Chapter 8 - The Way Forward With Vitamin D in Multiple Sclerosis

Vitamin D exposure has gained interest as a potential disease modifying treatment in multiple sclerosis. First trials show a positive effect of vitamin D supplementation on several important multiple sclerosis (MS)-related outcomes. Nevertheless, several issues need to be solved, centering around the questions why (which disease outcomes should be targeted), who (which patients at which stage in their disease or even healthy individuals prior to clinical disease onset), and how (which therapeutic strategies). In this chapter, we elaborate in detail on these issues. We conclude that there is consistent evidence for the beneficial effect of vitamin D supplements on selected disease outcomes in RRMS and clinically isolated syndrome. The way forward for vitamin D in MS is the design of further supplementation trials to better understand and analyze the precise benefit of vitamin D supplements for our MS patients, and possibly also for subjects prior to clinical MS onset.