Background: Multiple sclerosis (MS) is associated with low ambient ultraviolet B (UVB) light in childhood and in utero (relative risk of developing MS is 1.2 for those born in spring). Besides, the MS-linked HLA-DRB1 allele interacts strongly with vitamin D in vitro, and vitamin D levels are lower in MS patients. Fatigue and musculoskeletal aches/pains are prominent symptoms in both MS and vitamin D deficiency. Moreover, having any chronic disease may predispose to staying indoors thus not photosynthesising vitamin D. Aims: MS patients are well-informed and increasingly ask for their vitamin D levels to be checked when attending outpatient appointments with MS specialist nurses. We sought to audit the effectiveness of nurse-led lifestyle advice +/− patient self-medication with supplements in local MS patients, by relating serum vitamin D levels to ranges given in Institute of Medicine guidelines and draft North-of-Tyne guidelines.
Methods: The biochemistry dataset was interrogated for serum levels of vitamin D (& PTH where available) under consultant codes for the Lead Neurologists for MS.
Results: Of 62 MS patients, 63% of had suboptimal vitamin D levels (24% deficient [<25 nmol/L]; 39% insufficient [<2549 nmol/L]). 32% of them had adequate (5075 nmol/L) vitamin D levels with 5% having optimal levels (>75 nmol/L).
Conclusions: Despite MS patients being a well-informed group and despite input from MS specialist nurses, most of them have biochemical vitamin D insufficiency or deficiency. The extent to which this correlates (or not) with clinical symptoms remains unknown.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.