Rehabilitation of Patients With GBS After Diagnosis Through Early Vitamin D Supplementation

What is it about?

Although Guillain-Barré syndrome (GBS) has been known and intensively described for over 100 years, the therapist cannot predict the course of the acute disease, a subsequent autoimmune remission phase or a degenerative late phase after diagnosis. This fact justifies the need to consider an add-on therapy with vitamin D as a therapy option in the context of early rehabilitation in addition to therapy with immunoglobulin G, plasmapheresis/plasma exchange. The pathoimmunological background and the association with 1,25-dihydroxy-vitamin D3, the active metabolite of vitamin D, is shown and conclusions are drawn about daily high-dose vitamin D supplementation from the beginning of diagnosis. This supportive therapy is linked without significant side effects, inexpensive and generally available everywhere. Immunoglobulin G plasmapheresis/plasma exchange is not available in all countries at an adequate time, is limited in stock for financial reasons and is used in different ways. The indication will depend on the place of residence of the person with GBS (whether urban or rural), the type of health insurance, the country. In the case of a long period of remission, physical disabilities can remain and have serious effects on everyday professional life and the psyche, especially in young people. Even if the therapeutic success of vitamin D could be limited, the broad spectrum of action of vitamin D on immunopathogenesis, pain symptoms, comorbidity such as anxiety and depression, as well as on the prevention of infection should be exhausted at an early stage in people with Guillain - Barré syndrome. Success will depend crucially on optimal 25-hydroxy vitamin D levels in the blood.

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Why is it important?

1,25(OH)2D3, the active form of vitamin D, has a supportive function in immunoglobulin therapy G due to similar immunological mechanisms. It provides support in pain therapy and can reduce anxiety and depression. In cases of perennial clinical symptoms of GBS, CIDP (chronic inflammatory demyelinating polyneuropathyyradic must be considered in the differential diagnosis. It is biologically plausible that the therapeutic effect of calcitriol on dysimmunity is adequate in both GBS and CIDP.

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