About Barbara M. van Amerongen, DDS, PhD.

Dr. Barbara M. van Amerongen received her dental degree from the University of Amsterdam in 1974 and earned her PhD in 1985. At the University of Amsterdam, she was working at the Department of Preventive Dentistry; in addition she had her own part-time dental practice. In 1990 she was diagnosed with multiple sclerosis (MS), the symptoms having started around 1975. In 1997 she closed her dental practice, due to MS-related fatigue. She joined the Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, part of the MS Center, to study MS and Vitamin D. This resulted in two papers (van Amerongen et al., 2004 and Kragt et al., 2009). These papers led her to test her hypothesis (that vitamin D aids MS) on herself. 

 
About Dr. van Amerongen's Case Study

In January 2001 Dr. van Amerongen started with vitamin D3 800 IU/day, resulting in serum levels between 33-40 ng/ml (84-102 nmol/L). September 2004 she increased to 4000 IU/day, which seemed to keep the serum level around 40 ng/ml (100 nmol/L). In December 2005 she increased again to 6000 IU/day, and serum levels rose to above 55 ng/ml (135 nmol/L). Although there were rises and falls in the serum level throughout the 10 year period, her vitamin D level was always within a "safe" physiological range of 30-80 ng/ml (75-200 nmol/L). She found it took her about 8 months at a new dosage level to reach a steady state 25(OH)D level. Calcium was also taken daily - initially 240 mg/day, and only from March to July 2009 increased to 1332 mg/day. 

She used patient related outcome measures - ambulation (walking distance in km/day) and muscular pain (pain killers yes/no) - to keep track of her progress. In addition bone mineral density (BMD) and serum levels were monitored.

Ambulation was the key patient related outcome measure. The walking distance increased, as vitamin D levels increased, from 1 km/day to 14 km/day. 

Unfortunately, her PTH level did not reach the lower limit of its normal (reference) range and her BMD decreased. She was diagnosed with osteopenia in 2009.

Adverse events including hypercalcaemia, nephrolithiasis or fracture, were not observed. Serum calcium levels remained within the normal range. In January 2009, a scan with a sonographer revealed no renal calculus (kidney stones) after eight years of vitamin D supplementation. Additionally, no hypercalciuria was observed. 

This paper discusses the blunted parathyroid hormone (PTH) response, vitamin D resistance, and ways to reduce PTH level as found in the literature.

Conclusion

The authors recommend that periodic assessment of vitamin D3, calcium and magnesium intake, bowel problems and the measurement of serum 25(OH)D, PTH, Ca levels, UCa/Cr and bone health become part of the integral management of persons with MS. 

While a clinical trial of one will not make headlines, it is a very interesting, detailed case-study of one person with MS who took vitamin D3, in increasing dosages, calcium and magnesium and improved her quality of life. She can walk for exercise and enjoyment and she is no longer in pain. 

Van Amerongen publishes a web site (Vitamin D and MS) where she collects news on Vitamin D and MS, gives an overview of the ongoing clinical trials with Vitamin D in MS, and presents a growing number of researchers, including neurologists, interested in vitamin D and MS. There is also an outreach to Dutch people with MS.