Vitamin D for the management of multiple sclerosis

Multiple sclerosis (MS) is an immune-mediated demyelination chronic disorder of the central nervous system that manifests in neurological disability of varying levels. Typical clinical features of MS include motor weakness, visual loss, spasticity, tremor, cognitive deficits and sensory loss or impairment. The pathogenesis of MS remains mostly undetermined, which contributes to the lack of efficacy of therapy for this condition.

Vitamin D deficiency is considered to be an environmental risk factor for MS (Rhead et al, 2016). Numerous studies have reported an association between low serum 25-hydroxyvitamin D (250HD) concentration and MS before and after the disease is triggered (Pierrot-Deseilligny and Souberbielle, 2017). Epidemiologic studies indicate that the prevalence of MS is minimal at the equator and greater at higher latitudes and tends to peak in areas with the lowest exposure to ultraviolet light (Correale et al, 2017). Furthermore, observational studies have implied that there is a correlation between the level of serum vitamin D and MS risk and disease activity (Sintzel et al, 2018). A reduced risk for developing MS and a reduction in relapse and disease activity in established MS are associated with higher levels of vitamin D (Runia et al, 2012). Due to the lack of consensus on the possible benefit of vitamin D for patients with MS, the available evidence requires closer consideration.