What is Multiple Sclerosis?
The term multiple sclerosis comes from the multiple areas of scarring (sclerosis) that represent many patches of demyelination in the nervous system. The cause of MS remains a mystery. We know what happens—the myelin sheath that surrounds the nerves is destroyed—but we don't know precisely why.
Interestingly, people from higher latitudes are at higher risk for developing the disease: High-risk areas include the northern United States, Canada, Great Britain, Scandinavia, Northern Europe, New Zealand, and Tasmania. The intriguing exception to this geographic distribution is Japan, where MS is rare. The peculiar geographic spread of the disease has led researchers to study environmental factors as contributing to MS.
People born in May in the northern hemisphere have a higher than average risk of developing multiple sclerosis. An analysis of data from studies of more than 42,000 people in Canada, Britain, Denmark and Sweden showed that May babies have a 13 percent increased chance of suffering from the illness later in life, but that having a November birthday decreased the average odds by 19 percent. The effect was similar in all the countries but most prominent in Scotland, which has the highest rate of multiple sclerosis MS in the world. Although the scientists cannot explain the correlation between birth month and MS, they suspect it could be linked to exposure to sunlight and the mother's vitamin D levels, which could influence the child's development.
Viruses have long been studied for their relation to MS. Recent research in Norway proposed a connection between exposure to a virus such as Epstein-Barr at a critical age—between thirteen and twenty—and the development of the disease, the speculation being that the Epstein-Barr virus acts as a trigger for MS. The measles virus has also been implicated in this way.
Lately a great deal of scrutiny has been placed on MS as an autoimmune disease, that is, a disease in which the body does not recognize its own cells and sends out antibodies against them. In MS the speculation is that the antibodies are attacking the myelin that covers the nerve fibers. A recent and exciting discovery seems to confirm the autoimmune connection: Researchers have identified two types of white blood cells that are thought to cause MS by attacking the nerve tissue. Earlier studies with animals demonstrated that a peptide made specifically to react to the white blood cells could block them from attacking the nerve tissue. Studies are under way to determine whether the same process will be effective with humans.
Signs and Symptoms
The diagnosis of multiple sclerosis is challenging since there is no single blood test or other test that can be used to confirm multiple sclerosis. The process of multiple sclerosis diagnosis usually involves a doctor asking a patient about symptoms, doing a physical exam, and performing a few laboratory test.
The possible neurologic signs and symptoms of multiple sclerosis are so diverse that doctors may miss the diagnosis when the first symptoms appear. Multiple sclerosis symptoms often include reduced or abnormal sensations, weakness and fatigue, visual changes, clumsiness, loss of bladder control, and so on. Symptoms of multiple sclerosis might appear in any combination and be mild or severe. They are usually experienced for unpredictable periods of time.
While multiple sclerosis often worsens slowly over time, affected people usually have periods of relatively good health (remissions) alternating with debilitating flare-ups (exacerbations). Fatigue is the most common symptom of multiple sclerosis and is associated with a reduced quality of life. It is described as the worst symptom of their disease by 50-60% of patients. Brain fog also occurs in multiple sclerosis causing problems in thinking or being able to focus clearly.
Erectile dysfunction is a common symptom with multiple sclerosis. Although Viagra may help, the risk of permanent blindness is a concern. Natural options are available.
Possible Triggers for MS
The pathogenesis of multiple sclerosis remains unknown. Although inflammation, demyelination and axonal injury are all involved, the primary pathogenic process is not clear. On-the-job exposure to organic solvents may increase a person's risk of developing multiple sclerosis. Infection with a common bacteria known as C. pneumoniae may increase the risk of developing multiple sclerosis. Immunization with the synthetic hepatitis B vaccine may be associated with an increased risk of developing multiple sclerosis.
Infection with Epstein-Barr virus (EBV), resulting in infectious mononucleosis, which primarily effects adolescents and young adults, more than doubles the risk of developing multiple sclerosis (MS) later in life. Elevated serum levels of Epstein-Barr virus (EBV) antibodies can be seen in multiple sclerosis patients decades before the clinical onset of disease.
Cerebrospinal fluid from multiple sclerosis patients commonly contains varicella zoster virus DNA. The use of immune suppressive therapy could more easily lead to viral reactivation and to the development of viral diseases in multiple sclerosis patients.
Those with multiple sclerosis should avoid excessive body heat elevation such as sauna, whirlpool, sun bathing or spending time outdoors in high heat. Elevation of core temperature in patients with multiple sclerosis leading to transient or permanent adverse neurologic signs and symptoms has been documented for several decades. A modestly increased core body temperature, even from a usually innocuous activity such as sunbathing, may be fatal in patients with multiple sclerosis.
Dietary Treatments for MS
While pharmaceutical drugs such as beta-interferon are necessary for treatment of MS, there are many natural, complementary means that have proven helpful in retarding the progress of the disease. These natural therapies have been found to be most effective when started early on in the development of the disease. Someone who has suffered from MS for a long time and is severely symptomatic will probably have less success with natural methods than someone newly diagnosed.
Studies point to a high correlation between a high animal-fat diet and development of the disease. One of the most comprehensive treatments devised for patients with MS was created by Dr. Roy Swank in 1948. Dr. Swank believes that a diet that is low in animal fat can "arrest the disease in a high proportion of cases," as he says. And he has had great success over the years in working with patients on his program. His basic recommendations include:
- Saturated fat intake of no more than 10 g (about a half ounce) daily.
- A daily intake of 40 to 50 g of polyunsaturated oils (margarine, shortening, and hydrogenated oils are forbidden).
- A supplement of one teaspoon of cod liver oil daily.
- Normal protein intake of 6 to 10 ounces daily.
- Consumption of fish three or four times weekly.
In addition, Dr. Swank recommends avoiding physical, emotional, and mental strain and fatigue as well as getting plenty of rest. For sixteen years, 146 patients followed his program; their attacks were reduced by 95 percent. Dr. Swank points to longer, more fruitful lives for people with MS who follow his program, and he also says that when the treatment is started early, "Ninety to ninety-five percent of the cases remained unchanged or actually improved during the following twenty years." For detailed information on his program, you can refer to his book The Multiple Sclerosis Diet Book (Doubleday, 1977). As to why the diet is effective, it seems that three factors come into play. The diet promotes less platelet aggregation, it reduces the autoimmune response, and it normalizes the essential fatty acid levels found in the serum, red blood cells, platelets, and, probably most important, in the spinal fluid in patients with MS.
Some researchers have found a connection between MS and allergies. Dr. Herman Weinreb at New York University Medical Center, who noticed that the changes in the nervous system of patients with MS resembled the changes caused by allergies, worked to eliminate all allergens in an effort to reduce MS attacks. His treatment had positive results, with bedridden patients becoming wheelchair-bound, wheelchair patients becoming ambulatory, and some patients becoming symptom-free. While food allergies are not a cause of MS, if we accept that it is an autoimmune disease, it follows that eliminating any allergens, which also stimulate an autoimmune response, would be very helpful. I believe it is useful to review the potential for allergic reactions and to eliminate as much as is possible any allergen sources.
The connection between MS and allergies may be the reason that the MacDougall treatment is effective for some people. Roger MacDougall was severely affected by MS. Confined to a wheelchair and almost blind, he created a diet and, over the course of years, became virtually free of symptoms. His diet forbids all gluten-containing cereals such as wheat, oats, rye, and barley. Like Swank, MacDougall recommends severely limiting saturated fats and strictly forbids dairy products including butter, cream, and cheeses. In addition he recommends taking vitamins and minerals including the B complex vitamins as well as vitamins C and E, calcium, magnesium, and zinc.
- Patients with MS should be under the care and follow the recommendations of a neurologist.
- Reduce the amount of saturated fat in the diet. This includes severely limiting all dairy foods, including whole milk, eggs, and cheese, and meats high in fat, such as red meats.
- Increase intake of polyunsaturated and monounsaturated oil including vegetable oils, olive oil, sunflower seeds, pumpkin seeds, and flax seed oil.
- Make every effort to eliminate any allergens from your diet and environment.
Supplements and MS
It appears that treatment with high levels of antioxidants can be helpful. The antioxidants include vitamin C, vitamin E, beta-carotene, and selenium. These antioxidants should be taken every day for the rest of your life. Intravenous Nutrient Therapy can get these into you fast.
There have been reports that diets high in linoleic acid can be helpful for MS patients. Patients who supplemented their diet with linoleic acid had longer remissions and reduced the severity of their attacks. The best sources for linoleic acid in supplement form include black currant seed oil and borage oil, both available at health food stores. Sunflower seed oil is also rich in linoleic acid and can be used in cooking. Boosting the linoleic content of the diet is most effective when it's done in conjunction with a diet that severely limits the intake of saturated or animal fats.
There is a great deal of evidence that certain trace minerals including calcium, magnesium, selenium, and zinc can be helpful for MS patients. No one knows why calcium, for example, is helpful for MS patients, but studies have shown that daily supplements of calcium can help relieve symptoms.
The following additional nutrients have shown to be helpful in lab studies and may be worth consideration:
- Alpha lipoic acid - Alpha lipoic acid has been helpful in a mouse study and recently showed biochemical marker improvement in a human trial. A dose of 1200 mg of alpha lipoic acid per day may be appropriate.
- L-Carnitine - L-carnitine has been found helpful in reducing fatigue in patients with multiple sclerosis. 500 mg to a maximum 1000 mg of l-carnitine should be sufficient.
- Curcumin - Curcumin is a naturally occurring phytochemical isolated from the rhizome of the medicinal plant Curcuma longa. It has profound anti-inflammatory activity and been traditionally used to treat inflammatory disorders. Curcumin is suggested for use in the treatment of multiple sclerosis and other Th1 cell-mediated inflammatory diseases.
- Fish Oil - Fish oil is an excellent vitamin D source, and diets rich in fish may lower MS prevalence or severity.
- Flavonoids - According to studies, the flavonoids luteolin, quercetin and fisetin most significantly decreased the amount of demyelination in MS. Because flavonoids are potent antioxidants, they may be able to limit the demyelination process during multiple sclerosis.
- Vitamin D - Vitamin D deficiency afflicts most MS patients, as demonstrated by their low bone mass and high fracture rates. High doses of vitamin D may be required for therapeutic efficacy. Patients with multiple sclerosis can take enough vitamin D to double their blood levels of vitamin D without the concern of causing hypercalcemia or hypercalciuria.
- Nicotinamide - Boosting concentrations in the nervous system of a vital compound called NAD, by giving its chemical precursor, nicotinamide has shown considerable therapeutic potential in a mouse model of multiple sclerosis.
- Bushen Gusui - Bushen Gusui could improve symptoms and signs of multiple sclerosis patients and reduce recurrence frequency. High dose Bushen Gusui could inhibit inflammatory reaction of brain and spinal cord as well as demyelination.
It is very difficult to know with any certainty which supplements, in what dosages, and in what combination(s) would be helpful for multiple sclerosis. There is no definite proof yet that these supplements will help, and much more research is needed. It is possible that someone's condition may get worse by stopping their existing medicines and using natural supplements exclusively. It is also possible that certain natural supplements may lead to a slight reduction of the necessary pharmaceutical medication dosage. If you do plan to use these supplements, please let your doctor know and keep the dosages low at first until you have a grasp on how they are influencing your condition or whether they are interfering or improving the actions of the pharmaceutical medicines.
Somatic Therapy for MS
Yoga - To determine the effect of yoga and of aerobic exercise on cognitive function, fatigue, mood, and quality of life in multiple sclerosis. Subjects with clinically definite multiple sclerosis and Expanded Disability Status Score less than or equal to 6.0 were randomly assigned to one of three groups lasting 6 months: weekly Iyengar yoga class along with home practice, weekly exercise class using a stationary bicycle along with home exercise, or a waiting-list control group. Subjects with multiple sclerosis participating in either a 6-month yoga class or exercise class showed significant improvement in measures of fatigue compared to a waiting-list control group. There was no relative improvement of cognitive function in either of the intervention groups.
Reflexology - Seventy-one multiple sclerosis patients were randomized to either study or control group, to receive an 11-week treatment. Reflexology treatment included manual pressure on specific points in the feet and massage of the calf area. The control group received nonspecific massage of the calf area. The intensity of paresthesias, urinary symptoms, muscle strength and spasticity was assessed in a masked fashion at the beginning of the study, after 1.5 months of treatment, end of study and at three months of follow-up. Fifty-three patients completed this study. Significant improvement in the differences in mean scores of paresthesias, urinary symptoms and spasticity was detected in the reflexology group. The improvement in the intensity of paresthesias remained significant at three months of follow-up. Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in multiple sclerosis patients.
While anyone with MS should be under the care of a neurologist, there are many natural complementary ways of improving symptoms of MS, especially if implemented during the early stages of the disease. Naturopathic medicine can help find the right combination of treatments to fit your needs.