Alternative Treatments for Multiple Sclerosis

Alternative Treatments for Multiple Sclerosis

In today's health field, there is a growing trend to explore different approaches to the side effects and treatment of many diseases, including Chinese medicine, vitamin therapy, homeopathic remedies and other non-invasive techniques. A number of diseases are more readily treatable through nontraditional treatments. Others either require traditional or a mixture of approaches to maintain the best quality of life or to cure the illness. According to the National Multiple Sclerosis Society (2010), these nontraditional medical treatments that derive from a variety of different disciplines are called "complementary and alternative medicines" (CAM). They include interventions such as exercise, dietary supplements, stress management, biofeedback and acupuncture. When nontraditional approaches are used together with conventional medicine, they are referred to as "complementary." When used instead of conventional medicine, they are referred to as "alternative." In the United States today, about 75% of MS victims use one form or another of CAM, generally in combination with their prescribed treatments. At this time, there is no actual cure for the disease. Research is already being conducted to evaluate the safety and effectiveness of traditional, alternative and combined therapies. Some treatments are expected to find their way into traditional medicine, while others will be considered nothing more than a "magic elixir" that may do more harm than good.

MS is a nervous system disease that affects the brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects the nerve cells, and slows down or blocks messages between a person's brain and body. This causes such symptoms as visual disturbances, muscle weakness, thinking and memory problems, difficulty with coordination and balance, and a feeling such as numbness, prickling, or "pins and needles. Although the disease has been studied at great length, no one knows its exact cause. It may be an autoimmune disease, which happens when an individual's body attacks itself. Women are affected more than men by MS, and the onset is normally between the ages of 20 and 40. Murray (2006) explains that MS was earlier believed to be an intermittent disease with inflammatory breakdown of myelin in patches in the white matter. However, evidence now shows that MS is more continuous, with diffuse changes in the white and grey matter, breakdown of myelin, and damage to axons. Approximately 85% of MS patients suffer the relapsing-remitting form, which consists of partial or complete episodic relapses and remissions. The first attack is considered a clinically isolated event. Most individuals will later have a phase of progression or secondary progressive MS that occurs with or without attacks. About 15% will not have relapses but a slow progression or primary progressive MS. A few may later relapse or have progressive-relapsing MS. Of those with the relapsing-remitting form, 15% will have benign MS, or a mild course with minimal disability after 15 years. Disease modifying drugs moderately reduce the number and severity of attacks, the number of new lesions on magnetic resonance imaging, and progression, especially if therapy is begun early (Murray, 2006).

CAM treatments for MS encompass a wide range of healthcare practices that are not routinely part of typical medical practice or even taught in the standard medical schools. Regardless, millions of healthcare consumers rely on common CAM interventions each year, which include chiropractic treatment, naturopathy, acupuncture, massage therapy, and herbal supplements. In fact, CAM are used so regularly that some estimates show that CAM healthcare costs among Americans exceed those of traditional healthcare (Campbell et al., 2006). CAM use is becoming increasingly widespread, and the numbers who utilize these methodologies are continuing to increase. The National Multiple Sclerosis Society (2010) reports that many people use CAM because of the misconception that over-the-counter items at a pharmacy or health food store are healthy and harmless. However, unlike conventional medical treatments that are carefully tested and regulated by the U.S. Food and Drug Administration, most CAM have thus far undergone very little, if any, scientific study. Some may be completely safe and others produce serious side effects or interact negatively with other medications someone is taking.

Some of the information available on MS is subjective, incorrect, and not based on empirical evidence. A survey of 50 lay books on CAM found that MS was sometimes incorrectly defined, on average five or six therapies were recommended and no books had the same recommendations, and few books discouraged the use of any CAM therapies (Bowling & Stewart, 2003). CAM companies may exaggerate claims and have limited MS-specific information and experience. Most traditional healthcare providers have little or no knowledge of, or experience with, CAM therapies.

Fortunately, scientists are making a greater effort to evaluate the safety and effectiveness of various types of CAM. Clinical trials are the best way to determine safety and effectiveness of treatment because the course of MS is variable. With each person's symptoms unpredictably coming and going, the only way to determine the effectiveness of a treatment is to test it on a large number of people. Most people, regardless of the disease, will respond positively to any new treatment, even if a placebo. The overall treatment's effectiveness can only be determined through a comparison with the placebo or to a proven treatment. Each treatment is at risk of expected and unexpected side effects, so evaluation of a treatment's safety depends on testing with a large number of people over a sufficient time period.

Research shows that many MS patients rely on dietary supplements of both vitamins and minerals as a major form of CAM. Despite the fact that there is little or no evidence, supplements are often claimed to be effective for disease or symptom management (Bowling & Stewart, 2003). Based on clinical studies, vitamin D may have immunological effects that are therapeutic for MS patients. Yet, thus far no large enough clinical studies have actually supported the use of vitamin D Hayes (2000) notes that Vitamin D deficiency afflicts most MS patients, as seen by their low bone mass and high fracture rates. In addition, MS prevalence increases with lower amounts of solar radiation, which suggests that sunlight may be a protective source in MS. Since the vitamin D endocrine system responds significantly to sunlight and MS prevalence is highest where environmental supplies of vitamin D are lowest, Hayes considered that vitamin D-rich diets such as those with fish oil may lower MS prevalence or severity. However, the evidence is not established. Hayes (p. 235) states that "the evidence that vitamin D might be a natural inhibitor of MS is compelling. Examining the benefit of vitamin D supplementation for MS prevention will require a major effort on the part of the scientific community, but it is clearly justified." In terms of antioxidant vitamins and minerals, they may have the ability to decrease MS injury. However, since these supplements normally have immune-stimulating components, they also carry theoretic risks for MS users. Healthcare providers sometimes suggest taking Vitamin B12 supplements, but no evidence is available to support their use except those with a known deficiency of the vitamin (Bowling & Stewart, 2003). Additional studies are needed to be conducted.

Based on research to date, as well as the fact that the long-term use of marijuana (cannabis) may be associated with significant serious side effects, the National Multiple Sclerosis Society's (2010) board members agree there are presently insufficient data to recommend marijuana or its derivatives as a treatment for MS symptoms. However, research continues to be conducted to determine if there is a possible role for marijuana or its chemical derivatives in the treatment of spasticity and pain. Meanwhile, Health Canada, the drug regulatory agency for Canada, has approved the use of the cannabis-derived drug Sativex® produced by GW Pharmaceuticals to treat MS-related pain. Jajicek et al. (2003) report that much anecdotal evidence suggests that marijuana could help with such MS symptoms as muscle stiffness, spasms, pain, and tremors. As a result, these researchers tested the notion that cannabinoids have a beneficial effect on spasticity and other symptoms related to MS. They conducted a randomized, placebo-controlled trial, with 667 participants with stable MS and muscle spasticity. Of these, 611 participants were treated with oral cannabis extract, 9-tetrahydrocannabinol (9-THC) or a placebo at 33 UK centers for a 15-week trial period. The authors (2003) noted no treatment effect of cannabinoids on the primary outcome. There was evidence of a treatment effect on patient-reported spasticity and pain, with improvement in spasticity respectively reported in 61%, 60%, and 46% of participants on cannabis extract, 9-THC, and placebo. There was a degree of improvement in pain suggesting that cannabinoids might be clinically useful, but, once again, additional studies needed to be conducted in order to determine the benefits.

Other alternative approaches to MS as noted by the MS Society include: 1) Food and diet: Despite the fact that a variety of diets have been promoted to cure or control this disease, no specific one has been proven to modify its course. The International Federation of MS Societies (2010) also conclude the following a) Allergen-Free Diet. Regularly using a diet from which foods are eliminated that are known to produce hives and other skin eruptions and asthmatic attacks shows no relationship with MS; b) Kousmine diet. This low-fat, low-concentrated sugar, high-fiber diet, supplemented by vitamins A, D, E, C, and B. complex does not indicate any scientific evidence in being effective in treating MS; c) Gluten-Free diet that excludes wheat and rye should be considered ineffective in MS treatment; d) Raw food, Evers diet that contains only natural and unprocessed foods, including a daily intake of germinated wheat, should be considered ineffective in MS treatment; and e) MacDougal diet, which combines a low-fat and gluten-free diet and adds supplements of vitamins and minerals, indicates no scientific evidence of being effective. MS specialists recommend that patients follow the same high-in-fiber, low-in-fat diet that is recommended for all adults. 2) Exercise: