MS – Vitamin D Evidence — SCE Neurology MCQ

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EasyMultiple Sclerosis & CNS InflammationMS – Vitamin D EvidenceSCE Neurology

A 40-year-old woman with known MS asks about the evidence for vitamin D supplementation in MS. What does the current evidence show?

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Correct answer: C — Low vitamin D levels are associated with MS risk and disease activity, and supplementation to maintain adequate levels (>50 nmol/L) is recommended — however, high-dose vitamin D has not been proven to reduce relapses in randomised trials

Observational studies consistently show that low vitamin D levels are associated with higher MS risk, more relapses, and greater MRI activity. However, randomised controlled trials of high-dose vitamin D supplementation (CHOLINE, VIDAMS, SOLAR trials) have not convincingly demonstrated a reduction in relapses or disability progression. Despite this, maintaining adequate vitamin D levels (>50 nmol/L, ideally 75–125 nmol/L) is recommended for general health and may have modest immunomodulatory benefits. NICE NG100 recommends checking vitamin D levels and supplementing if deficient. A: Vitamin D has a role, though the exact benefit is debated. C: It does not cure MS. D: It does not worsen MS. E: Ongoing supplementation is recommended.

Reference: NICE NG100 MS; ABN MS Guidelines; SOLAR Trial; CHOLINE Trial