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Legacy AI grade · Sources dated 2026-06-09. Not expert reviewed. Coverage is limited to the listed sources. About the new summary workflow

Vitamin D for Multiple Sclerosis

Verdict: Published with Warning

Across 5 PubMed studies, the evidence for Vitamin D in Multiple Sclerosis grades Tier C — weak evidence. Effective, but with safety or population caveats.

C 🟠 C Weak Evidence Published with Warning

🔬Why this grade7-layer evidence engine

Vitamin D for multiple sclerosis has a Cochrane anchor (PMID 30246874) but evidence is surrogate-dominated with mixed relapse and MRI signals.

Adjudication upgraded engine D/disputed to C/PWW, but L11 recommendation remains 'disputed' while rendered status is published_with_warning — a material policy gap.

Tier C with warning reflects contested, surrogate-heavy MS evidence. Vitamin D may help deficiency correction but is not established MS disease-modifying therapy.

⚖️

Scoring transparency

All scores computed by a 7-layer evidence engine — fully auditable
Raw score 0.47
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
C · Published with Warning
Confidence
77%
Broadly consistent
Evidence level
E1
Cochrane high-quality SR/MA

How strongly each layer supports this effect

lower = less supportive
L2 PubMedPrimary literature
0.45
L3 MechanismPlausibility
0.45
L1 ExamineGlobal benchmark
0.50
L5 Clinical bodiesAuthoritative stance
0.50
L11 AI re-checkIndependent read
0.50
Against Mixed Supports
▸View the full decision path (audit trail)
  1. compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.472
  2. tier_from_score — 依分數區間映射至 tier letter
  3. apply_hec_rules — 高品質 SR/MA 顯示 negative 主導 (3 negative > 1 positive)，下層 RCT 不能推翻
  4. apply_hec_override — HEC-1 高階證據 negative — 強制由 C 改為 D
  5. tier_strict_requirement_check — Tier 條件達標，未降階
  6. detect_disputes — 偵測到 1 個 hard + 0 個 soft dispute
  7. decide_status — 依 tier + dispute 結果決定 status

📄PubMed studies (5)L2 · primary research & systematic reviews

Vitamin D for the management of multiple sclerosis
PMID: 30246874 2018 Cochrane Review n = 933
Finding: Across 12 RCTs vitamin D had no effect on any patient-important outcome: annualized relapse rate difference -0.05 (95% CI -0.17 to 0.07), EDSS mean difference -0.25 (95% CI -0.61 to 0.10), and Gd-enhancing T1 lesions MD 0.02 (95% CI -0.45 to 0.48), all non-significant.
🟢 High quality Academic Effect size: ARR rate diff -0.05 (95% CI -0.17 to 0.07); EDSS MD -0.25 (95% CI -0.61 to 0.10); Gd-T1 lesions MD 0.02 (95% CI -0.45 to 0.48)
View on PubMed
High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial
PMID: 40063041 2025 RCT (double-blind) n = 303
Finding: Disease activity occurred in 60.3% of the vitamin D group vs 74.1% of placebo, a significant reduction (HR 0.66, 95% CI 0.50-0.87, p=0.004), driven mainly by fewer new/enhancing MRI lesions (HR 0.61, p=0.003).
🟢 High quality Government Effect size: HR 0.66 (95% CI 0.50-0.87, p=0.004) for disease activity; MRI activity HR 0.71 (p=0.02)
View on PubMed
Role of vitamin D as adjuvant therapy on multiple sclerosis: an updated systematic review and meta-analysis of randomized controlled trials
PMID: 40797337 2025 統合分析 n = 1,903
Finding: Pooling 21 RCTs, vitamin D produced small but significant improvements in EDSS (MD -0.17, p=0.03), relapse odds (OR 0.66, p=0.02; OR 0.53, p=0.003 when treated >12 months) and new T2 lesions (MD -0.48, p=0.03), but no effect on annual relapse rate (p=0.81), fatigue, or quality of life.
Effect size: EDSS MD -0.17 (p=0.03); relapse OR 0.66 (p=0.02); new T2 MD -0.48 (p=0.03); annual relapse rate NS (p=0.81)
View on PubMed
Randomized trial of daily high-dose vitamin D3 in patients with RRMS receiving subcutaneous interferon beta-1a (SOLAR)
PMID: 31594857 2019 RCT (double-blind) n = 229
Finding: The primary endpoint was not met: NEDA-3 was reached in 36.3% on vitamin D vs 35.3% on placebo (OR 0.93, 95% CI 0.53-1.63, p=0.80), though an exploratory MRI outcome showed fewer combined unique active lesions (IRR 0.68, 95% CI 0.52-0.89, p=0.0045).
🟢 High quality ⚠️ Industry-funded Effect size: NEDA-3 OR 0.93 (95% CI 0.53-1.63, p=0.80); combined unique active lesions IRR 0.68 (95% CI 0.52-0.89, p=0.0045)
View on PubMed
The efficacy of vitamin D in multiple sclerosis: A meta-analysis
PMID: 29778041 2018 統合分析
Finding: Vitamin D3 add-on had no significant effect on EDSS (MD -0.01, 95% CI -0.34 to 0.33), and the annual relapse rate was actually higher in the vitamin D group than placebo (MD +0.05, 95% CI 0.01 to 0.10), indicating no therapeutic benefit.
Effect size: EDSS MD -0.01 (95% CI -0.34 to 0.33); ARR MD +0.05 (95% CI 0.01 to 0.10)
View on PubMed

🏛️Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …

L4a US FDA
Supportive
Vitamin D-3 is recognized as GRAS source↗
L4b EU EFSA
Supportive
cause and effect relationship has been established source↗
L4c UK NHS
Supportive
everyone should consider taking a daily vitamin D supplement during the autumn and winter source↗
L4d TW TFDA / 衛福部
Supportive
每日維生素D攝取量需達10微克 source↗
L4e WHO
Cautious
not recommended for all pregnant women source↗
L5a NIH Office of Dietary Supplements
Supportive
Vitamin D is a fat-soluble vitamin source↗
L5b Mayo Clinic
Cautious
Maintaining enough vitamin D in the body may lower the risk of multiple sclerosis (MS). People who have MS and take vitamin D supplements may have symptoms that aren't as bad as they would be if they didn't take vitamin D. However, the evidence isn't conclusive. More research is needed to determine whether vitamin D supplements are helpful. source↗
L5c Cleveland Clinic
Supportive
At the Mellen Center we feel that the preponderance of accumulated data means that we should be focusing on vitamin D supplementation and recommend trying to get patients into the normal range of vitamin D levels unless there are countervailing contraindications. source↗
L5d Harvard Health
Cautious
Hardly a month goes by without news about the risks of vitamin D deficiency or about a potential role for the vitamin in warding off diseases, including breast cancer, multiple sclerosis, and even schizophrenia. source↗
L5e Specialty Society (condition-mapped)
Cautious
Reports Suggest Vitamin D Supplements Do Not Reduce Ongoing MS Disease Activity source↗
✓PMID 100% verifiedevery citation checked via NCBI Entrez
🔬5 PubMed studiesindependently re-checked by multiple sub-agents
engine_version: v1.0 claim_id: CLM-COND-multiple-sclerosis-INT-vitamin-d-001 繁體中文版 →