Sunlight Key to Battling MS and Flare-Ups

Researchers have long known about the link between sunlight and multiple sclerosis

Because vitamin D primarily comes from the sun, it’s essential to be outside without covering, which includes sunscreen. Antonio Guillem/Shutterstock

People suffering from multiple sclerosis or at risk of developing it can live more rewarding lives when they increase and monitor their vitamin D levels.

Your body makes vitamin D in skin, the largest organ, when it’s exposed to sunlight. Higher vitamin D levels lower the risk of developing multiple sclerosis (MS), and boosting vitamin D also appears to be beneficial for curbing disease relapses and even putting symptoms into remission.

Vitamin D is one of several natural remedies for MS that continues to draw the intrigue of researchers. Several organizations are using vitamin D and sunlight studies to formulate guidelines so they can inform patients, motivate them to get exposure to sunlight and take supplements when needed, and offer specific dosing.

Vitamin D is an essential vitamin that helps to regulate calcium and phosphorus in your body. Vitamin D is found in food such as fish, eggs, and milk.

Besides playing a role in MS, a vitamin D deficiency is thought to be associated with many other health conditions such as autoimmune conditions, allergies, asthma, COVID-19, heart disease, and others. Worldwide, a lack of vitamin D is a concern, particularly in colder climates and countries with longer winters. Experts say at least 1 billion people are deficient in vitamin D around the world.

Yale research in 2015 indicates that high levels of vitamin D in the blood act as a neuroprotector and are associated with fewer lesions in MS patients’ brains. Supplementing vitamin D or increasing sunlight exposure is thought to increase gray matter in the brain, which indicates tissue regeneration.

University of Cambridge researchers found a positive relationship between vitamin D and a molecule that plays a role in the repair of myelin, which insulates the nerves. MS damages myelin. In this case, increasing vitamin D would speed up the process of myelin cell production, thereby protecting nerves from damage.

While the inner workings of the relationship are still somewhat of a mystery, the positive connection between vitamin D and MS is readily accepted as fact by MS organizations worldwide.

Kassandra Munger, a senior research scientist at Harvard University who specializes in MS, said in a March 9 interview with BioNews that studies of people with higher levels of vitamin D show a decreased risk of MS, while those who are deficient in vitamin D have an increased risk. Additionally, studies on low levels of vitamin D in pregnant women and newborns are predictors of increased risk of MS as an adult.

“There is also remarkable consistency between many studies using different measures of vitamin D—assessing amount of sun exposure, vitamin D blood levels, or eating foods high in vitamin D in different populations worldwide—with nearly all pointing to vitamin D being an important risk factor for MS,” Munger said.

While there’s no official tracking system, one 2019 study in the journal Neurology concluded that there are more than 900,000 adults living with MS in the United States—more than twice the number reported in a 1975 national study.

One of the complications of diagnosing MS is the long list of possible symptoms that vary from one person to another and even fluctuate within a person over time.

The more common symptoms, according to the National Multiple Sclerosis Society, are dysesthesia (a squeezing sensation around the torso), fatigue, walking difficulties, numbness, tingling, stiffness or spasms in muscles of the legs, weakness, vision problems, vertigo, significant pain, itching, cognitive changes, and emotional changes. Also common are bladder, bowel, and sexual problems, as well as depression.

One criterion for diagnosing MS is excluding other potential diagnoses. Physicians must also find evidence of damage in at least two areas of the central nervous system, which is composed of the brain, spinal cord, and optic nerves. Evidence must exist that the damage occurred at different times.

Are You Getting Enough Vitamin D?

It’s wise to test your vitamin D level as soon as you learn you have MS, either through your general practitioner or by using an online lab.

Everyone aged 4 and older should have 125 micrograms of vitamin D daily, the equivalent of 5,000 international units (IU). By comparison, an egg offers about 0.9 micrograms of vitamin D—all from the yolk. This recommended daily intake is for the general population; those with MS need a higher dose to get the same benefits, according to Overcoming MS, a nonprofit based in the United Kingdom and Australia.

Vitamin D is a critical part of the protocol Overcoming MS has been using across the globe to help people live symptom free. You can read about its entire program online, which also includes diet, exercise, meditation, and community support.

Overcoming MS recommends a vitamin D supplement of 5,000 IU to 10,000 IU and says the risk of overdosing on vitamin D is rare.

“The results of the first test (after MS diagnosis) often show that vitamin D levels are low, which may be what brings on the attack,” the organization states on its website. “If vitamin D levels are very low, it can be brought up quickly with a one-off megadose of vitamin D3 (e.g., 600,000 IU), followed by regular capsules or sprays.”

Another approach, called the Coimbra protocol, recommends dosing ranging from 40,000 IU to 300,000 IU per day that must be carried out under the supervision of a qualified physician. The protocol was developed by Dr. Cicero Coimbra, a neurologist and professor at the Federal University of São Paulo for those with autoimmune diseases. There are a handful of doctors in the United States who oversee this protocol.

Sunlight and Vitamin D

Because vitamin D primarily comes from the sun, it’s essential to be outside without covering, which includes sunscreen.

“Sun exposure is the primary way most people get vitamin D. Ten to 20 minutes of skin exposure can produce the equivalent of 10,000 IU of vitamin D. Compare that to diet where a serving of salmon has about 400 IU,” Munger said.

Sunscreens are used to protect the skin from ultraviolet A (UVA) and UVB waveband exposure commonly associated with skin damage and cancer. However, UVB exposure is needed for vitamin D synthesis, and the National Institutes of Health has confirmed that sunscreen will interfere with this process.

The Journal of Internal Medicine published a study in 2014 that found subjects who avoided sun exposure were twice as likely to die of any cause compared to those with the highest exposure to sun. That research also indicated women with normal sun exposure habits weren’t at an increased risk of melanoma (skin cancer) or related death.

Studies have also continued to show a higher occurrence of MS among people who live the farthest from the equator.

“MS prevalence is still strongly positively associated with increasing latitude and that the gradient is increasing, suggesting that potentially modifiable environmental factors, such as sun exposure, are still strongly associated with MS risk,” concluded an updated review published in 2019 in the Journal of Neurology, Neurosurgery and Psychiatry.

In addition to raising vitamin D levels, sunlight increases the feel-good hormones of endorphins and serotonin, said Marc Sorenson, who founded Sunlight Institute to inform the public on the benefits of sunlight.

It’s fairly easy to get vitamin D from sunlight, though it must be weighed against the fact that heat can exacerbate MS symptoms.

Overcoming MS suggests going outside to expose as much skin as possible when the UV index is high, since that means spending less time in the sun. You can swim outdoors, since UV light penetrates water. To find out the UV index, use a local weather app or the Environmental Protection Agency’s website. If you go outside at 10 a.m., you can spend a third longer in the sun.

What Is the Right Form of Vitamin D?

Vitamin D is found in two major forms—D2 and D3. Vitamin D2 is a man-made form added to fortify foods, and vitamin D3 is the type synthesized in the skin and mostly found in animal-based foods.

D2 is made in irradiated yeast and mushrooms, that is yeast and mushrooms exposed to UVB light. While mushrooms don’t require sunlight to grow, it can affect the nutrient content of some mushrooms.

Both forms of vitamin D are used in food fortification and dietary supplements. A decade ago, the National Institutes of Health considered the two to be relatively similar in terms of benefits.

“​​At this time, firm conclusions about different effects of the two forms of vitamin D cannot be drawn; however, it would appear that at low doses, D2 and D3 are equivalent, but at high doses, D2 is less effective than D3,” according to a 2011 Institute of Medicine Committee report reviewing intakes for vitamin D.

That same year, a study of 33 healthy adults followed for 12 weeks determined that D3 is 87 percent more potent in raising and maintaining vitamin D in the body and produces two- to three-fold greater storage of vitamin D than D2. The study was published in Journal of Clinical Endocrinology and Metabolism.

“These two nutrients are not biologically equivalent or interchangeable. Any suggestion that vitamin D3 and D2 are both good options falls into the ‘bad science’ bucket,” writes Ashley Jordan Ferira, vice president of scientific affairs at mindbodygreen, a health information website.

Can You Prevent MS or Relapses?

Certain people are at risk of developing MS and having relapses. Vitamin D plays a role in both circumstances.

If you have an identical twin with MS, you also have a 25 percent chance of being diagnosed, according to Overcoming MS. An immediate family member (parent, sibling, or child) with MS gives you a 1 in 10 chance of also developing the disease.

But getting adequate sun exposure and supplementing with vitamin D are strategies that can improve your chances of staying healthy. Others are quitting smoking, eating a healthy diet, managing stress, and exercising regularly.

“Evidence indicates that people with high vitamin D levels have a lower risk of developing MS. The benefits of this vitamin are also evident among MS patients—those with higher vitamin D have less inflammation and reduced clinical activity,” according to Patricia Inacio, author of several MS research projects.

A study in Medical Hypotheses from 1986 found that younger MS patients treated with vitamin D and calcium and magnesium cut the number of relapses in half.

The biggest key to prevention seems to be sunlight exposure at a young age.

Newborns with low levels of vitamin D were found to have an increased risk of MS, according to research of 521 patients published in the journal Neurology in 2017.

Another study of 1,320 patients compared vitamin D levels starting before age 20 and up to age 49. Published in European Journal of Neurology, it’s thought to be one of the biggest studies of presymptomatic MS patients. Not only do the findings support the hypothesis that high levels of vitamin D at a young age reduce the risk of developing MS, but they also suggest vitamin D deficiency may be causal or at least a contributing factor to causing MS.

Besides vitamin D, MS patients are finding additional support and symptom improvement in natural solutions such as diet, exercise, meditation, emotional regulation, and sleep support.