Scientists have learned a lot about this debilitating nerve
disease, but there is still no cure. According to research or other evidence, the following
self-care steps may help you manage MS:
- Discover Padma Basic
- Improve muscle strength and other symptoms by taking two pills of
this herbal remedy three times a day
- Switch to the Swank diet
- Reduce disability and mortality by eating a diet low in animal
fats and hydrogenated oils and high in linoleic acid from natural vegetable oils, and by
supplementing with 5 grams of cod liver oil daily
- Say good-bye to smoking
- Kick the habit to reduce the risk of impaired movement
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full multiple sclerosis article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About multiple sclerosis
Multiple sclerosis (MS) is a slowly progressive, degenerative condition in which the myelin
sheaths surrounding nerves in the brain and spinal cord are lost. Myelin sheaths are a type of
connective tissue, composed of fats and proteins, that insulate nerve fibers. They protect
nerves and are required for effective transmission of nerve impulses.
Indirect evidence suggests that MS may be an autoimmune disease, wherein the immune system
attacks myelin in the central nervous system. MS is more common among people who live in
temperate climates compared with those who live in tropical climates and receive greater
exposure to the sun. Possible causes for MS may include genetic susceptibility, diet,
environmental toxins, viral infections, and exposure to dogs, cats, or caged
birds.1 Epstein-Barr virus has also been named as a risk factor,2 though
the real cause or causes of MS are unknown.
Product ratings for multiple
sclerosis
What are the symptoms?
MS is characterized by various neurological symptoms, with remissions and recurrent
exacerbations. The most common symptoms are paresthesia (numbness and tingling) in the
extremities, trunk, or on one side of the face. Muscle weakness, loss of coordination of a leg
or hand, and visual disturbances (such as partial blindness in one eye, dim vision, or double
vision) are common in MS. Limbs that fatigue easily, difficulty in walking, difficulty with
bladder control, vertigo, and mood
disturbances may appear years before MS is diagnosed. The course of the disease is highly
varied and unpredictable. In most people, the disease remits for varying periods of time.
However, symptoms usually recur, and the progression is often relentless.
Medical options
Corticosteroids, such as prednisone
(Deltasone), is the most common prescription drug used. Though they may shorten the duration
of flare-ups, they have little or no effect on long-term disability. Interferon-beta (Avonex, Betaseron) may reduce the
frequency of relapses and delay long-term disability. Intravenous gamma globulins (Gamimune N,
Sandoglobulin) given monthly may also control relapses. A variety of immunosuppressive drugs
are also used, such as methotrexate
(Rheumatrex), azathioprine (Imuran), cyclophosphamide (Cytoxan), and cladribine
(Leustatin). However, these drugs are reserved for more severe forms of MS, have limited
potential benefits, and are highly toxic. A large variety of drugs, including antispasmodics,
antidepressants, and pain relievers, are also
used to manage the various symptoms of MS.
Dietary changes that may be helpful
The amount and type of fat eaten may affect
both the likelihood of healthy people getting the disease and the outcome of the disease for
those already diagnosed with MS. For many years, the leading researcher linking dietary fat to
MS risk and progression has been Dr. Roy Swank.
In one of Dr. Swank’s reports, a low-fat diet was recommended to 150 people with
MS.3 Although hydrogenated oils, peanut
butter, and animal fat (including fat from
dairy) were dramatically reduced or eliminated, 5 grams per day of cod liver oil were added, and linoleic acid from vegetable oil was used. After 34 years, the
mortality rate among people consuming an average of 17 grams of saturated fat per day was only
31%, compared with 79% among those who consumed a higher average of 25 grams of saturated fat
per day. People who began to follow the low-fat diet early in the disease did better than
those who changed their eating habits after the disease had progressed.
A survey of people in 36 different countries also suggests that the types of fat people eat
may impact MS.4 In that report, people with MS who ate foods high in polyunsaturated and monounsaturated fatty acids were likely to live longer
than those who ate more saturated fats. In
another survey, researchers gathered information from nearly 400 people (half with MS) over
three years.5 They found that people who ate more fish were less likely to develop MS, while those who
ate pork, hot dogs, and other foods high in
animal (saturated) fats were at greater risk. This same report found consumption of vegetable
protein, fruit juice, and foods rich in vitamin C, thiamine,
riboflavin, calcium, and potassium correlated with a decreased MS risk. Eating
sweets was linked to an increased risk.
Despite research showing improvement with a low-fat diet in some people with MS, the link
between foods containing animal fat and MS risk may not necessarily be due to the fat itself.
Preliminary evidence from one report revealed an association between eating dairy foods (cows’milk,
butter, and cream) and an increased
prevalence of MS, yet no link was found between (high fat) cheese and MS in that same report.6
MS has been associated with a variety of dietary components apparently unrelated to fat
intake,7 and the link between MS and diet remains poorly understood. Nonetheless,
the most consistent links to date appear to involve certain foods containing animal fat.
People with MS wishing to pursue a nutritional approach that incorporates an understanding of
this research should consult with a doctor familiar with the “Swank diet.”
Some people with MS avoid gluten (a protein
found in wheat, rye, and
barley) in hopes of diminishing symptoms, because a preliminary study reported that
consumption of grain (bread and
pasta) was linked to development of MS.8 However, another trial found an
association between eating cereals and breads
and reduced MS risk.9 Other researchers have found gluten sensitivity to be no more
common among people with MS than among healthy people.10 Thus, the idea that
avoiding gluten will help MS remains speculative.
Lifestyle changes that may be helpful
While some studies dispute it,11 12 there is preliminary evidence
that exposure to organic solvents,13 insecticides,14 and
X-rays15 may cause or aggravate MS. This may explain why clusters of multiple
sclerosis cases occasionally occur in certain geographical areas or even in work
sites.16
Swiss researchers found that nicotine temporarily impairs arm movement in people with
MS.17 In one study, when people with MS smoked cigarettes, movement capacity was
diminished for 10 minutes in 76% of them. Although this evidence is preliminary, there are
many other adverse health effects of smoking. Smokers with MS should quit smoking.
While the outcome of some research disputes the connection between MS and mercury
exposure,18 other investigations have reported an association between dental
amalgams and this disease. One study found that mercury levels in the hair of people with MS
are higher than in the hair of healthy people.19 This same report found that people
with MS who had their amalgam fillings removed experienced one-third fewer relapses than
people who kept their fillings. Another preliminary study found that people having a large
number of fillings that had been in place for a long time appeared to be at increased risk for
MS compared with those having fewer fillings.20 Preliminary evidence has also
identified an association between tooth
decay—as opposed to fillings—and MS.21 The importance of the
reported links between mercury, tooth decay, and risk of MS has not been clearly
established.
Vitamins that may be helpful
Although some doctors recommend fish oil
capsules for people with MS, few investigations have explored the effects of this supplement.
In one small trial, people with MS were given approximately 20 grams of fish oil in capsules
per day.22 After one to four months, 42% of these people received slight but
significant benefits, including reduced urinary incontinence and improved eyesight. However, a
longer double-blind trial involving over 300 people with MS found that half this amount of
fish oil given per day did not help.23 A preliminary, two-year intervention trial
tested the effects of fish oil supplements (5 ml of fish oil per day, providing 400 mg of EPA
and 500 mg of DHA) combined with other dietary
supplements and dietary changes in people with newly diagnosed, relapsing-remitting
MS.24 The other supplements included 3,333 IU of vitamin A per day, 400 IU of vitamin D per day, and approximately 5.5 IU of vitamin E per day. The dietary recommendations
included reducing intake of sugar, coffee,
tea, saturated fat from meat and
dairy products, and alcohol, while increasing intake of fish,
fruit, vegetables, and whole-grain bread.
Sixty-nine percent of those following the regimen improved, 25% remained the same, and 6% (one
person) deteriorated. The many interventions used in this trial make it impossible to
determine what was responsible for the positive outcomes. Given the lack of other effective
treatments for MS, though, this approach is worth trying while awaiting further evidence. In
another trial, combining fish oil supplementation (6 grams per day) with a low-fat diet (15%
of total calories) appeared to reduce the relapse rate in people with the relapsing-remitting
form of MS.25
In a small preliminary trial, people with MS were given 20 grams of cod liver oil, as well as approximately 680 mg of magnesium and 1,100 mg of calcium per day in the form of dolomite
tablets.26 After one year, the average number of MS attacks decreased significantly
for each person. Unlike fish oil capsules, the cod liver oil in this trial contained not only
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), but 5,000 IU of vitamin D. Therefore, it is not known whether the
vitamin D or fatty acids were responsible for the cod liver oil’s effects. (One
preliminary study found that giving vitamin D-like drugs to animals with MS was
helpful.)27 It is also possible that the magnesium and/or calcium given to these
people reduced MS attacks. Magnesium28 and calcium29 levels have been
reported to be lower in the nerve tissue of people with MS compared with healthy people.
Animal studies have demonstrated that vitamin D can prevent an experimental form of
multiple sclerosis. In humans, striking geographical differences in the prevalence of multiple
sclerosis suggest that sun exposure (which promotes the synthesis of vitamin D) may protect
against the development of the disease. While some scientists have theorized that vitamin D
may help prevent MS, clinical trials are needed to validate that hypothesis.30
The omega-6 fatty acids, found in such oils as
evening primrose oil (EPO) and sunflower seed oil, also may be beneficial. When people
with MS were given 4 grams of EPO for three weeks, their hand grip improved.31 In a
review of three double-blind trials, two of the trials reported that linoleic acid reduced the
severity and length of relapses.32 When the data were re-examined, it was found
that taking linoleic acid decreased disability due to MS in all three trials. According to
these researchers, taking linoleic acid while following a diet low in animal fat and high in
polyunsaturated fat may be even more
beneficial. Amounts used in these trials were approximately 17 to 23 grams of linoleic acid
per day, provided by 26 to 35 grams of sunflower seed oil.
Deficiency of thiamine (vitamin B1) may
contribute to nerve damage.33 Many years ago, researchers found that injecting
thiamine34 into the spinal cord or using intravenous thiamine combined with niacin35 in people with MS led to a
reduction in symptoms. Using injectable vitamins requires medical supervision. No research has
yet studied the effects of oral supplementation with B vitamins in people with MS.
Inosine is a precursor to uric acid, a compound that occurs naturally in the body. Uric
acid is believed to block the effect of a toxic free-radical compound (peroxynitrite) that may
play a role in the development of multiple sclerosis.36 In an attempt to raise uric
acid levels, ten patients with MS were treated with inosine in amounts up to 3 grams per day
for 46 weeks. Three of the ten treated patients showed some evidence of improved function and
the others remained stable.37 Controlled studies are needed to confirm these
preliminary results.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
A commercial herbal product called Padma Basic was given to 100 people with
MS.38 After taking two pills three times per day, 44% of these people experienced
increased muscle strength and general overall improvement. The composition of Padma Basic is
based on a traditional Tibetan herbal formula.
Inflammation of nerve tissue is partly responsible for the breakdown of myelin in people
with MS. When intravenous injections of a constituent of Ginkgo biloba, known as ginkgolide B, were
given to people with MS for five days, 80% of them reportedly improved.39 This
specialized treatment is experimental, and it is not known whether oral use of ginkgo extracts
would have a similar effect.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
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