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Story at a Glance:
Autoimmune disorders disproportionately affect women, yet the exact causes remain unclear.
High-dose vitamin D supplementation significantly delays disease progression in multiple sclerosis (MS) patients.
Vitamin D supplementation has demonstrated a considerable reduction in dementia risk, particularly in women.
Neuro Athletes,
This newsletter was born from urgency and necessity. Yesterday, standing before the OBGYN department at Lenox Hill Hospital to deliver grand rounds, I felt a surge of responsibility and resolve. It's clearer than ever that advocating for women's health isn't merely important—it’s a vital act of resistance against decades of medical oversight and policy neglect. We must amplify this message until it's no longer ignored.
The disproportionate prevalence of autoimmune disorders among women remains a profound yet inadequately addressed mystery in medical science. Approximately 80% of autoimmune conditions affect women, posing a significant health burden and highlighting a glaring gap in our understanding of disease pathology and treatment.
Multiple sclerosis (MS) exemplifies this gender disparity vividly, prompting an urgent need for deeper scientific investigation into potential interventions, such as vitamin D supplementation.
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Women and Autoimmune Disorders: An Unresolved Medical Enigma
Autoimmune disorders are characterized by aberrant immune responses where the body mistakenly targets its own tissues. Women constitute about 80% of autoimmune patients, a statistic that underscores significant gaps in our understanding of immune regulation influenced by gender-specific factors such as hormonal variations, genetic predispositions, and environmental exposures.
Autoimmune Disorders:
Autoimmune diseases predominantly affect women, comprising around 80% of all cases.
Conditions include systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, and multiple sclerosis.
Potential explanations involve interactions between hormones (especially estrogen), genetics, and environmental triggers such as infections, diet, and notably, vitamin D deficiency.
MS: An Autoimmune Challenge with Gender Bias
Multiple sclerosis, an autoimmune disorder affecting the central nervous system, manifests through progressive demyelination of nerve fibers, impairing neurological functions. It disproportionately affects women, particularly those in the prime of their reproductive years (20–40 years old), adding urgency to the exploration of sex-specific factors that may contribute to disease susceptibility and progression.
Women are approximately 2–3 times more susceptible to MS compared to men.
Clinical manifestations include vision problems (optic neuritis), sensory disturbances, motor dysfunction, cognitive impairment, and fatigue.
MS pathology involves immune-mediated damage to myelin sheaths, resulting in disrupted nerve signal transmission.
Here’s where it gets interesting…
Vitamin D, commonly known for its role in bone health, functions significantly as a steroid hormone, modulating various physiological processes including immune response regulation and neurological health. Vitamin D deficiency is notably prevalent among women diagnosed with autoimmune disorders, suggesting a potential therapeutic role in these conditions.
It acts as an immune modulator, influencing the proliferation and differentiation of immune cells.
It shares structural similarities with steroid hormones such as estrogen and cortisol, enabling broad physiological impacts.
It regulates gene expression relevant to immune system functionality, inflammation control, and neuronal health.
Evaluating Vitamin D in MS: Insights from the D-Lay MS Clinical Trial
The D-Lay MS trial investigated whether high-dose vitamin D supplementation could mitigate disease progression in patients experiencing clinically isolated syndrome (CIS), an early indicator of MS. This rigorous randomized clinical trial offers significant evidence supporting vitamin D's potential role in MS management.
Comprehensive Breakdown of the D-Lay MS Trial:
Participants: 303 adult patients (70% female), median age 34, recently diagnosed with CIS.
Study Design: Randomized placebo-controlled trial administering 100,000 IU vitamin D biweekly over two years.
Significant Outcomes:
Reduction in MS disease activity: 60.3% (vitamin D) vs. 74.1% (control).
Significant decrease in MRI indicators of MS activity.
Median delay in disease progression nearly doubled (432 days vs. 224 days).
Safety Profile: No serious adverse effects related to high-dose vitamin D supplementation were observed.
Clinical Implications:
Early high-dose vitamin D intervention could significantly reduce MS progression and disease burden.
Highlights the necessity of routine vitamin D screening and supplementation, especially in populations at elevated risk.
Cognitive Protection: The Broader Neurological Benefits of Vitamin D
Vitamin D's protective roles extend beyond autoimmune conditions to cognitive health, notably in dementia prevention. A landmark study involving over 12,000 participants demonstrated a notable reduction in dementia risk associated with regular vitamin D supplementation.
Key Findings on Vitamin D and Dementia:
Conclusions This randomized clinical trial showed the efficacy and low risk of adverse events of oral cholecalciferol 100 000 IU monotherapy every 2 weeks to reduce disease activity in patients with CIS and early RRMS. These results make highdose vitamin D an interesting candidate for further studies evaluating add-on therapy in the therapeutic strategy for managing MS.
Vitamin D supplementation correlated with a 40% reduction in dementia risk over a decade.
84% dementia-free status among supplement users at five years compared to 68% among non-users.
The greatest benefits were observed in women, cognitively normal individuals, non-carriers of the APOE e4 gene, and non-depressed participants.
Mechanisms of Cognitive Benefit:
Vitamin D functions as a potent neurosteroid, regulating gene expression crucial to neuronal survival and plasticity.
Clinical trials have confirmed improvements in cognitive performance, memory
Retention, and intellectual capacity among older adults.
Despite compelling scientific evidence, healthcare policies remain insufficiently attentive to vitamin D’s potential therapeutic roles. The slow integration of vitamin D screening and supplementation into standard medical practice raises important questions about health policy priorities and pharmaceutical influences.
Critical Policy Considerations:
Routine vitamin D screening should be standardized, particularly targeting at-risk groups like women predisposed to autoimmune conditions.
Health policies should actively incorporate vitamin D supplementation as preventative and adjunctive therapy.
Ethical considerations demand urgent policy reform to prioritize accessible, low-cost interventions such as vitamin D supplementation.
Recommended Actions:
In summary, the potential of vitamin D as a significant modulator in autoimmune disorders, particularly MS, and as a neuroprotective agent, demands immediate policy attention. It is not merely a supplement, but an essential, scientifically-supported component of preventative healthcare, especially crucial for women who disproportionately bear the burden of autoimmune and neurological diseases.
Regular screening and management of vitamin D levels, particularly among women and individuals at risk for MS.
Clinical consideration of high-dose vitamin D supplementation under medical guidance following CIS diagnosis or dementia risk identification.
Advocacy for comprehensive health policy reform integrating vitamin D assessment and supplementation into routine care.
Ultimately, healthcare systems must realign their priorities to integrate scientifically validated, cost-effective interventions such as vitamin D supplementation to address the critical health disparities affecting women's health.
Have you had your vitamin D levels checked?
Let me know.
Louisa x
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