Complementary and Alternative Medicine with MS
Complementary and alternative medicine (CAM) refers to therapies which typically fall outside of conventional or mainstream medicine. Depending upon where you live, what is considered conventional may vary considerably. Complementary therapies are used along with conventional medicine, while alternative therapies are used instead of conventional medicine.
The National MS Society reports that approximately 75 percent of people with MS use at least one form of CAM, generally in combination with disease-modifying treatments. Common forms of CAM used in MS include exercise, dietary supplements, herbal medicine, mind-body practices, yoga, and acupuncture. Therapies that have been found to be ineffective in MS are hyperbaric oxygen and bee venom therapy.
Here are some of the more common complementary and alternative treatment options for MS.
Popular CAM approaches are divided into two categories - natural products and mind-body practices - by the National Center for Complementary and Alternative Medicine (NCCAM) at the US National Institutes of Health. Natural products include use of diet and fatty acid supplements (e.g., fish oil, omega-3), herbal medicine (e.g., echinacea, marijuana), orthomolecular medicine (e.g., vitamins, minerals), probiotics, antioxidants, and homeopathic remedies.
Eating a diet low in saturated fats and high in polyunsaturated fatty acids, such as in the Swank Diet or Best Bet Diet, is a popular approach to treating MS. Research suggests that consuming short-chain fatty acids may contribute to the development of immune cells that can regulate attacks to the central nervous system (in mice), supporting the importance of dietary interventions in MS.
Studies have shown that vitamin D (25-OH-D) levels in the blood are inversely related to MS risk and MS disease activity. Research indicates that higher 25-OH-D levels may have mild disease-modifying properties as well as provide symptomatic benefits for MS patients. However, patients should have their blood tested to help determine an appropriate daily dose - typically between 4000-10,000 IU of vitamin D3 - to achieve desirable serum levels between 40-80 ng/mL.
Leaves of the Cannabis sativa plant, or marijuana, contain tetra-hydro-cannabinol (THC) which has been shown effective in the treatment of MS-related pain, spasticity, and bladder disturbance in clinical trials. Psychological side-effects of cannabis are generally mild, although people with MS with impaired cognition or depression may suffer more serious effects.
Mind-body practices include a diverse group of procedures or techniques often guided by a trained practitioner. Common mind-body techniques used in MS include exercise, meditation, relaxation techniques (e.g., breathing exercises, guided imagery, progressive muscle relaxation), movement therapies (e.g., yoga, pilates, Alexander technique, Feldenkrais method), spinal manipulation (e.g., chiropractic medicine), and massage therapy. Tai Chi and Qi Gong are mind-body practices which combine specific movements or postures, coordinated breathing, and mental focus.
Treatments which are part of the system of Traditional Chinese Medicine (TCM) are often considered CAM in the US. Acupuncture is one such therapy that seeks to balance life energy, or qi, along pathways called meridians throughout the body. The acupuncturist inserts very fine, sterile, disposable needles on the surface of the skin at specific points along meridians to manipulate qi. Practitioners of TCM may also prescribe Chinese herbs aimed to balance energy.
Naltrexone is a medication approved to treat opioid and alcohol addictions at doses of 50-100 mg/day. The use of naltrexone at significantly lower doses (3-5 mg/day) has been touted as a treatment for a variety of diseases, including cancer, HIV/AIDS, Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), emphysema, as well as MS and other autoimmune diseases. Few studies have investigated low dose naltrexone (LDN) as a treatment for MS symptoms.
Results from a single-center, double-masked, placebo-controlled, crossover study evaluating the efficacy of 4.5 mg naltrexone (low-dose) on self-reported quality of life for MS patients were published in 2010. Researchers found that LDN significantly improved quality of life (specifically, mental health, pain, and self-reported cognitive function), but no impact was observed on aspects of physical quality of life (such as fatigue, bowel and bladder control, sexual satisfaction, and visual function (Cree, 2010). LDN was well tolerated with vivid dreaming reported by some patients during the first week of treatment while no other adverse effects were reported. Further studies are warranted.
While several CAM approaches have been widely accepted for the promotion of improved health and well-being, be cautious of unsubstantiated claims or “secret formulas.” Look for results from clinical trials to help you evaluate the usefulness and safety of any therapies you consider. Discuss the CAM therapy with your neurologist or MS nurse before trying anything new. Remember to always tell your doctors and nurses about ALL treatments - including supplements, over-the-counter medications, or herbal preparations - you use or have used.
For more information, read the “Complementary and Alternative Therapies in MS” special issue of MS in Focus published by the Multiple Sclerosis International Federation (2010).
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