Editing Vitamin D3

[[Information on nutritional supplements people with ALS have been taking]]

* [https://en.wikipedia.org/wiki/Vitamin_D Wikipedia]

==Vitamin D and ALS==

"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."{{#pmid:23815870|Karam2013}}

"RESULTS: The mean vitamin D concentration was below our laboratory's lower limit of normal (P < 0.0001) and did not change during the course of the disease. The '''concentrations were higher in patients with bulbar onset (P = 0.003) and were negatively associated with body mass index (BMI)''' (P = 0.0095). '''Models with ALSFRS-R (ALS Functional Rating Scale-Revised) and BMI as a covariates showed that vitamin D concentrations predicted worse prognosis'''. CONCLUSION: The distribution of vitamin D concentrations in our cohort was consistent with previous reports. '''Surprisingly, we noted a negative effect of higher vitamin D levels on prognosis in ALS'''. More detailed research is warranted to determine whether manipulation of vitamin D could be beneficial to patients.""{{#pmid:26096806|Blasco2015}}

"Most subjects had either insufficient or deficient 25(OH)D levels. Lower 25(OH)D was associated with lower ALSFRS-R gross motor scores, but not lower ALSFRS-R total scores at baseline. Levels of 25(OH)D were not predictive of disease progression over the next 12 months... 25(OH)D was associated with baseline gross motor ALSFRS-R scores but did not predict the rate of disease progression. Vitamin D levels may reflect poor mobility in patients with ALS."{{#pmid:28044349|Paganoni2017}}

"The vitamin D levels in the ALS patients did not correlate with recorded clinical parameters. '''No clinical differences in terms of ALSFRS-R, MRC or FVC were found between the treated and the untreated patients''' over time. In ALS, as in other chronic neurological diseases, levels of vitamin D in blood appeared reduced, but no difference was found between the levels in ALS patients and in healthy subjects. '''Oral vitamin D supplementation in ALS patients was not associated with better prognosis in comparison with untreated ALS patients'''. Further prospective controlled studies are needed to clarify the effect of vitamin D on the progression of ALS disease."{{#pmid:28380322|Libonati2017}}

== ALSUntangled evaluation ==

''At this time, there is evidence that '''PALS, like those with other chronic illnesses, are at increased risk for vitamin D deficiency'''. It is therefore reasonable to screen PALS for this. '''If vitamin D deficiency is found, it seems reasonable to supplement vitamin D according to established guidelines''' (31 [https://nctu.partners.org/ProACT]) in order to avoid medical complications of vitamin D deficiency. '''It is not yet clear, however, that vitamin D supplementation can slow disease progression, improve muscle strength, or reduce falls''' in PALS. We support further studies to answer these questions.''{{#pmid:24689759|Alsuntangled2014}}

== References ==

[[Category:Supplement data pages]]
[[Category:Anti-inflammatory supplements]]
@@ Line 16: / Line 16: @@
 ''At this time, there is evidence that '''PALS, like those with other chronic illnesses, are at increased risk for vitamin D deficiency'''. It is therefore reasonable to screen PALS for this. '''If vitamin D deficiency is found, it seems reasonable to supplement vitamin D according to established guidelines''' (31 [https://nctu.partners.org/ProACT]) in order to avoid medical complications of vitamin D deficiency. '''It is not yet clear, however, that vitamin D supplementation can slow disease progression, improve muscle strength, or reduce falls''' in PALS. We support further studies to answer these questions.''{{#pmid:24689759|Alsuntangled2014}}
-==A hypothesis on why Vitamin D is prevented from entering compromised cells in skeletal muscle of ALS patients==
-It will be found that Vitamin D is prevented from entering compromised cells in skeletal muscle of ALS patients. This does not apply to un-compromised skeletal muscle cells, or other healthy cells throughout the body. Compromised muscle cells in sALS have increased activation of Interleukin 1 beta, (IL-1 beta), which activates PLC beta>DAG>PKC within the cell. Activated Protein kinase C, (PKC), inhibits the vitamin D receptor, (VDR), preventing the entry of vitamin D into the compromised skeletal muscle cell.
-Taking vitamin D supplements will only help if vitamin D levels are low; and bed-ridden or highly immobilized patient that cannot get out in the sun will probably have lower levels of Vitamin D than healthy subjects. The healthy areas of skeletal muscle will gain some benefit from Vitamin D supplements in this case, but the compromised areas of skeletal muscle will receive no benefit as the Vitamin D cannot enter these cells.
 == References ==