Can Vitamin D Help Manage MS?

Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.

A potential link between low vitamin D levels and the development of multiple sclerosis (MS) isn’t new to researchers — in fact, the concept has been around since the late 1970s.

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Since then, a growing body of research has gradually solidified this connection. “Epidemiological studies have consistently shown that low serum vitamin D levels are linked to increased risk of MS development,” says board-certified neurologist Mary Ann Picone, MD, medical director at Holy Name Medical Center and multiple sclerosis specialist in Teaneck, New Jersey. “Evidence supports maintaining adequate vitamin D status for MS prevention.”

There’s also some evidence that supplementing with vitamin D may help manage certain MS symptoms. But some questions remain — such as which symptoms the nutrient is most likely to benefit. Here’s what experts have to say about the latest research on vitamin D and MS.

The Connection Between Vitamin D Levels and MS

According to Andrew Wolf, MD, neurologist at the Rocky Mountain MS Center at UCHealth University of Colorado Hospital in Aurora, Colorado, the underlying reasons for vitamin D’s involvement with MS aren’t perfectly clear. But so far, it appears the vitamin’s impact on inflammation in the nervous system is probably at play. 

“Vitamin D helps to suppress pro-inflammatory immune responses and may enhance neuroprotection and remyelination in the central nervous system,” says Dr. Picone.

[2] (Remyelination involves repairing the myelin sheath — the spinal cord’s protective layer that is damaged by MS.)

[3] “Since MS is an immune-mediated disease, these are important benefits,” she adds.

One review, for example, suggested that low vitamin D levels could make the central nervous system vulnerable to inflammation, since the vitamin affects the function of cells called microglia. Microglia release inflammatory substances that can damage the myelin sheath, and low levels of protective vitamin D could make this process worse, leading to an increase in symptoms.

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Per the National Multiple Sclerosis Society, vitamin D also supports the immune system, which could also help people avoid other illnesses, such as urinary tract infections and upper respiratory tract infections, that might worsen MS symptoms.

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Vitamin D Deficiency and MS Risk: Is There a Link?

There is strong research showing that vitamin D deficiency is a risk factor for developing MS, says Picone. 

According to 2019 Endocrine Society guidelines, vitamin D deficiency is defined as having a level below 30 nanomoles per liter (nmol/L).

[5] One Australian systematic review and meta-analysis of 14 studies found that people with vitamin D deficiency, defined in this review as levels below 50 nmol/L, had a 54 percent higher risk of MS than those with sufficient vitamin D status.

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For this reason, it’s a good idea to maintain adequate vitamin D status, especially if you have other MS risk factors, such as smoking, obesity, or prior Epstein-Barr virus exposure, says Picone.

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“To reduce the risk of developing MS, the optimal 25-hydroxyvitamin D level [the primary form of vitamin D in the blood] appears to be at least 40 nanograms per milliliter (ng/mL), with evidence suggesting that levels above this threshold are associated with the greatest reduction in MS risk, especially in individuals of European ancestry,” she explains. (People with this background may be especially susceptible to MS, due to a genetic variant passed down over thousands of years.)

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Everyone should get their vitamin D levels tested with a blood draw at least yearly as part of their routine healthcare, Picone adds.

Can Vitamin D Supplements Help With MS Management?

If you’ve already been diagnosed with multiple sclerosis, research shows that supplementing with vitamin D may alleviate certain symptoms of the disease.

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May Reduce Intensity of Flares

According to Dr. Wolf, per the results of a recent clinical trial from France with 303 participants, there’s good evidence that vitamin D supplementation for MS patients with low levels of the nutrient could modestly reduce disease activity.

[10]For some people, this could mean less intense MS flares.

“I generally recommend getting the vitamin D level to 40 ng/mL, as it’s an inexpensive and [generally] safe intervention [with monitoring by your healthcare provider],” Wolf says. Talk to your healthcare provider about getting your levels tested, and about the optimal vitamin D level for you.

That said, it’s important to set your expectations appropriately. “Vitamin D supplementation is associated with fewer new MRI lesions and reduced radiological activity, particularly in patients who maintain higher serum vitamin D levels,” Picone says.

[11] “However, these improvements do not consistently translate into fewer clinical relapses.”

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