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Before looking at this and other supplements in more detail, readers unfamiliar with the biology of MS may appreciate the following brief overview. About multiple sclerosisThe Multiple Sclerosis Society (of the UK) has this simple, clearly-written description of MS on their website: “Multiple Sclerosis (MS) is a condition of the central nervous system. It is the most common disabling neurological disease among young adults … and women are almost twice as likely to develop it as men. … Although its cause is not known and a cure has yet to be identified, research continues into all aspects of the condition.” [Forgive my cynicism, but it’s hard to believe that “research continues into all aspects of the condition” when the truth is that no research at all has been focused on many promising treatments such as P. leucotomos extracts. — Zarkov] The MS Society continues: “Surrounding and protecting the nerve fibres of the central nervous system is an important substance called myelin, which helps messages travel quickly and smoothly between the brain and the rest of the body. “… In MS, [a wayward] immune system attacks myelin … and strips it off the nerve fibres, either partially or completely, leaving scars known as lesions or plaques. This myelin damage disrupts messages travelling along nerve fibres … “[T]here can also sometimes be damage to the actual nerve fibres. It is this nerve damage that causes the accumulation of disability that can occur over time.” Standard medical therapies for MSStandard therapies for MS (i.e., those used by medical specialists) fall into two categories: so-called ‘disease-modifying treatments’, and ‘symptomatic treatments’. Standard disease-modifying treatments include anti-inflammatory, immunomodulatory, and immunosuppressive treatments, generally using drugs. Their effectiveness varies from negative to modest, depending upon factors that are not understood. Generally speaking, these treatments may slow the progression of MS but seldom stop it or reverse it. The symptomatic treatments are basically techniques for ameliorating spasticity, bladder dysfunction, chronic pain, and various intermittent symptoms. I won’t be dealing with this category of treatments in this article. Alternative dietary treatments for MSAn Internet search produced a long list of disease-modifying treatments for MS. Since there are so many possibilities here, I’m going to deal with them in categories and try to indicate why each category might have an anti-MS effect. Oils
Proteins and polysaccharides
Biofactors
Herbs and extracts
OilsIn 1980 a study was published that compared the incidence of multiple sclerosis in Greenland Eskimos with that in Danes. Unlike the Danes, the Eskimos showed a complete absence of multiple sclerosis. Although the possibility exists of there being genetic factors involved, suspicion settled on dietary factors. And one of the most striking dietary factors that differed between Eskimos and Danes was fish consumption. As a final link in this chain of reasoning, researchers noted that fish contain far more omega-3 unsaturated fatty acids (“n-3 PUFAs”) than most other foods do. The hypothesis was therefore made that the consumption of n-3 PUFAs might prevent or treat MS. Since 1980 various efforts have been undertaken to test this hypothesis, some with MS patients but most using other models. The results have been less than definitive — some studies show benefits to MS patients who consume n-3 PUFAs, others do not. Meanwhile, the theory behind this approach has been developed. PUFAs appear to be regulators of inflammation — the process whereby certain signalling molecules are produced by the body in large amounts and cause such side effects as swelling, auto-immune reactions, and cell-death. A deficiency of n-3 PUFAs might therefore trigger auto-immune reactions, resulting in diseases such as arthritis, lupus, and MS. The theory sounds plausible and is widely accepted despite the lack of absolute experimental proof. PUFA therapy is the most popular non-medical treatment for MS, and Evening Primrose Oil is the most widely used of the various PUFA supplements. Fish oil, another popular source of PUFAs, is gaining favor as an MS treatment because it contains large amounts of the specific n-3 PUFA called ‘eicosapentaenoic acid’ (EPA). EPA is considered to be an especially good substance for inhibiting auto-immune activities. Proteins and polysaccharidesSeveral population studies of MS have noted a correlation between the consumption of vegetable proteins, dietary fiber, and the incidence of MS — the higher the intake of these substances, the lower the incidence of MS. This information does not seem to have given rise to clinical studies to test the use of these substances as MS treatments. BiofactorsAcetyl-L-carnitine (ALC) has been studied in a cell-culture model of MS and found to be neuroprotective. The mechanism may involve suppression of free-radical nitrogen compounds, or perhaps the promotion of a nerve-growth factor. When given to MS patients in a clinical trial, ALC supplementation reduced fatigue and depression. Alpha-lipoic acid (ALA) is usually taken as an adjunct to acetyl-L-carnitine — to counteract the production of free-radicals caused by ALC. However ALA has an anti-MS effect in its own right. A recent study has shown that ALA reduces the production of an enzyme (MMP-9) that seems to be involved in MS progression. The Epstein-Barr Virus (EBV) is thought to play an important role in the pathogenesis of MS. Curcumin (aka ‘turmeric extract’) is a known inhibitor of this virus. It follows that curcumin is a candidate for treating MS. Population studies have shown correlations between MS incidence and the consumption of various vitamins and minerals. In particular, the consumption of vitamin C, vitamin D, thiamin, riboflavin, calcium, and potassium were associated with lower incidence of MS, whereas niacin consumption was associated with higher incidence. On the other hand, another study reported no such correlation for vitamin C, vitamin E, and carotenoids. Of these biofactors, only vitamin D and calcium have actually been tested as an MS treatment; their efficacy is well established. According to several Scandinavian studies, supplementation with selenium, vitamin C and vitamin E can improve the antioxidant status of MS patients and inhibit mental deterioration. Inosine has been suggested for treating MS because it is a precursor of uric acid synthesis in humans, and high uric acid levels seem to correlate with lower incidence of MS. Lecithin, choline, and phosphatidylcholine are substances involved in forming and maintaining cell membranes. They have been proposed as MS treatments because the demyelination process that occurs in MS involves alterations in the composition of cell membranes in nerves. Very little clinical work has been done to test this concept. Herbs and extractsI discussed the herb Polypodium leucotomos at the beginning of this article. As for Ginkgo biloba, the scientific medical literature is mute on this subject. However, a recent presentation at a conference of the American Academy of Neurology has made a case for using Ginkgo biloba to prevent cognitive decline due to MS. Various other herbs and extracts are used by MS patients — for example, St. John’s Wort, Valerian root, Asian ginseng, and Echinacea. These are all symptomatic treatments rather than disease-modifying treatments, and while some of them are probably useful, they are off-topic here. (Echinacea, however, is being strongly discouraged by medical professionals because of the theoretical possibility that it may exacerbate MS by stimulating the immune system.) In summaryPolypodium leucotomos has encouraging anecdotal reports to its credit as an MS treatment. The omega-3 polyunsaturated fatty acids have some scientific support and are definitely worth trying — especially fish oil. The use of dietary fiber and vegetable protein are supported indirectly, by population studies. Acetyl-L-carnitine, alpha-lipoic acid, and curcumin each favorably affect processes known to be involved in MS progression. Vitamin D and calcium are a must for MS patients, while vitamin C and the B vitamins (except for niacin) are considered helpful. In theory, at least, lecithin, choline, and phosphatidylcholine should have anti-MS properties. — Dr. Alexis Zarkov, Ph.D. You can contact Dr. Zarkov at AskDrZarkov@yahoo.com. Last modified 2005.Jun.27 ReferencesWebsite of Multiple Sclerosis Society (Britain) Management of fatigue in patients with multiple sclerosis. Drugs. 2004;64(12):1295-304. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002 Dec;21(6):495-505. Exogenous lipids in myelination and myelination. Kaohsiung J Med Sci. 1997 Jan;13(1):19-29. Lipoic acid in multiple sclerosis: a pilot study. Mult Scler. 2005 Apr;11(2):159-65. Epstein-Barr virus in pediatric multiple sclerosis. JAMA. 2004 Apr 21;291(15):1875-9. Vitamin D and multiple sclerosis. Proc Soc Exp Biol Med. 1997 Oct;216(1):21-7. Multiple sclerosis and nutrition. Mult Scler. 2005 Feb;11(1):24-32. Disclaimer: The information provided in this “Ask Dr. Zarkov” article contains no medical advice whatsoever — it contains ‘biological information’. Nothing in the article constitutes an effort to persuade readers to use, or not to use, this biological information as a basis for action. |
The fern Polypodium leucotomos is becoming a hot topic on Internet forums that deal with multiple scerosis. Do you have any information about the value
of this herb as an anti-MS treatment? Are there other anti-MS supplements that MS patients should be considering?
First I want to point out that I could not find a single scientifically conducted study of the use of Polypodium leucotomos for treating multiple sclerosis. Nevertheless, I did find many anecdotal reports of success from MS patients who use this
substance, and I found some of these reports impressive. If I were an MS patient I would certainly give this herb a try, but
would keep in mind the fact that it clearly does not work for everyone.
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