Conditions:
Multiple Sclerosis

Principal Proposed Treatments
  • · There are no well-established natural treatments for multiple sclerosis.
Other Proposed Treatments
  • Linoleic Acid, Evening Primrose Oil, Fish Oil, Threonine, Vitamin B12, Vitamin D, Phenylalanine, Neural Therapy, Bee Venom, Ginkgo, Adenosine Monophosphate (AMP), Biotin, Glycine, Proteolytic Enzymes, Selenium, Vitamin B1, Vitamin E, Vitamin C

Multiple sclerosis (MS) is a disease affecting the fatty sheath that covers nerve fibers in the brain and spinal cord. This sheath, made of a substance called myelin, normally insulates the nerve fibers, allowing nerve impulses to move swiftly and efficiently between brain, spinal cord, and body. In MS, patchy areas of this insulating material are destroyed and replaced by scar tissue, which results in the slowing or blocking of nerve signals. People with MS may experience symptoms such as blurred vision, muscle weakness and spasticity, difficulty walking, poor coordination, bladder problems, numbness, and fatigue. In its most common form, the disease begins between the ages of 20 and 40 with an initial attack of symptoms followed by partial or complete remission. Further attacks usually follow and can eventually lead to progressive disability. Another form of the disease progresses more quickly.

Although the cause of MS isn't known for sure, scientists generally assume that MS is an autoimmune disease in which the immune system attacks the body's own myelin cells. Scientists theorize that something, perhaps a toxin or virus, triggers this autoimmune response in susceptible people. Not everyone appears to be equally susceptible. Gene studies suggest that genetics plays a role in who gets the disease, but other factors seem to be important as well. For example, MS tends to be more common the farther one goes from the equator.¹ The disease is also more prevalent in societies with greater dietary intake of meat and animal fat, lower intake of unsaturated fats compared to saturated fats, and lower intake of fish.^2,3,4 Not everyone agrees that all of these factors actually contribute to the disease. Some factors may simply be statistically associated with the actual cause.

There is no cure as yet for MS, but several new drugs—including two forms of the antiviral substance interferon and an unrelated drug, glatiramer acetate (Copaxone)—appear able to reduce the frequency of relapses in people with certain forms of MS. One of these drugs, interferon beta1a (Avonex), has been found to actually slow the rate of disability. Other medications reduce the severity of acute attacks or treat specific symptoms such as muscle spasticity.

Proposed Treatments for Multiple Sclerosis

While there are no well-documented natural treatments for multiple sclerosis, there are a few options that may provide some help.

There is some evidence that changing the type and amount of fat in the diet might alter the course of MS. Based on observations from population studies linking diets lower in fat or saturated fat to lower rates of MS, physician R.L. Swank developed a special low-fat diet for MS in which unsaturated fats replace most saturated fat. This approach, called the Swank diet, has been used by many people with MS. When he analyzed the long-term effects of the diet on his patients, Swank found that those adhering closely to the diet for 20 to 34 years developed significantly less disability than those who ate more saturated fat.^5,6 Because these were not controlled trials, they do not actually prove that the Swank diet works. Nonetheless, the possible connection between MS and fatty acids continues to arouse interest, and a variety of essential fatty acids have been proposed as possible treatments for MS (see below). Although a link between fat intake and MS is intriguing, research has not yet provided clear-cut evidence that any of these treatments help.

Linoleic Acid

One of the omega-6 essential fatty acids, a group of fats as necessary to the body as vitamins, linoleic acid is found in high concentration in sunflower and safflower oil as well as most other vegetable oils. Several researchers have investigated whether linoleic acid in the form of sunflower seed oil can help MS, but the results of their research were equivocal.

Three groups of investigators performed double-blind studies, using olive oil as a placebo, to see if linoleic acid supplements could affect the symptoms or course of MS.^7,8,9 Two of these studies (one involving 75 people, the other 116) found that those taking linoleic acid had shorter and less-severe attacks of MS compared to those taking placebo.^10,11 However, in the two years of the trials, the frequency of attacks and overall levels of disability were not significantly affected. The third study of 76 people found that linoleic acid had no effects on either MS attacks or degrees of disability over 2 1/2 years, as compared to olive oil.¹²

Another researcher suggests that these studies may have been too short—that it may take far longer than two years for linoleic acid to exert its effects on myelin.¹³ Olive oil also contains important fatty acids; others have wondered if the olive oil could have been an effective treatment on its own, thereby obscuring the benefits of linoleic acid. Finally, yet another researcher carefully examining the study reports found that linoleic acid might have been effective in those individuals with less severe MS symptoms.^14,15

Although interesting, this type of after-the-fact analysis must be interpreted with caution. More studies are needed to confirm whether linoleic acid, taken early in the course of MS or at other times, has the power to prevent, delay, or improve disability.

Dosage

In the three double-blind studies described above, participants received 17 to 20 g of linoleic acid per day, the equivalent of 1 ounce of sunflower seed oil.

Safety Issues

As a nutrient found in food, linoleic acid is considered to be safe. However, maximum safe dosages for young children, pregnant or nursing women, or people with severe liver or kidney disease have not been determined.

Other Essential Fatty Acids

There has been much excitement about other essential fatty acids as treatments for MS, including omega-3 fatty acids found in fish oil and gamma-linolenic acid (GLA), an omega-6 fatty acid present in evening primrose oil. Evidence of their effectiveness, however, is still relatively weak.

Blood tests among people with MS have found lower levels of omega-3 fatty acids in their body fluids and tissues compared to those without MS.^16,17 Preliminary research also suggests that omega-3 supplements may decrease the production of certain inflammatory chemicals (including cytokines and interleukins) in people with and without MS.¹⁸ One uncontrolled study noted fewer relapses among people with MS taking cod liver oil (a form of fish oil that also provides vitamins A and D), calcium, and magnesium.¹⁹

However, these findings by themselves do not prove that supplements will help treat the disease; for that, double-blind placebo-controlled studies are needed. Unfortunately, the only reported double-blind study of fish oil for MS had inconclusive results. In this 2-year study of 292 people with MS, comparing fish oil's omega-3 fatty acids with an olive oil placebo, there were no significant differences between the two groups.²⁰

Some researchers have suggested that gamma-linolenic acid (GLA), might be beneficial in MS.²¹ So far, however, little evidence suggests that it helps, and one uncontrolled study did not find it effective.^22,23,24

Threonine

Early evidence suggests that threonine, a naturally occurring amino acid, might be able to decrease the muscle spasticity that often occurs with MS.

Two small double-blind studies found a modest but statistically significant improvement in muscle spasticity among people who took threonine compared to those who took placebo.^25,26 In one study of 26 people with MS, the improvement was so slight after 8 weeks of treatment that it was detectable by doctors but not by the participants themselves.²⁷ In the other, both researchers and a few of the 33 participants noticed improvement after 2 weeks of treatment, with some individuals reporting fewer spasms and milder pain.²⁸ Interestingly, this shorter trial that showed more improvement also used lower doses—6 g daily of L-threonine, as opposed to 7.5 g daily of threonine. No significant side effects were noted in either study.

Vitamin B₁₂

Because several studies have found MS to be occasionally associated with vitamin B₁₂ deficiency,^29,30,31 some doctors recommend that people with MS be screened for this condition, and treated with B₁₂ if deficient.³² (Vitamin B₁₂ deficiency can sometimes cause neurological problems on its own.) One highly preliminary study suggested that massive doses of B₁₂ could improve certain test results ("evoked potentials"), but not disability, in people with chronic progressive MS.³³ However, a double-blind study of 50 people with MS found that high doses of injected hydroxocobalamin, a form of B₁₂, did not affect the course of disease or number of relapses.³⁴

Vitamin D

Our bodies normally obtain vitamin D in one of two ways: through our diet or through exposure of our skin to the sun. More than one group of researchers has noted that areas with less sunshine tend to have a higher incidence of MS, unless the residents eat more fish that is rich in vitamin D.^35–38 This has led to a theory that vitamin D might confer some protection against MS. So far, no human studies have adequately tested this hypothesis, although one open study (mentioned above) did investigate a combination of calcium, magnesium, and vitamin D given in the form of cod liver oil.³⁹

Phenylalanine and TENS

Phenylalanine is an essential amino acid, meaning that we need it for life and our bodies can't manufacture it from other chemicals. We normally obtain all the phenylalanine we need for nutritional purposes from high-protein foods. Supplemental phenylalanine has been studied for MS only in combination with another treatment: transcutaneous nerve stimulation (TENS), a portable electrical device used to decrease pain and muscle spasticity.

Two small double-blind trials compared phenylalanine to placebo among a total of 16 people with MS being treated with TENS.⁴⁰ In both studies, those treated with phenylalanine and TENS experienced less muscle spasticity, fewer bladder symptoms, and less depression after 4 weeks of treatment than those treated with TENS and placebo. Following the double-blind studies, the same physician used phenylalanine and TENS on 50 people, 49 of whom were reported to improve.⁴¹

Other Treatments

A small double-blind trial suggests that neural therapy, a treatment related to acupuncture, might be helpful for MS.⁴²

Bee venom has generated a great deal of interest over the years, despite the lack of reliable research supporting its use. Georgetown University researchers are currently conducting a study of its safety in people with MS.

Although ginkgo is sometimes suggested as a treatment for MS, one double-blind study examined ginkgolide B, a chemical in ginkgo, for treating MS attacks, but found no evidence of benefit.⁴³

Other treatments sometimes suggested for MS include adenosine monophosphate (AMP), biotin, glycine, proteolytic enzymes, selenium, vitamin B₁, vitamin C, and vitamin E, but little to no evidence supports these recommendations.

Last reviewed March 2002 by Medical Review Board

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