I think there is a general consensus that vitamin D is of interest in MS. Studies have identified vitamin D as an important environmental factor and suggest a link between vitamin D and autoimmunity – although this link is not yet fully understood.
Although a large proportion of people with MS already take vitamin D for therapeutic purposes, it is not yet finally clarified whether therapy with vitamin D has a positive effect on the course of the disease. For example, the SOLAR study, which compared interferon-beta therapy plus placebo with interferon-beta therapy plus high-dose vitamin D, missed the primary endpoint – the study was thus formally negative, the additional therapy with vitamin had no advantage. However, interesting results were shown when looking at the MRI data in the group that had taken additional vitamin D.
In view of this situation, I understand the desire of many patients to take vitamin D as an interesting and harmless additional therapy – I usually advise pragmatically to take 2,000 IU daily or a single weekly dose of 20,000 IU vitamin D. But I also remind that by far the most effective way to raise the vitamin D level is to stay outside.
The approach of the Brazilian doctor Dr. C. Coimbra (Coimbra Protocol) has been circulating in the media for some time. The “Coimbra Protocol” promises MS patients that by using high-dose vitamin D, no relapses occur anymore and the symptoms of the disease regress. Claims that about 95% of MS patients have a lasting remission under the protocol are making the rounds and the net is literally overflowing with messages of salvation and gratitude from individual “successfully treated patients” ….
What is behind this approach? In short, Dr. Coimbra believes that patients with the autoimmune disease MS have a genetically determined resistance to the effect of vitamin D, which is supposed to lead to a “Th17 reaction” (Th 17 cells are a subgroup of pro-inflammatory T lymphocytes that play a role in the pathogenesis of MS, note from the author). The extent of vitamin D resistance is determined by measuring the parathyroid hormone (PTH = a hormone that regulates the calcium level, note from the author) – the daily dose of vitamin D is then determined based on the result, which can be up to 100,000 IU per day. Patients should also follow a special low-calcium diet and avoid dairy products – in addition, they should exercise a lot.
Maybe you’re thinking now, that sounds quite plausible and reasonable? It may be, but in science it is also necessary for ethical reasons to test a hypothesis with scientific methods before marketing a concept worldwide. Ultimately, it is unclear whether the correlations postulated by Dr. Coimbra are correct, because the scientific evidence is missing – the Coimbra Protocol has never been tested in a controlled study and never seriously published. In addition, there are no published basic scientific data on his “research”.
Now one must bear in mind that the “Coimbra Protocol” is not free of charge – the whole procedure is associated with high costs that must be borne by the patient themselves. According to Internet research, you pay between 400 – 1,000 euros in the first year for the laboratory tests and treatment hours at so-called “certified” doctors; after that you can expect treatment costs between 100 – 300 euros/year, the costs for the vitamin D itself vary between 20 – 200 euros per month.
