Tuesday, 23 September 2014

ClinicSpeak: Vitamin D in pregnacy

Should we be supplementing vD during pregnancy? #MSBlog #MSResearch #ClinicSpeak

"The following study shows that vitamin D deficiency is common in woman with MS in pregnancy and post-partum. It is interesting that MSers had lower levels than normal control subjects, which raises the issue of whether or not MSers are consuming more vD as part of their disease. The so called consumptive hypovitaminosis D3 hypothesis."

"I currently recommend to woman with MS who are planning to fall pregnant, or who are pregnant, to take 10,000IU of vD3 per day and test blood levels after 4-6 weeks to adjust the dose; I target blood levels above 100 nmol/L and less than 250 nmol/L. My recommendation is simply based on an evolutionary medicine perspective as proposed by Reinhold Vieth. There is epidemiological evidence that low vD levels in utero and childhood may increase your risks of developing MS. This is particularly relevant to children of MSers who are already at increase risk due to genetic loading. I say vD supplementation may reduce your risk of getting MS, but I cannot be sure. Until we do a well powered definitive MS prevention studies we can't be sure of this."

"For  those of you interested in vD and pregnancy the following YouTube talk by Professor Reinhold Vieth may be of interest to you."





Epub: Jalkanen et al. Multiple sclerosis and vitamin D during pregnancy and lactation. Acta Neurol Scand. 2014. doi: 10.1111/ane.12306.

BACKGROUND: Both pregnancy and high vitamin D concentration seem to generate a protective environment against MS relapses. Longitudinal case-control analysis of vitamin D concentrations during pregnancy and lactation of MS mothers is lacking.

AIMS OF THE STUDY: To examine serum 25-hydroxyvitamin-D3 levels of MSers during and after pregnancy and compare these to the levels measured in healthy controls.

METHODS: Fifteen relapsing-remitting MS mothers underwent repeated testing for 25-hydroxyvitamin-D3 at 10-12, 26-28 and 35-37 gestational weeks and 1, 3 and 6 months post-partum. An identical series of samples was collected from six control mothers.

RESULTS: The prevalence of vitamin D deficiency (<50 nmol/l) during pregnancy was high (73%) among MSers. Vitamin D levels were significantly higher during pregnancy when compared to early post-partum values among MS patients. At the end of the follow-up period, the vitamin D levels returned to levels observed in early pregnancy. In healthy controls, the alterations during and after pregnancy were similar in nature, but the vitamin D concentrations were higher at all time points when compared to MSers (P = 0.037).

CONCLUSIONS: Vitamin D deficiency during the pregnancy and lactation seems to be common in mothers with MS and needs to be treated adequately.

2 comments:

  1. Is Vit D a component of prenatal vitamins? If so, how did this study adjust for that?

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    Replies
    1. The level of vitamin d in prenatal vitamins is 10 micrograms, 400IU, a day. It is close to a homeopathic dose. On average it would raise the 25(OH)D level by less than 5ng/ml, but only if you were severely deficient. The dose to 25(OH)D relationship has been shown not to be linear.

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