Multiple Sclerosis

Multiple Sclerosis

        Natural treatment and nutritional factors to consider in treatment

Multiple sclerosis (MS) is an often debilitating (and sometimes fatal) neurological disorder that strikes more than a quarter of a million people in the United States each year. The symptoms of MS often first appear in early adulthood and can include numbness, impaired vision, weakness, loss of balance, and bladder dysfunction. Fatigue is a common early symptom. Depression is more common in people who have MS than in the general population. In recent years, scientists have made dramatic advances in understanding and treating this enigmatic disease. Holistic and complementary practitioners have also added natural therapies which can provide exceptional support to the quality of life for MS patients.

What Causes MS?

        While it's unclear exactly what causes MS, researchers have made progress in understanding the underlying chemical reactions that occur during MS. In recent years, nitric oxide has been implicated in the development of MS. In the vascular system, nitric oxide acts as a dilator, expanding arterial walls and lowering blood pressure. In the central nervous system, however, nitric oxide generates free-radical byproducts that contribute to myelin destruction and the loss of nerve function (Smith KJ et al 2002). The picture is complicated, however, by the fact that nitric oxide also has good effects in MS, including modulating the immune system (Smith KJ et al 2002). Studies hoping to manipulate nitric oxide production have yielded mixed results in people who have MS. Research is ongoing.

        Researchers have identified a number of factors that are associated with MS. It is unlikely that MS has any single cause. Rather, it appears that a multitude of factors likely work together to trigger and exacerbate the disease. These include:

Genetic disorders.

        Studies examining the incidence of the disease in the general population, in families, and in twins support a genetic component to MS. However, no single gene has been identified that determines susceptibility to the disease; rather, a number of genes are believed to be involved. About one quarter of all people who have MS have a relative who is also afflicted with the disease

Studies of identical twins show that MS occurs in both twins in about 25 percent to 35 percent of cases. This finding suggests that up to 75 percent of MS must be attributable to nongenetic factors and that the contribution of genetics is actually relatively minor. It appears that, in addition to genetically predisposing factors, external triggers must be encountered in order for the disease to be initiated. These triggers activate the immune system to identify myelin as a nonself molecule and sets in motion the inflammatory cascade that ultimately ends in destruction of the myelin sheath.

Infectious agents

        Various infectious agents have been proposed as triggers for MS. There is significant data that infection is involved in both the initiation of the disease and in damage to the nerves. Several organisms have been proposed as potential triggers, including human herpesvirus type 6, Mycoplasma pneumoniae, and the relatively common primitive bacterium Chlamydia pneumoniae, among others. In addition, virtually all people who have MS are infected with the Epstein-Barr virus, which is widespread in the general population. Epstein-Barr virus causes the childhood illness infectious mononucleosis. Some researchers believe that a dual infection with a retrovirus and the Epstein-Barr virus may serve as a trigger.

Environmental toxins

        Exposure to chemical toxins, such as organic solvents and pesticides, has been suggested as another possible MS trigger. Similarly, exposure to heavy metals, such as mercury, has been implicated in MS. Mercury is believed to be one of the most toxic of all nonradioactive elements; it is widely known to affect neurological tissue. Recently, researchers in the Czech Republic removed mercury-containing amalgam dental fillings from patients who had autoimmune diseases, including MS. On follow-up, the patients who had MS in particular experienced an improvement in their symptoms after the procedure. This suggests that mercury, which is known to leach out of such fillings, may play an adverse role in the disease. Other studies have also found a possible link between mercury exposure from dental fillings and the incidence of MS. This idea is controversial because there is also data supporting the position that mercury from dental amalgam fillings is not a health threat.

Organic solvents

        In the mid 1990s, researchers in Sweden evaluated 13 studies on the connection between solvent exposure and autoimmune disease between 1966 and 1994. Organic solvents include chemicals such as toluene, paint thinner, and acetone, the latter of which is commonly found in nail polish remover. Ten of those studies indicated a significant relationship between organic solvent exposure and MS. All the analyses suggested that exposure to solvents increases a person's relative risk of developing MS.

More recently, a team of scientists in Norway analyzed the occupational health records of more than 57,000 workers in their country, covering a 16-year period. They concluded that workers (such as painters) who were routinely exposed to organic solvents had a significantly greater incidence of MS than men and women who were not occupationally exposed to solvents. These results were compatible with the hypothesis that organic solvents are a possible risk factor for MS.

Vitamin D's Benefits

        In addition to reducing the risk of developing MS, supplemental vitamin D may also provide relief for those actively afflicted with the disease. Scientists have also discovered that vitamin D effectively blocks development of MS in animals. When the biologically active, hormone form of vitamin D was administered to animals in a laboratory, the disorder was prevented. Conversely, a deficiency of vitamin D tended to increase the animals' susceptibility to the induced disease. When animals were given vitamin D after developing the disease, progression of symptoms was blocked. When vitamin D supplementation was withdrawn, the disease resumed.

Hormone Imbalances and MS

        In recent years, researchers have made great progress understanding how hormone status affects autoimmune disorders, including MS. Numerous studies have observed that MS is more common in women, and that the disease course is affected by the normal ebb and flow of steroid hormones during a woman's monthly menstrual cycle. Interestingly, it is also well known that pregnancy tends to neutralize the disease course, or even positively affect it, enabling women who have MS to bear children safely.

These findings point to the important role of steroid hormones in influencing the course of the disease. This theory makes even more sense considering that sex steroid hormones such as estrogen, testosterone, progesterone, and dehydroepiandrosterone (DHEA) are known to have immunomodulatory effects. Hoping to better understand the role of hormones in MS, a number of researchers have conducted studies. Their findings include: In a study on rats, researchers found that animals given progesterone alone experienced greater motor defects and inflammation than rats treated with estrogen. The negative effects of progesterone were negated when estrogen was added.
        Administering estrogen (including estriol and beta-estriol) along with progesterone was shown to inhibit production of nitric oxide in central nervous system cells. This effect was enhanced when the levels of estrogen and progesterone were maintained at levels found during late pregnancy.
        Estriol treatment significantly reduced disease severity in animals with MS, while treatment with progesterone had no effect. Administering estriol until treatment levels reached levels consistent with those in late pregnancy completely ameliorated the disease.
        During a human study that examined the presence of MS lesions by magnetic resonance imaging (MRI), patients with high estradiol and low progesterone levels had more lesions that those who had low levels of both hormones, while patients with a high estrogen to progesterone ratio had a significantly greater number of active lesions than patients who had a low ratio.
        According to a recent review, more studies are needed to determine the exact relationship between MS and hormonal imbalances.DHEA also deserves attention in people of both sexes who have MS. DHEA is a steroid hormone. Altered levels of DHEA have been associated with various autoimmune diseases and their symptoms, including MS . One study found that people with MS have relatively lower DHEA levels compared to healthy control subjects and that, at least in animals, DHEA therapy reduces T-cell proliferation, secretion of pro-inflammatory chemicals, and nitric oxide synthesis. Similarly, researchers have found that people with MS have a higher ratio of cortisol (the body's main stress hormone) to DHEA than do healthy control subjects, although this is probably a symptom of the disease rather than a causal factor.

Hormonal therapy with bioidentical hormones may also be considered, especially in women. Numerous studies have shown that hormone levels that approximate late pregnancy can reduce the severity of MS, although there is controversy surrounding this idea, and studies have shown a rebound effect in MS symptoms after pregnancy.

        Recent advances in the understanding and treatment of MS have improved the prognosis and quality of life of MS patients. People with MS have a substantial ability to affect the course of their illness. By adhering to a proper diet; avoiding toxins (such as solvents or heavy metals) and known triggers; getting mild, regular exercise; taking recommended supplements; and working with qualified physicians, it is possible to positively affect the course of this frustrating disease.

Supplements that have been studied in animals and people with MS include:

Vitamin D
EPA/DHA
GLA
DHEA
NAC
Vitamin E
CoQ10
R-Lipoic acid
Vitamin B12 (Methyl B12)