Document Detail


Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis.
MedLine Citation:
PMID:  19383644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Vitamin D is important for bone health and immune regulation, and has been shown to be low in multiple sclerosis (MS). We sought to determine the effect of over the counter low dose cholecalciferol (LDC) and high dose ergocalciferol (HDE) on the vitamin D levels in MS patients. METHODS: We retrospectively evaluated serum 25-hydroxy-vitamin D [25(OH)D] levels of 199 patients (CIS, n = 32; RRMS, n = 115; PPMS, n = 10; SPMS, n = 16; Transverse Myelitis (TM), n = 9; other neurological diseases, n = 16) attending our clinic between 2004 and 2008. We examined the change in 25(OH)D levels in 40 MS patients who took either LDC (< or =800 IU/day) or HDE (50,000 IU/day for 7-10 days, followed by 50,000 IU weekly or biweekly). RESULTS: The average 25(OH)D level was 71 +/- 39 nmol/L (Mean +/- SD), and 167(84%) patients had insufficient levels (< or =100 nmol/L) of 25(OH)D. The patients supplemented with LDC did not have a significant increase in their 25(OH)D levels. However, 25(OH)D levels increased by 42 nmol/L (P = 0.01) in the patients originally taking LDC and then prescribed HDE. Optimal levels (> or =100 nmol/L) were only achieved in less than 40% of patients. CONCLUSIONS: We conclude that large numbers of patients with MS and TM in our cohort are deficient in vitamin D. HDE significantly elevated 25(OH)D levels in MS patients and was more effective at increasing 25(OH)D levels than LDC. Prospective studies are required to determine appropriate dosing regimen to achieve optimal levels in the majority of MS patients and to ascertain the safety, immunological response, and ultimately the clinical efficacy of vitamin D replacement therapy.
Authors:
G S Hiremath; D Cettomai; M Baynes; J N Ratchford; S Newsome; D Harrison; D Kerr; B M Greenberg; P A Calabresi
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Publication Detail:
Type:  Journal Article     Date:  2009-04-21
Journal Detail:
Title:  Multiple sclerosis (Houndmills, Basingstoke, England)     Volume:  15     ISSN:  1352-4585     ISO Abbreviation:  Mult. Scler.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9509185     Medline TA:  Mult Scler     Country:  England    
Other Details:
Languages:  eng     Pagination:  735-40     Citation Subset:  IM    
Affiliation:
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cholecalciferol / administration & dosage*,  blood
Demyelinating Diseases / blood,  drug therapy
Dose-Response Relationship, Drug
Ergocalciferols / administration & dosage*,  blood
Female
Humans
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis / blood,  complications,  drug therapy*
Retrospective Studies
Vitamin D Deficiency / blood,  complications,  drug therapy*
Vitamins / administration & dosage*,  blood
Chemical
Reg. No./Substance:
0/Ergocalciferols; 0/Vitamins; 67-97-0/Cholecalciferol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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