An integrated approach to Multiple sclerosis
There is evidence of alternative & complementary therapies working to support treatment in Multiple Sclerosis (MS).
Ongoing research is being undertaken by the National Institutes for Health in the USA (1A) I provide references to my statements here and you may also choose to review the Vitasearch site link (4) that lists published studies on natural and environmental issues surrounding multiple sclerosis.
There are a considerable number of studies on non-conventional therapies that do not enter conventional treatment because they lack evidence of efficacy. This is in part because studies are simply not performed on natural, un-patentable, non-commercially beneficial therapies but I consider that ‘A lack of evidence is not evidence of a lack of effectiveness. It reflects a lack of research’.
MS is predominantly considered an autoimmune disease (1, 2, 3) which, is a lable which does not fully reflect underlying cause as it does not explain what causes the autoimmunity. Please see my Autoimmunity Document attached that explains the theoretical causes of autoimmunity and, possibly therefore, the underlying cause of MS.
Conventional medicine may be greatly beneficial and provide short and long-term benefits. These tend to focus on therapies that supress or modulate immune response or suppress inflammation. I strongly emphasise that you should never substitute alternative treatment as replacement therapy prescribed by your specialists.
Integrated therapy combines natural therapies with conventional treatment. The main difference is the importance given to finding the underlying cause such as infection, toxicity, or an underlying trigger of autoimmunity. This may include investigation into chronic infection (14,25) or toxicity (14a). There is clear association of toxins of all sorts as a cause of MS. Mercury, lead, arsenic, nickel and organic solvents and other environmental toxicity are all sited as possibly associated with demyelinating diseases, such as MS (1,13).
A specific mention needs to be made of stress. Stress is both psychological (anxiety, depression, fear, sadness etc) and physical (lack of sleep, lack or too much exercise, ‘free-radical’ or oxidation by toxins such as smoking) All illnesses cause physical stress responses. Little research has been done into how acute or chronic (long-term) stress might influence myelination, but evidence is mounting (15,16).
In complementary and functional medicine, the focus is on trying to return dysfunctional cells back to normal function. That process involves investigation into underlying cause and the prescribing of natural therapies that may influence immunity, detoxification, and increased healing rate of damaged tissues.
Although a lack of research leaves science stating that more studies are needed, there is evidence regarding antioxidant deficiencies being associated with multiple sclerosis and of possible benefit in therapy (18). The antioxidants Glutathione and Alpha-Lipoic acid (23,24). are of particular interest. Similarly, B12 and Folic acid are of benefit (19) as are treatment with essential fatty acids and phospholipids, important in the formation of nerves and their function. (20)
The evidence of benefit of healthy and balanced bowel flora in MS is clear (22). Good bowel flora is necessary to maintain blood-brain barrier integrity (according to research on animals as human studies have not been done) and this is known to be associated with many nerve conditions including MS (21).
An important body of work in understanding multiple sclerosis is the association of the disease with mitochondrial dysfunction. Mitochondria are small parts of cells that combine oxygen and nutrients to form energy. Dysfunctional mitochondria reduce the ability of the nerve to function or repair and reduces immune system cellular function and general detoxification. Whatever causes mitochondrial damage may also be the cause of neuronal (nerve) damage (11,12).
There are between 5000 to an estimated 2 million mitochondria in every nerve cell (12a) illustrating how dependent the nerves are on the proper functioning of these small parts of the cell. As there are no drugs at this time that can stimulate mitochondria there is limited research into treatment. The only therapeutic process is through nutritional, supplemental, and herbal therapies.
The benefits of Functional Medicine investigations and tests
I think it is preferable to undergo testing prior to treatment options being decide upon. It is not necessary to do all (or any) of the tests, but it narrows down and directs therapy if we have some suggestion of what may be involved in the cause of the MS.
The options regarding testing, therefore, involve tests on neurological function and causes of autoimmunity as well as the physiological function of each individual. The choice of tests is based on the history of the development of the disease and selected following my patient in consultation.
Neurological Testing
- Neuroinflammation. This identifies the current level of inflammation in the nervous system and can further help differentiate between the cause being infective, a toxic underlying cause or autoimmunity. (This blood test costs £470)
Tests relevant to Autoimmunity
- A leaky gut test - see accompanying information. (£475 for the preferred more extensive blood tests. See CDSA below regarding stool Zonulin tests).
- Comprehensive digestive stool analysis (CDSA). If a leaky gut is shown to be present or if the history of development of the autoimmune issue has any association with bowel infection or the use of antibiotics, then establishing whether bad bacteria, yeasts or other fungi and parasites are present is important. Such stool tests indicate what compounds may remove these organisms and also tell us if there is enough of the beneficial bacteria such as Lactobacillus and bifidobacteria. CDSA will also highlight inflammation in the gut and measure a compound known as secretory IgA which reflects both bowel and general immunity. (£435 + £150 for the Zonulin add on)
- Blood tests to highlight suppression or activation of the immune system to identify chronic infection and/or activation of autoimmunity (£600.) Recommendations for specific tests may be suggested based on the case history or results obtained. These include tests for Lyme disease and its co-infections including herpes and especially Epstein-Barr virus (EBV) which is sited as a cause for MS (26) & several autoimmune conditions, based on history of tick bites (Cost: Variable £400-£1,600).
Other Tests for consideration based on results of the above or if specific areas of investigation are necessary based on the individual case history:
- A blood and urine test including a broad nutritional and metabolic profiling including quantitative metal toxicity, antioxidant activity, reflection of bowel flora health and detoxification activity (£950)
- Testing for food intolerance can be considered if an individual has a history of recognition of health issues associated diet.
- Adrenal stress profiling, hormone assessment for oestrogen dominance and measuring neurotransmitters not only gives evidence of a stress response that is being poorly controlled but can also advise on what natural therapeutic options can be considered to bolster the calming and relaxing neurohormones that can quell excessive immune response. (£335)
- Quantitative Metal toxicity with essential mineral profile levels – urine (£340).
- White blood cell sensitivity testing for metals or common environmental toxins to assess level of destructive activity which then governs intensity of therapy (£495)
- Hepatic Detoxification profile (Urinalysis - £340) to assess detoxification activity.
- Neurotransmitter levels if stress is an initiating or currently severe symptom (£480)
All the costs stated here are inclusive of admin, courier charges and my full written report (but not necessarily blood draw).
Therapeutic options
As discussed above, there is considerable evidence of nutritional and natural therapies having benefit (4). This benefit will include the replenishment of nutrients that reactivate mitochondria. A primary recommendation of mine is to start any program with the protocol of Dr Heinrich Kremer called Cell Symbiosis Therapy. CST can be given orally or intensified through the use of IV therapy. If you wish to know more detail, please read through these links:
https://aonm.org/a-technical-introduction-to-cst/
http://ummafrapp.de/krebs/Meyer/Chronically_healthy.pdf
Upregulation of detoxification to remove toxins, especially metals and environmental compounds, is important. This includes chelation (binding) of metals. The removal of metal, if found, using EDTA, DMSA and other metal chelators have some evidence in scientific literature (17).
If there is any history of chronic or recurring infections, such as Herpes (oral, genital, shingles and especially HHV-6), Epstein-Barr virus (glandular fever) or Lyme & Co-infection following tick-bite, then immune stimulation and anti-viral therapy is needed.
An emerging pioneering treatment for neurological disease called Phospholipid Exchange (PLX) (7) should be considered and discussed fully. I attach information compiled by one of my senior colleges, with research references.
Treatment is also based on counteracting the adverse and side effects of any conventional therapy if required.
CST therapy constituents
- Pro Basan complete – a combination of probiotics to support/rebuild healthy bowel flora containing a broad range of nutrients for bowel health.https://drive.google.com/file/d/0B8ToBiT4VsbiS0pwMTRxTkJZN28/view
- Pro Curmin Complete – a herbal combination that stimulates mitochondrial activity. https://drive.google.com/file/d/0B8ToBiT4VsbiMWZvZVZLZ0FMcHc/view
- Pro Dial Vit 44 – a multi nutrient combination providing intracellular and mitochondrial nutrients necessary for optimal function https://drive.google.com/file/d/0B8ToBiT4VsbiR3N3Y05FQk5KUmc/view
- Pro Sirtusan – a plant-based extract combination of high potency antioxidants and components called proanthocyanins necessary for optimal cellular and mitochondrial function. https://drive.google.com/file/d/0B8ToBiT4VsbiY1BnbklndmgwcDg/view
- Pro Omni Neuro – a collection of nutrients to help neurological health and repair. I attach information on this.
- Oral, IM or IV B12
- Multimineral/vitamin supplementation inc. zinc/copper and Vitamin D, Krill or plant-based omega oils/Flaxseed oil, 5 MTHF (activated folic acid)
- Immune stimulants including immune-glycans and other mushroom extracts
- Phosphatidyl choline
- Phosphatidyl serine
- Liposomal Glutathione
- HEEL homeopathic MS combination
- In Relapsing Remitting MS consider Co Q 10 (10)
- Low Dose Naltrexone - Please read this link: https://www.healthline.com/health/naltrexone-for-MS
Other treatments include:
- PLX through oral and IV therapy (mentioned above)
- Far Infrared Sauna
- Hyperbaric oxygen.
- Herbal medicine and Eastern disciplines (8,9) in the form of Chinese, Ayurvedic or Tibetan treatment
Benefit may also be obtained from Structural Therapies – physio, osteopathic, chiropractic (6).
Diet and Lifestyle
There are many diet programs claiming benefit suggesting there are different strokes for different folks. Exploration to find what best suits an individual is important. The most concise advice, I feel, is given through the work of Prof George Jelinek in his book: Overcoming Multiple Sclerosis: The Evidence-Based 7 Step Recovery Program https://tinyurl.com/33c3xhy5
Dr R Sharma
July 2022
A note on my position in advising on MS
When commenting on specific illnesses that do not have simple conventional treatments, it is important not to give the impression that Complementary, Integrated, Functional, or alternative medicines offer ‘magical’ answers. An individual must follow down the path offered by their specialists and discuss with them any ‘alternative’ they consider trying.
I must stress here that I am not a neurologist, I do not specialise in neurological conditions and my comments are made as a doctor with a specialist interest in Complementary & Alternative and Functional Medicine. I do not make claims about resolving incurable conditions and focus my attention on helping individuals optimise their health in the hope that their body can repair dysfunction.
I always strongly recommend that patients use Alternative/Complementary/Functional Medicine in conjunction with the optimal conventional treatment prescribed by neurologists in an Integrated Medical Program.
References
- Sterzl I., et al. Mercury and nickel allergy: Risk factors in fatigue and autoimmunity. Neuroendocrinology Letters. 1999; 20: 221-228.
1A Yadav et al Expert Rev Clin Immunol. May 2010; 6(3): 381–395. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901236/ - Prochazkova, J., et al. The beneficial effect of amalgam replacement on health in patients with autoimmunity. Neuroendocrinology Letters. 2004; 25(3): 211-218.
- Stejskal, J. and Stejskal, V. The role of metals in autoimmunity and the link to neuroendocrinology. Neuroendocrinology Letters. 1999; 20: 351-364.
- Vitasearch – http://search.vitasearch.com/search?sort=date%3AD%3AL%3Ad1&output=xml_no_dtd&oe=UTF-8&ie=UTF-8&client=CP_frontend&proxystylesheet=CP_frontend&filter=0&getfields=*&q=multiple+sclerosis&btnG=Search&site=Summaries
- Lindh U. Removal of dental amalgam and other metal alloys supported by antioxidant therapy alleviates symptoms and improves quality of life in patients with amalgam-associated ill health. Neuroendocrinology Letters 2002; 23(5/6):459-482.
- http://cre.sagepub.com/content/17/2/181.short
- R T Holman, S B Johnson, and E Kokmen PNAS, June 1, 1989 vol. 86 no. 12 http://www.pnas.org/content/86/12/4720.abstract?tab=author-info
- http://www.neurologycare.net/ayurveda.html
- http://www.healthcommunities.com/multiple-sclerosis/alternative-medicine/traditional-chinese-medicine-and-ms.shtml
- Sanoobar M, Eghtesadi S, et al, Int J Neurosci, 2013 May 10;
- Mitochondria & Neurological symptoms https://www.ncbi.nlm.nih.gov/pubmed/20818726
- Mitochondria in Multiple sclerosis (MS) https://www.ncbi.nlm.nih.gov/pubmed/31083577 & http://acta.tums.ac.ir/index.php/acta/article/view/6901 & https://www.ncbi.nlm.nih.gov/pubmed/28069137
12a Misgeld T, Schwarz TL. Mitostasis in Neurons: Maintaining Mitochondria in an Extended Cellular Architecture. Neuron. 2017;96(3):651-666. doi: 10.1016/j.neuron.2017.09.055 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687842/#:~:text=If%20mitochondria%20are%20present%20at,mitochondria%20per%20cell%20is%20reasonable - https://iaomt.org/resources/dental-mercury-facts/dental-amalgam-mercury-multiple-sclerosis/
- https://www.urmc.rochester.edu/news/story/4815/hidden-herpes-virus-may-play-key-role-in-ms-other-brain-disorders.aspx
14a. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334728/ - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193283/ Briones-Buixassa, Laia et al. “Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress.” Health psychology open vol. 2,2 2055102915612271. 4 Nov. 2015, doi:10.1177/2055102915612271
- https://onlinelibrary.wiley.com/doi/abs/10.1111/neup.12522
- Metals as cause MS. https://www.ncbi.nlm.nih.gov/pubmed/23906103
- van Meeteren, M., Teunissen, C., Dijkstra, C. et al. Antioxidants and polyunsaturated fatty acids in multiple sclerosis. Eur J Clin Nutr 59, 1347–1361 (2005). https://doi.org/10.1038/sj.ejcn.1602255
https://www.nature.com/articles/1602255 - B12 and Folic acid benefits https://multiplesclerosisnewstoday.com/2019/02/20/vitamin-supplements-yield-multiple-benefits-ms-patients/
- Essential fatty acids benefits - https://www.ncbi.nlm.nih.gov/pubmed/31462182
- Bowel flora and BBB - Braniste V, Al-Asmakh M, Kowal C, Anuar F, Abbaspour A, Tóth M, Korecka A, et al. The gut microbiota influences blood-brain barrier permeability in mice. Sci Transl Med. 2014 Nov 19;6(263):263ra158.
- Bowel flora and MS - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163724/
- Glutathione in MS - https://www.ncbi.nlm.nih.gov/pubmed/24842957
- ALA in MS - https://www.ncbi.nlm.nih.gov/pubmed/31056714
- Infection in MS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924524/
- MS & EBV: https://tinyurl.com/3f9h59pa
