primarily found in fish oils (including cod liver oil), some vegetables, and fortified milk, cereals, and breads. If appropriate, vitamin D supplements may be prescribed.

    Vitamin D deficiency is one of the many endocrine disorders that will be addressed during the Clinical Congress. New research involving diabetes, thyroid cancer, osteoporosis, lipid disorders, androgen use, and performance enhancing drugs will be presented during three days of plenary lectures and interactive workshops.

    In addition, hundreds of medical abstracts ranging from osteoporosis to reproductive endocrinology will be presented at exclusive poster sessions for registered media. A preview of all abstracts, as well as an online registration form, an invitation to the media poster session preview, and facts about endocrine disorders can all be found by logging on to the AACE Annual Meeting media page at http://www.aace.com .

    AACE is a professional medical organization with more than 5,300 members in the United States and 85 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.

    Source: Newswise.com © 2006 Newswise. All Rights Reserved.

    Letter: Vitamin D: More Research Needed

    By Dr Miles D Witham

    Sir: Although superficially attractive, the suggestion that boosting vitamin D intake (report, 28 December) can reduce the risk of cancer, heart disease, multiple sclerosis and other illnesses is premature to say the least.

    Observational studies, such as those analysed by Professor Garland and his colleagues, can only show an association between lower rates of disease and higher vitamin D levels. All observational studies, however carefully carried out, are open to bias " often from factors that we know nothing about and therefore cannot control for.

    The way around this is to carry out randomised controlled trials " where some people are given vitamin D and others are given a dummy tablet. Such trials constitute the current gold standard of medical evidence. These trials have not been carried out, and until they are, there is no justification for the public to take vitamin D indiscriminately.

    The history of medicine is full of examples where promising insights from epidemiology have not proven to be useful when subject to controlled studies; interestingly, vitamins C and E have failed to reduce heart deaths in large controlled trials despite early observations being promising. Until large controlled trials have been carried out, vitamin D should be taken only by specific groups of people requiring it to treat rickets and other bone diseases such as osteoporosis.

    DR MILES D WITHAM

    CLINICAL LECTURER IN AGEING AND HEALTH, UNIVERSITY OF DUNDEE

    Source: Independent, The; London (UK)

    Vitamin D sales soar in response to research findings

    Health and beauty retailers have seen a significant increase in sales of Vitamin D following recent research highlighting the supplement's positive benefits in reducing the risk of cancer.

    The Moores Cancer Center team published their research online last week, through the American Journal of Public Health.

    The study found that a large dose of vitamin D every day can halve the chance of developing cancer and also suggested that vitamin D deficiency may be responsible for thousands of cancer deaths a year. The vitamin is also thought to play a role in preventing heart disease, lung disease, diabetes, high blood pressure, schizophrenia, multiple sclerosis, rickets and osteoporosis.

    According to the research, the daily dose of Vitamin D needed to maintain health is 25mg - five times the current recommended daily allowance in the UK. Multivitamin pills contain about a quarter of that amount, though there are higher levels in cod liver oil capsules and combined vitamin D and calcium pills.

    Following the study's release last week, stores across the UK have been inundated with health conscious customers buying such 'preventative' supplements.

    UK health and beauty retailer Superdrug, which usually sells on average around 60,000 supplements containing Vitamin D per month, said that in the two days after the research was released it witnessed around a 100% increase in sales of this kind.

    By Jeremy Laurance, Health Editor

    A daily dose of vitamin D could cut the risk of cancers of the breast, colon and ovary by up to a half, a 40-year review of research has found. The evidence for the protective effect of the "sunshine vitamin" is so overwhelming that urgent action must be taken by public health authorities to boost blood levels, say cancer specialists.

    A growing body of evidence in recent years has shown that lack of vitamin D may have lethal effects. Heart disease, lung disease, cancer, diabetes, high blood pressure, schizophrenia and multiple sclerosis are among the conditions in which it is believed to play a vital role. The vitamin is also essential for bone health and protects against rickets in children and osteoporosis in the elderly.

    Vitamin D is made by the action of sunlight on the skin, which accounts for 90 per cent of the body's supply. But the increasing use of sunscreens and the reduced time spent outdoors, especially by children, has contributed to what many scientists believe is an increasing problem of vitamin D deficiency.......]

    What it can do

    Multiple sclerosis

    Lack of vitamin D leads to limited production of 1.25-dihydroxyvitamin D3, the hormonal form of vitamin D3 which regulates the immune system, creating a risk for MS. ]

    For the full article please click the link above.

    Source: The Independent Online © 2005 Independent News and Media Limited

    Be Tenacious About Soaking Up Vitamin D

    Even in an age of fortified milk and cereal, some doctors worry that we're short on vitamin D--to our detriment.

    Historically, most people have gotten their quota from the sun, which stimulates the cells in the skin to produce it. But now that we're either slathered in sunscreen or parked in front of the computer, vitamin D deficiency appears to be fairly common. One study in Boston found that of 307 adolescents tested, 75 were vitamin D deficient. African-American kids were more likely to be low, since the pigment in dark skin acts as a sunblock.

    The National Academy of Sciences' Institute of Medicine currently recommends that adults get 200 international units, or IU s, a day of vitamin D, which the body needs to absorb calcium. But some scientists argue for even more, since studies now suggest that extra might help prevent fractures in elderly people and that a shortage could even play a role in cancer, type 1 diabetes, and multiple sclerosis.

    Most light-skinned people can get enough sun in just a few minutes a day outdoors without sunscreen. But that might not do it for people who live farther north or who have darker skin. And even short periods without protection make dermatologists nervous; such exposure may increase your risk of skin cancer. Endocrinologist Bess Dawson-Hughes, a professor at Tufts University, recommends supplements to her patients, for a total of 1,000 IU s a day. Don't go overboard--too much D can be toxic.

    Source: USNews.com Copyright © 2005 U.S.News & World Report, L.P. All rights reserved.

    The December issue of Photochemistry and Photobiology, the official journal of the American Society for Photobiology, contains a symposium-in-print exploring public health issues that surround vitamin D.

    Vitamin D is produced via a series of biochemical steps in different parts of the human body. The first step takes place in the skin when it is exposed to UVB wavelengths contained in sunlight; the same ultraviolet wavelengths that are thought to cause skin cancer. The UVB content of sunlight depends on the height of the sun in the sky; the higher the sun the more the UVB. This means that when the sun is low, such as in winter in Northern latitudes, e.g. Boston, there is insufficient UVB in sunlight to trigger the vitamin D making process. This is evident by marked seasonal variation in vitamin D status with very low levels in mid-winter.

    It is well established that vitamin D is vital for good bone health and lack of vitamin D results in rickets in children and osteomalacia, the adult equivalent. Vitamin D deficiency also results in osteoporosis in the elderly. Studies in different parts of the world show that a surprisingly large number of people are vitamin D deficient, and deficiencies are often more marked in people with brown or black skins. There is however increasing evidence that vitamin D status may be important in the prevention of internal cancers such as breast, colon and prostate. Such cancers result in death if not diagnosed and treated early (estimated 127,510 deaths in US in 2005). There is also emerging evidence for a role for vitamin D in autoimmune diseases such as multiple sclerosis and type I diabetes.

    The acknowledged vitamin D deficiency in many populations begs the question “What is the best way to maintain good vitamin D status”? This question is difficult to answer, not least because there is no agreed definition of “good vitamin D status”. Diet alone, even with fortification, is unlikely meet vitamin D requirements in most countries. Another option is increased exposure to UVB from the sun or in tanning parlours, but this raises concern about increased risk of skin cancer especially in fair skinned sun-sensitive people. Tanning salons are popular but there is evidence that their use is associated with an increased risk of malignant melanoma, the most deadly type of skin cancer (estimated 7,770 deaths in US in 2005). Dermatologists are concerned that people may increase their risk of skin cancer by increasing exposure to UVB when supplementation is another safer option. However, some experts think that it is difficult to achieve good vitamin D status with the products widely available on the market because the levels of vitamin D are not high enough. Others are concerned about vitamin D toxicity, which can happen with supplementation but not from UVB because the body has self-regulatory mechanisms that prevent this.

    The role of vitamin D for human health and the best way to achieve good vitamin D status is a controversial area of ongoing scientific and medical research. Vitamin D, especially the role of UVB, is clearly a major public health issue that may ultimately have to balance risk of skin cancer against protection from other cancers that claim greater mortality. In addition, this has important financial consequences. The current papers, by internationally acknowledged experts, show that consensus is unlikely in the near future.

    John D. Simon, Editor-in-Chief, Photochemistry and Photobiology, Duke University
    Antony R. Young, St. John's Institute of Dermatology

    Photochemistry and Photobiology
    101 Gross Chemical Laboratory
    Duke University
    Durham, NC
    http://www.duke.edu

    Women who take vitamin D supplements are 40% less likely to develop multiple sclerosis, research suggests.

    The Harvard University team found eating a diet rich in vitamin D alone was not enough to provide the same protection.

    Nearly 190,000 women took part in the study, published in Neurology.

    Researcher Dr Kassandra Munger said: "It's exciting to think something as simple as taking a multivitamin could reduce your risk of developing MS."

    However, she said further research was needed to confirm the findings.

    To read the full article please click the link above.

    Unpublished Study says sunshine may prevent MS

    As if the snow weren't enough, there may be another reason to head south in the winter. Sunbathing may be the best way to protect yourself against Multiple Sclerosis. It has been known for at least 50 years that people in high latitudes face a 100 times greater risk of contracting the disease than people living at the equator.

    There is even a four-fold variation in the number of cases in the United States between the southern states and the state of Washington, the Royal Geographical Society/Institute of British Geographers' conference in Plymouth was told last week. Graham Bentham, from the environmental sciences department of Britain's East Anglia University, has conducted a statistical study that he believes explains these geographical variations for the first time. He said his study, which has yet to be published, successfully tested the hypothesis that the variation could be explained by geographical differences in exposure to ultraviolet-B (UVB) radiation, the body's principal source of Vitamin D.

    The study found that the higher proportion of oily fish, rich in Vit. D, in the diet of Norwegians and Icelanders was likely to account for their lower rates of contracting MS compared with other northern Europeans. Bentham also found that populations that tended to eat a lot of animal fat were more likely to get MS.

    Ref: National Post, Jan. 8, 2001

    Possible correspondence vitamin D levels and lesion activity in MS

    By Ashton F. Embry, Ph.D., Lloyd R. Snowdon, Ph.D. and Reinhold Vieth, Ph.D.
    Annals of Neurology, 2000, v. 48, p.271-272

    Vitamin D and Seasonal Fluctuations of Gadolinium-Enhancing Magnetic Resonance Imaging Lesions in Multiple Sclerosis

    Auer et al recently showed a striking, near sinusoidal annual variation in the number of active magnetic resonance imaging lesions in 53 Multiple Sclerosis (MS) patients. Their results provide solid support for past, less-well documented claims of seasonal fluctuation in MS disease activity. Furthermore, the seasonal fluctuation in lesion activity may provide an important clue for identifying environmental factors which are part of MS etiology.

    Auer et al proposed that seasonal changes in the rate of common infections might partially explain the seasonal fluctuation in lesion activity. They noted that climatic factors such as temperature, amount of sunlight and UV light exposure might also be involved. We suggest that vitamin D supply, which fluctuates with seasonal UV light exposure, is the main environmental factor involved. Vitamin D and its metabolites have been implicated in MS etiology by epidemiological, experimental and immunological data2. Moreover, circulating 25-hydroxyvitamin D [25(OH)D] also shows a near sinusoidal annual fluctuation at higher latitudes.

    To investigate a possible correspondence between the fluctuations in vitamin D intake and lesion activity, we compared published monthly 25(OH)D levels in 415 people, aged 50-80, from southern Germany4 with the data of Auer et al which were also collected in southern Germany (Figure). Third order polynomial curves fit both the 25(OH)D and lesion data significantly. When the 25(OH)D data are lagged by two months, there is a close correspondence between the two curves with high levels of 25(OH)D correlating with low levels of lesion activity and vice versa. A two-month lag is within reason and is taken to reflect the time for a given 25(OH)D level to affect detectable lesion occurrence.

    The inverse correlation between lesion activity and 25(OH)D level suggests that vitamin D nutrition may have a notable immuno-modulating effect on CNS inflammation, a conclusion also reached through experimental and immunological studies. The impressive correlation also supports the need for proper clinical trials to test whether improved vitamin D nutrition (not the vitamin D hormone, 1,25(OH)2D) can reduce formation of CNS lesions and slow the progression of MS. Until definitive results are available, clinicians may want to ensure their MS patients are receiving a meaningful vitamin D intake (3000-4000 IU/day) throughout the year. Although well above current nutritional guidelines (200-400 IU), such an intake is physiological and safe and most importantly, provides a desirable target amount of circulating 25(OH)D5.

    Month-to-month variation of average number of active lesions in multiple sclerosis patients from southern Germany as reported by Auer et al and month-to-month variation in the median levels of the vitamin D metabolite, 25(OH)D, in 50-80 year olds from southern Germany as reported in Scharla. The two, fitted, third order polynomial curves show a close correspondence when the 25(OH)D data are lagged two months.

    Vitamin D Causes positive changes in blood chemistry in people with MS

    By Emma Patten-Hitt, PhD
    Atlanta (Reuters Health)

    Taking vitamin D supplements may positively influence the immune systems of patients with Multiple Sclerosis (MS), according to researchers. A small study conducted by researchers at Penn State and Helen Hayes Hospital in New York has shown that a daily dose of vitamin D - 1000 IU or two and a half times the recommended dose for adults - causes changes in blood chemistry that indicate positive effects for Multiple Sclerosis patients. Dr. Margherita Cantorna, assistant professor of nutrition, says the study has not been in progress long enough to observe changes in the clinical symptoms of the disease in the patients who participated "Vitamin D status affects chemicals that modulate the immune system called cytokines, and these changes may benefit patients with MS," lead researcher Dr. Margherita Cantorna, of Pennsylvania State University, University Park, told Reuters Health.

    According to Cantorna, the study findings are supported by the fact that the number of cases of MS is nearly zero near the equator and increases with latitude in both hemispheres. The increased sunlight near the equator allows the body to produce more vitamin D, and may theoretically reduce the incidence of MS, Dr Cantorna noted in a press release accompanying the abstract last week.

    "Doctors should be aware of the detrimental effects of vitamin D insufficiency for their MS patients and make sure they are vitamin D adequate." However, Cantorna also pointed out that vitamin D at high doses is toxic." MS patients should not take large amounts of vitamin D supplements. They should increase their vitamin D intake under the supervision of their doctors," she warned.

    For further information, please refer to the original article.

    Sunshine and MS

    Lower Risk of MS in Queensland Australia due to Vitamin D from sunshine!

    British and Irish people who migrate to Queensland in Australia enjoys a 75% reduction in their risk of getting MS compared to those who stay at home.

    Yet in Tasmania the reduction in risk is zero. Queensland has year-round sunshine whereas Tasmania does not. This is the strongest evidence yet that an environmental factor, thought to be vitamin D from sunshine, has a protective effect against MS.

    Ref: "Risk of Developing MS for British & Irish Immigrants to Australia" - Ashton Embry phD, Reinhold Vieth PhD, & Colleen Hayes.

    Can Vitamin D impact MS?

    Could doing something as simple as taking Vitamin D have an effect on Multiple Sclerosis?

    There is some evidence that Vitamin D might play some part in the development of MS and other diseases such as diabetes, and perhaps even have a positive effect once the disease is present.

    It’s an intriguing question that Dr. George Ebers hopes to answer with some colleagues in Canada with funding support from the MS Society of Canada.

    The head of neurology at the University of Oxford and former director of the MS Clinic in London, Ont., is organizing a meeting in the next few months to discuss a study on whether Vitamin D supplements could prevent the onset of MS in people at high risk — probably relatives of people who have the disease.

    Others are interested in the question as well including Ashton Embry of Calgary ( Direct MS). When his son Matthew developed MS six years ago at the age of 18, Mr. Embry began searching for clues as to what might trigger MS, he told The Globeand Mail.

    He first became interested in the possibility that diet might have an influence and more recently in Vitamin D. He learned that a number of scientists were interested in Vitamin D and some were convinced that people who live in northerly climates receive far less Vitamin D than they should because of the lack of sunlight six months of the year.

    A researcher in Boston, Dr. Michael Holick, calls Vitamin D deficiency an epidemic among North American adults, since in more northerly areas people aren’t receiving Vitamin D from the sun from four to six months of the year. The sun doesn’t shine as much in the winter, and people are more covered because of the cold.

    “These are intriguing clues that a common vitamin may be able to play a positive role in reducing the risk of developing MS or even be a possible therapy. It is too early to draw any definite conclusions,” said Dr. William J. McIlroy, national medical advisor.

    The lack of natural Vitamin D from the sun correlates to the geographic distribution of MS. The rate of MS increases the further people live from the equator, but in some Scandinavian countries there appears to be a lower rate of MS among people who eat a lot of fish, a rich source of dietary Vitamin D.

    Recently, some small studies are providing a few more details. Researchers at Pennsylvania State University and Helen Hayes Hospital in New York have preliminary results that show a daily dose of Vitamin D causes positive changes in blood chemistry.

    Although it is too early to show any clinical effects, the blood samples after six months of Vitamin D supplementation show an increase in cells associated with suppression of immune system attacks and a decrease in cells associated with triggering attacks. In animal experiments, Vitamin D supplementation prevented the animal model of MS, according to the researchers.

    At the University of Wisconsin, researchers have used a form of Vitamin D to see if it can inhibit the development of the animal model of MS in mice. Those treated with the hormone 1,25-(OH)2D3 did not develop the disease while those on placebo became ill.

    “These are intriguing clues that a common vitamin may be able to play a positive role in reducing the risk of developing MS or even be a possible therapy. It is too early to draw any definite conclusions,” said Dr. William J. McIlroy, national medical advisor.

    “If people with MS are considering trying Vitamin D as a supplement, they should be aware that high doses of Vitamin D can be toxic, and they have been linked to heart problems and kidney failure,” he added.

    The publication Compendium of Pharmaceuticals and Specialties recommends a daily dosage of Vitamin D at 400 to 800 IU for adults. Those who believe in additional supplementation suggest that 1,000 to 4,000 IU daily can be taken without harmful side effects. People considering taking Vitamin D supplements should discuss it with their physicians.

    Ref: MS Society of Canada Publication, Volume 29, Feb. 2002

    Sun exposure while young may protect against Multiple Sclerosis

    An important paper in the prestigious British Medical Journal supports the theory that Vitamin D in sunlight may protect against Multiple Sclerosis.

    A study by Ingrid van der Mei and colleagues in Tasmania, Australia, which has a high prevalence of MS, found that insufficient ultraviolet radiation may influence the development of Multiple Sclerosis. Higher sun exposure between the ages of 6 and 15 years, especially in winter, was associated with a one third decreased risk of Multiple Sclerosis. Extract from the paper: One of the most striking epidemiological features of Multiple Sclerosis is a gradient of increasing prevalence with latitude.

    An inverse association between solar radiation and prevalence of Multiple Sclerosis was first observed in 1960. Recent photo-immunological work has rekindled interest in this observation because ultraviolet radiation can attenuate T helper cell type 1 mediated immune responses through several mechanisms.

    Also, administration of ultraviolet radiation or 1,25-dihydroxycholecalciferol, the active form of vitamin D3, which is produced under the influence of ultraviolet radiation, has shown protective effects against the induction or progression of experimental allergic encephalomyelitis. In humans, ultraviolet radiation or vitamin D may also protect against multiple sclerosis.

    A strong ecological association between regional levels of ultraviolet radiation and prevalence of multiple sclerosis is evident in Australia (r = -0.91). In a death certificate based case control study, high residential or occupational exposure to sunlight was negatively associated with mortality from Multiple Sclerosis.

    Exposure to ultraviolet radiation early in life may alter immunological development during a critical developmental phase. However, the finding of a strong latitudinal gradient of prevalence of Multiple Sclerosis in Australia even among immigrants from the United Kingdom and Ireland (70% who migrated after age 15) suggests that cumulative exposure to ultraviolet radiation or exposure later in life might also be important.

    Tasmania, the island state of Australia, is located at latitudes 41-3'S and has a high prevalence of Multiple Sclerosis at 75.6 per 100,000 population." We conducted a case control study in Tasmania to examine whether high past sun exposure was associated with a reduced risk of Multiple Sclerosis.

    Ref: BMJ 2003;327:316 (9 August) "Past Exposure to Sun, Skin Phenotype and Risk of Multiple Sclerosis": Case-Control Study

    Full text and references can be found at www.bmj.com.

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