Multiple sclerosis

The right kind of diet and dose of supplements may help prevent multiple sclerosis from progressing.

At SLO Integrative Medicine, we’re offering evidence-based supplemental treatment for multiple sclerosis, to help you optimize your health and treatment of multiple sclerosis. We’ll get you started on evidence-based treatments, as integrative and add-on therapies to the medication you are already receiving for your condition from your neurologist or primary health care provider.

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1-805-439-2569
dr cannell

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About multiple sclerosis

Multiple sclerosis (MS) is an immune-mediated disease where the body’s immune system appears to attack myelin (the insulating fibers surrounding the nerve fibers in the brain and spinal cord). The multiple areas of damaged myelin form scar tissue (thus the name multiple sclerosis). MS is common in women between the ages of 20-40. In many cases, the condition becomes worse over time, as the immune system continues to destroy both myelin and nerve tissue. Scientists now think one or more unknown environmental factors trigger the disease in genetically susceptible patients.

Symptoms may be mild, such as numbness, or severe, such as paralysis. The progress, severity, and symptoms of MS are unpredictable and vary greatly between patients. These regions of damage in the body vary greatly so symptoms vary depending on where in the nervous system the damage occurred. The four classifications of MS are relapsing-remitting (clearly defined attacks or relapses followed by periods of quiescence), primary-progressive (slowly worsening neurologic function from the beginning), secondary-progressive (the disease worsens steadily after initially being relapsing-remitting), and progressive relapsing (progressive disease with relapse but few or no remissions).

If you have MS, no matter what stage you are in, it is important that you take your regularly prescribed medications. There are ten different FDA approved medications to treat MS. However, the right diet and supplements will probably improve the effectiveness of the prescription drugs you take.

Treatment with vitamin D

A very strong correlation between MS and low sun exposure supports the role vitamin D plays in fighting the disease. For example, MS is very rare around the equator. A study showed patients having relapses have lower serum vitamin D levels. In 267 Dutch patients with relapsing remitting multiple sclerosis (RRMS), higher vitamin D levels were associated with a better chance of remaining relapse-free.

In 134 North American patients with RRMS, the strongest predictor of further relapse was their vitamin D level. In a prospective Australian study of 145 patients with RRMS, each increase of 4 ng/ml in baseline serum vitamin D level was associated with a 12% reduction in the risk of a relapse.

Goldberg first suggested the potential therapeutic effect of vitamin D supplementation way back in 1986. A Canadian trial of 49 patients with RRMS who took escalating doses (40,000 IU/day) of vitamin D over a 52-week period showed a trend toward relapse reduction in the actively treated group. There were no side effects. The results from this trial and others suggest that pharmacologic doses of vitamin D are safe, and may reduce the risk of relapse by a factor superior even to the 30% reduction reported from the pivotal trials of the most common current treatment, interferon.

Many other medical scientists are now realizing that it is very important to get the right amount of vitamin D as well as ultraviolet radiation of the correct wavelength such as in summer sunshine. Scientists at the Harvard School of Public Health recently concluded: “a genuine protective effect of vitamin D itself remains the most parsimonious and plausible explanation” for the results of studies to date. [1]

Some randomized controlled trials (the highest standard of proof in medicine) suggest the proper dose of vitamin D may help keep active MS from progressing. One such study concluded, “vitamin D add-on treatment to interferon reduces MRI disease activity in MS.” [2] In another study, no patients in the high dose vitamin D group experienced a second demyelinating attack, while five of the placebo patients did. [3] In a large longitudinal study, each 10 ng/ml increase in blood vitamin D levels was associated with a 32% lower risk of developing new MRI brain lesions.[4]

References

  1. Munger KL, Ascherio A. Prevention and treatment of MS: studying the effects of vitamin D. Mult Scler. 2011 Dec;17(12):1405-11.
  2. Soilu-Hänninen M, et al. A randomised, double blind, placebo controlled trial with vitamin D3 as an add on treatment to interferon β-1b in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2012 May;83(5):565-71.
  3. Derakhshandi H et al. Preventive effect of vitamin D3 supplementation on conversion of optic neuritis to clinically definite multiple sclerosis: a double blind, randomized, placebo-controlled pilot clinical trial. Acta Nerol Belg, 2012
  4. Mowry EM, Waubant E, Mcculloch CE, et al. Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis. Ann Neurol. 2012;72(2):234-40.

Case reports from Dr Coimbra

Below are three case reports from a Brazilian neurologist, Cicero G Coimbra, MD, PHD, using mega-doses of vitamin D to treat relapsing remitting multiple sclerosis. These case reports have not been verified or published.

  1. 30 year old female
  2. 60 year old female
  3. 31 year old female
Treatment with omega-3s

In MS, the right kind and dose of omega-3 fatty acids, including flaxseed oil, may be helpful. It may be important that the fish oil be second-generation fish oil as that is absorbed better. In Norwegian countries it has long be known that higher fish consumption along the coasts is associated with less MS. in Japan, where fish is often consumed, there are fewer brain lesions in MS patients compared to Caucasians. MS patients consuming fish more frequently and those taking omega 3 supplements had significantly better quality of life, in all domains, and less disability.

Studies have shown that fish oil, especially when combined with a low fat diet, may help MS patients. For example, levels of certain omega-3 fatty acids were lower in MS patients then controls. [1] Another study concluded, “fish oil supplementation given together with vitamins and dietary advice can improve clinical outcome in patients with newly diagnosed MS.” [2] Yet another randomized controlled trial, showed fish oil and a low fat diet helped MS patients. [3] Another randomized controlled trial of omega-3 fatty acids showed trends towards benefiting MS patients. [4]

References

  1. Aupperle RL, Denney DR, Lynch SG, Carlson SE, Sullivan DK. Omega-3 fatty acids and multiple sclerosis: relationship to depression. J Behav Med. 2008 Apr;31(2):127-35.
  2. Nordvik I, Myhr KM, Nyland H, Bjerve KS. Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand. 2000 Sep;102(3):143-9.
  3. Weinstock-Guttman B, et al.  Low fat dietary intervention with omega-3 fatty acid supplementation in multiple sclerosis patients. Prostaglandins Leukot Essent Fatty Acids. 2005 Nov;73(5):397-404.
  4. Bates D, et al. A double-blind controlled trial of long chain n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis. J Neurol Neurosurg Psychiatry. 1989 Jan;52(1):18-22.

Other supplements and dietary measures

One study showed that alpha-tocopherol blood levels are associated with “simultaneous and subsequent MRI disease activity” in MS patients. [1] Total antioxidant levels are lower in MS patients than in unafflicted controls. [2] Another study showed that levels of  antioxidants such as beta-carotene and ascorbic acid are decreased in the blood of MS patients during an attack. [3] Vitamin B12 levels are lower in MS patients than in unaffected controls. [4] That is not all, there are other studies indicating milk proteins, wheat products, probiotics, vitamin  C, polyphenols, ginkgo biloba and curcumin may all play a role in MS.

References

  1. Løken-Amsrud KI, et al. Alpha-tocopherol and MRI outcomes in multiple sclerosis–association and prediction. PLoS One. 2013;8(1):e54417.
  2. Hadžović-Džuvo A, et al. Serum total antioxidant capacity in patients with multiple sclerosis. Bosn J Basic Med Sci. 2011 Feb;11(1):33-6.
  3. Besler HT, Comoğlu S, Okçu Z. Serum levels of antioxidant vitamins and lipid peroxidation in multiple sclerosis. Nutr Neurosci. 2002 Jun;5(3):215-20.
  4. Zhu Y, He ZY, Liu HN. Meta-analysis of the relationship between homocysteine, vitamin B₁₂, folate, and multiple sclerosis. J Clin Neurosci. 2011 Jul;18(7):933-8.

About San Luis Obispo Integrative Medicine

SLO Integrative Medicine is a medical practice that combines the best of prescription medicines with the best diet and best supplements to optimize your health outcome. SLO Integrative Medicine is led by John Cannell, MD.

Dr. Cannell has over 35 years of clinical experience. He is board certified by the American Academy of Psychiatry and Neurology. He obtained his MD degree from the University of North Carolina School of Medicine. Dr. Cannell has published 17 scientific papers in the peer-reviewed medical literature; three of his papers are the most cited papers in the history of their respective journals.

He has written and spoken widely on integrative medicine, including speaking about vitamin D supplementation before the 92nd annual meeting of the Pacific Division of the American Association for the Advancement of Science (AAAS) in 2011. In the spring of 2013, he served as a visiting professor at Marshall University School of Medicine.

San Luis Obispo office
1411 Marsh St. Suite #203
San Luis Obispo, CA 93401
1-805-439-2569
Fax: 1-805-439-1073

Office hours
Monday – Friday : 10:00 am – 5:00 pm
Saturday, Sunday : Closed

What you can expect from therapy
Professional service

Professional service

John Cannell MD is an experienced physician, having served the medical field for over 35 years. You can expect to be treated professionally.

Supplement and diet regimen

Supplement and diet regimen

We will place you on a supplement regimen, tailored to helping MS. As need be, we will continually alter your regimen.

Lab work

Lab work

We will regularly send you in for lab work to see what your vitamin D and calcium blood levels are. This will ensure safe and effective treatment.

Tracking of your condition

Tracking of your condition

We will track clinical markers to see if the add-on treatment is improving your condition.

Financial information
  • Our rate is $300/hr. Initial appointments are about 1-1.5 hours. Follow up appointments are approximately 20-30 minutes.
  • At the moment, we only accept self pay fee for service.
  • This means at this moment, we do not accept insurance of any kind.
  • For those patients who are seen in our San Luis Obispo office, if you want to be reimbursed by your insurance company, we will help you send in a superbill. It is your responsibility to see if your insurance will cover our care, lab work or x-rays.
  • For tele-educational sessions, you do not have the option to send in a superbill.
  • We do not accept Medicare or MediCal.
Appointment cancellation
  • It is your responsibility as a patient to come to your appointments in a timely fashion.
  • If you need to cancel an appointment, you need to cancel 24 hours prior to the appointment.
  • If you fail to keep to an appointment and cancel in time, your account will be charged $300.00.

DrCannell2
“MS can be a devastating disease. There are new and useful medications in treating MS. As long as complimentary treatment is safe, physicians have an ethical duty to act on what is known today not what may or may not be shown in future clinical trials. People suffering from MS cannot wait for future studies. They need to try everything that can safely improve their condition today.

I have a complimentary medical practice limited to treating medical conditions with supplements with solid, evidence-based science behind them. I do not sell supplements in my office, I am interested in treating you as a physician. Call for an appointment. However, I have three requisites. First, my therapies must be add-on therapy only; they never take the place of your regularly prescribed medications. Second, you must agree to careful blood monitoring of supplements if needed. Third, you must keep all your regularly scheduled appointments with your attending neurologist or treating physician.”

— John Cannell, MD