Iron and the folate-vitamin B12-methylation pathway in multiple sclerosis

Metab Brain Dis. 2006 Sep;21(2-3):121-37. doi: 10.1007/s11011-006-9019-0. Epub 2006 May 26.


Some subjects with multiple sclerosis (MS) present with low blood iron parameters. Anecdotal reports and a single patient study suggest that iron supplementation may be beneficial in these subjects. Myelin is regenerated continually, but prerequisites for this process are iron and a functional folate-vitamin B12-methylation pathway. The aim of this study was to determine iron status, folate and homocysteine in MS subjects, and to evaluate the effect on MS symptoms if deficiencies were addressed.

Results: In relapsing-remitting MS subjects, serum iron concentration correlated significantly with age at diagnosis (r=0.49; p=0.008). In Caucasian female MS subjects, serum iron and ferritin concentrations were significantly lower than in matched controls. In a 6-month pilot study, 12 subjects taking a regimen of nutritional supplements designed to promote myelin regeneration, improved significantly neurologically as measured by the Kurzke EDSS (Total Score means 3.50 to 2.45, 29.9%; p=0.021). These were significantly improved (p=0.002) compared to 6 control group patients taking multivitamins (Kurzke Score increased by 13.9% from 4.83 to 5.50). Both groups had significantly reduced homocysteine concentrations at 6 months, suggesting that methylation is necessary but not sufficient for myelin regeneration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Continental Ancestry Group
  • Anti-Inflammatory Agents / therapeutic use
  • Dietary Fats / therapeutic use
  • Dietary Supplements
  • European Continental Ancestry Group
  • Female
  • Folic Acid / metabolism*
  • Homocysteine / blood
  • Humans
  • Interferons / therapeutic use
  • Iron / blood
  • Iron / metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Methylation
  • Multiple Sclerosis / blood
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / metabolism*
  • Nutritional Status
  • Patient Compliance
  • Pilot Projects
  • Prednisone / therapeutic use
  • Vitamin B 12 / metabolism*


  • Anti-Inflammatory Agents
  • Dietary Fats
  • Homocysteine
  • Interferons
  • Folic Acid
  • Iron
  • Vitamin B 12
  • Prednisone