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Alternative Therapies for Multiple Sclerosis

By David Steenblock, M.S., D.O.

This review is for educational purposes only and is not intended to be a substitute for your physician's advice.

Depression and Stem Cell Therapy

One of the most common symptoms of Multiple Sclerosis is depression. A new model of depression is emerging, related to the inhibition of neural stem cell growth in the hippocampal dentate gyrus (39). Factors such as stress-related glucocorticoids that inhibit stem cell growth also induce depression.

In animals studies, corticosterone significantly reduces the proliferation of oligodendrocyte precursors throughout the white and gray matter regions of the brain (2). Since oligodendrocyte precursors play a major role in remyelination, the use of anti-inflammatory therapies may actually perpetuate depression as well as brain injury. In contract to the use of steroids for treating MS, stem cell therapies promote the proliferation of new oligodendrocytes, with the secondary benefit of alleviating depression. Generally, depression clears within 30 days following CD34+ stem cell transplantation.

Methylation and Multiple Sclerosis

Folate and vitamin B12 deficiencies (methylcobalamin has greater neurological importance than cyanocobalamin) can cause neurologic and psychiatric disturbances, including depression, dementia, and demyelinating myelopathy (9). In most cases, folate and methylcobalamin injections improve MS symptoms and prevent relapses. Treatment with additional methyl donors such as S-adenosylmethionine, betaine, or methionine can also relieve depression and promote remyelination in patients with inborn errors of folate metabolism (8).

A Comprehensive Program for MS

Stem cells seem to have the ability to greatly assist in regenerating the glial cells injured and destroyed in MS. Other wholistic approaches such as anti-virals, growth factors, antioxidants, nutritional therapies, and heavy metal detoxification should be helpful as well. Such a program could include stem cell injections while inflammation is present in the CNS (but not in other organs), followed by anti-virals, growth factors, antioxidants and nutrients to continue protecting the oligodendrocytes and axons from oxidative stress. Care must be taken for several months after stem cell administration to avoid products that inhibit neurogenesis and stem cell proliferation. Such products include cortisone, alcohol, and monosodium glutamate. Physical and emotional stress increases glucocosteroid release, and should also be avoided as much as possible.

Autoimmune Disease and Patterns of Relapsing-Remitting Episodes

The first two patterns of lesions observed in Lucchinetti's research were most common and resembled the autoimmune destruction observed in T-cell mediated and antibody-augmented forms of experimental autoimmune encephalomyelitis (13).

The Myelin Sheath

Myelin sheaths are formed around axons by spiraling plasma membranes of Schwann cells in the peripheral nervous system and oligodendrocytes in the central nervous system. Glycoproteins are prominent components of the plasma membranes and include protein zero and peripheral myelin protein-22 in peripheral nervous system myelin, myelin-associated glycoprotein located on the inside of sheaths in both the PNS and CNS and which functions in glia-axon interactions, and myelin-oligodendrocyte glycoprotein (MOG) located on the outside of CNS myelin sheaths. MOG appear to be an important target antigen in multiple sclerosis (70).

Autoimmune T-cell responses to myelin components are being investigated for their role in initiating and/or maintaining inflammatory responses resulting in myelin destruction. Myelin oligodendrocyte glycoprotein (MOG) is a myelin protein that in one study, elicits greater anti-MOG B-cell responses (38) in MS patient samples, and in another study, elicits similar T cell responses in MS patient samples and controls but with different cytokine activity. The MS samples elicited increased levels of TNF-alpha upon stimulation compared to the control samples (93). Tejada-Simon and associates found that MS patient MOG samples elicited anti-MOG antibodies reacting predominatly to the extracellular 1-60 region while control samples elicited anti-MOG antibody reactions to the transmembrane/cytoplasmic domains (residues 154-218) (89).

Autoimmune reactions have also been shown against cardiolipin (important in heart and brain mitochondrial function) and DNA in MS patients (80).

Patterns resembling Virus and Toxin-induced Immune Responses

Pattern IV was found only in patients with primary progressive disease and patterns III and IV both resembled viral or toxin-induced oligodendrocyte dystrophy.

Mercury Toxicity

Mercuric chloride is toxic at low concentrations to oligodendroglial cells, resulting in cell death through apoptosis. (34). Symptoms of mercury toxicity include chronic fatigue, depression, poor memory and cognitive function, emotional instability, peripheral numbness or tingling, decreased sensations of touch, hearing or vision, hypersensitivity and allergies, persistent infections including chronic yeast overgrowth, compromised immune function and cardiovascular disease (71). Mercury levels are often elevated in MS patients, and may result from a variety of sources.

1. Dental Amalgams Though research findings are contradictory, Huggins found a change in cerebrospinal fluid proteins following dental intervention, using CSF photolabeling. Changes were seen in ceruloplasmin, transferrin, IgG heavy and light chains, Apo E, transthyretin and other proteins. Additional markers that can be used to monitor MS include CSF, S100B and Glial-Fibrillary Acidic Protein (GFAP) (32b). S100 B was found to be a good marker for relapsing MS and GFAP correlated with Disability Scales and may therefore be a marker for neurological damage (67).

2. Mercury contamination in fish and soil Mercury is a major environmental concern, traditionally in freshwater fish and more recently because of the toxic effects on soil microorganisms. Those patients living near mercury emission sources are at greater risk of mercury contamination (58). Shark and Swordfish are reported to have the highest methyl mercury levels, and shrimp, scallops and salmon the lowest concentrations in ocean fish (31). Fish farms may not be safer than ocean fish. Fish farms may be producing fish with higher pesticide and mercury concentrations due to the use of contaminated feed sources (21).

3. Elevated insulin levels allow the cellular entry of heavy metals. Insulin is elevated by large meals, high sugar and refined carbohydrate diets, and oxidative stress. Antioxidants can help protect the cells from heavy metal toxicity.

4. Leaky Gut Syndrome can be caused by Candida endotoxins, alcohol, nutritional deficiencies,etc.which allows heavy metals and macromolecules to enter the bloodstream, causing immune and autoimmune responses, free radicals, and cell injury and death. An animal study by Keshavarzian and associates demonstrated that supplementation with oats prevented gut leakiness and endotoxin-induced liver damage (40).

Chelating factors in various foods can prevent mercury absorption, including citric acid, tartaric acid, and cysteine, (22), selenium (29), garlic (46), chlorella (also an anti-inflammatory) (101), and cilantro (64). Methyl mercury can bind with L-cysteine and be transported across the blood brain barrier. L-leucine inhibits this transport. A balanced leucine/cysteine ratio is found in whey protein (71). Calcium and magnesium are also protective against mercury and methyl mercury toxicity (81). EDTA oral and i.v. chelation methods are currently being promoted for the removal of mercury and methylmercury as well as other heavy metals. Since heavy metals can inhibit stem cell growth, chelation is advised before stem cell therapy. Oral DMSA is a proven generally safe and effective method for removing mercury and lead.

Anti-virals:

Multiple Sclerosis is associated with viral infections, including Herpesvirus 6, Epstein-Barr virus, herpes simplex, infectious mononucleosis, measles and mumps (especially after 15 years of age), Chlamydia, Mycoplasma pneumoniae, Varicella zoster, retroviruses, and nidoviruses (42).

Medicinal Plants

Ecinacea purpurea and Panax ginseng significantly enhanced Natural Killer activity and antibody-dependent cellular immunity against human herpesvirus 6 infected cells (77b).

Reticulosa

Reticulosa is a peptide-nucleic acid immunomodulator that boosts immune system activity in virally-infected patients (45). It has broad-spectrum antiviral activity that includes the stimulation of gamma interferon, interleukin-1, interleukin-6 and Tissue Necrosis Factor-alpha (32). In general, it appears free of side effects, is reasonably priced and often effective.

Acyclovir

The antiviral drug acyclovir inhibits herpesvirus-6 infection and markedly reduces the frequency of disease exacerbations in patients with MS (42).

Sea Cucumber

Sea cucumber (Cucumaria japonica) (91) and coumarins from lemon peels (59) have been shown to have an inhibitory effect on Epstein-Barr virus.

Palm Oil

Gamma- and delta-tocotrienols derived from palm oil exhibit a strong activity against Epstein-Barr virus expression (27) and may be of benefit to MS patients.

Factors that Promote Remyelination

The Ciliary Neurotrophic Family :

CNTF, leukemia inhibitory factor, cardiotrophin-1, and oncostatin M have been shown to induce a strong promyelinating effect by promoting oligodendrocyte maturation, mediated through the 130 kDa glycoprotein receptor to the CNTF family (86).

Thyroid:

T4 administration to experimental allergic encephalomyelitis animals resulted in an up-regulation of oligodendrocyte progenitors and mature oligodendrocytes in the spinal cord, ofactory bulb, and subventricular zone (11).

Thymus:

Ikehara reports that the success rate of bone marrow transplants in patients over 45 years of age is low, due to the aging of the thymus. BMT plus embryonal thymus grafts can be used to treat late-onset autoimmune disease in mice and can be a valuable strategy for treating older patients with various intractable diseases, including autoimmune diseases. (33). NatCell Thymus, a thymus extract providing a broad spectrum of thymic peptides (www.atrium-bio.com) is being used successfully to restore immune balance in patients with autoimmune disease who are not on immunesuppressants.

Adrenal Support:

Krenn presents a case of Adrenoleukodystrophy that mimicks the symptoms of multiple sclerosis. Both conditions include lesions of the white matter which may be alleviated with adrenal support. (44). Adrenal insufficiency is present in 85% of the childhood cerebral forms and in about 70% of the adult forms of adrenoleukodystrophy (26) and may contribute to white matter lesions in multiple sclerosis as well. Since adrenal extracts may also promote corticosteroid-induced stem cell injury, products such the Atrium adrenal extracts should be used several weeks before stem cell therapy to strengthen the adrenal glands.

Interleukin-1:

Mason writes that interleukin-1 beta promotes remyelination and CNS repair through inducing astrocyte and microglia-macrophage-derived insulin-like growth factor-1 (55).

Interleukin-10:

Interleukin-10 was found to protect against oligodendroglial death evoked by lipopolysaccharide and interferon-gamma. IL-10 downregulates the function of inflammatory cells and promotes survival of progenitors and differentiated oligodendrocytes. (60).

Immunoglobulin Therapy:

High-dose intravenous immunoglobulin (IVIg) treatment is being used for inflammatory demyelinating disease. The treatment protects oligodendrocyte precursor cells and oligodendrocytes by inhibiting inflammatory mechanisms (85). Unfortunately, it has a high cost, needs to be given every three weeks and does not result in remissions.

Growth Factors

Glial Growth Factor :

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of oligodendrocytes. Mice with experimental autoimmune encephalomyelitis were treated with recombinant human GGF2 during both acute and relapsing phases leading to increased remyelination, decreased symptom severity and statistically significant reductions in relapse rate (52).

Granulocyte Colony-Stimulating Factor and Stem Cells:

Telomere length decreases with cell divisions and age, and at a crucial length, is associated with chromosomal instability and cell senescence. Telomerase is a reverse transcriptase enzyme that adds nucleotides to chromosomal ends. Resting haematopoietic stem cells retain low levels of telomerase and long telomeres. Chemotherapy and stem cell transplantation may lead to the accelerated shortening of telomere length. Szyper-Kravitz and associates found that granulocyte colony-stimulating factor upregulated telomerase activity in CD34+ hematopoietic cells (thereby lengthening the telemeres) and prevents telomere attrition after chemotherapy (88).

Uric Acid:

Uric acid suppresses the MS animal model experimental autoimmune encephalomyelitis. In a study involving humans, the MS patients were found to have lower average serum uric acid levels than the controls. (17). Scott and associates showed that uric acid selectively inhibits peroxynitrite-mediated activity in multiple sclerosis and improves experimental autoimmune encephalomyelitis in mice (77).

Glatiramer acetate has been approved by the FDA for use in relapsing MS and may improve clinical symptoms by increasing uric acid levels. However, the drug can have adverse effects. Chlorella and/or Inosine may also be effective but with fewer side effects. High copper levels induce low levels of uric acid while also having a pro-inflammatory effect. Thus a low copper diet may be indicated. Vitamin B2 is a cofactor for xanthine oxidase, whose deficiency can also contribute to low uric acid levels (36).

Inosine:

Inosine is a precursor of uric acid. High levels of inosine given to 11 MS patients stopped the progression of disease in all of the patients and improved clinical symptoms in 3 of the patients (83).

Chen and associates found that the administration of inosine to rat models for experimental stroke resulted in significant axonal rewiring and improved motor function (15) and may therefore also improve axonal growth in MS patients. Further work concluded that the mode of inosine in experimental allergic encephalomyelitis was via its metabolism to uric acid (77).

Chlorella:

This single cell fresh water detoxifying algae raises uric acid levels safely and consistently and should be considered by any person with MS.

Creatine:

Phosphocreatine increases ATP regeneration which is important in supporting remyelination by oligodendrocytes (78a).

Vitamin B12 Injections (Methylcobalamin rather than cyanocobalamin):

Cyanocobalamin activates glutamate receptors and promotes inflammation. Methylation is important in remyelination. Methyl donors include folate, betaine, methionne and S-adenosylmethionine. Vitamin B12 deficiencies are associated with demyelination and axonal degeneration (14a). Methylcobalamin improves evoked potentials and nerve regeneration (43a,44a).

Ginseng:

Ginseng increases Nerve Growth Factor which stimulate the growth of new oligodendrocytes (34a).

Gingko biloba:

Gingko biloba contains factors that stimulate Glial Cell Line-derived Neurotropic Factor in astrocytes. However, Gingko may also inhibit cytochrome P450 metabolism of other medications.

Vitamin A:

Retinol levels for untreated relapsing-remitting (RR) MS patients was found to be lower than for patients with noninflammatory neurological disease (73a). All-trans-retinoic acid (in cod liver oil) increases Ciliary Neurotrophic Factor, important in oligodendrocyte maturation and myelin production (99a, 50a). Retinoic acid also promotes myelin immune defense (50a).

Moderate sunshine/vitamin D:

Vitamin D is associated with alleviating autoimmune disorders. Vitamin D stimulates Brain Derived Neurotropic Factor which protects thymocyte precursors and regulatory feedback mechanisms involved in thymocyte differentation and immune function (52a).

Spasticity

Threonine:

Hauser and associates used the amino acid L-threonine with 26 ambulatory MS patients with spasticity. Threonine at a daily dose of 7.5 g reduced signs of spasticity without the side effects of sedation and increased motor weakness found in anti-spasticity drugs used for MS. Threonine is a precursor for glycine biosynthesis and may enhance glycinergic postsynaptic inhibition of the motor reflex (30). Also see the section on magnesium below.

Antioxidants

Free radicals, including peroxynitrite are induced in Multiple Sclerosis. Antioxidants can help protect the neural tissue from damage, induced by inflammatory cascades that result in free radical pathology and oxidative stress. Nordik investigated the clinical effects of providing dietary advice, vitamin supplementation and fish oil supplementation to newly diagnosed multiple sclerosis patients. At the end of a two year period, there was a significant reduction in the mean annual exacerbation rate and the mean Expanded Disability Status Scale (EDSS) as compared to pre-study values. Plasma total phospholipid n-3 fatty acids increased and n-6 fatty acids decreased significantly (62). The cod liver oil and fish oils used should be free of heavy metals.

Antioxidants and Tissue Necrosis Factor alpha:

TNFalpha, a pro-inflammatory cytokine, has been associated with demyelinating disorders, including Multiple Sclerosis. It reduces the gene expression (PPARdelta), responsible for oligodendrocyte survival and differentiation in oligodendrocyte progenitor cells. The reduction in PPARdelta gene expression results in reductions in myelin synthesis, maturation and turnover (16). TNFalpha is inhibited by green tea, curcumin, (76), quercetin (35) and resveratrol (98).

Antioxidants and Lipopolysaccharide / Foods as Medicine

1. The "leaky gut" syndrome allows bacterial lipopolysaccarides to enter the blood stream. Lipopolysaccharides (LPS) are associated with extensive oligodendrocyte death (47). Several natural products have the ability to protect the microglia from lipopolysaccharide-induced neurotoxicity. LPS is a component of the bacterial wall of gram-negative bacteria and is one of the most potent activators of host inflammatory response and tissue injury. LPS treatment of microglial cells activates both p38 mitogen-activated protein kinase and nuclear factor-kappaB (NFkappaB), with consequent increases in interluekin-1 alpha, tumor necrosis factor-alpha (TNF-alpha), and nitric oxide (NO) production (49). LPS also increases stress indices, including plasma corticosterone and glucose concentrations; alterations in brain oxidative status, including elevated malondialdehyde levels (a lipid peroxidation index) and decreases in reduced glutathione; and brain metabolism disturbances including reductions in ATP/ADP ratios and increases in mitochondrial/cytosolic hexokinase ratios (41).
2. Silymarin from milk thistle can reduce LPS-induced superoxide generation and nuclear factor kappaB activation (99).
3. In in vitro studies, Vitamin E (alpha-tocopherol) activates microglial activity and silences an LPS-activated NF kappa B signaling cascade. The results suggest that alpha-tocopherol can induce quiescence to pathways associated with acute or chronic inflammatory conditions in the central nervous system (21b).
4. Melatonin functions as an antioxidant and has the ability to protect neurons from lipopolysaccharide-induced oxidative stress (72).
5. N-acetylcysteine, a thiol antioxidant significantly reduces LPS-induced ROS production (superoxide anion), TNF alpha levels and NF-kappa B activity in macrophages from mice with lethal endotoxic shock. The levels approached those of macrophages from the control animals (94).
6. Estrogen and progesterone, at concentrations consistent with late pregnancy, inhibit LPS-induced nitric oxide and TNF-alpha production by activated microglia, and may contribute to the decreased severity of MS symptoms associated with pregnancy (20). Dr. Bansil and associates found a relationship between relapsing-remitting MS in 30 women and hormone fluctuations in the menstrual cycle. Those patients with a high estrogen to progesterone ratio had a significantly greater number of active MRI lesions than those with a low ratio (4). Progesterone is a known immune quieting agent.
7. Green Tea, containing catechin and (-)-epigallocatechin-3-gallate (EGCG), has the ability to inhibit lipoplysaccharide and gamma-interferon-induced oxidative stress (3). Black tea has similar effects from inhibiting LPS-induced IkappaB kinase and NFkappaB activity (66).
8. Artichoke (102) has protective properties against inflammatory mediators, TNF alpha and LPS, in vitro.
9. Carnosol is a naturally occurring phytopolyphenol found in rosemary. Carnosol functions as an antioxidant and anticarcinogen. Carnosol significantly reduced LPS-induced nitric oxide and NF-kappa B production in a dose-dependent manner (50).
10. Quercetin (in onions and garlic) significantly inhibited LPS-induced nitric oxide production and suppressed the release of NF-kappaB (61).
11. The combination of Ginkgo biloba and quercetin were effective in inhibiting LPS-induced NF-kappa B as well as TNF-alpha activation (96).
12. Avocado contains antioxidants (persenone A and B) that can inhibit superoxide and nitric oxide generation induced by lipopolysaccharide and interferon-gamma in mouse macrophage cells (43).
13. Resveratrol in grape juice (red wine's alcoholic content can increase homocysteine levels-(7) has antioxidant and anti-inflammatory effects. Resversatrol strongly inhibits LPS-induced superoxide radical and hydrogen peroxide, arachidonic acid release, and cyclooxygenase-2 induction (54).

Alpha-Lipoic Acid

Alpha lipoic acid was administered to mice with experimental autoimmune encephalomyelitis resulting in minimal inflammation and reductions in demyelination and axonal loss in the spinal cord. Alpha lipoic acid inhibited the activity of metalloproteinase-9 in a dose-dependent manner. The authors conclude that alpha lipoic acid is highly effective at suppressing and treating experimental autoimmune encephalomyelitis and does so by inhibiting T cell trafficking into the spinal cord, perhaps by acting as a metalloproteinase inhibitor (52).

Vitamin E Succinate and all-trans-retinoic acid:

Vitamin E Succinate suppressed Epstein-Barr growth by 87% in vitro and all-trans-retinoic acid blocked Epstein-Barr activity by 58% in vitro, via transforming growth factor beta (92). Transforming Growth Factor Beta plays a role in neuronal survival and regeneration in Schwann Cell lesions (56). Vitamin E has direct neuroprotective antioxidant effects as well as anti-inflammatory indirect effects. Vitamin E inhibits microglial activation by suppressing the LPS-induced p38 MAPK and Nfkappa B signaling effects necessary for microglial activation (49).

Multiple Antioxidant Therapy

Odinak treated 14 patients with relapsing-remitting MS with a combination of antioxidants and neuroprotectors with various mechanisms of action (lipoic acid, nicotinamide, Acetyl cysteine, Beta-carotine, alpha-tocopheryl acetate, ascorbic acid, selenium, pentoxifylline, cerebrolysin, and Amantadine hydrochloride for a duration of one month, twice a year. The treatment resulted in a significant reduction (2-3 times) of relapse frequencies in multiple sclerosis patients and a decrease of required corticosteroid medication. After antioxidant therapy the content of lipid peroxide products was significantly reduced and the author recommends antioxidant and neuroprotective program in relapsing-remitting multiple sclerosis (63).

Autoimmune Suppression

Moderate Sunlight/Vitamin D

Dihydroxyvitamin D3 can either prevent or markedly suppress experimental autoimmune encephalomyelitis, rheumatoid arthritis, systemic lupus erythematosus, type I diabetes, and inflammatory bowel disease. The animals also needed to be on moderate to high calcium diets. Vitamin D hormone stimulates transforming growth factor and interleukin-4 production, which may suppress inflammatory T cell activity (19). In an animal study using the multiple sclerosis model of autoimmune encephalomyelitis, the administration of 1,25-dihydroxyvitamin D3 demonstrated rapid clinical improvement in the rats, accompanied by an inhibition of CD4, MHC class II and type II nitric oxide synthase expression (25). 1,25-dihydroxyvitamin D3 has also been reported to increase intracellular levels of glutathione, important in protecting neurons from oxidative stress-induced injury (79).

In addition, photoimmunology studies have shown that ultraviolet B can specifically attenuate autoimmune disease processes, perhaps by increasing vitamin D levels (68).

Cyclosporin A is widely used as an immunosuppressant by suppressing cytokine gene expression and inhibiting T lymphocytes. It may also protect against white matter lesions in stroke during hypoperfusion (97). However, the use of cyclophosphamide, either alone or in combination with Cyclosporin showed a significant reduction in oligodendrocyte-mediated remyelination in rat spinal cord demyelinated lesions (82).

Anti-inflammatory Diet

Vegan Diets

Quasi-vegan diets are beneficial in the management of rheumatoid arthritis, MS, and SLE (57) In his Integrative Management approach to Multiple Sclerosis, Dr. Kidd suggests a diet low in saturated fats, three fish meals per week, and the elimination of allergenic foods and products. Small frequent meals are preferable to large three meals a day. Also avoid animal fats, fried foods, sugars and sweets, and processed and refined foods.

Fresh, whole fruits, vegetables, grains, legumes, nuts and seeds include a synergy of bioavailable nutrients, enzymes, antioxidants and fiber that can retard and reverse age-related declines in cognitive and motor performance in rats (24) and can be an important component in a total lifestyle program for maximizing neuronal and cognitive function and reversing disease in humans.

Reduce Allergenic Foods

The avoidance of milk may benefit patients with MS. Peptides in milk can mimic antigens in myelin. CNS degeneration that resembles MS can be induced in mice with milk peptide injections (42).

Fatty Acids

Dietary omega-3 fatty acids can be of great benefit to MS patients. Omega-3 fatty acids have been shown to alleviate pain in autoimmune disorders by inhibiting inflammatory mediators (eicosanoids and cytokines) in peripheral tissues as well as in glial cells Omega-3 fatty acids modulate voltage-gated calcium channels in heart and brain cells, preventing electrical hyperexcitability and a cascade of events leading to cell depolarization, oxidative stress, inflammation, cell injury and pain. Omega-3 fatty acids are safe as long as they supply less than 10% of the total energy intake and are given with sufficient amounts of vitamin E (78). Cod liver oil with its vitamin A and D content (1 tablespoon 2-3 times a day) is often of great benefit to MS patients.

Lecithin

Abnormal lipid metabolism in the brain is often seen in subjects with multiple sclerosis. Lecithin cholesterol acyltransferase from the cerebrospinal fluid was investigated in 16 subjects, half control subjects and half with active demyelinating disease. The levels of lecithin cholesterol acyltransferase in patients with active demyelinating disease or multiple sclerosis was only about half of that found in the control subjects (1).

Magnesium

Magnesium, zinc and calcium have been found to be deficient in central nervous system tissue in MS patients, especially in white matter tissue (100). Magnesium is important for the metabolism of thiamine, calcium, potassium, phosphorus, iron, sodium, hydrogen chloride, acetylcholine, nitric oxide, and for many enzymes, and for the elimination of lead and cadmium. Calcium and magnesium are also important in the development, structure and stability of myelin (28). A magnesium deficiency is associated with increased inflammation. The pathologies associated with magnesium deficiency range from cardiovascular disease to cancer and include peroxynitrite damage in multiple sclerosis (37). The effects of magnesium glycerophosphate oral therapy were studied in a woman with severe spastic paraplegia resulting from MS. There was significant improvement in the spasticity after only one week of treatment. No side effects were reported (73). Natural sources of magnesium include fresh green vegetables (chlorophyll), raw wheat germ, soybeans, low fat milk, whole grains, fish, figs, corn, apples, and almonds.

Octacosanol contained in wheat germ and wheat germ oil increased endurance, total body reaction times, ECG, brachial pulse waves, pulse rate test, basal metabolism and oxygen intake tests in a physical training program with 894 subjects (18). Octacosanol is a constituent of Policosanol, now being used for cardiovascular health. Dr. Atkins was successful in treating MS patients with a low-carbohydrate diet, supplemented with vitamin B12, vitamin D3, fish oil, octacosanol, L-carnitine, coenzyme Q10, panthethine vitamin C, and calcium AEP (www.stkinscenter.com).

Digestion, Assimilation and Gut Flora

Patients with Inflammatory Bowel Disease have shown MS type lesions on the MRI, suggesting a link between gut dysbiosis and brain disorders (42).

Pancreatic enzymes

Pancreatic enzymes have been used to help reduce malabsorption and help disperse circulating immune complexes.

Anti-Candida Programs

Candida antibodies are often present in MS patients, suggesting an on-going chronic gastrointestinal yeast infection. This irritates the gut causing increased gut permeability and the subsequent absorption of glial toxic lipopolysaccharides. Transfer Factor, in conjunction with an aggressive anti-Candida program and probiotic recolonization should improve this condition.

In conclusion, there are a number of factors that can help promote stem cell proliferation and differentiation, reduce viral infections and inflammation, promote antioxidant defenses against oxidative stress and rebalance the gut flora, if needed. Test results of specific deficiencies should be used to devise rotating diets for each MS patient.

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