Multiple sclerosis, osteoporosis, and vitamin D

J Neurol Sci. 2009 Dec 15;287(1-2):1-6. Epub 2009 Oct 2.

Sioka C, Kyritsis AP, Fotopoulos A.

Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece.

Multiple sclerosis (MS) is associated with reduced bone mass and higher frequency of osteoporosis. Although high-dose short-term intravenous glucocorticoid regimens cause a decrease in bone formation, this effect is usually reversible and osteoporosis in MS patients may be independent of the short-term corticosteroid treatment. Clinical evidence suggests an important role of vitamin D as a modifiable risk factor in MS. Low circulating levels of vitamin D have been found in MS patients, especially during relapses, suggesting that vitamin D could be involved in the regulation of the clinical disease activity. Vitamin D mediates its function through a single vitamin D receptor (VDR). Polymorphisms of the VDR have major effects on vitamin D function and metabolism, and some VDR genotypes have been linked to osteoporosis and MS. Because the safety of high doses of vitamin D has not been established yet, vitamin D hasn’t been used in enough doses to increase the serum level to a desired therapeutic target. Future clinical trials should determine the upper limit of vitamin D intake in order to achieve therapeutic benefit in MS patients.

PMID: 19800081 [PubMed – indexed for MEDLINE]

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