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Tricia came home from a family vacation with an unusual, new, nervy sensation in the soles of both feet. Within days, this 32-yearold mother of five young children could no longer walk and had to The consequences of MS move around her house by crawling on her hands and knees. Her depend on what part of the diagnosis was fast and dire: malignant MS. In the hospital, she was CNS is under attack. Weakness, changes in sensation, optic instructed to go home and put her affairs in order. Fifteen years later, neuritis, urinary and sexual her MS is under control, but she lives in fear of permanent blindness. dysfunction, sensitivity to heat, and overwhelming fatigue are common. Loss of motor control with painful MS, UV Radiation, and Vitamin D spasms, cognitive changes, and motor and/or The geographic distribution of MS has always sensory paralysis are all possibilities. For this suggested that this disease is most common reason, MS in one person can look extremely in Caucasian populations living far from the different from MS in another person, and the equator. Canada, the United States, the United disease is sometimes called the "great imitator." Kingdom, and Scandinavia show the highest Its identification as an autoimmune disease has concentrations of people with this condition. led to much more consistent and successful treatment This observation has led to the hypothesis that options for patients than used to be available. A MS is mainly a disease of genetic predisposition, class of drugs called DMAMS (disease-modifying with prevalence among Northern Europeans, and agents for MS) includes substances that can shorten certainly that appears to be a major factor. But flares, prolong remission, and quell immune-system another important factor in the development and activity. Steroidal anti-inflammatories may also the severity of MS turns out to be a lack of exposure be used, with cautions for dangerous side effects. to sunlight, especially during childhood. The exact Additional drugs can help with cognitive changes, link of how exposure to ultraviolet (UV) radiation, fatigue, urinary symptoms, and other problems. All or more specifically the lack thereof, might lead to in all, the pharmacological treatment options for MS this condition has been a mystery, but some recent are better than they ever have been, but no treatment findings have begun to shine a light on this question. is successful for all patients, and no treatment can One of the things that happens when we are permanently correct the immune system activity exposed to the UV rays in sunlight is that our that leads to the damage in the first place. bodies manufacture vitamin D. This fat-soluble vitamin is important for bone health, but it also Vitamin D—How Much is Enough? The recommended daily allowance for vitamin D in the United States is a bit complex, because several variables affect its levels. The most accepted recommendation is 600 international units of vitamin D per day, but this does not differentiate between dietary sources, supplemental sources, and the vitamin D stimulated by sun exposure, which varies according to cloud cover, latitude, melanin level, and season. Cod liver oil, salmon, sardines, and swordfish may be the most efficient nutritional sources, but margarine, milk, some yogurt, and many breakfast cereals are fortified with vitamin D. Fortunately, the body can store this vitamin so that those living in northern climates can essentially stock up on vitamin D during the long days of spring and summer—but only if the skin is exposed to UV radiation. The use of sunscreen to prevent skin cancer has been seen to have an unexpected side effect, inhibiting the manufacture of vitamin D. www.abmp.com. See what benefits await you. 47