Multiple Sclerosis Linked to Sun, Melatonin, Vitamin D
A major push to solve the multiple sclerosis (MS) mystery over the past few years has revealed the importance of sunlight exposure. That is, along with living naturally and keeping the immune system strong.
This mysterious condition has claimed many over the past few years. One might recall that the recently passed Muhammad Ali had MS. Michael Fox and millions of others have suffered from the disease.
Many associations have been made with MS over the past decade or two. These have included smoking and Epstein-Barr virus – which causes mononucleosis.
A large review from the medical college of the University of British Columbia has listed the major associations with multiple sclerosis. The researchers tabulated the results of 169 studies on MS. They also reviewed 15 different reviews.
This massive investigation found the following associations – possible causes – for MS:
• Cigarette smoking
• Epstein-Barr virus (infectious mononucleosis)
• Obesity during teenage years
• Lung infections
• Reduced sunlight exposure
• Lower levels of vitamin D
• Reduced melatonin
These last three points – sunlight exposure and vitamin D levels – have received increasing attention over the last five years.
That’s because the associations are very real. But it is not a simple issue that can be solved with vitamin D supplementation. This is because sunlight and UV exposure provide a lot more for the body than simply vitamin D.
Let’s look more closely at some of the research.
Significant research has shown that multiple sclerosis occurs more frequently in regions of greater latitude. This of course means those regions that have less exposure to ultraviolet radiation from the sun.
In 2015, the journal BMC Neurology reported on research from the University of Melbourne on 2,301 people with multiple sclerosis around the world.
The research found that almost two-thirds of the patients lived in the Northern Hemisphere. Furthermore, with each one degree of latitude increase (away from the equator) there was an increased likelihood of MS disability.
Latitude was also linked with the rate of relapse among the respondents. And having more relapses each year (worsening symptoms) was also associated with greater latitudes.
Furthermore, they found that those who deliberately increased their sun exposure experienced better quality of life scores. Vitamin D supplementation also increased quality of life scores, with most taking between 2,000 and 5,000 IU per day.
In another 2015 study, researchers from Beijing’s Tiantan Hospital analyzed the records of 264 MS patients who entered the hospital between 2002 and 2012. The researchers analyzed their medical records. They found that most of the MS relapses occurred during the winter time. Furthermore, they found that significantly more of the MS patients lived in regions of higher latitudes.
Another 2015 study from the Utano National Hospital in Japan tested Japanese MS prevalence against latitude and found that MS was significantly correlated with higher latitudes.
In 2011, researchers from the University of Oxford examined hospital admissions between 1999 and 2005, and drew 56,681 cases of MS. The researchers found that MS is significantly associated with the degree of ultraviolet radiation exposure. The greater the UV exposure, the less incidence of MS. The researchers found that the higher the latitude, the more cases of MS there were – and this is just within the U.K.
Furthermore, cases were least among populations that were born outside the UK – in lower latitudes.
Research from the UK’s Queen Mary University and the London School of Medicine and Dentistry conducted a recent study of 151,978 people with multiple sclerosis. The study analyzed their birth month and cross-referenced that with the latitude of birth to correlate the relationship between possible vitamin D production in the mother and MS in the child.
The researchers found that MS incidence significantly increased for children born in the months of April and May, and significantly decreased for children born in the months of October and November.
This increase and decrease in MS incidence correlates precisely with sun exposure. Those expected mothers whose children were born in October and November had greater sun exposure during the summer, at the peak of their pregnancy. Meanwhile, those mothers whose children were born in April and May were exposed to significantly less sunshine during their peak pregnancy months. The children whose mothers had greater sun exposure had less incidence of MS.
As the peak months are calculated, the October and November’s children had 13-19% less MS incidence than April and May’s children.
The researchers concluded:
“Month of birth has a significant effect on subsequent MS risk. This is likely to be due to ultraviolet light exposure and maternal vitamin D levels, as demonstrated by the relationship.”
The assumption that MS risk is related to sun exposure is on solid ground.
Yes, as exposure to sunlight has gone down over the years, MS incidence has gone up. Research has found that reduced sunlight exposure is partly due to the increasing application of sunblock, but we must not ignore the fact that our modern civilization spends less time outdoors and more time indoors with the increasing array of video screens.
Circadian rhythms, melatonin and MS
Research from Brazil’s University of Campinas found an even more interesting correlation between MS and the sun. They tested the blood of 11 people with relapsing MS compared their blood and urine analyses with healthy controls.
They found that the MS patients had abnormal levels of overnight melatonin (6-sulfatoxymelatonin or 6-SMT) in their urine. Furthermore, those with more abnormal levels of overnight melatonin had significantly worse MS-related disability and fatigue. They also had more MS relapses.
The researchers wrote:
“In conclusion, disruption of melatonin circadian rhythm production is frequent among relapsing multiple sclerosis patients and seemingly related to higher disability and fatigue scores.”
In a 2016 study, researchers from Poland’s Medical University of Silesia took this association one step further. They tested 102 MS patients by supplementing melatonin over a 90-day period.
The researchers gave each blood tests together with healthy controls. The researchers found that those who took the melatonin supplements had significantly reduced chronic fatigue symptoms. They also found the melatonin improved their levels of plasma lipid hydroxyperoxides (LHP) and homocysteine. This corresponded with an improvement of MS-related fatigue symptoms.
Note that the body produces melatonin by converting melanin derived from UV sun exposure.
Vitamin D and Multiple Sclerosis
As the above research might indicate, researchers have found that MS patients often have lower levels of vitamin D. The assumption has been that vitamin D supplementation will be the appropriate treatment.
The research has indicated that that vitamin D supplementation is helpful for those who are deficient. That is, for those with vitamin D levels less than 30 ng/ml. The vitamin D dose recommended has approached 4,000 IU per day for those in higher latitudes.
Another 2015 study from Canada’s McGill University studied several databases together with 2,347 study subjects. They tested the genes specific for higher or lower levels of vitamin D in the body. They found that those with genes linked to lower vitamin D in the body were also associated with MS. This and other databases showed these gene variants are more likely in higher latitudes.
Those with these lower vitamin D genes had about double the risk of MS.
In another study, medical researchers from Sweden’s Umeå University analyzed blood samples from 164,000 people over a period of four decades (since 1975). Of these, multiple sclerosis cases were identified, and matched with control subjects. The researchers then cross-referenced the blood levels of 25-hydroxycholecalciferol or 25(OH)D – vitamin D within the blood – with the incidence of multiple sclerosis later on.
The research found that those who had 75 nmol/L or greater levels of 25(OH)D had a 71% decreased incidence of MS. They also found that across the entire population, overall levels of vitamin D in the blood reduced over the years. This occurred simultaneous to a dramatic increase in the rates of multiple sclerosis.
The researchers confirmed this multiple association in their conclusion:
“Decreasing 25(OH)D levels in the population may contribute to explain the increasing MS incidence that is suggested from epidemiologic studies.”
In another confirmation of this conclusion, researchers from the University of Florida College of Medicine conducted a large review of multiple sclerosis research from 1969 through 2012. The review found that vitamin D supplementation significantly helped reduce or prevent MS incidence, and also reduced inflammation among those with MS.
These medical researchers concluded emphatically:
“Vitamin D deficiency in MS patients should be avoided. In addition, the risk of developing MS might be reduced by maintaining optimal vitamin D levels in the healthy population.”
Obtaining vitamin D from the sun is the easiest and least expensive way for the body to get its vitamin D. However, exposure to enough UV-B rays is critical. UV-B occurs at certain times and is most prevalent at certain latitudes.
Furthermore, as discussed in this article, other research has indicated that supplemented vitamin D may not necessarily treat conditions once the deficiency is eliminated.
As I’ve discussed in my book and here, vitamin D supplementation may indeed interfere with the body’s production of the more therapeutic form of vitamin D from the sun – which also stimulates our melatonin cycles and our immunity.
I mentioned above the association between Epstein-Barr (infectious mononucleosis) and MS. Does this have anything to do with sun exposure? Yep.
Researchers from the UK’s University of Aberdeen studied Epstein-Barr for a period of 16 years. They found there were 38 percent more cases of infectious mono during the wintertime compared to the summertime. The researchers wrote:
“Infectious mononucleosis appears to be decreasing in incidence, which may be caused by changing environmental influences on immune systems. One such factor may be exposure to sunlight.”
Immunity and sunlight
Immunity and sunlight are linked. Our immune systems are stimulated by sunlight. This has been shown by numerous studies.
The sun’s UV rays are also the necessary components to adjust the variables related to both melatonin circadian cycles and the body’s own vitamin D production.
As summer approaches, it is helpful to know that adequate vitamin D production from the sun’s UV radiation can last the body for months – if it is sufficient. But adequate sunlight by getting outside is necessary on a daily basis.
Maybe all those MS telethons should have been held outside.
Find out more about the myriad of health benefits from sun exposure and how to obtain the optimal (and safest) doses of sunlight:
McKay KA, Jahanfar S, Duggan T, Tkachuk S, Tremlett H. Factors associated with onset, relapses or progression in multiple sclerosis: A systematic review. Neurotoxicology. 2016 Apr 1. pii: S0161-813X(16)30042-0. doi: 10.1016/j.neuro.2016.03.020.
Goldacre MJ, Wotton CJ, Seagroatt V, Yeates D. Multiple sclerosis after infectious mononucleosis: record linkage study. J Epidemiol Community Health. 2004 Dec;58(12):1032-5.
Ma J, Zhang X. The relationship between season/latitude and multiple sclerosis. Zhonghua Nei Ke Za Zhi. 2015 Nov;54(11):945-8.
Kinoshita M, Obata K, Tanaka M. Latitude has more significant impact on prevalence of multiple sclerosis than ultraviolet level or sunshine duration in Japanese population. Neurol Sci. 2015 Jul;36(7):1147-51. doi: 10.1007/s10072-015-2150-0.
Ramagopalan SV, Hoang U, Seagroatt V, Handel A, Ebers GC, Giovannoni G, Goldacre MJ. Geography of hospital admissions for multiple sclerosis in England and comparison with the geography of hospital admissions for infectious mononucleosis: a descriptive study. J Neurol Neurosurg Psychiatry. 2011 Jun;82(6):682-7. doi: 10.1136/jnnp.2010.232108.
Damasceno A, Moraes AS, Farias A, Damasceno BP, dos Santos LM, Cendes F. Disruption of melatonin circadian rhythm production is related to multiple sclerosis severity: A preliminary study. J Neurol Sci. 2015;353(1-2):166-8. doi: 10.1016/j.jns.2015.03.040.
Jelinek GA, Marck CH, Weiland TJ, Pereira N, van der Meer DM, Hadgkiss EJ. Latitude, sun exposure and vitamin D supplementation: associations with quality of life and disease outcomes in a large international cohort of people with multiple sclerosis. BMC Neurol. 2015 Aug 5;15:132. doi: 10.1186/s12883-015-0394-1.
Góral A, Brola W, Kasprzyk M, Przybylski W. The role of vitamin D in the pathogenesis and course of multiple sclerosis. Wiad Lek. 2015;68(1):60-6.
Mokry LE, Ross S, Ahmad OS, Forgetta V, Smith GD, Leong A, Greenwood CM, Thanassoulis G, Richards JB. Vitamin D and Risk of Multiple Sclerosis: A Mendelian Randomization Study. PLoS Med. 2015 Aug 25;12(8):e1001866. doi: 10.1371/journal.pmed.1001866.
van Pesch V, Sindic CJ. Vitamin D supplementation in multiple sclerosis patients in 2012: hype or reality as an adjunctive therapy? Acta Neurol Belg. 2012 Dec;112(4):325.
Dobson R, Giovannoni G, Ramagopalan S. The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude. J Neurol Neurosurg Psychiatry. 2012 Nov 14.
Salzer J, Hallmans G, Nyström M, Stenlund H, Wadell G, Sundström P. Vitamin D as a protective factor in multiple sclerosis. Neurology. 2012 Nov 20;79(21):2140-5.
Zawada M. Potential pathogens in multiple sclerosis (MS. Postepy Hig Med Dosw. 2012 Oct 22;66:758-70.
Mesliniene S, Ramrattan L, Giddings S, Sheikh-Ali M. Role of Vitamin D in the Onset, Progression and Severity of Multiple Sclerosis. Endocr Pract. 2012 Nov 27:1-22.
Ascherio A, Munger KL, Lünemann JD. The initiation and prevention of multiple sclerosis. Nat Rev Neurol. 2012 Nov 5;8(11):602-12.
Adams C. Healthy Sun: Healing with Sunshine and the Myths About Skin Cancer. Logical Books, 2012,2015.