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Vitamin D deficiency and its supplementation in patients with amyotrophic lateral sclerosis

      Abstract

      We studied 25-hydroxyvitamin D (vitamin D) levels in patients with amyotrophic lateral sclerosis (ALS) and the effect of vitamin D supplementation. Vitamin D levels were checked in 37 consecutive patients with ALS. Demographic data, vitamin D supplementation, change in Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) score, and side effects from vitamin D were noted over a 9 month follow-up period. ALSFRS-R scores were compared between patients who took vitamin D and those who did not. The median age was 55 years and median time since symptom onset was 61 months. The mean vitamin D level was 22.3 ng/mL (normal range, 30–80 ng/mL). Eighty-one percent of patients had a vitamin D level lower than 30 ng/mL and 43% had a vitamin D level lower than 20 ng/mL. Twenty patients took 2000 international units of vitamin D daily. After adjustment for age and baseline vitamin D levels in a linear regression model, the ALSFRS-R score decline was smaller in patients taking vitamin D at 9 months (p = 0.02) but was not significantly different at 3 or 6 months. Median vitamin D levels rose from 18.5 to 31.0 ng/mL at 6 months in the group taking vitamin D. No side effects secondary to vitamin D supplementation were reported. Vitamin D supplementation at 2000 international units daily was safe over a period of 9 months and may have a beneficial effect on ALSFRS-R scores. Further studies are warranted to determine whether there is a benefit in vitamin D supplementation for all ALS patients.

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      References

        • Holick MF.
        High prevalence of vitamin D inadequacy and implications for health.
        Mayo Clin Proc. 2006; 81: 353-373
        • Holick M.F.
        • Matsuoka L.Y.
        • Wortsman J.
        Age, vitamin D, and solar ultraviolet.
        Lancet. 1989; 2: 1104-1105
        • Sato Y.
        • Honda Y.
        • Asoh T.
        • et al.
        Hypovitaminosis D and decreased bone mineral density in amyotrophic lateral sclerosis.
        Eur Neurol. 1997; 37: 225-229
        • Vanselow B.K.
        • Keller B.U.
        Calcium dynamics and buffering in oculomotor neurones from mouse that are particularly resistant during amyotrophic lateral sclerosis (ALS)-related motoneurone disease.
        J Physiol. 2000; 525: 433-445
        • Beers D.R.
        • Ho B.K.
        • Siklós L.
        • et al.
        Parvalbumin overexpression alters immune-mediated increases in intracellular calcium, and delays disease onset in a transgenic model of familial amyotrophic lateral sclerosis.
        J Neurochem. 2001; 79: 499-509
        • Alexianu M.E.
        • Robbins E.
        • Carswell S.
        • et al.
        1Alpha, 25 dihydroxyvitamin D3-dependent up-regulation of calcium-binding proteins in motoneuron cells.
        J Neurosci Res. 1998; 51: 58-66
        • Karam C.
        • Scelsa S.N.
        Can vitamin D delay the progression of ALS?.
        Med Hypotheses. 2011; 76: 643-645
        • Brooks B.R.
        • Miller R.G.
        • Swash M.
        • et al.
        El Escorial 4. Revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis.
        Amyotroph Lateral Scler Other Motor Neuron Disord. 2000; 1: 293-299
        • Neary D.
        • Snowden J.S.
        • Gustafson L.
        • et al.
        Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria.
        Neurology. 1998; 51: 1546-1554
        • Cedarbaum J.M.
        • Stambler N.
        • Malta E.
        • et al.
        A revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF ALS study group (phase III).
        J Neurol Sci. 1999; 169: 13-21
        • Vickers A.J.
        The use of percentage change from baseline as an outcome in a controlled trial is statistically inefficient: a simulation study.
        BMC Med Res Methodol. 2001; 1: 6
        • Suzuki M.
        • Yoshioka M.
        • Hashimoto M.
        • et al.
        25-hydroxyvitamin D, vitamin D receptor gene polymorphisms, and severity of Parkinson’s disease.
        Mov Disord. 2012; 27: 264-271
        • Buell J.S.
        • Dawson-Hughes B.
        • Scott T.M.
        • et al.
        25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services.
        Neurology. 2010; 74: 18-26
        • Gianforcaro A.
        • Hamadeh M.J.
        Dietary vitamin D supplementation at 10× the adequate intake improves functional capacity in the G93A transgenic mouse model of ALS, a pilot study.
        CNS Neurosci Ther. 2012; 18: 547-557
        • Solomon J.A.
        • Gianforcaro A.
        • Hamadeh M.J.
        Vitamin D3 deficiency differentially affects functional and disease outcomes in the G93A mouse model of amyotrophic lateral sclerosis.
        PLoS One. 2011; 6: e29354
        • Tangpricha V.
        • Pearce E.N.
        • Chen T.C.
        • et al.
        Vitamin D insufficiency among free-living healthy young adults.
        Am J Med. 2002; 112: 659-662
        • Dawson-Hughes B.
        Serum 25-hydroxyvitamin D and functional outcomes in the elderly.
        Am J Clin Nutr. 2008; 88: 537S-540S