Sunday, 30 November 2014

VitaminD levels do not predict relapse after a baby

Runia TF, Neuteboom RF, de Groot CJ, de Rijke YB, Hintzen RQ.The influence of vitamin D on postpartum relapse and quality of life in pregnant multiple sclerosis patients. Eur J Neurol. 2014 Nov 28. doi: 10.1111/ene.12594. [Epub ahead of print]

BACKGROUND AND PURPOSE: In relapsing-remitting MS patients, lower serum vitamin D concentrations are associated with higher relapse risk. In a number of conditions, low vitamin D has been associated with fatigue. Pregnant women are at particular risk for vitamin D insufficiency. Our objective was to investigate whether vitamin D status is associated with postpartum relapse and quality of life during pregnancy.
METHODS:Forty-three pregnant relapsing-remitting MS patients and 21 pregnant controls were seen at regular times before, during and after pregnancy. At every clinical assessment visit, samples for 25-hydroxyvitamin D (25(OH)D) measurements and quality of life questionnaires were taken.
RESULTS:Lower 25(OH)D concentrations were not associated with postpartum relapse risk. Pregnancy 25(OH)D levels of patients and controls were not significantly different. In controls, but not patients, higher 25(OH)D concentrations were correlated with better general health, social functioning and mental health, but not with vitality.
CONCLUSION:Low vitamin D levels are not associated with postpartum relapse. In pregnant MS patients, vitamin D levels are similar to levels in healthy women and are not associated with quality of life. Therefore, with regard to quality of life and postpartum relapse, no arguments were found for advising pregnant MS patients to take more vitamin D supplements than healthy women.


This study looks at pregnant women  and finds that potential for developing a relapse is unrelated to their vitamin D level. 
Is this surprising?.

Maybe not when other sudies look in to the ability of vitamin D we find a neutriceutical. 

However the major question is: What does vitamin D do to the unborn in pregnant women? Does this limit MS suceptibility.

5 comments:

  1. "Vitamin D was such a fantastic immunomodulator, people taking loads of vitamin D would be immunocompromised". I don't think it is an immunomodulator, it is a shortage of supply that leads to inflammation and increased immune activity. 25(OH)D in the blood is as far as anyone can tell is inert, until very high levels are reached. It is what the cells do with it 25(OH)D that affects the immune system and that is tightly controlled. Vitamin d as taken is not a drug or an active hormone, you are not disrupting a balanced system. The argument is about what is a sensible blood 25(OH)D level, remembering that there are 2 effects controlling the 25(OH)D level in the blood: Supply and consumption. People who cannot 'scrape the bottom of the barrel' will have higher 25(OH)D levels than those who can, but they will be more deficient.

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    Replies
    1. Vitamin D the brake....I like the idea

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    2. Vitamin D the brake.... I like the concept.
      I will remove whilst I have a think Ta

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  2. I don't even think it is a brake, I think it is the active immune system rising as the innate immune system limits itself to conserve 25(OH)D. I think it was a short term survival mechanism that was supposed to only operate for a month or so a year, but due to modern behaviour operates continuously. We have it the wrong way round, vitamin d does not suppress the active immune system, a lack of vitamin d activates it.

    If the point where the innate immune system limits itself is set by the lowest vitamin d level in pregnancy, and low levels in pregnancy set it higher then more 25(OH)D is conserved for calcium control and the risk of rickets in babies and death to the mother is reduced, but at the cost of higher auto-immunity. The body is programmed to expect long winters if the mother experienced a long winter. If this is true you cannot use 25(OH)D, certainly at low levels, as a measure of sufficiency as each person has a different threshold. Those with higher levels may be more deficient. In the paper are not those who relapsed on average higher than those who do not? I only had a quick look.

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  3. You may be interested in PLoS One. 2014 Nov 5;9(11):e111265. doi: 10.1371/journal.pone.0111265. eCollection 2014.
    The importance of body weight for the dose response relationship of oral vitamin d supplementation and serum 25-hydroxyvitamin d in healthy volunteers. Ekwaru JP1, Zwicker JD2, Holick MF3, Giovannucci E4, Veugelers PJ1. Note the relationship between vitamin d supply and 25(OH)D it is as though consumption is increasing because vitamin d is not building up. Note also the lack of effect on blood calcium, so fairly large doses do not cause blood calcium problems.

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