Q: 32 year old female is admitted to ICU with acute exacerbation of Multiple Sclerosis (MS). She is responding well to steroid treatment. Out of the following, which Vitamin is recommended as an adjuvant treatment in MS and should be added to her profile?

A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin D
E) Viamin E


Answer: D

Multiple studies have shown the direct beneficial effect of Vitamin D on preventing acute flares of MS. Though still, the exact mechanism is not clear but the answer may lie in the old wisdom of protective sunlight effect on MS. Use of Vitamin D in MS is now considered as a standard of treatment.



References:

1.  van der Mei IA, Ponsonby AL, Dwyer T, et al. Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ 2003; 327:316. 

2. Salzer J, Hallmans G, Nyström M, et al. Vitamin D as a protective factor in multiple sclerosis. Neurology 2012; 79:2140. 

3. Mowry EM, Waubant E, McCulloch CE, et al. Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis. Ann Neurol 2012; 72:234. 

4. Ascherio A, Munger KL, White R, et al. Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurol 2014; 71:306.