Vitamin D Supplementation Practices among Multiple Sclerosis Patients and Professionals

Abstract

Vitamin D serum level increase is associated with a reduction in clinical relapse rate, gadolinium-enhancing lesions, new or enlarging T2 lesions and new active lesions in the MRI in MS patients. However, current RCTs assessing the vitamin D supplementation therapeutic effect in MS provide inconclusive results. Experts recommend vitamin D measurements and implementations among patients with MS. This article discusses an observational study, performed without any intervention to evaluate the vitamin D status and practices among MS patients and professionals in the clinical setting. A total of 139 patients with MS treated by disease-modifying therapy were recruited and fulfilled the standardized questionnaire assessing the vitamin D supplementation practices and vitamin D level influencing factors such as education, insolation, smoking, obesity and current treatment. The collected data were then compared to the patients’ vitamin D serum levels available in medical records at the baseline and after 12 months of observation. Professionals’ practices and recommendations were also assessed. A total of 74.1% patients confirmed vitamin D supplementation, and all patients were administered cholecalciferol, taken orally. However, only 43.69% of the patients achieved an optimal vitamin D concentration (30–50 ng/mL). The lack of a doctor’s recommendation was the most frequent reason for the absence of vitamin D supplementation. The most often recommended vitamin D daily dose was 4000 IU. There was no adverse effect of supplementation observed. Vitamin D status in patients with MS is currently better than in the general population, but still, a significant percentage of patients do not implement vitamin D.

Radiological Benefits of Vitamin D Status and Supplementation in Patients with MS—A Two-Year Prospective Observational Cohort Study

“…Furthermore, 95 out of 133 patients declared vitamin D supplementation (71.4%) in the study group. This percentage is comparable with another study in the Polish population, in which 103 out of 139 patients were supplementing vitamin D [ 41 ]. A lower percentage of MS patients supplementing vitamin D was reported by Pape et al (60.0%) [ 42 ] and Masullo et al (52.78%) [ 43 ].…”

Multiple Sclerosis—Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics

“…GM appeared to be a pivotal element influenced not only by the type of diet but also by therapies. In fact, vitamin D supplementation, commonly prescribed for MS [ 121 ], may also influence gut bacterial populations by increasing the frequency of certain genera [ 122 ]. In vitro studies have shown that some MS drugs (e.g., fingolimod and teriflunomide) also have anti-inflammatory and antioxidant effects and can shape GM and inhibit the growth of neurotoxin-secreting gut bacteria.…”