Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin D (Cholecalciferol) and Multiple Sclerosis: Evidence Overview

There is a growing body of scientific evidence suggesting a link between vitamin D status and multiple sclerosis (MS), an autoimmune disease affecting the central nervous system. Epidemiological studies have consistently shown that the prevalence of MS is higher in populations with lower sun exposure and, by extension, lower vitamin D levels. Observational studies further support an association between low serum 25(OH)D concentrations and increased risk of developing MS, as well as higher relapse rates and disease activity in those already diagnosed.

Clinical trials evaluating vitamin D supplementation in people with MS have produced mixed results. Some small-scale randomized controlled trials (RCTs) have found that vitamin D supplementation may reduce disease activity as measured by MRI lesion counts or relapse rates, while others have not demonstrated significant clinical benefit. There is also evidence that vitamin D is important for immune regulation and may influence the pathogenesis of MS by modulating T-cell and cytokine profiles.

Current clinical guidelines recognize vitamin D insufficiency as common in people with MS and generally recommend supplementation to maintain adequate serum vitamin D levels, though not all guidelines endorse high-dose supplementation specifically for disease modification. Overall, while there is scientific rationale and some supportive data, definitive large-scale RCTs are still needed to establish vitamin D as a standard disease-modifying therapy for MS. Thus, the evidence supporting its use can be considered moderate but not conclusive.

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