This month the Multiple Sclerosis Journal published a series of articles asking neurologists if they would take a supplement of 10,000 IU of vitamin D a day if they had a clinically isolated syndrome (one attack of MS before definite diagnosis) and an MRI scan suggestive of multiple sclerosis. The conclusion was that yes they would, which probably doesn’t surprise anyone anymore. The authors identified that (when causes of an abnormally raised calcium level have been excluded) a supplement of 10,000 IU of vitamin D a day is safe, achieves levels of vitamin D in the band 150-225nmol/L, the level at which vitamin D has its optimal effect on the immune system (and is safe up to levels of 380nmol/L), and reduces disease activity and relapse rate. The really surprising part however, is that despite stating that this is the course of action they would take themselves or recommend to relatives, the accompanying editorial notes that they would not prescribe the same supplement to their patients with MS as there isn’t yet conclusive evidence. By conclusive they mean there are as yet no large scale randomised controlled trials.
This is a really surprising position and makes one reflect on what evidence-based medicine has done to doctors, to have made them so pedantic that they would not prescribe a naturally occurring vitamin, taken at physiological doses at which there are no known side effects, that has been shown to reduce the incidence of cancers and other autoimmune diseases, as well as reduce the risk of relapse of MS, despite being enthusiastic about taking the same supplement themselves. It also makes one wonder about the humanity of our medical advisors, who would do one thing for themselves and quite another for their patients, despite being convinced enough of the value and safety of the supplement to take it themselves.
While neurologists wait for conclusive trials we hope that PwMS will follow the advice neurologists would follow themselves or give to their own relatives, and which we at OMS have advocated since 1999. PwMS should take vitamin D in doses of 5,000IU to 10,000IU a day, aiming at a blood level above 150nmol/L. Their relatives should also take vitamin D supplements, aiming at levels above 100nmol/L.