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Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis.

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

    , , , , , , ,

    Source

    MeSH

    Adult
    Cholecalciferol
    Demyelinating Diseases
    Dose-Response Relationship, Drug
    Ergocalciferols
    Female
    Humans
    Longitudinal Studies
    Male
    Middle Aged
    Multiple Sclerosis
    Retrospective Studies
    Vitamin D Deficiency
    Vitamins

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    19383644

    Citation

    Hiremath, G S., et al. "Vitamin D Status and Effect of Low-dose Cholecalciferol and High-dose Ergocalciferol Supplementation in Multiple Sclerosis." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 15, no. 6, 2009, pp. 735-40.
    Hiremath GS, Cettomai D, Baynes M, et al. Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. Mult Scler. 2009;15(6):735-40.
    Hiremath, G. S., Cettomai, D., Baynes, M., Ratchford, J. N., Newsome, S., Harrison, D., ... Calabresi, P. A. (2009). Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England), 15(6), pp. 735-40. doi:10.1177/1352458509102844.
    Hiremath GS, et al. Vitamin D Status and Effect of Low-dose Cholecalciferol and High-dose Ergocalciferol Supplementation in Multiple Sclerosis. Mult Scler. 2009;15(6):735-40. PubMed PMID: 19383644.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. AU - Hiremath,G S, AU - Cettomai,D, AU - Baynes,M, AU - Ratchford,J N, AU - Newsome,S, AU - Harrison,D, AU - Kerr,D, AU - Greenberg,B M, AU - Calabresi,P A, Y1 - 2009/04/21/ PY - 2009/4/23/entrez PY - 2009/4/23/pubmed PY - 2009/8/22/medline SP - 735 EP - 40 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. VL - 15 IS - 6 N2 - 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. SN - 1352-4585 UR - https://www.unboundmedicine.com/medline/citation/19383644/Vitamin_D_status_and_effect_of_low_dose_cholecalciferol_and_high_dose_ergocalciferol_supplementation_in_multiple_sclerosis_ L2 - http://journals.sagepub.com/doi/full/10.1177/1352458509102844?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -