Thursday, August 14, 2008

MS Answers - High-dose cyclophosphamide shows promise for aggressive multiple sclerosis

Daily Living with MS

Dr. Devonshire

Director of the University of British Columbia MS Clinic
View BIO


Q :
Recent research has shown that Vitamin D in high doses may help those with MS. It was recommended that 4000 I.Us be taken daily. Should the whole dosage be taken at once in the morning, or spaced out during the day?

A :

There are studies showing that many people with MS have low levels of vitamin D. There is also a possible association with low levels of sunlight (and therefore vitamin D) with the development of MS in populations. Support for this include the increased incidence of MS the further from the equator (the North-south gradient). There is no clinical or scientific evidence that supplementing with vitamin D helps MS. However, because vitamin D is involved in aspects of the immune system, and because in Canada our UV exposure is low, it makes sense to get these levels up. The Health Canada guidelines of 800 units per day are low and will likely be revised. However, there is no recommended dose. The University of Toronto recently reported their results on using doses of vitamin D supplementation at levels above 4000 units/day and found no real toxicity, at least in the short term. The University of Calgary had previously found that on average it takes about 2000 units to get most people with MS out of their D deficiency. Thus, most clinicians working in the area of MS are recommending 2000 units per day. Probably 4000 units is as high as one should go unless levels are to be checked. It can be taken as a full once per day dose, or can be divided. Many people will experience nausea at doses above 2000, and if this is the case, dividing the dose is suggested. But before you make any decision please discuss this with your family doctor.
8/14/2008 1:39:51 PM

More answers from Dr. Virginia Devonshire
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DISCLAIMER: Please be aware that this information does not necessarily represent the opinion of the MS Society of Canada, and is not intended as medical advice. For specific advice and opinion, always consult a physician.
© 2008 Multiple Sclerosis Society of Canada | www.mssociety.ca

http://www.msanswers.ca/QuestionView.aspx?L=2&QID=2048



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Intermedics-McCullough, which sold replacement hip joints, knee and shoulder implants and other orthopedic and surgical products, was an independent contractor for Sulzer-Medica Inc., which sold exclusively for the firm in western Pennsylvania and West Virginia. However, Intermedics asserts that between 1988 and 2007, the defendants crowded it out of the market with inferior and more-costly products by paying kickbacks.

The Intermedics suit follows on a federal investigation of the six companies named, which are estimated to account for 95 percent of the hip and knee surgical implant market. A criminal complaint in the New Jersey-based investigation held that the firms set up consulting agreements with orthopedics surgeons as a means of inducing them to specify the companies' products. The companies (other than Stryker Orthopedics, which cooperated with authorities) reached agreements late last year with the U.S. attorneys' office to avoid criminal prosecution. They agreed to pay $311 million in fines, as well having their payments to providers monitored.
To learn more about the suit:
- read this Pittsburgh Post-Gazette article

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