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MULTIPLE  SCLEROSIS

John G. Connor, M.Ac., LAc.,

Nov. 2003

TABLE  OF  CONTENTS

1.      Introduction

2.      What is Multiple Sclerosis?

3.      What causes Multiple Sclerosis?

4.      Chinese Medical view of Multiple Sclerosis

5.      Use of Acupuncture, Craniosacral Therapy & Hara Visceral Work in treating MS symptoms

6.      Recommended foods

7.      Swank’s Dietary Protocol

8.      Foods to Avoid

9.      Nutritional and Herbal Support

10.  Herbal and Nutritional Supplement Safety Issues

11.  Lifestyle Recommendations

12.  References

INTRODUCTION

In our treatment of multiple sclerosis (MS) Barbara and I use a combination of acupuncture, craniosacral therapy, hara visceral work, diet and lifestyle recommendations and, under certain circumstances, supplements and herbs.  None of the treatment modalities we employ can cure MS but we believe our treatments can help with symptom management and with some of the side effects of the conventional drugs used for MS.  We recommend that anyone wishing to use complementary and alternative medicine (CAM) to consult with their physician before using any CAM therapy. 

Over the last decade medications, such as Betaseron, Avonex and Copaxone, have been developed that favorably alter the disease process in MS.  The majority of people with MS should be using one of these medications under the supervision of a physician with expertise in treating MS.  We realize that MS is a very complicated disease and we sincerely hope the following article helps clarify the role that our treatments can play in helping people with multiple sclerosis to have a better quality of life. 

WHAT  IS  MULTIPLE  SCLEROSIS?

·        Multiple sclerosis is a disease of the central nervous system (CNS), including the brain, the optic nerve and the spinal cord.  It affects various parts of the nervous system by destroying the myelin sheaths that cover the nerves and leaving scar tissue called plaques, ultimately resulting in destruction of the nerves.  This process is known as sclerosis.  Because the sclerotic lesions can heal, this disease goes through characteristic phases of remission and relapse.

·        MS involves autoimmune inflammatory attack against the myelin insulation of neurons.  Thymus derived (T) cells sensitized against myelin self-antigens secrete tumor necrosis factor, cytokines, prostaglandins and other inflammatory mediators that strip away the myelin and sometimes destroy the axons.

·        Symptoms vary from person to person.  They usually begin with fatigue followed by visual problems (double vision and blind spots), numbness and tingling, speech disturbances, dizziness, bowel and bladder disorders, weakness, lack of coordination (difficulty walking, foot dragging), paralysis, loss of balance and emotional instability.

·        According to Dr. Andrew Weil although many of us associate MS with eventual paralysis, the course of MS is extremely individual, ranging from periodic, mild flare-ups in some people to severe progression of symptoms in others.  In fact more than 75% of people with MS will never need to use a wheelchair.

WHAT  CAUSES  MULTIPLE  SCLEROSIS?

• The cause of MS is still unknown, although it is widely believed to be an autoimmune disease in which white blood cells attack the myelin-producing cells in the CNS as if they were a foreign substance.  T-cells reactive to the major constituents of myelin, such as myelin basic protein (MBP) and proteolipid protein, migrate from the peripheral circulation, across the blood-brain barrier, and into the brain.  There they proceed to attack myelin-ensheathed axons and myelin-producing cells, initiating an inflammatory cascade that eventuates in the white matter lesion or plaque of MS.

• Myelin-reactive T-cells in the peripheral circulation may become activated by microbes. Structural similarities between the foreign antigens on the microbes, and the self-antigens of myelin may lead to inadvertent auto-sensitization of the T-cell against self.  Cytokines, which are small peptide substances that act as cell-to-cell messengers to regulate immune cell activity, may also play a role.  Cytokine production can set the immune system into one of two major modes: T-helper types 1 (Th1) or 2 (Th2).  Th1 activation features mainly cell-mediated cytotoxicity, and inflammatory and hypersensitivity reactions.  In MS the Th1 pattern dominates.  Therapeutics are being pursued that down-regulate Th1 cytokines, with the goal of systemically turning off the autoimmunity of MS.

• Some experts suggest that an as-yet-unidentified virus may be involved.  Heredity may also be a factor.  Another theory is that it is caused by food intolerances or allergies, especially allergies to dairy products and to gluten.  It has been seen to follow malnutrition, emotional stress, and infections.

• The cerebrospinal fluid (CSF) of most MS patients contains an elevated level of antibodies, which is characteristic of an infectious process. One hypothesis states that this is in fact due to an unrecognized infectious agent that causes MS.  Epidemiological studies suggest MS is initiated by a primary encounter with an environmental agent during childhood or early adulthood.  Viruses are obvious candidates for the infectious agents in MS because several cause demyelination in humans and animals.  The demyelination of MS may result from direct viral damage to brain cells, or from viral infection leading to the formation of antibodies, which then attack the myelin.

·  Chemokine Receptors in MS:

According to an article published by R&D Systems entitled “Chemokine Receptors and Multiple Sclerosis Pathogenesis” (Fall 2003) - as a result of the myelin reactive T cells crossing the blood brain barrier into the CNS an inflammation cascade is initiated with release of inflammatory mediators that damage or destroy oligodendrocyte-formed myelin sheaths and underlying axons.  Several lines of evidence suggest that chemokines, small secreted proteins important for regulating leukocyte trafficking, play a role in directing or maintaining T cells in regions where myelin destruction takes place.

The article goes on to say that several studies show that T cells isolated from the blood and CSF of MS patients exhibit increased levels of chemokine receptors including CCR5 and CXCR3.  In addition, some studies show that elevated levels of CCR2, CCR5, CXCR3 on cells in blood and CSF are associated with relapse in individual patients, while treatment of MS with IFN-β results in down regulation of CXCR3 and CCR5.  Chemokines undoubtedly play critical roles in directing lymphocytes to regions of inflammation.  Further studies will be needed to determine whether chemokines and their receptors might represent effective targets for future MS therapies.

·        According to an article by Parris M. Kidd, PhD, on multiple sclerosis published in Alternative Medicine Review (2001) agents that can trigger MS exacerbations include viral infections, emotional stress, pregnancy, heat exposure, allergic reactions to foods and irritation or provocation by environmental agents.  The major etiological factors best supported by the available evidence are inherited susceptibility, microbial infections and environmental toxin exposure.  Diet has been less studied but undoubtedly makes important contributions.

Some of the factors that may contribute to the causation, exacerbation or progression of MS as outlined in Dr. Kidd’s article are as follows:

    o       Viruses Linked to MS:

q       Human Herpesvirus Type 6 (HHV-6)

q       Chlamydia

q       Mycoplasmas

q       Varicella zoster

q       Retroviruses

q       Nidoviruses

• Toxins and other Environmental Factors which may be Linked to MS:

q       Solvents and pesticides

q       X-rays

q       Exposure to cats, dogs and caged birds

q       Mercury

• Dietary Factors Contributing to the Worsening of MS:

q       High animal fat diet

q       Diets high in gluten and milk (T-lymphocytes reactive with milk proteins are very common in persons with MS, and small proteins from milk have been found to be molecular mimics of self-antigens in myelin.)

q       Allergies to tobacco, house dust, etc.

q       Sulfite food additives

CHINESE  MEDICAL  VIEW  OF  MULTIPLE  SCLEROSIS

• In Chinese Medicine MS is considered a type of Atrophy or Flaccidity (Wei) Syndrome.  Demyelination – a loss of fatty substance surrounding the nerve fibers – corresponds to a description in Chinese Medicine involving the loss of vital fluid Essence or Jing.  The quality of the myelin sheath is similar to the Chinese Medicine quality of Essence.  In Chinese Medicine the brain and spinal cord are understood to be an extension of the Kidney system, the storehouse of Essence.  Kidney yin and yang are the key factors in the regulation and balancing of yin, yang, qi, blood and all the body’s immune mechanisms.  Proper regulation of the normal immune response is achieved through balance.  Therefore the focus in treating the autoimmune aspect of MS in Chinese Medicine is to nourish the Kidney Essence and establish a balance in physical, emotional, mental and spiritual energy as well as in life style.

• The most common Chinese Medical patterns seen in multiple sclerosis are:

q       Damp-Phlegm with Spleen Deficiency which manifests as numbness, feeling of heaviness of the legs, tingling, dizziness and tiredness.

q       Liver and Kidney Deficiency which manifests as progressive weakness of the legs, weak back and knees, dizziness, poor memory, blurred vision, hesitancy or urgency of urination.

q       Liver Yang Rising which manifests as stiffness of the legs, vertigo and vomiting.

q       Liver Wind which manifests as tremors, spasms and paraplegia.

USE  OF  ACUPUNCTURE, CRANIOSACRAL  THERAPY  AND HARA VISCERAL WORK IN  TREATING  MS  SYMPTOMS

Barbara and I believe that acupuncture, especially when it is combined with craniosacral therapy and visceral manipulation, helps with MS related symptoms by releasing not only energy blockages in the meridians and energy centers but also restrictions in the fascia which surrounds muscles and organs as well as blood vessels and nerves.  The focus of our treatment strategy is to promote the flow of nutrients and energy throughout the body especially to the muscles, nervous system and immune system and encourage the balancing of these vital systems so that people with MS can lead a healthier life.  For more information on how we work we refer you to the following articles on our website: How Acupuncture Works, What is Craniosacral Acupuncture, Craniosacral Acupuncture Treatment and What is Hara Visceral Work?.

RECOMMENDED  FOODS

• Eat only organically grown foods with no chemical treatments or additives, including eggs, fruits, gluten free grains, raw nuts and seeds, vegetables, soaked raw oats, sprouted wheat (if there is no gluten sensitivity), rice, raw goats milk, fresh wheat germ and GLA rich oils. (MS patients have a severe deficiency in various fatty acids, particularly linoleic acid).

• Also recommended are tofu, tempeh, soy sprouts, soy milk, cabbage and cauliflower which are all rich lecithin sources. (Lecithin is often deficient in MS.)

• Liver Yin tonics such as leafy green vegetables, mung beans, mung bean sprouts, millet, seaweeds, cereal grass concentrates, micro-algae, and in cases of severe deficiency gelatin or animal liver.

• Cold-water fish - are rich in omega-3 oils which are important in maintaining normal nerve cell function and myelin production. They are incorporated into the myelin sheath where they may increase fluidity and improve neural transmission.

• Maintain a low fat diet because a high fat diet impairs the conversion of linoleic acid to prostaglandin E₁ (PGE₁).  (PGE₁ regulates brain function and nerve impulses, is required for proper functioning of the immune system, is a vasodilator, controls blood pressure and inhibits blood clotting.)

• Eat plenty of raw sprouts and alfalfa, plus foods that contain lactic acid such as sauerkraut and dill pickles. Also good are drinks that contain lots of chlorophyll.

• Drink at least eight 8 oz. glasses of quality water each day to prevent toxic buildup in the muscles.

• Take a fiber supplement. Fiber is important for avoiding constipation.

• Never consume saturated fats, processed oils, oils that have been subjected to heat (either in processing or in cooking), or oils that have been stored without refrigeration.

SWANK’S  DIETARY  PROTOCOL

Devised by Dr. Roy Swank, Professor of Neurology, Univ. of Oregon Medical School, this diet may help MS symptoms.  Swank’s diet recommends:

• Fresh whole foods should be emphasized and animal foods (with the exception of fish) should be reduced, if not completely eliminated.

• Fish should be eaten three or more times a week.

• Saturated fat intake should be no more than 10 grams per day.

• Daily intake of polyunsaturated oils should be 40-50 grams (margarine, shortening and hydrogenated oils are not allowed).

• Normal amounts of protein are recommended.

• Swank's diet significantly reduces the platelet adhesiveness and aggregation which is observed in atherosclerotic processes as well as in MS.  Excessive platelet aggregation and micro-emboli are thought to result in damage to the blood-brain barrier, alterations in the micro-circulation of the brain and spinal cord and lack of oxygen to the brain. 

• In addition to reducing platelet stickiness Swanks diet probably benefits MS in several other ways: 

1)      It would be expected to lower cholesterol. 

2)      Polyunsaturated oils appear to help prevent MS deterioration (cod-liver oil inhibits autoimmunity in experimental animals)

3)      Keeping the “bad” fatty acids low reduces their competition with the “good” ones such as omega-6 GLA and omega-3 ALA, EPA and DHA.

FOODS  TO  AVOID

• Avoid saturated fats, cholesterol and alcohol because they lead to the production of PGE₂ which promotes the inflammatory response and worsens MS symptoms.  Alcohol also interferes with unsaturated fatty acid conversion, increases the saturated-fat blood count and destroys various B vitamins.

• Avoid red meat.  Animal source fats have a significant content of saturated fats; a low content of the anti-inflammatory omega-3 fatty acids DHA and EPA; and a high proportion of their omega-6 fatty acids are in the form of long-chain omega-6 arachidonic acid.  Arachidonic acid is a precursor to pro-inflammatory prostaglandins.  The delicate endothelial linings of the blood vessels are vulnerable to pro-inflammatory attack, and inflammation of blood vessels in the brain is characteristic of MS.  Plaques frequently arise around a vein or venule.  Omega-3 fatty acids help maintain anti-inflammatory balance in the circulation, while supporting myelination and nerve cell membrane renewal.

• Avoid cow’s milk.  Cow’s milk contains only 1/5 the linoleic acid of human milk.  According to a study appearing in Lancet in 1974 people who were fed cow’s milk as children were found to be more susceptible to MS as adults than people who were breast-fed. 

• Also avoid tobacco, chocolate, sugar, (eating sweets has been linked to increased MS risk), coffee, fried foods, highly seasoned foods, meat, refined foods, salt, processed, canned or frozen foods and nitrates (found in certain smoked sausages).  In case you may be allergic to gluten you may wish to try eliminating gluten from your diet and see if it helps.

• Avoid black pepper in cases of muscular weakness.  It has been shown that a component of pepper inhibits convulsions and it may have a mild inhibitory action on muscular contraction.

• Avoid cinnamon.  Cinnamon contains cinnamaldehyde.  Persons with MS should avoid aldehydes as they may inhibit nerve transmission.

NUTRITIONAL  AND  HERBAL  SUPPORT

CAUTION: Be sure and check with your doctor before using any supplements or herbs.

• Essential Fatty Acids (EFA) - The omega-6 EFA, linoleic acid, has an inhibitory effect on the inflammatory response and the omega-3 EFA, alpha-linolenic acid, has a greater effect on platelets (interferes with blood clotting) and is required for normal CNS composition. Both omega-3 and omega-6 EFAs are found in flaxseed oil.  A study published by Homa et al in J Neurol Neurosurg Psychiatr 1980;43:106-110 found abnormally low levels of linoleic acid in the red cells of 14% of their MS patients.

• Gamma-linolenic acid (GLA) - is produced in the healthy body from omega-6 EFAs and is also found in spirulina, borage seed oil, evening primrose oil and black currant seed oil. GLA is converted into PGE₁ by the body.  PGE₁ regulates brain function and nerve impulses, is required for proper functioning of the immune system, is a vasodilator, controls blood pressure and inhibits blood clotting. GLA contributes to anti-inflammatory balance by competing with the pro-inflammatory arachidonic acid.  Avoid non-steroidal anti-inflammatory agents such as aspirin, ibuprofen and indomethacin as they not only block the production of PGE₂ but also PGE₁.

• Evening Primrose Oil - may be helpful in the event that there is a block in the conversion of linoleic acid to GLA (gamma-linolenic acid) as evening primrose oil has a high concentration of GLA. A non-controlled study done by Simpson et al published in New Zealand Med J 1985;98: 1053-1054 concluded that GLA from primrose oil improved peripheral blood flow characteristics and consequently, hand-grip strength.

• Eicosapentaenoic acid (EPA) and docosahexanoicacid (DHA) - EPA greatly inhibits platelet aggregation and DHA is present in large concentrations in lipids in the brain. Supplementation may be helpful in areas where cold-water fish are not available as both EFA & DHA are found in cold-water fish oils.  A small clinical trial published by Cendrowski in Br J Clin Practice 1986;40: 365-367 with no patient control group suggested that omega-3 fatty acid supplements from fish oil might reduce MS exacerbations. 

• Vitamin B₁₂ - aids in cellular longevity and helps prevent nerve damage by maintaining the protective myelin sheaths. Use a lozenge or sublingual form.  : Food sources include: Brewer's yeast, clams, eggs, herring, mackerel, dairy products, meat and fish; also dulse, kelp, kombu, nori, soybeans and soy products.

• Vitamin A – is an important antioxidant.  Oxidative stress is increased in MS.  Food sources include liver, fish liver oils, green and yellow fruits and vegetables, apricots, asparagus, beet greens, broccoli, cantaloupe, carrots, collards, dandelion greens, dulse, garlic, kale, mustard greens, papayas, peaches, pumpkin, red peppers, spirulina, spinach, sweet potatoes, Swiss chard, watercress and yellow squash.
• Vitamin C - promotes production of the antiviral protein interferon in the body. It is also an antioxidant and immune stimulant.  Consuming foods rich in vitamin C has been correlated with decreased MS risk. Food sources include berries, citrus fruits, green vegetables, asparagus, avocados, broccoli, Brussel sprouts, cantaloupe, collards, kale, mangos, onions, papayas, green peas, persimmons, pineapple, spinach, strawberries and tomatoes.
• Vitamin E - protects the nervous system, is important for circulation and is also a powerful antioxidant.  Vitamin E has been reported low in MS patients’ serum.  Food sources include cold pressed vegetable oils, dark green leafy vegetables, legumes, nuts, seeds and whole grains; also brown rice, dulse, eggs, kelp, flaxseed, oatmeal, cornmeal, soybeans, sweet potatoes, watercress, wheat and wheat germ.

• Vitamin B₁ (Thiamine) – acts as a coenzyme participating in the complex process of glucose conversion into energy and is vital in certain metabolic reactions.  It is involved in the maintenance of the heart and nervous system, and acts as an antioxidant, protecting the body form the degenerative effects of aging.  Consumption of foods rich in thiamine is correlated with a decreased MS risk.  Food sources include brown rice, fish, legumes, peanuts, peas, poultry, rice bran, wheat germ and whole grains.

• Vitamin B₂ (Riboflavin) – is necessary for cell respiration because it works with enzymes that take the oxygen from the cells.  It is part of a group of enzymes that are involved in the production of bodily energy, which utilizes carbohydrates, fats and proteins. Consumption of riboflavin rich foods is correlated with decreased MS risk. Food sources include cheese, egg yolks, fish, legumes, meat, milk, poultry, spinach, whole grains and yogurt; asparagus, avocados, broccoli, Brussels sprouts, currants, dandelion greens, dulse, kelp, leafy greens, mushrooms, molasses, nuts and watercress.

• Vitamin B₆ (Pyridoxine) - is required by the nervous system and is needed for normal brain function. It aids immune function and is involved in more bodily functions than almost any other single nutrient. Deficiency may cause MS in susceptible persons. Food sources include: brewer's yeast, carrots, chicken, eggs, fish, peas, spinach, sunflower seeds, walnuts, and wheat germ.

• Potassium – is needed for normal muscle function. Consuming foods rich in potassium has been correlated with decreased MS risk.  Food sources include: fish, fruit, legumes, poultry, vegetables and whole grains.  It is specifically found in apricots, avocados, bananas, blackstrap molasses, brewer’s yeast, brown rice, dates, dulse, figs, dried fruit, garlic nuts, potatoes, raisins, winter squash, torula yeast, wheat bran and yams.

• Vitamin B complex - aids immune system function and maintains healthy nerves. (Use hypoallergic formulas for all B vitamins.)

• CoenzymeQ10 – is needed for improved circulation and tissue oxygenation. It strengthens the immune system. Food sources include mackerel, salmon, sardines, beef, peanuts and spinach.

• Sulfur - protects against toxic substances.  Garlic is an excellent source of sulfur.

• Manganese – is needed for healthy nerves and a healthy immune system. It is an important mineral often deficient in people with MS.  Food sources include: avocados, nuts and seeds, seaweed and whole grains as well as in blueberries, egg yolks, legumes, dried peas, pineapples and green leafy vegetables.

• Choline and Inositol - stimulate the central nervous system and aid in protecting the myelin sheaths from damage. Food sources of choline include: egg yolks, lecithin, legumes, soybeans and whole grain cereals.  Food sources of inositol include: brewer’s yeast, fruits, lecithin, legumes, unrefined molasses, raisins, vegetables and whole grains.  Caution:  The consumption of large amounts of caffeine may cause a shortage of inositol in the body.

• L-glycine - aids in supporting the myelin sheaths. Glycine has been recommended for persons with MS since it counteracts aldehyde accumulation and has antispasmodic properties (daily dosage is about 3 grams per day).

• Calcium - deficiency may create a predisposition to developing MS. Calcium is needed for prevention of muscle cramps, prevents bone loss associated with osteoporosis, helps to keep the skin healthy and aids in neuromuscular activity.  Foods high in calcium include kelp, cheddar cheese, collard leaves, kale, turnip greens, almonds, brewer's yeast, parsley, dandelion greens, hazel nuts, Brazil nuts, watercress, goat's milk, tofu, dried figs, buttermilk, sunflower seeds, yogurt, whole milk, olives, broccoli, clams and spinach. If supplementing use supplements consisting of calcium citrate and/or calcium malate. Use chelate form for best assimilation.  Caution: Calcium supplements should not be taken by persons with a history of kidney stones or kidney disease.

• Magnesium – is needed for calcium absorption and for proper muscular coordination. A deficiency of magnesium interferes with the transmission of nerve and muscle impulses, causing irritability and nervousness. Food sources include dairy products, fish, meat, seafood, apples, apricots, avocados, bananas, brown rice, dulse, figs, garlic grapefruit, green leafy vegetables, kelp, lemons, peaches, soybeans, tofu, wheat and whole grains.

• Vitamin D - aids in calcium absorption.  Food sources include fish liver oils, fatty saltwater fish, eggs, dandelion greens, liver, sweet potatoes, salmon, tuna and vegetable oils.

• Valine, Isoleucine and Leucine - work together to protect muscle.

• Lecithin (granules or capsules) – needed for normal brain function.

• Acidophilus - helps to detoxify harmful substances, enhances absorption of nutrients and aids digestion.

• Milk thistle – Numerous controlled studies in Germany have demonstrated that milk thistle can benefit the health of the liver. Conventional drug management of MS through interferon β-1a (Avonex) and glatiramer acetate (Copaxone) and most of the other injectable treatments tax the liver as can chronic use of medications such as Ibuprofen and Imodium.

HERBAL  AND  NUTRITIONAL  SUPPLEMENT  SAFETY  ISSUES

• On the question of enhancing immune system function with tonic herbs in MS: 

According to a review on herbal safety published in an article on the Rocky Mountain MS Center website, people with MS should be aware of individual herbs or mixtures of herbs that may activate the immune system.  The article asserts that since MS is characterized generally by excessive immune system activity, these herbs pose theoretical risks.  That these herbs may be immune-stimulating does not necessarily imply that they are “bad” for people with MS.  Instead, it means that there is a theoretical risk to be considered before using these herbs that are poorly studied in MS. 

• The question of glutamine supplementation in MS: 

In an article by Subhuti Dharmananda on the dangers of excess glutamine in MS, he notes that in some neurological diseases, it is found that glutamate levels in the central nervous system become unusually high at sites of pathology.  In one of these processes that takes place glutamate is excreted by immune cells that take part in inflammatory processes, the result is high local concentrations at the neurons in progressive neurological diseases such as MS and ALS.  The excess glutamate at the neuron acts as a poison; at high enough levels, the nerves exposed to glutamate can be completely and permanently damaged, so that they are no longer capable of transmitting signals.  Thus, while glutamate is a major component of the body, and an essential part of the nervous system, high levels localized in the nerve cells can be quite toxic.

The role of glutamate in ALS and MS has raised the question as to whether persons with these diseases might have to be careful not to get high levels of either glutamine or glutamate via their diet and/or by taking glutamine supplements.  Until more is known about glutamine supplementation in relation to ALS and MS, it is recommended that patients who have these diseases limit their intake of supplemental glutamine.  One can avoid excessive intake of glutamate by minimizing ingestion of foods containing MSG and hydrolyzed vegetable protein, and by limiting the dosage of glutamine supplementation.  A modest glutamine supplement level of about 5-10 grams/day is likely to have some benefit in relation to muscle wasting, immune responsiveness, or intestinal disorders, without promoting increased glutamate levels in the blood.

• Use of Chinese herbs in the treatment of MS: 

According to a study done by Xi and Yaohua entitled “Thirty-five cases of multiple sclerosis treated by traditional Chinese medical principles using differential diagnosis” published in the Chinese Journal of Integrated Traditional and Western Medicine1990; 10(3): 174-175 thirty patients received specific herbal decoctions over a period of 3-13 years and relapses were prevented except for two patients who each experienced only one minor exacerbation, each event following a viral infection (common cold).  Two of the cases were deemed basically cured after taking 45 – 68 doses, 15 were markedly improved and another 15 somewhat improved, most of them taking 20-40 doses.  Unfortunately this study was not a double-blind placebo controlled study and, therefore, such controlled studies will be needed to determine if, in fact, Chinese herbs are effective in treating MS.

LIFESTYLE RECOMMENDATIONS

• Avoid stress and anxiety.  They often precipitate attacks of MS.

• Avoid exposure to heat such as hot baths, showers, sunbathing and overly warm surroundings; avoid becoming overheated when working or exercising; and avoid exhaustion and viral infections. They all may trigger an attack or worsen symptoms.

• Get regular exercise and keep mentally active.  These are extremely helpful in maintaining muscle function and bring about remission of symptoms. Exercises that increase body temperature can make the symptoms worse. Swimming is the best exercise. Stretching exercises are helpful.

• When an exacerbation begins, take at least two days of complete bed rest. This can often stop a mild attack.

• Maintain a strong immune system to avoid infections which often proceed the onset of MS.  Avoid being around persons who have viral infections.  Avoid getting chilled.  Treat all infections promptly.

• Treatments to reduce Candida activity have been found to reduce the fatigue experienced by many people with MS.

• Utilize practices that evoke spiritual rejuvenation such as meditation, yoga, qi gong, tai chi and prayer.

REFERENCES

Abbate. Skya, DOM, “The Management of Multiple Sclerosis with the Extraordinary Vessels”, Acupuncture Today, Dec. 2003 38-39

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Berkow, Robert, MD, Editor, The Merck Manual, Rahway, NJ: Merck & Co., Inc., 1992

Blackstone, Margaret, The First Year – Multiple Sclerosis, New York: Marlowe & Co. 2003

Dharmananda, Subhuti, PhD, “Amino Acid Supplements I: Glutamine” Portland, OR: Institute for Traditional Medicine, Sept. 1997

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Dharmananda, Subhuti, PhD, “Evaluation of DHEA levels in Multiple Sclerosis” Portland, OR: Institute for Traditional Medicine, Sept. 1997

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Rocky Mountain MS Center website www.MS-CAM.org “Traditional Chinese Medicine: Acupuncture, Asian Herbal Medicine and Asian Proprietary Medicine” Englewood, CO, 2003

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