Multiple Sclerosis

Many of us have family members or friends affected by multiple sclerosis (MS) and we know the kind of toll it can take, not only on the MS sufferer, but on the whole family.

In North America and Europe MS is the most common disabling neurologic disease, affecting young and middle-aged adults, typically between the ages of 20 and 40. As in other autoimmune diseases, MS is significantly more common (at least two to three times more) in women than in men.

What it is

MS is an inflammatory disease of the nervous system in which the insulating myelin sheaths surrounding nerve fibres are damaged by the body’s own immune system. MS commonly exhibits a pattern of remissions and relapses. The severity of the disease also varies, from mild and manageable to severe and permanently disabling.

What causes it

For many years researchers explored the possibility that a virus or other infection might be the underlying cause of MS. Although many infectious agents have been associated with MS, including Epstein-Barr virus, canine distemper, measles, herpes, chlamydia, and others, there is currently no compelling evidence demonstrating a conclusive link between MS and any virus.

Who gets it

MS is more common in Caucasians. Identical twins have a much greater chance of both having the disease than fraternal twins, suggesting a genetic component. Gender clearly affects the susceptibility and course of the disease.

MS is far more prevalent in women, possibly due to the effects of sex chromosomes and steroid hormones on the immune system and central nervous systems (CNS). It is well known that the disease improves significantly during late pregnancy, and these improvements have been linked to hormonal changes (including vitamin D levels).

Both clinical and experimental studies indicate that sex steroid supplementation may be beneficial for MS. This could be related to anti-inflammatory actions on the immune system or CNS and to direct protective properties of such hormones on the nervous system.

Natural therapies

Although there is no known cure for MS at this time, several natural therapies appear promising to decrease the damaging inflammation that mediates the disease in the nervous system.

Diet low in saturated fats
Pioneered by Dr. Roy Swank, a diet that is low in saturated fats has reportedly helped many people with MS. By reducing intake of animal fats (including dairy products), peanut butter, and hydrogenated oils, MS sufferers were able to significantly reduce their symptoms, particularly if they began following the diet early on in the course of their disease.

Unfortunately, because Dr. Swank did not employ a comparison group or placebo in his study design, many researchers have since questioned his results; however, it is well known that such a diet is linked to a decreased risk of heart disease and certain cancers.

Omega-3 fatty acids
Omega-3 fatty acids, as from fish oil, have been used to reduce inflammation in a variety of autoimmune diseases. Preliminary research has shown that MS patients taking 9.6 grams per day of fish oil (containing 2.9 grams of EPA and 1.9 grams of DHA) experienced a 58 percent decrease in a key inflammatory mediator called MMP after three months, though no significant differences in quality of life were observed. Longer, controlled studies on the effects of omega-3 fatty acids on clinical outcomes in MS are warranted.

Alpha lipoic acid (ALA)
An antioxidant that acts to regenerate other antioxidants in the body, such as glutathione, ALA is known to cross the blood brain barrier and to be active in the central nervous system. Although there are no controlled clinical trials of ALA for MS, animal research suggests that the nutrient may limit the passage of inflammatory lymphocytes into the spinal cord, which could have potential benefits for people with MS. Further research is needed.

Vitamin D
Areas with high sunlight exposure have a relatively low prevalence of MS and vice versa. Since sunlight is the main inducer of vitamin D synthesis in the skin, researchers have suggested that vitamin D deficiency could be a factor in the development of the disease.

Preventive daily supplementation with vitamin D appears to be among the most promising alternative therapies for MS. (See "Recommended vitamin D intake", below). One large study found that vitamin D supplementation was associated with a 40 percent reduction in the risk of developing MS, and four small, uncontrolled studies found that vitamin D supplementation could decrease worsening of symptoms.

Recommended vitamin D intake

The current recommendations for vitamin D intake were established in 1997 and are currently under review by the Institute of Medicine (funded jointly by the US and Canadian governments).

—Source: Health Canada (hc-sc.gc.ca)

Sources of vitamin D

• Fish oil (cod liver oil is an excellent source)
• Salt water fish (herring, salmon, and sardines)
• Fortified foods (such as margarine, butter, and cereal)
• Egg yolks
• Veal
• Beef
• Butter
• Some vegetable oils

Importance of vitamin D

The only clearly defined function of vitamin D is to maintain blood levels of calcium and phosphorus in a range that supports cellular processes, neuromuscular function, and bone formation. Without vitamin D, the body would be unable to utilize calcium from the diet, which is why many calcium supplements contain vitamin D.

Vitamin D also appears to be important for the development of muscle strength, immunity, secretion of insulin, and the development of blood-forming cells.

At any age, vitamin D deficiency will impair normal bone formation, most commonly occurring after winter, because of restricted sunlight exposure. Vitamin D deficiency is also more common in strict vegetarians, people with dark skin, alcoholics, people with liver or kidney disease, people with intestinal malabsorption syndromes, and in women with hyperthyroidism or MS.

Symptoms

MS symptoms can vary, depending upon which nerves are affected, and include:

• Numbness and tingling in the extremities, trunk, or on one side of the face
• Muscle weakness
• Loss of coordination of a leg or hand
• Visual disturbances
• Fatigue easily
• Difficulty walking
• Difficulty with bladder control
• Vertigo
• Mood disturbances