Vitamins, Minerals, and Supplements

Along with disease-modifying treatments (DMTs), many people try other options to help manage their multiple sclerosis (MS). Vitamins, minerals, and supplements are common examples. They are sold over the counter and easy to find. However, not much is known about their effect on MS. Some studies show they may have mild benefits, though other studies showed no evidence of benefits. Large, controlled clinical trials or other studies are needed to find out more.^1-4

What are vitamins and minerals?

Vitamins and minerals are compounds the body needs to carry out its normal functions. We get most vitamins and minerals from the food we eat. Some people who do not get enough vitamins and minerals in their diet take supplements that contain them.^1,5,6

Vitamins and MS

Some people with MS adjust their diet or take over-the-counter vitamin supplements. While much more research is needed to understand their effect on MS, vitamins that are commonly taken include the following.^1-5,7

Vitamin D

Our bodies make Vitamin D when we are outside in the sunlight. We also can get it through foods we eat, including fish, eggs, or foods that are fortified with it (have vitamin D added to them, like some cereals or milk). Vitamin D plays a role in:^1-5,7

• Bone growth
• Calcium balance
• Muscle function
• Nerve function
• Immune system function

Of all vitamins, vitamin D has the most research related to its effect on MS. Some studies show it might reduce the risk of getting MS. Others link it to a decreased risk for relapses and new brain lesions. However, some studies did not show these benefits. Higher levels of vitamin D can also protect against bone weakening (osteoporosis).^1-5,7

Antioxidant vitamins (A, C, and E)

Free radicals (oxidants) are unstable compounds that can cause damage to cells. Antioxidants, like vitamins A, C, and E, can reduce the effects of free radicals in the body. These vitamins also help build strong teeth, bones, skin, and more.^1-5

People get antioxidants through various fruits and vegetables. Vitamin A is also found in eggs. Vitamin E is present in vegetable oils, nuts, and meat. Research on their effects is mixed.^1-5

Vitamin B7

Vitamin B7 is also known as biotin. It plays a role in hormone and cholesterol balance. It also helps the body make energy from proteins and carbohydrates. Biotin can be found in eggs, nuts, seeds, and mushrooms, among other sources. Some small studies of biotin and MS have had positive effects. Others found no effect on MS or a worsening of symptoms.^1-5

Vitamin B12

Vitamin B12 is also called cobalamin. It helps the nervous system work. It also helps make red blood cells. B12 can be found in beef, fish, eggs, and dairy products. Low B12 levels may increase the risk of developing MS. However, studies have shown mixed results when it comes to the impact of vitamin B12 on already diagnosed MS.^1-5

Minerals and MS

Like vitamins, minerals are also sometimes used to treat symptoms of MS. Research on these is limited, and the results are mixed. However, minerals thought to have an effect on MS include the following.^1,6,8,9

Calcium

Calcium helps us build strong teeth and bones. Having adequate amounts of calcium helps reduce the risk of bone weakening. It can be found in eggs, dairy, and leafy green vegetables. Calcium is a macronutrient. This means we need more of it than micronutrients like zinc or selenium.^1,6,8,9

Zinc

Zinc has wide-reaching effects on the body. It plays a role in the immune system, the nervous system, and more. Zinc can be found in shellfish, beef, chicken, nuts, and whole grains.^1,6,9

Selenium

Selenium is an antioxidant. It is found in beef, turkey, chicken, fish, beans, lentils, and nuts.^1,6,8

Other supplements

There are other possible supplements that some people with MS turn to. However, as with vitamins and minerals, research is limited and results vary. Some supplements people with MS sometimes take include:^2-4

• Coenzyme Q
• Carnitine
• Polyunsaturated fatty acids (omega-3 and omega-6 fatty acids)
• Probiotics
• Lipoic acid
• Folic acid

Things to consider with taking vitamins or supplements for MS

Like any potential treatment, there are risks when taking vitamins or supplements for MS. Some vitamins and supplements may have adverse effects, especially at high doses. Certain products can interfere with traditional MS treatment options or have side effects. Before starting any new vitamin, mineral, or other supplement, talk with your doctor or a nutritionist.^1,5-9

In addition, many MS treatments work by turning down the immune system. This helps prevent immune cells from attacking the body and causing damage. More research is needed to understand how vitamins, minerals, and supplements might affect MS symptoms and progression.¹

Supplements are not regulated by the US Food and Drug Administration (FDA). This means no agency confirms the ingredients. For example, a fish oil supplement may have more or less fish oil than listed on the label. A supplement may also contain ingredients that are not labeled correctly or at all. This can be dangerous. It can lead to taking too much or taking unwanted ingredients.

The FDA created good manufacturing practices (GMPs) to help this situation. GMPs are guidelines for companies to follow when making supplements. The FDA rarely inspects facilities making supplements in the United States. Companies outside the United States do not have these inspections. But many more supplements are sold than are tested. Your doctor can help you decide if a supplement is safe.