Most people with multiple sclerosis have to deal with extreme tiredness. If you’re one of them, you know it can make your life harder. Although there’s no magic pill that can fix MS fatigue, some vitamins may help you better handle the fatigue.
How can vitamins help? Because MS damages your nerves and disrupts their signals, you may need more energy to do the same tasks than you did before. Vitamins help your body turn the carbohydrates, protein, and fat from food into fuel, says Mona Bostick, a registered dietitian nutritionist specializing in multiple sclerosis and owner of MSBites.com. Getting enough vitamins can keep you from becoming more drained than you already feel.
Certain vitamins can also lessen some of the symptoms that can contribute to the fatigue and interfere with sleep, Bostick says. These include muscle tightness and spasms, bladder problems, numbness and tingling, and depression. For example, if you aren’t in as much pain at night, you may be able to sleep more soundly – and feel less tired throughout the day
Important Vitamins for MS Fatigue
The right vitamins may lessen your MS fatigue and help you feel better. The best way to get them is through a healthy diet, Bostick says. “Whole foods serve up nutrients in a balance of vitamins, minerals, and other compounds that work together to support health better than supplements alone.”
If you don’t get enough of a certain vitamin, you may need to take a supplement. Talk to your doctor before you start taking one. High doses of some vitamins and minerals may worsen your symptoms, cause side effects, or interfere with medications, Bostick says.
Research suggests that the following vitamins may ease some of your MS symptoms and improve your fatigue:
Vitamin D
How it helps. Research shows that getting enough vitamin D can lessen your exhaustion. One review of five studies found that people with MS who took a vitamin D supplement regularly — ranging from 1 microgram to 50,000 international units (IU) at least once a week — reported having 18% less fatigue compared to those who didn’t.
Vitamin D may help regulate the immune system and lower the amount of inflammation in the body, according to the National Multiple Sclerosis Society. Getting enough of the vitamin may reduce the disease's flares and its symptoms, such as pain and fatigue.
How much you need. The recommended amount of vitamin D is at least 600 IU a day for adults (800 IU for those over age 70). But more than 40% of adults don’t have enough vitamin D. If a blood test shows that your level is low, your doctor may recommend taking 2,000-5,000 IU. In some cases, you may need 50,000 IU once a week for up to three months to bring up your vitamin D levels.
Foods high in vitamin D. Vitamin D is made when your skin is exposed to sunlight, Bostick says. It’s also found in a few foods, including:
Salmon: 570 IU per 3 ounces
Mushrooms: 366 IU in 1/2 cup
Fortified milk: 120 IU in 1 cup
Eggs: 44 IU per egg
How to get it from supplements. There are two types of vitamin D:
- Vitamin D2 (ergocalciferol): Found in plant foods, such as mushrooms
- Vitamin D3 (cholecalciferol): Comes from sunlight and animal-based foods
Both forms can raise your vitamin D, but D3 is usually better at maintaining your vitamin D level over time, Bostick says. It’s a better option for people who have a deficiency.
Because vitamin D is fat-soluble, take the supplement with foods that contain some fat, Bostick says.
Potential risks. Too much vitamin D is toxic and can cause side effects, such as nausea, constipation, weakness, and weight loss. It can also cause high levels of calcium in the blood, causing kidney stones. Because of these risks, experts recommend getting no more than 4,000 IU of vitamin D a day if you don’t have a deficiency.
Vitamin B12
How it helps. Your body needs vitamin B12 to maintain the tissue that protects nerves called the myelin sheath. Not getting enough of the vitamin can cause MS-like symptoms, including fatigue, numbness, and tingling. If you don’t have enough vitamin B12, getting more can help you feel better and lessen the muscle weakness and spasms.
How much you need. The recommended daily amount of vitamin B12 is 2.4 micrograms. But if you’re low in vitamin B12, you may need 1,000 micrograms a day to raise your levels.
Foods high in vitamin B12. Vitamin B12 is mostly found in animal foods. Some plant-based foods are fortified with the vitamin.
Beef liver: 71 micrograms per 3 ounces
Clams: 17 micrograms per 3 ounces
Beef: 2.4 micrograms per 3 ounces
Milk: 1.3 micrograms per 1 cup
How to get it from supplements. You can take vitamin B12 by mouth or through an injection. “It depends on the reason for your vitamin deficiency and its severity,” Bostick says. If you have a mild to moderate deficiency, a pill, liquid, or capsule is usually recommended. People with severe deficiencies may need a vitamin B12 shot. They’re often given daily for two weeks until symptoms improve and your levels rise.
Potential risks. Vitamin B12 is considered safe, even in high doses.
Folate (Vitamin B9)
How it helps. Research shows that people with MS whose diets were low in folate had more fatigue than those who got enough of the vitamin. Scientists think folate — and its manmade version, folic acid — protect nerves from a harmful amino acid.
How much you need. You need 400 micrograms of folate daily. Because your body absorbs more folic acid, which is found in supplements and fortified foods, you need 240 micrograms of folic acid daily.
Foods high in vitamin B9. Folate is found in a wide variety of foods, including:
Spinach: 131 micrograms per 1 cup, cooked
Black-eyed peas: 105 micrograms per 1/2 cup
Rice: 90 micrograms per 1 cup
Brussels sprouts: 78 micrograms per 1 cup, cooked
How to get it from supplements. One study found that people with MS don’t get enough folate, averaging 224 micrograms daily. If you don’t eat a lot of folate-rich food, or if your level is low, you may need to take a supplement. It’s available as pills and liquids, and it’s sold as vitamin B9 or folic acid.
Potential risks: The folate found in food isn’t harmful. But too much folic acid may cause side effects, such as nausea or stomach cramps. You shouldn’t get more than 1,000 micrograms of folic acid a day.
Vitamin A
How it helps. Vitamin A may lower the inflammation caused by MS and protect the brain. Although more study is needed, some early research suggests that vitamin A may help ease depression and fatigue in MS patients.
How much you need. Women need 700 micrograms and men require 900 micrograms of vitamin A (or retinol activity equivalents) daily. There are two forms of vitamin A. Vitamin A is found in animal products, while plant foods contain beta-carotene. Your body converts beta-carotene into vitamin A.
Foods high in vitamin A. Orange and yellow vegetables and leafy greens are rich in vitamin A. Other good sources include fish, eggs, and dairy products:
Sweet potato: 1,403 micrograms per potato
Spinach: 573 micrograms per 1/2 cup cooked
Carrots: 459 micrograms per 1/2 cup
Milk: 142 micrograms per cup
How to get it from supplements: You can get vitamin A or beta-carotene in pill or liquid form. Because it’s a fat-soluble vitamin, you should take it with food containing some fat.
Potential risks. Too much vitamin A can become toxic, so it’s important not to overdo it. Experts recommend that adults get no more than 3,000 micrograms per day.
Risky Vitamins for People with MS
In high doses, certain vitamins can cause side effects and even worsen your MS fatigue:
Vitamin C. Although vitamin C may improve MS symptoms, you can get too much of a good thing. Research shows that a high dose of vitamin C promotes a toxic reaction, which may increase inflammation and actually worsen those symptoms. Adults should get no more than 2,000 mg of vitamin C a day.
Biotin (vitamin B7). Research shows that a high dose of biotin doesn't benefit MS symptoms but may worsen things for some people. One study found that one-third of people with progressive MS who took 300 milligrams of biotin a day had increased symptoms, such as weakness and falling.
Always talk to your doctor before you take a supplement.
