Get answers to your Multiple Sclerosis questions.
People with multiple sclerosis should make every effort to preserve their general health. A healthy diet, sufficient rest, establishing priorities to conserve energy, and developing emotional support networks can all be very helpful.
Patients with MS can benefit from various rehabilitation services to help them cope with the physical and emotional symptoms of their condition.
Physical Therapy. Physical therapists can provide professional guidance on exercise programs. Patients with MS should engage in a variety of exercises including stretching, muscle strengthening, and range-of-motion. Exercise can help reduce fatigue and relieve muscle spasticity. Physical therapists can also provide advice on how to best use mobility aids (canes, crutches, scooters) and other assistive devices.
Occupational Therapy. Occupational therapists help patients learn how to improve their functioning and independence within their home and workplace environments. They can provide professional advice on what sort of adaptive tools, such as grab bars, should be used in the bathroom, bedroom, and kitchen. Occupational therapists may also be able to evaluate and treat problems with thinking and memory.
Vocational Therapy. Vocational therapists provide guidance on how patients can best manage in the workplace.
Speech / Language Therapy. Speech/language therapists treat problems with speech and communication, and can also help address problems with swallowing.
Some dietary suggestions for patients with MS include:
Special diets, such as those that are gluten- or yeast-free, do not have any direct effect on the symptoms or course of MS.
Body overheating causes demyelinated nerves to function less efficiently than usual. Although this effect is resolved within a few hours of regaining normal body temperature, active cooling can help reduce fatigue and improve stability. As a result, researchers are studying the effectiveness of cooling suits.
The following measures may help:
MS symptoms worsen during a cold or the flu, probably because of increased immune system activity. Doctors recommend that patients with MS receive a flu shot in the fall. However, patients should not take the nasal spray version of the flu vaccine (FluMist Intranasal). Unlike the flu injection vaccine, which uses an inactivated virus, FluMist contains a live virus. Live virus vaccinations may be harmful for people with MS, especially those who take immune-suppressing drugs.
Many patients with MS try some form of nontraditional remedies. Research on any benefits is slim, and there may be some danger with certain herbal remedies. Alternative therapies used to treat MS include:
Relaxation and Meditation Techniques. Patients may try relaxation, meditation, biofeedback, music therapy, yoga, tai chi, and massage therapy. They are generally harmless, and possibly helpful.
Acupuncture. Some patients report benefit from acupuncture.
Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should check with their doctor before using any herbal remedies or dietary supplements
The following warnings are of particular importance for people with multiple sclerosis:
Antioxidants. Some patients use antioxidant vitamins or supplements, since the destruction in the MS disease process may be partly due to oxidation (chemical damage from particles called oxygen-free radicals). Theoretically, however, antioxidants can trigger T cells and macrophages (inflammatory components of the immune system) and, therefore, may pose some danger to patients. Small studies to date have not found any worsening of the disease from taking vitamin supplements, but patients should be cautious. No vitamins studied for MS, including carotenoids, vitamin C, vitamin E, B12 injections, or vitamin D, have been proven to be beneficial.
Gingko. Although the risks for gingko appear to be low, there is an increased risk for bleeding at high doses. Ginkgo can also interact with high doses of vitamin E, anti-clotting medications, aspirin, and NSAIDs. Large doses have also been known to cause convulsion. Randomized trials have failed to show any benefit.
Bee Venom. For years, anecdotal reports have claimed that bee stings relieve some MS symptoms, although a study on mice indicated that it may worsen MS. Bee venom contains many chemicals, some of which can cause severe and sometimes deadly allergic reactions in some people.
Linoleic Acid. Linoleic acid, commonly known as evening primrose oil, is a polyunsaturated fatty acid believed by some people to be helpful because myelin is composed of fatty acids. No study has proven that it is beneficial, but supplements sold in health food stores do not appear to be harmful.
Calabresi P. Multiple sclerosis and demyelinating conditions of the central nervous system. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 436.
Correale J, Fiol M, Gilmore W. The risk of relapses in multiple sclerosis during systemic infections. Neurology. 2006 Aug 22;67(4):652-9. Epub 2006 Jul 26.
Farinotti M, Simi S, Di Pietrantonj C, McDowell N, Brait L, Lupo D, Filippini G. Dietary interventions for multiple sclerosis. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004192.
Goodin DS, Cohen BA, O'Connor P, Kappos L, Stevens JC; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008 Sep 2;71(10):766-73
International Multiple Sclerosis Genetics Consortium, Hafler DA, Compston A, Sawcer S,Lander ES, Daly MJ, et al. Risk alleles for multiple sclerosis identified by a genomewide study. N Engl J Med. 2007 Aug 30;357(9):851-62. Epub 2007 Jul 29.
Kappos L, Freedman MS, Polman CH, Edan G, Hartung HP, Miller DH, et al. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet. 2007 Aug 4;370(9585):389-97.
Khan F, Ng L, Turner-Stokes L. Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD007256002819.
Lovera J, Bagert B, Smoot K, Morris CD, Frank R, Bogardus K, et al. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebo-controlled trial. Mult Scler. 2007 Apr;13(3):376-85. Epub 2007 Jan 29.
Multiple Sclerosis Therapy Consensus Group (MSTCG), Wiendl H, Toyka KV, Rieckmann P, Gold R, Hartung HP, et al. Basic and escalating immunomodulatory treatments in multiple sclerosis: current therapeutic recommendations. J Neurol. 2008 Oct;255(10):1449-63. Epub 2008 Oct 29.
Prakash RS, Snook EM, Lewis JM, Motl RW, Kramer AF. Cognitive impairments in relapsing-remitting multiple sclerosis: a meta-analysis. Mult Scler. 2008 Nov;14(9):1250-61. Epub 2008 Aug 13.
Ransohoff RM. Natalizumab for multiple sclerosis. N Engl J Med. 2007 Jun 21;356(25):2622-9.
Rojas JI, Romano M, Ciapponi A, Patrucco L, Cristiano E. Interferon beta for primary progressive multiple sclerosis. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006643.
Schippling S, Heesen C, Zander A, Martin R. Stem cell transplantation in multiple sclerosis. J Neurol. 2008 Dec;255 Suppl 6:43-7.
Wiendl H, Hohlfeld R. Multiple sclerosis therapeutics: unexpected outcomes clouding undisputed successes. Neurology. 2009 Mar 17;72(11):1008-15.
© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.866.408.6885