Multiple Sclerosis : by Ray Sahelian, M.D., Natural treatment

Multiple Sclerosis information by Ray Sahelian, M.D. Natural treatment for multiple sclerosis

Nerve fibers inside and outside the brain are wrapped with many layers of insulation called the myelin sheath. Much like the insulation around an electrical wire, the myelin sheath permits electrical impulses to be conducted along the nerve fiber with speed and accuracy. When myelin is damaged, nerves don't conduct impulses properly. Multiple sclerosis is a disorder in which the nerves of the eye, brain, and spinal cord lose patches of myelin. IgG antibodies to the myelin oligodendrocyte glycoprotein appear to participate in the more severe type of multiple sclerosis.
Children who spend more time in the sun have a lower risk for developing multiple sclerosis as adults.Something in relation to sunlight and/or vitamin D exposure during childhood may play a protective role.

Natural Treatment for Multiple Sclerosis MS
At this point 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, if at all. We also have little idea how these supplements interact with medicines currently used for multiple sclerosis. My aim is to just mention the research regarding the role some nutrients may play in this condition. If you have multiple sclerosis, make your doctor aware of some of these preliminary studies, and perhaps he or she would want to monitor you while you give them a try. There is no definite proof yet that these supplements will help. Much more research is needed before natural options are considered. 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, 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.

Alpha lipoic acid has been helpful in a mouse study and recently showed biochemical marker improvement in a human trial. A dose of 10 to 25 mg of R lipoic acid may be appropriate. Most R lipoic capsules come in 50 mg, so, opening a capsule and taking a portion is one option.
Carnitine has been found helpful in reducing fatigue in patients with multiple sclerosis.
Curcumin blocks the progression of multiple sclerosis in a laboratory study.
Fish Oil capsules and ginkgo biloba have shown intriguing preliminary evidence of efficacy.
Flavonoids may be helpful
Consider Vitamin D.
Nicotinamide has been studied in rodents.
Yoga is helpful

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Alpha lipoic acid and multiple sclerosis
Lipoic acid in multiple sclerosis: a pilot study.
Multiple Sclerosis. 2005 Apr;11(2):159-65. Yadav V, Marracci G, Lovera J, Woodward W, Bogardus K, Marquardt W, Shinto L, Morris C, Bourdette D. Department of Veterans Affairs Medical Center, Portland, OR
Alpha Lipoic acid is an antioxidant that suppresses and treats an animal model of multiple sclerosis, experimental autoimmune encephalomyelitis. The purpose of this study was to determine the pharmacokinetics (PK), tolerability and effects on matrix metalloproteinase-9 (MMP-9) and soluble intercellular adhesion molecule-1 (sICAMP-1) of oral Alpha Lipoic acid in patients with multiple sclerosis. Thirty-seven multiple sclerosis subjects were randomly assigned to one of four groups: placebo, Alpha Lipoic acid 600 mg twice a day, Alpha Lipoic acid 1200 mg once a day and Alpha Lipoic acid 1200 mg twice a day. Subjects took study capsules for 14 days. We found that subjects taking 1200 mg Alpha Lipoic acid had substantially higher peak serum Alpha Lipoic acid levels than those taking 600 mg and that peak levels varied considerably among subjects. We also found a significant negative correlation between peak serum Alpha Lipoic acid levels and mean changes in serum MMP-9 levels. There was a significant dose response relationship between Alpha Lipoic acid and mean change in serum sICAM-1 levels. We conclude that oral Alpha Lipoic acid is generally well tolerated and appears capable of reducing serum MMP-9 and sICAM-1 levels. Alpha Lipoic acid may prove useful in treating multiple sclerosis by inhibiting MMP-9 activity and interfering with T-cell migration into the CNS.
Caution: High dosages of alpha lipoic acid may cause heart rhythm problems. Use less than 30 mg of R alpha lipoic acid.

Nicotinamide and Multiple Sclerosis
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. In mice with the MS-like disease EAE, nicotinamide treatment profoundly prevents the degeneration of axons already showing signs of degeneration. Daily under-the-skin injections of nicotinamide in the EAE mouse also prevents inflammation of the axons and loss of myelin -- the underlying problem in MS -- and delays the onset and severity of disability.
Nicotinamide had beneficial effects even when treatment was delayed until 10 days after the induction multiple sclerosis -like disease, when most of the animals had clear signs of neurologic disability, hinting that it may have an impact at later stages of multiple sclerosis. The Journal of Neuroscience, September 20, 2006.

Carnitine and multiple sclerosis
Levocarnitine administration in multiple sclerosis patients with immunosuppressive therapy-induced fatigue.
Mult Scler. 2006 Jun;12(3):321-4. Department of Neurology, Hôpital Pasteur, 30 voie romaine, 06002 Nice, France.
The aim of this prospective open-labelled study was to collect and study serum carnitine levels in MS patients with and without disease-modifying treatment-induced fatigue syndrome. Treatment consisted of oral levocarnitine, 3-6 g daily. All patients achieved normal plasma carnitine levels. For 63% of patients treated with immunosuppressive or immunomodulatory therapies, oral l-carnitine adjunction decreased fatigue intensity, especially in patients treated with cyclophosphamide and interferon beta.
Comments: In the real world, 500 mg or maximum 1000 mg of l-carnitine should be sufficient.

Vitamin D and Multiple sclerosis
Vitamin D3 appears to be helpful in several diseases, including multiple sclerosis. High doses of vitamin D may be required for therapeutic efficacy. Patients with mulptle sclerosis can take enough vitamin D to double their blood levels of vitamin D without the concern of causing hypercalcemia or hypercalciuria.

Multiple Sclerosis Symptoms and Signs
The term multiple sclerosis comes from the multiple areas of scarring (sclerosis) that represent many patches of demyelination in the nervous system. 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. Yoga helps reduce fatigue in patients with multiple sclerosis. Brain fog occurs in multiple sclerosis with 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.

How common is multiple sclerosis?
Multiple sclerosis is one of the most common causes of neurological disability in young and middle-aged adults. About 400,000 Americans, mostly young adults, have multiple sclerosis.

Possible triggers for multiple sclerosis
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. Those with multiple sclerosis should avoid excessive body heat elevation such as sauna, whirlpool, sun bathing or spending time outdoors in high heat.
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.

Multiple Sclerosis Cause - Sun Exposure?
A 27-year-old white woman with a history of multiple sclerosis was found dead lying on a lounger, clad in a bathing suit. She had been sunbathing for 4 hours. Autopsy findings consisted of numerous variably sized demyelinated plaques involving the periventricular cerebral white matter and cerebellum. 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. This case illustrates that a modestly increased core body temperature, even from a usually innocuous activity such as sunbathing, may be fatal in patients with multiple sclerosis.

Multiple sclerosis diagnosis
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.

Multiple Sclerosis Treatment - Medical therapy
Injectable beta-interferon, a relatively new multiple sclerosis treatment, reduces the frequency of relapses. Other promising multiple sclerosis treatments still under investigation include other interferons, oral myelin, and glatiramer to help keep the body from attacking its own myelin. The benefits of plasmapheresis and intravenous gamma globulins haven't been established, and these treatments aren't practical for long-term therapy.
Corticosteroids such as prednisone taken by mouth or methylprednisolone given intravenously for short periods to relieve acute symptoms have been the main form of therapy for decades. Treatment with high-dose steroids for multiple sclerosis and other disorders may impair long-term memory, according to a report in the medical journal Neurology. The good news is that mental functioning usually returns to normal a few days after stopping the drug.
Multiple sclerosis treatment with cannabinoids may help prevent episodes of urge incontinence. Treatment with Marinol, a synthetic version of cannabinoid chemicals found in marijuana, can reduce the pain often experienced by people with multiple sclerosis.

Multiple Sclerosis Betasteron treatment
December 2006 - Berlex, Inc., a U.S. affiliate of Schering AG, Germany, announced that the U.S. Food and Drug Administration (FDA) has expanded the indication of Betaseron (interferon beta-1b) to include patients with multiple sclerosis who have experienced a first clinical episode and have MRI features consistent with multiple sclerosis. Betaseron is indicated for the treatment of relapsing forms of multiple sclerosis to reduce the frequency of clinical exacerbations. Betaseron is the only high-dose, high-frequency interferon beta indicated for patients at the earliest stage of multiple sclerosis. The new indication is based on results from the BENEFIT (BEtaseron in Newly Emerging multiple sclerosis for Initial Treatment) Study of patients with a first clinical demyelinating event and MRI features suggestive of multiple sclerosis. The two-year study showed that treatment with Betaseron delayed the time to a second clinical event by one year compared to placebo(1). BENEFIT is the only trial to demonstrate the efficacy of a high dose, high frequency interferon beta, Betaseron, as an effective treatment for patients with early MS. In addition to establishing efficacy in this group of patients, the study also showed that patients with early multiple sclerosis found Betaseron to be a safe and well- tolerated treatment, as evidenced by the findings that 93% of patients completed the study.

Multiple Sclerosis - Tysabri Drug Treatment
Tysabri, a drug made by Biogen Idec and Elan Pharmaceuticals, significantly reduces the rate of disease progression in patients with relapsing multiple sclerosis. The available drugs for multiple sclerosis, interferon and Copaxone, have been shown to reduce relapse rate by one third. The effectiveness of Tysabri appears to be good, and possibly better than that of the other available drugs. However, a review of more than 3000 patients treated with Tysabri (which is known as natalizumab, generically) reveals that the drug is associated with a small risk of a serious neurological disease called progressive multifocal leukoencephalopathy or PML.
June 2006 - FDA has approved an application that will allow withdrawn multiple sclerosis drug Tysabri to be marketed again. The drug was initially approved in 2004 but taken off the market in 2005 after three patients in clinical trials developed progressive multifocal leukoencephalopathy (PML), a rare brain infection. FDA is allowing the drug to be reintroduced with a patient registration program designed to minimize PML risks.
March 2006 - A panel of independent experts unanimously urged the U.S. return of Biogen Idec's multiple sclerosis drug Tysabri, a medicine abruptly pulled from the market last year after it was linked to a life-threatening side effect. If the Food and Drug Administration follows the recommendation, it would signal a reversal of fortune for Biogen and partner Elan Corp. of Ireland, and a victory for some multiple sclerosis patients who have pleaded for access to the medicine. The advisory panel said Tysabri must have mandatory controls to ensure that patients are aware of risks and that any new cases of a possibly fatal brain infection are found quickly. All 12 members voted in favor of resuming Tysabri sales. Biogen and Elan voluntarily suspended Tysabri sales in February 2005 after three patients developed the infection known as progressive multifocal leukoencephalopathy, or PML. Two of them died.

Multiple Sclerosis and Pregnancy
Pregnant women being treated with beta-interferon, a drug used to fight multiple sclerosis and other diseases, face an increased risk of miscarriage or having a low birthweight baby.

Seasonal Variations of Multiple Sclerosis Symptoms
Investigators in Japan have found that multiple sclerosis symptoms were more common in the warmest (July and August) and coldest (January and February) months.

Multiple Sclerosis MS Human Research Update
A randomized crossover study of bee sting therapy for multiple sclerosis.
[Wesselius T and others. Neurology 65:1764-1768, 2005]
Bee sting therapy found ineffective against multiple sclerosis. A 24-week study of 26 patients with relapsing-remitting or relapsing secondary progressive multiple sclerosis has found no benefit from bee-sting therapy. Live bees were used to administer bee venom three times per week. The treatment did not reduce disease activity, disability, or fatigue and did not improve quality of life.

Contrary to what the "hygiene hypothesis" suggests, the youngest children in a family are not less likely than older siblings to develop multiple sclerosis.

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.

Clinical implications of benign multiple sclerosis: A 20-year population-based follow-up study.
Department of Neurology, Mayo Clinic, Rochester, MN.
Ann Neurology. 2004 Aug;56(2):303-6.
In 2001, we followed up all patients from the 1991 Olmsted County Multiple Sclerosis prevalence cohort. We found that the longer the duration of multiple sclerosis and the lower the disability, the more likely a patient is to remain stable and not progress. This is particularly powerful for patients with benign multiple sclerosis with Expanded Disability Status Scale score of 2 or lower for 10 years or longer who have a greater than 90% chance of remaining stable. This is important because these patients represent 17% of the entire multiple sclerosis prevalence cohort. These data should assist in the shared therapeutic decision-making process of whether to start immunomodulatory medications.

Randomized controlled trial of yoga and exercise in multiple sclerosis.
Neurology. 2004 Jun 8;62(11):2058-64.
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. CONCLUSION: 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.

Vitamin D intake and incidence of multiple sclerosis MS.
Munger KL. Harvard School of Public Health, Boston, MA
Neurology. 2004 Jan 13;62(1):60-5.
A protective effect of vitamin D on risk of multiple sclerosis has been proposed, but no prospective studies have addressed this hypothesis. Dietary vitamin D intake was examined directly in relation to risk of multiple sclerosis in two large cohorts of women: the Nurses' Health Study (NHS; 92,253 women followed from 1980 to 2000) and Nurses' Health Study II (NHS II; 95,310 women followed from 1991 to 2001). Diet was assessed at baseline and updated every 4 years thereafter. During the follow-up, 173 cases of multiple sclerosis with onset of symptoms after baseline were confirmed. RESULTS: The pooled age-adjusted relative risk (RR) comparing women in the highest quintile of total vitamin D intake at baseline with those in the lowest was 0.67. Intake of vitamin D from supplements was also inversely associated with risk of multiple sclerosis; the RR comparing women with intake of >or=400 IU/day with women with no supplemental vitamin D intake was 0.59. No association was found between vitamin D from food and multiple sclerosis incidence. CONCLUSION: These results support a protective effect of vitamin D intake on risk of developing multiple sclerosis.

Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study.
Multiple Sclerosis. 2003 Aug;9(4):356-61.
To evaluate the effect of reflexology on symptoms of multiple sclerosis in a randomized, sham-controlled clinical trial. METHODS: 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. RESULTS: 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. Improvement with borderline significance was observed in the differences in mean scores of muscle strength between the reflexology group and the controls. The improvement in the intensity of paresthesias remained significant at three months of follow-up. CONCLUSIONS: Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in multiple sclerosis patients.

Omega-3 fatty acids in inflammation and autoimmune diseases.
Simopoulos AP. The Center for Genetics, Nutrition and Health, Washington, DC
J Am Coll Nutr. 2002 Dec;21(6):495-505.
Among the fatty acids, it is the omega-3 polyunsaturated fatty acids (PUFA) which possess the most potent immunomodulatory activities, and among the omega-3 PUFA, those from fish oil-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)--are more biologically potent than alpha-linolenic acid (ALA). Some of the effects of omega-3 PUFA are brought about by modulation of the amount and types of eicosanoids made, and other effects are elicited by eicosanoid-independent mechanisms, including actions upon intracellular signaling pathways, transcription factor activity and gene expression. Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and, therefore, might be useful in the management of inflammatory and autoimmune diseases. Coronary heart disease, major depression, aging and cancer are characterized by an increased level of interleukin 1 (IL-1), a proinflammatory cytokine. Similarly, arthritis, Crohn's disease, ulcerative colitis and lupus erythematosis are autoimmune diseases characterized by a high level of IL-1 and the proinflammatory leukotriene LTB(4) produced by omega-6 fatty acids. There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

Vitamin D: a natural inhibitor of multiple sclerosis.
Hayes CE. University of Wisconsin-Madison, 433 Babcock Drive, Madison, Wisconsin
Proc Nutr Soc. 2000 Nov;59(4):531-5.
Inheriting genetic risk factors for multiple sclerosis is not sufficient to cause this demyelinating disease of the central nervous system; exposure to environmental risk factors is also required. multiple sclerosis may be preventable if these unidentified environmental factors can be avoided. Multiple sclerosis prevalence increases with decreasing solar radiation, suggesting that sunlight may be protective in multiple sclerosis. Since the vitamin D endocrine system is exquisitely responsive to sunlight, and multiple sclerosis prevalence is highest where environmental supplies of vitamin D are lowest, we have proposed that the hormone, 1, 25-dihydroxycholecalciferol (1,25-(OH)2D3), may protect genetically-susceptible individuals from developing multiple sclerosis. Evidence consistent with this hypothesis comes not only from geographic studies, but also genetic and biological studies. Over-representation of the vitamin D receptor gene b allele was found in Japanese MS patients, suggesting it may confer multiple sclerosis susceptibility. Fish oil is an excellent vitamin D source, and diets rich in fish may lower MS prevalence or severity. Vitamin D deficiency afflicts most MS patients, as demonstrated by their low bone mass and high fracture rates. However, the clearest evidence that vitamin D may be a natural inhibitor of multiple sclerosis comes from experiments with experimental autoimmune encephalomyelitis (EAE), a model of MS. Treatment of mice with 1,25-(OH)2D3 completely inhibited EAE induction and progression. The hormone stimulated the synthesis of two anti-encephalitogenic cytokines, interleukin 4 and transforming growth factor beta-1, and influenced inflammatory cell trafficking or apoptosis. If vitamin D is a natural inhibitor of multiple sclerosis, providing supplemental vitamin D to individuals who are at risk for MS would be advisable.

Multiple Sclerosis Animal Studies
Clinical and experimental study on multiple sclerosis with bushen gusui tablet]
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001 Jan;21(1):10-4.
To observe the therapeutic effect of Bushen Gusui tablet in treating multiple sclerosis and its effects on experimental allergic encephalomyelitis (EAE) in guinea pigs. METHODS: Forty-three multiple sclerosis patients were treated with Bushen Gusui and their clinical symptoms, signs of nerve function, recurrent frequency, evoked potential and changes in magnetic resonance imaging (MRI) were observed. RESULTS: Bushen Gusui could improve symptoms and signs of multiple sclerosis patients and reduce recurrent frequency. The total effective rate was 88.37%. High dose Bushen Gusui could obviously inhibit inflammatory reaction of brain and spinal cord as well as demyelination, and simultaneously inhibit the activity of serum IL-2, IL-6, TNF in comparing with model group. There were insignificant difference as compared with prednisone acetate group. CONCLUSION: Bushen Gusui had certain effect on both multiple sclerosis patients and EAE model animals, which indicated that it was worth further studying and clinical application.

Alpha lipoic acid inhibits T cell migration into the spinal cord and suppresses and treats experimental autoimmune encephalomyelitis.
Marracci GH. regon Health and Science University, Portland, OR 97201, USA.
J Neuroimmunol. 2002 Oct;131(1-2):104-14.
Oxidative injury may be important to the pathogenesis of multiple sclerosis. We tested the antioxidant alpha lipoic acid in an experimental murine model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE). Alpha lipoic acid was administered to SJL mice 7 days after immunization with proteolipid protein (PLP) 139-151 peptide. Mice that received 5-100 mg/kg/day of alpha lipoic acid had dose-dependent reductions in their 10-Day Cumulative Disease Scores (10-Day CDS) by 23-100%. Minimal inflammation, demyelination and axonal loss occurred in the spinal cords (SC) of alpha lipoic acid-suppressed mice, and there was a marked reduction in CD3+ T cells and CD11b+ monocyte/macrophage cells within the SC. Mice treated with alpha lipoic acid (100 mg/kg/day) commencing on the first day of clinical EAE had a significant reduction in 10-Day CDS. SC of alpha lipoic acid-treated mice had reduced demyelination and axonal loss and a rapid reduction in CD3+ T cells. In vitro, alpha lipoic acid and its reduced form, dihydrolipoic acid, inhibited the activity of matrix metalloproteinase-9 (MMP-9) in a dose-dependent fashion. Alpha lipoic acid is highly effective at suppressing and treating EAE and does so by inhibiting T cell trafficking into the SC, perhaps by acting as a matrix metalloproteinase inhibitor.

Multiple Sclerosis Laboratory Studies
Alpha lipoic acid inhibits human T-cell migration: implications for multiple sclerosis.
J Neurosci Res. 2004 Nov 1;78(3):362-70.
Marracci GH, McKeon GP, Marquardt WE, Winter RW, Riscoe MK, Bourdette DN.
Portland Veterans Affairs Medical Center, Portland, Oregon
We have demonstrated previously the ability of the antioxidant alpha lipoic acid (ALA) to suppress and treat a model of multiple sclerosis, relapsing experimental autoimmune encephalomyelitis (EAE). We describe the effects of ALA and its reduced form, dihydrolipoic acid (DHLA), on the transmigration of human Jurkat T cells across a fibronectin barrier in a transwell system. ALA and DHLA inhibited migration of Jurkat cells in a dose-dependent fashion by 16-75%. ALA and DHLA reduced matrix metalloproteinase-9 (MMP-9) activity by 18-90% in Jurkat cell supernatants. These data, coupled with its ability to treat relapsing EAE, suggest that ALA warrants investigation as a therapy for multiple sclerosis.

Flavonoids inhibit myelin phagocytosis by macrophages; a structure-activity relationship study.
Biochem Pharmacol. 2003 Mar 1;65(5):877-85.
Demyelination is a characteristic hallmark of the neuro-inflammatory disease multiple sclerosis. During demyelination, macrophages phagocytose myelin and secrete inflammatory mediators that worsen the disease. Here, we investigated whether flavonoids, naturally occurring immunomodulating compounds, are able to influence myelin phagocytosis by macrophages in vitro. The flavonoids luteolin, quercetin and fisetin most significantly decreased the amount of myelin phagocytosed by a macrophage cell line without affecting its viability. IC(50) values for these compounds ranged from 20 to 80 microM. The capacity of the various flavonoids to inhibit phagocytosis correlated well with their potency as antioxidant, which is in line with the requirement of reactive oxygen species for the phagocytosis of myelin by macrophages. Our results implicate that flavonoids may be able to limit the demyelination process during multiple sclerosis.

Curcumin inhibits experimental allergic encephalomyelitis by blocking IL-12 signaling through Janus kinase-STAT pathway in T lymphocytes.
J Immunol. 2002 Jun 15;168(12):6506-13.
Experimental allergic encephalomyelitis (EAE) is a CD4(+) Th1 cell-mediated inflammatory demyelinating autoimmune disease of the CNS that serves as an animal model for multiple sclerosis. IL-12 is a proinflammatory cytokine that plays a crucial role in the induction of neural Ag-specific Th1 differentiation and pathogenesis of CNS demyelination in EAE and multiple sclerosis. Curcumin is a naturally occurring polyphenolic 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. In this study we have examined the effect and mechanism of action of curcumin on the pathogenesis of CNS demyelination in EAE. In vivo treatment of SJL/J mice with curcumin significantly reduced the duration and clinical severity of active immunization and adoptive transfer EAE. Curcumin inhibited EAE in association with a decrease in IL-12 production from macrophage/microglial cells and differentiation of neural Ag-specific Th1 cells. These findings highlight the fact that curcumin inhibits EAE by blocking IL-12 signaling in T cells and suggest its use in the treatment of multiple sclerosis and other Th1 cell-mediated inflammatory diseases.

Alpha Lipoic Acid and Multiple Sclerosis
In the last issue of the newsletter I mentioned that nutritional or herbal therapies for medical conditions were a century behind the times compared to the advances we have made in surgery. As most of you know, this is because there is little incentive to do research on supplements since they cannot be patented. So, it's nice and surprising when nutritional research is done in the United States as in the case of scientists from the Department of Veterans Affairs Medical Center, Portland, Oregon, who tried to learn more about the role of Alpha Lipoic Acid in multiple sclerosis.
Alpha Lipoic Acid (ALA) is a powerful antioxidant. Thirty-seven multiple sclerosis subjects were given alpha lipoic acid 1200 mg a day for 14 days. The results were positive. ALA was able to lower levels of two markers for multiple sclerosis called MMP-9 and CAMP-1. The researchers say, "ALA may prove useful in treating multiple sclerosis by inhibiting MMP-9 activity and interfering with T-cell migration into the CNS." MMP-9 is a matrix metalloproteinase substance which is high in multiple sclerosis patients. MMP-9 has been implicated in the pathogenesis of cancer, autoimmune disease, and various pathologic conditions characterized by excessive fibrosis. The fact that ALA was able to reduce it is a positive indication.
My comments: I'm fascinated by the possibilities of nutritional substances in altering the course of chronic medical conditions for which modern medicine does not have good options. Although this study in no way says ALA will be a cure or long term benefit for those with multiple sclerosis, it does open the door for further exploration. I think the dose of 1200 mg is extremely high, and I would not recommend more than 50 mg a day of R-Alpha Lipoic Acid for long term use.

Multiple Sclerosis Drug Treatment
Natalizumab is the first alpha 4 integrin antagonist in a new class of selective adhesion-molecule inhibitors. Natalizumab reduces the risk of the sustained progression of disability and the rate of clinical relapse in patients with relapsing multiple sclerosis. Adhesion-molecule inhibitors hold promise as an effective treatment for relapsing multiple sclerosis.

Multiple Sclerosis Emails
Q. Could bee propolis help someone who suffers from multiple sclerosis? What about a multiple sclerosis diet?
A. We don't know. We haven't seen any studies regarding the association between bee propolis and multiple sclerosis although flavonoids in bee pollen could theoretically be beneficial. As to a multiple sclerosis diet, again I really don't know at this time what foods would help or not help.

Q. My husband has been diagnosed with Multiple Scleroses five years ago. It took a toll on his body and mind. My husband is taking an injection of Avonex once a week. Needless to say, our love life went from great to almost non existent. A friend talked to me about your product Passion Rx and suggested we should give it a try. I thought, at worst the only thing I could lose would be the cost of the product. So I placed an order, I received my Passion Rx and started giving it to my husband, who at first was reluctant to take it. Much to our surprise, he started feeling the positive effects of Passion Rx approximately one week later. He was taking one capsule every other day. We now enjoy a healthy, longer lasting and full filling love life once more. Thank you for putting forth the effort of finding natural remedies, that people who do have to be on medication can also take.

Q. Dear Dr. Sahelian, the information you provide on your website in very informative and outstanding! I have recommended your website to so many people within the last week you would think I'm making a profit. ! The reason I am writing is to inquire if Inositol would be a good supplemental for people who are suffering from Multiple Sclerosis. I read through the multiple sclerosis research that has already been performed but didn't see any clinical trials that have been conducted with diseases such as multiple sclerosis. I await an answer from your Superb Team.
A. Thank you for the positive feedback. In March 2007 we searched Medline and could not find any clinical trials using inositol for the treatment of multiple sclerosis.

Q. I have been diagnosed with multiple sclerosis. I want to try bushen gusui tablets, but cant seem to find them anywhere. Can you tell me where I can get these tablets?
A. You may consider asking a Chinese Medicine doctor or a Chinese herb shop, we can't seem to find it.

Q. I experienced the diagnosis of multiple sclerosis in 1967, and began yoga in 1970. The practice of yoga, and assurance from research that myelin can regenerate spontaneously, enabled me to recover full function after every episode of disease activity. My book is called Black Patent Shoes Dancing With MS, copyright 1989. You will find a PUBMED review of the work of Robert Keith Wallace PhD RE: yoga, meditation and consciousness informative.
Wallace has authored numerous papers and 2 books The Neurophysioogy of Enlightenment copyright 1986 and
Physiology of Consciousness copyright 1993. Another important work is Molecules of Emotion by Dr Candace Pert
copyright 1997, In health, Eva Marsh Meng BSc.

Q. I was recently diagnosed with remitting relapsing multiple sclerosis. I would like to know the best supplements and herbs to take to rebuild the myelin. Any information you could give me would be helpful. I am a firm believer in alternative health.
A. We will update this site on natural supplements or alternative treatment for multiple sclerosis as more research is published.

Q. This question is in regards to High Dose Thiamine to treat Multiple Sclerosis; The Dr. Klenner Protocol; using Thiamine and Niacin; with vitamin B12 and Vitamin C etc. My friend is a 58 year old lady with advanced multiple sclerosis has tried everything. Vitamins; Minerals; antibiotics prescriptions; nothing has helped her; she is on LDN today, Low Dose Naltrexone. I do not recommend LDN to people because no research done. I was informed of The Dr. Klenner Protocol by a rep. from Twin Lab. I think Dr. Sahelian has the best website; easy to read and very informative. I was taking Sam-d and i didn't feel right; so I read the article reduced my dose and I am fine.
A. I am not familiar with the Dr. Klenner protocol for the treatment of multiple sclerosis with vitamins.

Q. I just wanted to drop a brief positive comment on the Source Naturals Vitamin B Coenzyme product in relation to Multiple Sclerosis. I love this product. After reading an article on multiple sclerosis and Nicotinamide, I tried taking a couple different brands of Nicotinamide. I didn't care for them. Then, I saw that NAD (nicotinamide adenine dinucleotide 10 mg) was available in the Vitamin B Coenzyme product. I found this product immediately very beneficial. Is it just the natural vitamin B effects? Or is the NAD providing direct protection against my multiple sclerosis symptoms? That's hard to say, of course. But I have found this product invaluable, and I haven't had a multiple sclerosis attack since I've been on it. Also, I feel I've used it to "fend off" attacks. That said, I haven't had an MRI in quite a while. When you're doing well, you aren't motivated to get them. All of this could be coincidental. However, you may want to research this product and consider recommending on your multiple sclerosis page under your comments on Nicotinamide. According to the article on Nicotinamide, the protection provided by NAD was dose dependent, and would require tons more than the small 10 mg I am taking to match what the mice were given. Still, I can't deny the positive benefits it seems to provide, even if my comments are anecdotal and unproven by a trial.
I cut the Coenzyme B vitamin tablet into quarters, so I can take a quarter every few hours. It's a sort of makeshift time-release pill. Finally, I also take SAM-e with the Coenzyme B vitamin. Too much SAM-e gives me insomnia, so I moderate to a couple days on, and a couple off. But the combination of SAM-e with the Coenzyme B vitamin makes my body extremely efficient. I have a high metabolism and can burn through food fast, but this combination allows me to maintain balance which appears to be good for reducing my multiple sclerosis.