Here comes the sun!
Can Vitamin D help me feel better?
After a dark winter, the sun’s rays are finally warming the land across our little corner of Cymru. Signs of spring awakening are everywhere – new green growth on the trees, flowers erupting seemingly out of nowhere, and birds waking me every morning with their riotous dawn chorus. It’s not just animals and plants that are awakening – people feel it too! This is due to many things, but one of the most important is the reappearance of sustained sunlight, which gives humans an opportunity to rebuild our stocks of Vitamin D, an essential vitamin that our bodies create directly from sunlight exposure on our skin.
Though it’s possible to get small amounts of Vitamin D3 (the form produced by our bodies) from some foods (oily fish, red meat and eggs), by far the best way is directly from sunlight through skin exposure. If you have fair skin, you just need 20-30 minutes of sunlight on your face and forearms 2-3 times a week to generate enough vitamin D for your needs during the summer months in the UK. The sunshine should never feel painfully hot or cause your skin to redden or burn because though some sun exposure is required, excessive sun carries a risk of skin cancer. If your skin is dark, if you prefer to cover up more of your body, or are forced to spend more time indoors (eg like me, due to disability), you will generate less vitamin D than you need. This deficiency is even worse in the winter since, in the UK, sunlight between October and April is not strong enough to stimulate our skin to make enough vitamin D. Regardless of the seasonal availability of sunlight, due to our modern lifestyles in urban areas we are spending more of our time indoors - working, studying, recreation. Therefore, as a population most of us are no longer getting the amount of sunlight we need to ensure we have enough Vitamin D for health.
What counts as 'low vitamin D'? (MS Trust figures)
A lack of vitamin D is thought to be common in the general UK population. The government estimates that over a quarter of adults and children have less than 25 nmol/l of vitamin D in their blood. During the winter months, this figure may be higher. Despite this, most healthy people with low vitamin D levels do not usually fall ill, and experts do not agree on what constitutes the 'right' level of vitamin D to have for best health. There is quite a range in healthy people and across the year. Experts do agree that at the lowest levels - falling into the 'deficient' category on the table below - we are at risk from bone disease. This takes the form of rickets in children and osteoporosis and osteomalacia in adults.
Vitamin D and MS
Vitamin D deficiency can have serious health implications in normal, healthy children and adults, but the effects appear to be magnified or even causative in people with MS. Low vitamin D has been suggested as one of the risk factors for getting MS, which may work alongside viral infection and other triggers to increase one’s chances of acquiring the illness. Several large studies from around the world have shown evidence of this link, for example one study compared 15,000 people with MS and 24,000 people without, and found lower vitamin D levels in the people with MS. Two further studies looked at those joining the US Army or Nursing professions, and compared their blood levels of vitamin D with their subsequent chance of getting MS. Those with lower levels of vitamin D were more likely to develop MS. Nearer the equator, the sunlight is stronger and less seasonal, meaning that it is easier for your skin to make sufficient vitamin D all year round. Further from the equator, vitamin D levels and sunshine levels are lower and MS rates are higher. There is a higher rate of MS in Scotland compared with England, and in New Zealand compared with Australia for instance.
For people like me, who already have MS, elevating vitamin D levels might help avoid relapses and slow progression to more serious forms of the disease. This has been shown in several ways, including lower measures of disability (EDSS), larger brain volume and developing fewer brain lesions.
Possible reasons for this link:
Having low vitamin D levels could cause your MS to be more active.
Having more active MS could cause your vitamin D levels to be lower. For example, you spend less time outdoors when your MS is active.
Another unknown factor causes both low vitamin D levels and more active MS, but the two are not directly linked.
Sun exposure has been shown to reduce the severity and progression of MS and also lift depression, which implies that increasing vitamin D intake could also help, but the advice on what we should do about it is mixed. Nonetheless it’s one easy thing I can try to improve my own condition so as an “auto-experiment” (aided and abetted by my GP) have started trying to increase my own Vitamin D3 levels using a daily supplement. I have high hopes because the MS Trust reports that a...
“recent trial looked at the difference in MRI outcomes for those taking vitamin D supplements alongside fingolimod. They found less depression, reduced brain volume loss and fewer new and enlarging lesions among those who took vitamin D every day, compared with casual takers and those who never took vitamin D.”
Vitamin D3 supplements
The UK Scientific Advisory Committee on Nutrition has recently set recommended dietary intakes for vitamin D for the first time. These can come from your general diet or from supplements:
Everyone in the general population aged 4 and over should have 10 micrograms of vitamin D per day, throughout the year. (This includes pregnant and breastfeeding women and population groups at particular risk of low Vitamin D).
It is safe for all infants from birth to 1 year old to have 8.5 to 10 micrograms per day.
It is safe for children between the ages of 1 and 4 years to have 10 micrograms of Vitamin D a day.
Vitamin D supplements come as tablets, capsules or drops. Their strength is measured in both micrograms (µg or mcg) and International Units (IU). It is essential to choose supplements that provide vitamin D3 (cholecalciferol) rather than vitamin D2 (ergocalciferol) which tend to produce a higher and more sustained level of 25D in the blood.
These recommended intakes (RNI) are based on the amount needed to maintain bone health in normal healthy individuals They are not related to MS specifically, and most trials in MS are looking at much higher doses. People with MS, like me may need a higher dose of vitamin D supplement than a person without MS. I have been prescribed 1000 IU of D3 a dy – hopefully that will make a difference. On sunny days, I also try to sit in direct sun for 15-20 minutes a day.
To find out more look here:
Will keep you updated on how things progress! No blog next week – having a break for half term – hope we can all catch some rays!