Vitamin D and sunshine go together. Among other ailments, a D deficiency increases the risk of “adult rickets” or osteomalacia, a painful bone disease that can lead to muscle weakness, bone pain and bone fracture.

Osteomalacia, according to Dr. Michael Holick, director of the Vitamin D, Skin and Bone Research Laboratory at Boston University, is often misdiagnosed as arthritis or fibromyalgia. Many patients with aching bones and muscles, Dr. Holick points out, are often simply suffering from a lack of D vitamins.

Insufficient sun exposure and D deficiencies are also linked to multiple sclerosis, congestive heart failure, high blood pressure and some cancers, including non-Hodgkin’s lymphoma (NHL). A recent study published in the International Journal of Cancer shows that people with the highest sun exposure had 35% less NHL.

Scientists have also known for some time that Caucasians, when compared to darker skinned ethnic groups worldwide, have a much lower diabetes 2 risk. They believe this is due to white skin’s greater sensitivity to sun exposure. A recent study, for example, showed that people with white skin and a high D vitamin level had one quarter the risk of diabetes than those with low levels.

Ten minutes to as much as an hour and a half of sunlight two or three times a week for darker skinned people should be sufficient to produce adequate vitamin D. The best food sources of D are dairy products, organ meats (liver), egg yolks, cod liver oil and seafood, particularly halibut, salmon and tuna.

Since the 1930’s, authorities have recommended limiting D vitamin intake to less than 2,000 I.U. a day. But recent studies show that at least 5,000 I.U. and up to 10,000 I.U. a day are safe and healthy. “It’s virtually impossible to get that much from diet,” Dr. Holick says. “And there’s never been a reported case of D toxicity because of too much sun.”

So, if you’re stuck inside all day, have dark skin or live north of Atlanta or Los Angeles, where there’s just not enough sunlight from November through February, be sure to supplement your diet with vitamin D. Dr. Holick recommends at least 1,000 I.U. daily. Typical multiple vitamin supplements usually have only about 400 I.U.’s.

Moss Greene is the Nutrition Editor for BellaOnline.com and an authority on essential fatty acids, such as fish oil. Over the past 30 years, she’s helped thousands of people to look better, think smarter and feel great – naturally. Visit Moss at nutrition.bellaonline.com to learn more and subscribe to her free health and fitness newsletter.

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First Trial Assessing Therapeutic Benefit of Two Different Dosage Regimens of Disease Modifying Therapy in People With First Clinical Symptoms Suggesting Multiple Sclerosis

GENEVA, Switzerland, December 12 /PRNewswire-FirstCall/ — Serono (virt-x: SEO and NYSE: SRA) announced today the initiation of a Phase III clinical trial to evaluate the effect of two dosage regimens of the new formulation of Rebif(R) (interferon beta-1a 44 mcg, three times a week or once a week) on the time to conversion to multiple sclerosis (MS) in people with first clinical symptoms suggestive of the disease. The trial, called the REFLEX study (REbif FLEXible dosing in early MS), will involve 480 patients considered at risk of developing MS because of a recently experienced isolated demyelinating event and of typical magnetic resonance imaging (MRI) brain scans. “It has been demonstrated that early treatment with interferon-beta can reduce the risk of developing multiple sclerosis. Optimizing the impact of such treatment on development of irreversible neurological damage and ascertainment of long term outcomes is still subject of active experimental and clinical research”, said Professor Ludwig Kappos, from the Department of Neurology, University Hospital Basel, Switzerland, and a member of the Steering Committee of the REFLEX study. “The REFLEX study will determine the respective therapeutic benefit of two different dosage regimens of the new formulation of Rebif(R) for people at risk of developing multiple sclerosis.”

The REFLEX study is a randomized, double-blind, placebo-controlled, multicenter trial. Study participants will receive either the new formulation of Rebif(R) 44 mcg three times a week (160 patients), or the new formulation of Rebif(R) 44 mcg once a week (160 patients), or placebo (160 patients) as a subcutaneous injection for a period of 24 months, unless they suffer from a second attack leading to a diagnosis of clinically definite MS. In this case, patients will be offered open label treatment with the new formulation of Rebif(R) 44 mcg three times a week. The primary endpoint of the study is time to conversion to MS, according to the McDonald criteria. Other endpoints will include assessments of MRI brain scans, clinical relapses and disability progression. The REFLEX study will also evaluate the effect of the new formulation of Rebif(R) on cognitive function as measured by the Paced Auditory Serial Addition Test (PASAT)[1]. Cognitive dysfunction can occur early in MS and impact memory, ability to process information and learning. A sub-study will assess retinal nerve fiber thickness (a marker of axonal loss) by means of optical coherence tomography (OCT). This sub-study will be conducted in selected centers, equipped with this leading edge technology. In addition, the REFLEX study will aim at identifying genetic/genomic profiles associated with disease and treatment outcomes.

The new formulation of Rebif(R) has been developed by an innovative approach, using state-of-the-art technologies. It is under regulatory review by the European Medicines Agency, the US Food and Drug Administration and other healthcare authorities, and is not currently approved.

About Rebif(R)

Rebif(R) (interferon beta-1a) is a disease-modifying drug used to treat relapsing forms of multiple sclerosis (MS) and is similar to the interferon beta protein produced by the human body. Interferon helps modulate the body’s immune system, fight disease and reduce inflammation. Rebif(R), which was approved in Europe in 1998 and in the US in 2002, is registered in more than 80 countries worldwide. In the United States, Rebif(R) is co-marketed by Serono, Inc. and Pfizer Inc. Rebif(R) has been proven to delay the progression of disability, reduce the frequency of relapses and reduce MRI lesion activity and area[2]. Rebif(R) is not approved for treatment of chronic progressive MS. Rebif(R) is available in a 22 mcg and 44 mcg ready-to-use pre-filled syringe and a titration pack, and can be stored at room temperature for up to 30 days if a refrigerator is not available. Most commonly reported side effects are injection site disorders, flu-like symptoms, elevation of liver enzymes and blood cell abnormalities. Patients, especially those with depression, seizure disorders, or liver problems, should discuss treatment with Rebif(R) with their doctors.

Interesting work that might help explain some memory issues in MS, even though it isn't MS research.

Previous research has shown that bundles of axons wither over time. These conduits, collectively referred to as white matter, help connect different regions of the brain to allow for proper information processing.

Now, researchers have found that white matter naturally degrades as we agecausing disrupted communication between brain regions and memory deficits.

The subject says it all. Now that's a ticket I'd be proud to get.

This one is on Medscape (free registration required). You'll find an interview with Dr. Mark Freedman, overviews of some of the topics presented (new treatment results, quality of life issues, use of MRI and other diagnostic tools, etc.), and a compilation of specific treatment-related news stories that came out of the conference.

Alan Weinberg, a volunteer with a video production company, pulled together this excellent video for the Accelerated Cure Project to use as an introduction and an appeal. So if you'd like to introduce a friend to our organization, forward them the link.

We're always looking for new ways to deliver drugs, other than injection. Hewlett-Packard and Crospon have develepoed a new technology in a patch that can effectively do micro-injections to deliver drugs. They don't mention MS specifically, but it would be great if they could replace daily injections with a patch like this. Pictures here.

Stem cells hold much promise for being able to treat degenerative diseases like MS. We post about advances in stem cell research on MSNews all the time. But we also caution that treatments may be quite a ways away. This article covers some of the issues involved in going from stem cells to treatments.

Abnormal blood flow into brain tissue (perfusion) has been previously documented in MS — both higher and lower blood flow into different tissue types have been reported. A new study now shows that blood drainage away from brain tissue is also abnormal in MS (see abstract or
full-text). This study used ultrasound to analyze blood flow through the deep middle cerebral veins and the transverse sinus in 89 people with MS and 60 normal controls. The technique assessed whether blood flowed out only, or both out and in, and how long any inward flow lasted. Only 20% of controls had any inward flow (this was through the transverse sinus only) compared with 65-81% of MS subjects. Furthermore, only 7% of the controls had "reflux" (inward flow lasting > 0.5 second) vs. 38-51% of the MS group.

Blood flow that is turbulent vs. smooth and single-direction can cause an inflammatory reaction in the blood vessel by upregulating adhesion molecules that facilitate the migration of T cells and other cells into the tissue. The authors suggest therefore that the source of this impaired blood flow be examined — does it start in the brain or is there also reduced blood flow downstream? If reduced flow is found only in the brain, it may be an effect of MS inflammation and neurodegeneration. However, if a reduction in blood flow downstream is in turn causing reflux in the brain, this downstream "back-up" may be a trigger for brain inflammation. The authors also suggest performing this study in subjects with other neurological disease to see whether or not these results are specific to MS.

This article is a bit long, and about depression rather than MS, but the topic is very relevant.

Here's an insider's view of what speaking as an MD for a pharma company is like and why it might unduly influence the doctor. This happens for most drugs, including the MS drugs, and it is probably worth reading it so you know what you are up against when you go to see these presentations.