ANALYSIS OF THE EFFECTS OF VITAMIN D SUPPLEMENTATION IN THE TREATMENT OF PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Multiple sclerosis (MS) is a chronic neuropathy that affects more than 2.8 million people worldwide, driving numerous studies for the development of effective treatments. In this context, nutritional therapy combined with vitamin D supplementation has proven essential for improving quality of life and delaying bedridden status in patients. These benefits are due to the immunomodulatory action of vitamin D, which is fundamental in inhibiting the development of the autoimmune condition characteristic of this pathology.This study is a descriptive literature review that aims to evaluate the possible immunomodulatory effect of vitamin D on the pathophysiology of MS. For the development of this analysis, scientific articles published between 2009 and 2014 were selected. Searches were conducted in the PUBMED and SCIELO databases using the keywords: multiple sclerosis, supplementation, and vitamin D. Consultation of books on nutrition, immunology, and neurology was also permitted, in addition to including undergraduate and postgraduate course completion papers and master's theses from various health-related fields. 154 results were obtained in the research area, and systematic or meta-analytical reviews on the topic and experimental research conducted on animals were used as exclusion criteria. As an inclusion criterion, only scientific articles dealing with case studies conducted on humans were selected. 29 scientific articles met the established conditions for the review. Within the selected studies, it was observed that there is an inversely proportional relationship between serum vitamin D levels and the incidence rate of relapses, and that each additional 10 ng/dL of vitamin D administered reflects a decrease of up to 15% in a new T2 lesion, 32% less chance of occurrence of a gadolinium-enhancing lesion, and a better response against the progression of disability level. Some findings in the literature suggest the control of neuropsychiatric manifestations such as depression, in addition to improved ambulation, fatigue, and reduced muscle pain. Although the vast majority of publications are related to a beneficial impact of vitamin D on the symptomatology of MS, there are publications that disagree with these statements, such as the study published in 2013 by Hatamian et al., which revealed no association between serum vitamin D levels and improvement in the patient's disability status. Furthermore, there are still few studies that clearly define the beneficial effects of vitamin D supplementation in patients with multiple sclerosis, and more robust studies are needed to better elucidate the benefits of vitamin D in the treatment of patients with MS.