MS is an unpredictable disease of the nervous system which manifests itself primarily through disorders in mobility. It is associated with a variety of other symptoms and complications. The most important fact about multiple sclerosis is its unpredictability and its uncertainty. There are very few certainties to be found anywhere in any aspect of this disease.
Multiple sclerosis is a demyelinating disease of the white matter of the central nervous system. Gray matter consists primarily of nerve cells. Axons (nerve fibers) are the connections between the cell body and the muscles, sensory organs, and primary organs such as the heart. These nerve cells are the communication system both within the central nervous system and between it and the rest of the body. Axons are sheathed in myelin, a white substance (hence the term “white matter”) that insulates them and speeds transmission of impulses along the cell fibers. Electrical impulses move along the nerve fiber to the synapse (the connection point between cells) to the next nerve cell.
The lesions or plaques of multiple sclerosis are areas of tissue damage arising from inflammation, which occurs when white blood cells and fluid accumulate around blood vessels. This inflammation causes destruction of myelin. After the fragments are cleared away, a scar is formed in the area which is the lesion, or area of demyelinization. These lesions impede conduction of signals by blocking or slowing communication, either completely or partially and from time to time. The process can be thought of as similar to an electrical short circuit. The symptoms of multiple sclerosis result from this loss in signal conduction.
MS is the most common demyelinating disease of the central nervous system. In the United States alone, there are at least 250,000 cases. For reasons that remain unclear, it is more prevalent in northern temperate zones and affects noticeably more women than men. The average age of onset is thirty years.
Studies indicate that an environmental factor, perhaps exposure to a virus, when combined with a genetic predisposition to the disease, may well dictate occurrence of the disease. MS is not a genetically transmitted disease; it may be an autoimmune disease, with some part of the body attacking itself.
Diagnosis
Diagnosis of MS is difficult. A medical history and clinical examination must show at least two separate lesions that have occurred at more than one time. Obviously, any other possible causes must be ruled out. Because of the difficulty of diagnosis, the presence of MS is usually deemed to be either definite, probable, or possible. There is no one specific diagnostic test that can either confirm or rule out its presence.
A neurological examination can indicate lesions through the presence or absence of various signs and reflexes. Computerized tomographic (CT) scans will show some lesions. Magnetic resonance imaging (MRI) usually reveals many more lesions than the CT scan, including some that may be subclinical, that is, they are not detectable through examination and may have no associated symptoms. An autopsy will usually show many more lesions than were suggested by either symptoms or signs. These lesions are probably the result of subclinical attacks of the disease.
Brain wave testing (evoked potentials) of responses to various forms of stimulation of the eyes, ears, or other parts of the body may demonstrate delays in these responses and indicate lesions that are clinically silent (producing no symptoms) and can sometimes firm up a questionable diagnosis from probable to definite MS. Testing of the cerebrospinal fluid (CSF) for protein content, the number and type of white blood cells, and the amount of IgG, a gamma globulin, can also support a diagnosis. An old diagnostic technique is to see whether a person becomes worse after a hot bath.
Symptoms
Symptoms of MS vary enormously, both from patient to patient and, over time, in one patient. There are three primary courses the disease may take:
- a benign course, involving a few early mild attacks followed by almost complete remission, leaving little or no disability (30%)
- an exacerbating remitting course with more early attacks with less complete remission resulting in some disability, followed by long periods of stability (40%)
- a progressive course involving a slow and continuing progression of the disease with no remission (30%)
Some of those with an exacerbating remitting course will eventually develop a slow progression involving fewer and less complete remissions with cumulative disabilities. Very rarely, there is a rapidly progressive course leading to death. MS itself is almost never the cause of death; death results from accompanying complications or infections. Generally speaking, the life expectancy of those with MS is at least 75% of normal.
Exacerbations and remissions are difficult to define. An exacerbation is an acute appearance of new symptoms or worsening of old symptoms which lasts at least 24 hours, while a remission is a total or more often partial clearing of symptoms and signs which lasts more than 24 hours.
Symptoms may appear very rapidly, within minutes or days, or very slowly, over a period of weeks. They may be very transient and come and go rapidly. New symptoms may accumulate; old symptoms may reappear and/or intensify. Exacerbations, episodes of new disease activity, are not easy to diagnose with certainty. New symptoms may result from old, not new, areas of disease that were previously silent. Conversely, recurrence of old symptoms is not a sure indication of lack of exacerbation. Over time, the disease process may result in the formation of new plaques or the enlargement of existing ones. Exacerbations can be caused by heat, physical trauma, extreme fatigue, psychological stress, infections, or any other kind of stress. While all of these factors have been associated with exacerbations, there is little empirical data to support these associations.
There does seem to be a direct correlation between the degree of remission from an exacerbation and its duration. For example, 85% will usually improve spontaneously from an exacerbation that lasts one week, but only 7% will improve after an exacerbation lasting one to two years. Over time, a series of exacerbations and remissions may result in a gradual accumulation of irreversible changes and disability.
There are factors that may be predictive of the course of the disease. An earlier age at onset may mean a more benign course. If, at onset, symptoms are sensory, the course of the disease may be less severe, while motor symptoms (weakness or poor coordination) at onset may be predictive of greater disability. Again, as with everything to do with this disease, variation is extreme and the course and progression of the disease is unpredictable.
Treatment
There is no cure for multiple sclerosis. There are claims that the number or degree of exacerbations can be reduced and that life expectancy can be extended. Many promising modes of treatment are being developed and tested but most remain experimental. An enormous amount of research is currently being done on the causes and processes of multiple sclerosis, and understanding of the disease continues to increase.
Here is an article that suggests infection with parasites may have a protective effect against MS relapses. A steady rise in autoimmune diseases such as multiple sclerosis (MS) has been noted in recent decades, and environmental factors could be the cause of this increase. One theory, similar to the “hygiene hypothesis” in which an excessively germ-free environment may contribute to an increase in allergies, holds that a decline in infectious diseases may play a role in increasing autoimmune disease incidence. The first study examining the relationship between parasite infections and MS in humans suggests that such infections may affect the immune response in a way that alters the course of MS.
Previous studies involving animals have shown that parasite infection can influence the course of autoimmune diseases. These studies suggest that individuals with parasite infections have a diminished T cell response when unrelated antigens (foreign substances that generate an immune response) are present. The current study, conducted by Jorge Correale, M.D., and Mauricio Farez, B.Sc., of the Raúl Carrea Institute for Neurological Research in Buenos Aires, Argentina, involved 12 patients with MS who also had a parasite infection, 12 controls with MS who were uninfected, and 12 healthy individuals. The two groups of MS patients had a similar disease course. Patients had a neurological exam every three months and a brain MRI every 6 months, while immunological evaluations were conducted during the last 12 to 18 months of the study. Patients were followed for an average of 4.6 years.
During the study period, there were three clinical relapses of MS in the infected group and 56 relapses in the uninfected group. Only two infected patients showed minimal Expanded Disability Status Score changes (EDSS is used to measure disability due to MS) that lasted less than three months, while the other 10 had no changes in EDSS scores. In the uninfected group, 11 patients showed an overall increase in EDSS. Since MS involves an inflammatory response associated with the production of certain regulatory proteins known as cytokines, the number of cells producing cytokine suppressants was measured and found to be significantly higher in infected patients.
Because parasites inhabit their hosts for long periods of time, they can develop molecules that generate strong anti-inflammatory responses, which enhance their survival. Further investigation is warranted in order to identify which molecules cause immune system effects that dampen the inflammatory reactions normally seen in autoimmune diseases, the authors note. They conclude that “induction of a regulatory anti-inflammatory network generated by persistent parasite infections may offer a potential explanation for environment-related suppression of MS development in areas with low disease prevalence.”
Researchers have found a promising new treatment that may be successful in slowing or stopping the progress of multiple sclerosis. The discovery, called the “DNA Vaccine” was developed without using any embryonic stem cells.
According to the report by Citizen Link, the treatment works by manipulating a person’s DNA, so it will reduce the attack on the “protective coating” around nerve fibers in the brain – which is caused by MS.
Dr. Amit Bar-Or explained, “The idea of these DNA-vaccine approaches would be to modulate or suppress just those cells that you might consider the bad guys cells, while sparing the rest of the immune system.”
“Unethical science tends to be a poisoned fruit,” added David Prentice, senior fellow for life sciences at Family Research Council. “You don’t need to go that direction. The adult stem cells and these other nonembryonic types of treatments are the ones where the real success happens.” (August 16, 2007)
Signs, symptoms & indicators of Multiple Sclerosis / Risk
Low lymphocyte count
Poor tolerance of heat
Damaged nerve fibers have a strongly diminished tolerance for heat. Increases as little as 0.1 degrees centigrade can decrease conduction or cause blockage, which will result in the appearance of symptoms.
Poor bodily coordination
Fatigue on light exertion
Demyelinated nerve fibers use more energy to conduct impulses and thus fatigue more easily than normal fibers. MS involves large numbers of nerve fibers in a state of borderline function, which suddenly turn off when the body temperature is elevated only one or two degrees. The signals suddenly cease to be transmitted, and one has to stop. Muscles that have been weakened result in a reliance on stronger muscles, which then tire faster. One recent report indicates that for those with MS the energy cost of walking is two to three times that of a normal person over the same distance. Such an increased use of energy obviously results in increased fatigue. The fatigue of MS is hard to describe.
Involuntary eyeball movement
Vision disturbances
Poor vision or being nearly blind
Being an incoherent speaker
Emotional instability
Individual weak muscles
Gait disorders varying from an inability to walk the usual distance to an inability to walk at all are the principal problems of patients with MS.
Hand tremors
(Severe/history of) muscle cramp/twitching
Numb/tingling/burning extremities
Paresthesia can be caused by disorders affecting the central nervous system, such as multiple sclerosis, transverse myelitis, and encephalitis.
Conditions that suggest Multiple Sclerosis / Risk
Counter Indicators
Gout / Hyperuricemia
It has been reported that MS (possibly associated with low uric acid) and gout (associated with high uric acid) are mutually exclusive. A study of 20 million Medicare and Medicaid records found no overlap between MS and gout.
Vertigo
Vertigo, vestibular and cerebellar ataxia and proprioceptive dysfunction are all relatively commonly seen in multiple sclerosis.
Risk factors for Multiple Sclerosis / Risk
Having an increased risk of MS
People with a family history of MS and those who live in a geographical area with a higher incidence rate for MS have a higher risk of the disease.
Uric Acid Levels Low
It has been proposed – and research is supporting the idea – that low uric acid levels are associated with increased frequency and longer bouts of multiple sclerosis. Uric acid works by inactivating peroxynitrite, a toxic compound that may cause damage to the central nervous system in MS patients. Researchers report that they found lower levels of uric acid in the blood of MS patients than of people without the disease. It appears that high serum uric acid levels protect against the development of MS. These results raise the possibility that the natural biologic product, uric acid, or a more soluble peroxynitrite scavenger that penetrates the blood brain-barrier more readily might have clinical utility in the treatment of MS. [Proceedings of the National Academy of Sciences 1998;95: pp.675-680]
Having white matter lesions
Patients with a first neurologic event consistent with demyelination and multiple white-matter brain lesions on MRI have a 5-year risk of MS of about 60%. The MRI as a marker of disease severity in MS. The MRI burden (number and size of white-matter lesions on MRI) correlates weakly with the clinical status of MS. The MRI also can detect attacks of demyelination that have no obvious clinical correlate. Nonetheless, MRI remains an excellent measure of disease severity and progression.
Counter Indicators
Absence of white matter lesions
Although the brain MRI may be normal in MS, this is an uncommon finding. In patients with an initial neurologic event consistent with CNS demyelination and a normal MRI, the 5-year risk of MS is less than 5%.
Stress
Stress appears to play a big part in the development of MS. A study suggested the stress that results from losing a child increases your chances of developing multiple sclerosis by 50%. Since it is believed severe cases of stress play a role in the development of MS, the severe stress caused to parents who lost a child make them likely candidates to study.
The study followed the parents for an average of 9.5 years. The risk was the same regardless of the age or sex of the child or parent. The cause of MS is not known and the average age of diagnosis is 30, but researchers believe that genetics and environment play a key role. [Neurology March 9, 2004; p.62, 76]
Vitamin D Requirement
The possibility that vitamin D could help protect people from developing multiple sclerosis (MS) has been posited by researchers in recent decades, but evidence to support that link has been scant. In the first large-scale, prospective study to investigate the relationship between vitamin D levels and MS, researchers at the Harvard School of Public Health (HSPH) have found an association between higher levels of vitamin D in the body and a lower risk of MS. The study appears in the Journal of the American Medical Association, December 31, 2006.
EFA (Essential Fatty Acid) Type 3 Requirement
Polyunsaturated omega-3 fatty acid deficiency may contribute to depressive symptoms in alcoholism, multiple sclerosis and postpartum depression.
It is interesting to note that the incidence of MS is quite low in Japan, where consumption of marine foods, seeds, and fruit oil is quite high. These foods contain abundant polyunsaturated fatty acids, including the omega-3 oils (alpha-linolenic, eicosapentaenoic, and docosahexanoic acids). Deficiencies of the omega-3 oils are thought to interfere with lipid elongation and permanently impair formation of normal myelin.
(History of/high) solvent exposure
A study showed that painters had almost double the risk of receiving a disability pension because of MS than a combined group of construction and food processing workers. Researchers believe the findings indicate that exposure to organic solvents might increase the risk of developing MS. [Epidemiology November 2002;13: pp.718-720]
Multiple Sclerosis / Risk suggests the following may be present
Low Progesterone or Estrogen Dominance
Progesterone has been shown in animal studies to promote the formation of new myelin sheaths [Human Reproduction 2000 Jun;15 Suppl 1: pp.1-13, J Steroid Biochem Mol Biol 1999 Apr-Jun;69 pp.97-107, Mult Scler 1997 Apr;3 pp.105-12]
Physicians have known for years that pregnancy can suppress some forms of immune response, such as allergies. In the early and mid-1980s, several doctors observed that MS patients had fewer symptoms during pregnancy and post-partum recovery. This may be due to the high progesterone level in the blood of a pregnant woman. Progesterone tends to be anti-inflammatory. Progesterone therapy may therefore be useful for MS especially as a medical report noted the association between enlarged adrenal glands and MS. Progesterone, being a steroid, often helps the adrenals deal with inflammation.
Other studies have indicated that symptoms are worse during periods when the progesterone to estrogen ratio is low.
Stress
Stress appears to play a big part in the development of MS. A study suggested the stress that results from losing a child increases your chances of developing multiple sclerosis by 50%. Since it is believed severe cases of stress play a role in the development of MS, the severe stress caused to parents who lost a child make them likely candidates to study.
The study followed the parents for an average of 9.5 years. The risk was the same regardless of the age or sex of the child or parent. The cause of MS is not known and the average age of diagnosis is 30, but researchers believe that genetics and environment play a key role. [Neurology March 9, 2004; p.62, 76]
Vitamin D Requirement
The possibility that vitamin D could help protect people from developing multiple sclerosis (MS) has been posited by researchers in recent decades, but evidence to support that link has been scant. In the first large-scale, prospective study to investigate the relationship between vitamin D levels and MS, researchers at the Harvard School of Public Health (HSPH) have found an association between higher levels of vitamin D in the body and a lower risk of MS. The study appears in the Journal of the American Medical Association, December 31, 2006.
Vitamin B1 Requirement
Dr. Fred Klenner, MD pioneered the use of injectable thiamine (vitamin B1) and injectable liver extract for the treatment of multiple sclerosis. His experience and that of others is that early treatment is important in producing symptomatic relief and a state of well-being.
EFA (Essential Fatty Acid) Type 3 Requirement
Polyunsaturated omega-3 fatty acid deficiency may contribute to depressive symptoms in alcoholism, multiple sclerosis and postpartum depression.
It is interesting to note that the incidence of MS is quite low in Japan, where consumption of marine foods, seeds, and fruit oil is quite high. These foods contain abundant polyunsaturated fatty acids, including the omega-3 oils (alpha-linolenic, eicosapentaenoic, and docosahexanoic acids). Deficiencies of the omega-3 oils are thought to interfere with lipid elongation and permanently impair formation of normal myelin.
Multiple Sclerosis / Risk can lead to
Vertigo
Vertigo, vestibular and cerebellar ataxia and proprioceptive dysfunction are all relatively commonly seen in multiple sclerosis.
Multiple Sclerosis / Risk could instead be
Lyme Disease
Lyme Disease has been called “The New Great Imitator”, a replacement for that old “great imitator” neurosyphilis. The two diseases share so many symptoms that Lyme disease should be ruled out if multiple sclerosis diagnosis is in question.
Recommendations for Multiple Sclerosis / Risk
Glutamine
Of particular concern is the finding that people with multiple sclerosis have increased levels of the enzyme glutaminase (the enzyme that converts glutamine into glutamate) in areas of nerve fiber damage. High levels of glutamine in the diet would increase glutamate levels near these injured areas magnifying the damage. It has been shown that excitotoxicity plays a major role in multiple sclerosis by destroying the cells (oligodendrocytes) that produce myelin. Russell L. Blaylock, M.D.
Fish Oil / Krill
Please also see the article about the approach that Fred Klenner, MD used with MS.
Glandular / Live Cell Therapy
2008. A preliminary study on the use of stem cells obtained from a patient’s own adipose tissue in the treatment of multiple sclerosis (MS) has shown promising results.
The three case studies, described in BioMed Central’s open access Journal of Translational Medicine support further clinical evaluation of what are known as stromal vascular fraction (SVF) cells in MS and other autoimmune conditions.
Thomas Ichim, from Medistem Inc., and Dr. Boris Minev, from the Division of Neurosurgery, University of California San Diego, worked with a team of researchers to demonstrate the possible effectiveness of SVF cells in MS treatment.
Minev said, “All three patients in our study showed dramatic improvement in their condition after the course of SVF therapy. While obviously no conclusions in terms of therapeutic efficacy can be drawn from these reports, this first clinical use of fat stem cells for treatment of MS supports further investigations into this very simple and easily-implementable treatment methodology.”
According to Minev, “None of the presently available MS treatments selectively inhibit the immune attack against the nervous system, nor do they stimulate regeneration of previously damaged tissue. We’ve shown that SVF cells may fill this therapeutic gap.”
Minev and his colleagues provided the SVF treatment to three patients with MS. The first had suffered frequent painful seizures for the previous three years; after treatment he reported that the seizures had stopped completely and that he had seen significant improvements in his cognition and a reduction of spasticity in his arms and legs.
The second patient reported improvements in his sense of balance and coordination, as well as an improved energy level and mood. The final patient had been diagnosed with MS in 1993. After SVF treatment in 2008, his gait, balance and coordination improved dramatically over a period of several weeks. According to Minev, “His condition continued to improve over the next few months and he is currently reporting a continuing improvement and ability to jog, run and even bicycle.”
Thymic Factors
Through his clinical experiences with thymic supplementation, Dr. Burgstiner said he observed 10 cases of multiple sclerosis go into remission.
Ginkgo Biloba
Three months of treatment with a Ginkgo biloba product (240 mg/d) maintained attention, memory and functioning, without adverse effects, in double-blind, placebo-controlled study of 23 patients with mild multiple sclerosis. Deterioration of function was observed in patients who had received a placebo. [American Academy of Neurology 54th Annual Meeting, April 13-20, 2002, Denver, Colorado, USA; P06.081]
Chocolate Avoidance
Epidemiology studies have documented a correlation between high cocoa consumption and high MS incidence. When cocoa is introduced to an area, MS incidence rises sharply. Cases are reported in which chocolate ingestion by MS patients was followed by exacerbations [Maas AG, Hogenhuis LAH. Multiple sclerosis and possible relationship to cocoa: A hypothesis. Ann Allergy 59: pp.76- 9, 1987]
Here is the abstract of this article: “The hypothesis presented in this paper suggests that MS may be caused by an allergic or other adverse reaction to certain foods, mostly cocoa products, cola, and coffee. Many MS patients have one or more manifestations of other well known reactions to those foods, such as migraine, urticaria, or gastrointestinal disturbances.”
Monounsaturated Oils
A minimum of 20gm (4 teaspoons) and a maximum of 50gm (10 teaspoons) per day is recommended as part of the Swank Diet for Multiple Sclerosis sufferers. Persons with MS should use mainly olive oil (monosaturated fat) in conjunction with fish oils to provide most of their fat intake.
Vegetarian/Vegan Diet
A vegan/vegetarian diet satisfies several of the requirements set out in the Swank Diet for Multiple Sclerosis. When the disease is treated early in its course, dietary measures can provide dramatic improvement. The dietary regimens which contain the most pro-inflammatory food types (e.g. gluten, dairy, saturated fat) and the least anti-inflammatory nutrients ( vitamin D, omega 3 fats) occur in areas in which MS and other autoimmune diseases are most common.
Animal/Saturated Fats Avoidance
Dr. Roy Swank has provided convincing evidence that a diet low in saturated fats over a long period of time can slow down and in some cases stop the degenerative process in multiple sclerosis. The Swank diet calls for:
Fried Foods Avoidance
The Swank diet includes strict avoidance of fried food and trans-fatty acids.
Dairy Products Avoidance
Avoid dairy products containing 1% butterfat or more. This is part of the Swank Diet for Multiple Sclerosis sufferers.
Increased Fish Consumption
The Swank diet includes eating fish at least 3 times per week. Alternately, fish oils could be substituted at 1500mg three or more times per week.
Sugars Avoidance / Reduction
Multiple Sclerosis is a disease of stress. Certain foods aggravate stress including the 5 C’s (candy, chocolate, cookies, cake, and cocktails).
Conventional Drugs / Information
A form of bacteria seems to be the organic cause of multiple sclerosis, claims a Dr. Hoekstra, MD. Its tentative name – not yet widely accepted by other microbiologists – is Borrelia mylophora, so named because its characteristics seem to resemble those of Borrelia burgdorferi, the bacteria believed responsible for Lyme disease. In cases of multiple sclerosis, the myelin sheath covering the nerves gets eaten away by the immune system, explains Dr. Hoekstra. “That is exactly like the hunters’ torches setting fire to the forest. Most of the destruction of the myelin sheath takes place from actions of the white blood cells and their antibodies. But their primary target is not the myelin sheath at all. It’s the Borrelia mylophora bacteria, running around in the nervous system. B. mylophora has an extremely high affinity for the myelin sheath. It loves it.”
The successful use of doxycycline against B. mylophora was first verified by a physician in South Dakota who reasoned that the symptoms of MS (which he had) were suggestively similar to those of Lyme disease, which responds fairly well to doxycycline. After dosing himself for three months with the antibiotic, he was symptom free. However, the long-term use of antibiotics has many drawbacks, cautions Dr. Hoekstra. It seriously damages the ecology of intestinal microflora and can lead to a condition of microbial imbalance called dysbiosis. This in turn can be the foundation for numerous diseases. It can also facilitate the growth of more cell wall deficient forms. To counteract this, probiotic replacement is required.
Researchers from the Medical University of South Carolina have produced the first clinical evidence that statins can help in multiple sclerosis in an article in The Lancet (May 2004).
A group of 30 patients with MS given 80mg a day of Zocor, or simvastatin, had a 44 percent reduction in brain lesions after three months of treatment, their study showed. Brain lesions are areas of inflammation, and are markers of the progression and severity of MS — a debilitating disease in which nerve cells lose their insulating sheath, leading to muscle weakness, fatigue, bladder problems and impaired vision.
Professor Chris Polman, an MS expert at the VU Medical Center in Amsterdam said more research was needed, including a large placebo-controlled clinical trial.
Tysabri was withdrawn in 2005 by Biogen Idec Inc. and Elan Corp. PLC, only months after it had been approved. The Food and Drug Administration has allowed testing to resume after the company said no more cases of the brain disease had emerged.
The new studies found that Tysabri alone or with standard interferon treatment cut the rate of relapse by as much as two-thirds after two years and reduced the number of people whose MS got worse, compared to those on a dummy treatment or interferon alone.
Tysabri was highly anticipated because it works in a different way than existing drugs, which offer only modest help. It blocks destructive immune cells from leaving the bloodstream and entering the brain to inflame and damage nerve tissue.
The studies “confirm that this drug is a significant advance for MS treatment,” said Dr. Allan H. Ropper of Boston’s Caritas St. Elizabeth’s Medical Center, who wrote an editorial in the journal. [NEJM March 1, 2006]
An useful pair of studies in the journal Neurology show that the sleep disorder drug called Provigil (modafinil) is not helpful to MS patients suffering from fatigue, while the common pain-reliever aspirin might be. While two earlier pilot studies had shown modest positive benefit from Provigil, this 56-person study showed the effect on fatigue to be indistinguishable from placebo. Meanwhile, a 30-person trial showed that aspirin did reduce fatigue compared to placebo.
Drs. Steven R. Schwid of the University of Rochester, New York, and T. Jock Murray of Dalhousie University in Halifax, Nova Scotia, observe that “until we make progress in distinguishing fatigue from other MS symptoms, in identifying its mechanisms and in measuring it accurately, we will not make substantial progress in treating this disabling symptom.”
In a crossover study, a daily dose of 1,300mg of aspirin was tested against a placebo in 30 patients. The effects were evaluated using the Modified Fatigue Impact Scale (MFIS), which is a self-reported measure of fatigue using interviews with patients about fatigue levels and impact of fatigue on daily activities. People taking the aspirin scored significantly better on the MFIS than those on placebo. The mechanism for aspirin in reducing fatigue is unknown.
According to Dr. Wingerchuk, one of the lead investigators, the results of aspirin treatment for fatigue were similar to those achieved by Symmetrel, which is about 40% effective in relieving MS fatigue in some studies.
Patients must be monitored for GI bleeding at this elevated dose of aspirin.
LDN - Low Dose Naltrexone
According to Dr. Bihari, LDN clearly halts the progression of multiple sclerosis.
The Promise Of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders. By Elaine Moore, co-author SammyJo Wilkinson Foreword by Dr. Yash Agrawal, MD, PhD.
This is perhaps the first, and so far only book on LDN, and as such represents a milestone in the effort to bring LDN into mainstream use. Written by Elaine Moore, a high level science writer with a portfolio of previous accomplishments, her LDN book is perhaps somewhat technical and may be difficult for the untrained non-professional to follow. It delves into the sophisticated jargon of the medical research world. For example, in Chapter 5 on LDN and Cancer, there is a discussion of Zagon’s work on Cyclin dependent kinases, P53 and protein 21 and how this relates to inhibition of cancer by LDN.
However, in addition to the esoteric technical sections of the book, there are also chapters devoted to the lay reader interested in learning how LDN can help them on a practical level. A listing of dispensing practitioners was included which I found contained my own office address and phone number.
The book is highly recommended for other health care practitioners who wish to get quickly up to speed in this new area of medicine which is destined to become the medical paradigm of the 21st century, casting a giant shadow over the rest of mainstream medicine.[ Comments on the LDN book by Jeffrey Dach MD]
Aerobic Exercise
A 1996 study of people with mild to moderate disability from MS demonstrated clear benefit. Regular aerobic exercise increased fitness, arm and leg strength, workout capacity, and improved the participants’ bowel and bladder control. People in the study also reported reduced depression, fatigue, and anger. Other studies have shown that exercise can combat the loss of fitness caused by a sedentary lifestyle and be therapeutic for such MS-related problems as spasticity and poor balance.
Low-level aerobic training in MS improves not only quality of life but also coordinative function and physical fitness. [J Neurol Sci. 2004 Oct 15;225(1-2):11-8]
Estrogen Replacement
In a small-scale, early-phase trial of the hormone estriol, a form of estrogen, women with relapsing-remitting multiple sclerosis showed decreases in MRI-detected brain lesion activity and immune responses during treatment.The six participants with relapsing-remitting MS experienced significant decreases in brain lesion numbers and volume, as well as a reduction in levels of immune proteins indicative of inflammation. When estriol treatment was stopped, lesion numbers returned to pre-treatment levels, and then decreased again when estriol treatment was resumed. During treatment, cognitive function scores improved significantly in women with relapsing-remitting MS. Women with secondary-progressive MS did not improve significantly during the course of the trial. [Annals of Neurology 2002;52: pp.421-428]
Histamine
Dr. George Gillson, M.D., Ph.D., reports that after six weeks of treatment with histamine in 19 individuals with multiple sclerosis
ACTH (Adrenocorticotropic Hormone)
One hormone which has been shown to shorten the duration and intensity of acute exacerbations is adrenocorticotropic hormone (ACTH), a pituitary gland substance that stimulates the adrenal glands to produce additional cortisone, which acts to reduce the inflammation in the brain or spinal cord. ACTH does not affect the underlying disease processes but may diminish the frequency and severity of exacerbations and even slow the progression of the disease.
Pregnenolone
Animal studies indicate that pregnenolone may aid in repairing the degeneration of the myelin sheath, the cause of Multiple Sclerosis. Further studies are required to determine if there is any benefit for humans with MS.
Test for B12 Levels
The first step when you receive a diagnosis of multiple sclerosis is to determine if you really have it. A vitamin B12 deficiency has very similar symptoms and is frequently misdiagnosed as MS; the type of anemia resulting from B12 deficiency is called pernicious anemia. [Hosp Pract (Off Ed) 1995 Jul 15;30(7): pp.47-52; discussion 52, 54]
Additionally, researchers found in 45 MS patients that vitamin B12 levels were significantly lower in those who experienced the onset of first neurological symptoms prior to age 18 years (10 patients) compared to patients in whom the disease first manifested after age 18 (35 patients). In contrast, serum folate levels were unrelated to age of onset of the disease. As vitamin B12 levels were statistically unrelated to chronicity of illness, these findings suggest a specific association between the timing of onset of first neurological symptoms of MS and vitamin B12 metabolism. In addition, since vitamin B12 is required for the formation of myelin and for immune mechanisms, a deficiency in MS is of critical pathogenetic significance. [PMID: 8407160, UI: 94011702]
Test Uric Acid Levels
Reports from researchers suggest that low uric acid levels are associated with increased frequency and longer bouts of multiple sclerosis. Uric acid levels should be monitored and, if low, raised by supplemental molybdenum and reducing any copper toxicity.
Calcium-2AEP
Calcium EAP protects the myelin sheath from damage by an autoimmune response. Dr. Nieper has found an EAP deficiency state in people with immune dysfunctional diseases, and says that all cell membranes in such people are defective. He claims this defect can be blocked with supplemental EAP.
Reading List
The Multiple Sclerosis Diet Book by Roy Swank and Barbara Dugan is a classic regarding the dietary treatment of Multiple Sclerosis. The revised version describes the history, symptoms, and treatment of multiple sclerosis, and contains many new recipes for a low-fat diet that is designed to alleviate the progressive effects of MS.
Also see the link between MS and Reading list for information about The Promise Of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders. By Elaine Moore, co-author SammyJo Wilkinson Foreword by Dr. Yash Agrawal, MD, PhD.
Essential Fatty Acids
The Swank diet includes a blend of 40-50gm per day of essential fatty acids as well as at least 1 teaspoon of cod liver oil per day. Please also see the article about the approach that Fred Klenner, MD used with MS.
Lecithin / Choline / GPC
Please also see the article about the approach that Fred Klenner, MD used with MS.
Acupuncture
Acupuncture treatments for Multiple Sclerosis have had much success in reducing pain and decreasing spasticity. Another area of success is improved bladder and bowel control. The reduction of stress and the improved feeling of well being contribute to an improvement in quality of life. The acupuncture treatments must be given frequently in order to maintain the improvements of symptoms, but Multiple Sclerosis is known for its cycles of remission. During periods of remission, the frequency of the acupuncture treatments can be reduced.
A Canadian study involved a survey of 217 people with MS who used acupuncture. The preliminary findings from this study indicate that approximately two-thirds reported some type of beneficial effect. Improvement was noted in many symptoms, including fatigue, pain, spasticity, walking difficulties, bowel and bladder difficulties, tingling and numbness, weakness, sleep disorders, incoordination, optic neuritis, and MS attacks (arranged from most-reported to least-reported). Approximately 10% experienced side effects, the most common of which were pain, soreness at the needle site, and worsening of some symptoms (fatigue, spasticity, dizziness, and walking unsteadiness).
Stress Management
See the link between Stress and MS.
Surgery
(Canada – May 2008)—Reuters reports that Multiple Sclerosis (MS) patients who received bone marrow stem-cell transplants in a study by Canadian researchers have mysteriously gone into remission.
Dr. Mark Freedman of the University of Ottawa, who is not sure why they went into remission, said: “Not a single patient, and it’s almost seven years, has ever had a relapse.”
Originally, Freedman was said to have set up an experiment in which doctors destroyed the bone marrow (and thus the immune systems of MS patients); then blood-forming stem cells taken from the bone marrow were transplanted back into the patients.
“We weren’t looking for improvement,” said Freedman, who was quoted as saying once MS is diagnosed it’s too late. “We figured we would reboot the immune system and watch the disease evolve. It failed.” Instead, he noted, improvements actually began to show up two years after the treatment.
“We have yet to get the disease to restart,” he added, noting that “those with a lot of inflammation going on were the most likely to benefit (from the treatment).”
Vitamin B1 (Thiamine)
See the link between MS and Vitamin B1 Need.
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin D
An abundance of scientific evidence indicates that vitamin D deficiency is associated with MS onset and progression. Small clinical trials have suggested that vitamin D has some efficacy in slowing autoimmune disease progression although no properly controlled trials have been conducted.
Vitamin D can be readily attained from exposure to sunlight and studies have shown that the optimal intake of vitamin D is about 4000 – 6000IU a day. This results in a circulation concentration of 25(OH)D of 100 – 125 nmol/litre and this level seems to be required for the proper functioning of all vitamin D-dependent systems. In colder, low sunlight areas such an intake from the sun is impossible for most of the year and it is important to use supplements to makeup the shortfall in vitamin D supply. A daily supplement of 4000IU of vitamin D3 seems warranted for people who do not get a lot of exposure to sunlight throughout the year.
Researchers have found women who eat a diet rich in vitamin D may reduce their chances of developing rheumatoid arthritis (RA) and multiple sclerosis (MS). Two studies involving women have shown proof of the vitamin’s benefits.
The RA study followed 29,368 women aged 55 to 69 years, and the MS study looked at more than 185,000 women. The participants were given questionnaires to fill out about their dietary habits and vitamin D intake at the beginning of each study, and researchers followed up with the women every four years for up to 20 years. They discovered that women were 30 percent less likely to develop RA, and 40 percent less likely to develop MS, when taking the recommended daily amount or more of vitamin D.
Out of 100 people worldwide, one or two will develop RA and around 0.04 percent have MS. Both of these conditions are thought to occur when the body’s immune system turns against itself. Researchers suggest that vitamin D may work by calming overactive immune cells.
Responding to this study, vitamin D experts advise future researchers studying vitamin D levels to administer a blood test to read the levels more accurately, and cautioned that this study did not use the best way to determine vitamin D levels in the participants. [Neurology January, 2004 13;62(1):60-5, Arthritis & Rheumatism January, 2004;50(1):72-7]
Please see the link between MS and vitamin D deficiency for a 2006 study supporting this connection.
Vitamin B12 (Cobalamine)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin B6 (Pyridoxine)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin C (Ascorbic Acid)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin B3 (Niacin)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin B2 (Riboflavin)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Vitamin B5 (Pantothenic Acid)
Please also see the article about the approach that Fred Klenner, MD used with MS.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
Glossary
Nervous System
A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.
Multiple Sclerosis
Demyelinating disorder of the central nervous system, causing patches of sclerosis (plaques) in the brain and spinal cord, manifested by loss of normal neurological functions, e.g., muscle weakness, loss of vision, and mood alterations.
Myelin
A substance made of protein and lipid (fat) that protects the nerves, especially in the brain. The myelin sheath is a jacket of insulation around axons to help them conduct their electrical discharges quickly down the axon.
White Blood Cell
(WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.
Virus
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Autoimmune Disease
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
MRI
Magnetic Resonance Imaging. A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.
Subclinical
Not manifesting characteristic clinical symptoms. Pertaining to a disease or condition.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Parasite
An organism living in or on another organism.
Allergy
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Antigen
A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.
Cytokines
Cytokines are chemical messengers that control immune responses. They are secreted by white blood cells, T cells, epithelial cells and some other body cells. There are at least 17 different kinds of interleuken and 3 classes of interferon called alpha, beta and gamma and various subsets. Interleukens and interferons are called “cytokines” and there are two general groupings, Th1 and Th2. Th1 (T-cell Helper type 1) promote cell-mediated immunity (CMI) while Th2 (T-cell Helper type 2) induce humoral immunity (antibodies).
Anti-inflammatory
Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.
Immune System
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.
DNA
Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.
Paresthesia
A skin sensation, such as burning, prickling, itching, or tingling, with no apparent physical cause.
Gout
A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.
Vertigo
The sensation of spinning or whirling; a state in which you or your surroundings seem to whirl dizzily.
Ataxia
Failed muscular coordination, irregular muscular action.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
CNS
Central Nervous System.
Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.
Polyunsaturated
Polyunsaturated fats or oils. Originate from vegetables and are liquid at room temperature. These oils are a good source of the unsaturated fatty acids. They include flaxseed with added vitamin B6 (pyridoxine), sunflower oil, safflower oil, and primrose oil.
Fatty Acids
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Postpartum Depression
The "baby blues" are a very frequent and completely normal consequence of childbirth, usually wearing off soon afterwards as hormonal and psychological systems get back to normal. Postpartum depression is a less common but severe depression that begins in the weeks following delivery. It impairs the ability of the mother to care for the child and fall in love with it. This makes her feel even more depressed and inadequate thinking that she can not be a good mother. At the extreme, postpartum depression may lead to dangerous delusions (for example, thinking the baby is in some way deformed or cursed) or hallucinations (that may command violent acts). This can occasionally result in a tragic episode of suicide and/or infanticide.
Lipid
Fat-soluble substances derived from animal or vegetable cells by nonpolar solvents (e.g. ether); the term can include the following types of materials: fatty acids, glycerides, phospholipids, alcohols and waxes.
Epidemiology
The study of the causes and distribution of disease in human populations.
Steroid
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Estrogen
One of the female sex hormones produced by the ovaries.
Thiamine
(Vitamin B-1): A B-complex vitamin that acts as a coenzyme necessary for the conversion of carbohydrates into glucose, which is burned in the body for energy. It is essential for the functioning of the nervous system.