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Personal Framework for
Multiple Sclerosis Prevention and Control
Sources:    Research References/Bibliography
Knowledge to Help Yourself Knowledge gives a person many options for managing Multiple Sclerosis and they can then personally take charge of the effect this disease is having on their life.
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Nutrient Associations


Vitamin B12

Vitamin E

Vitamin C


Nutrient Cofactors:
N-Acetyl Cysteine
Grape Seed Extract
Co-enzyme Q10
Bilberry Extract
Ginkgo biloba

  • Digestive Enzymes-- Like other autoimmune diseases, MS is associated with an increased level of circulating immune complexes. Experimental and clinical studies have shown that protein-digesting enzyme preparations are effective in reducing circulating immune-complex levels in several of these diseases. Furthermore, clinical improvements in MS symptoms correspond with decreases in immune-complex levels. In 1986 the German-based Drs. Ransberger and van Schaik conducted a treatment of multiple sclerosis using pancreatic digestive enzyme preparations. Their patients experienced reduced severity and frequency of symptom flare-ups [Ransberger, et al. "Enzyme Therapy in Multiple Sclerosis." Der Kassenarzt (German Journal) v.41. (1986) p.42-45]. Especially good results were noted in cases of visual disturbance, sensory disturbances, and urinary, bladder and intestinal malfunction. However, it should be pointed out that little effect on spasticity, dizziness, or tremor was reported.

  • Vitamin B12-- Acquired deficiency of vitamin B12, as well as inborn errors of metabolism involving this vitamin, are well-known causes of demyelination of nerve fibers in the central nervous system. There are several reports in the medical literature that vitamin B12 levels in the serum, red blood cells, and CNS are low in multiple sclerosis. The coexistence of a Vitamin B12 deficiency in MS may aggravate the disease or promote another cause of progressive demyelination [Sandyk, et al. "Multiple Sclerosis and Vitamin B12 Metabolism." Journal of Neuroimmunology. V.40. (1992) p.225-230].

  • Recently, researchers in Japan sought to (1) clarify the state of vitamin B12 metabolism in twenty- four Japanese patients with MS and (2) determine if vitamin B12 in massive doses provided any therapeutic benefit in chronic progressive MS. The researchers found that the level of vitamin B12 in the serum was normal, but that there was a significant decrease in the unsaturated vitamin B12 binding capacities in the patients with MS, indicating a defect in the transport of vitamin B12 into cells. In six patients with severe chronic progressive MS, the oral administration of 60 mg of vitamin B12 per day improved both visual and brain-stem auditory response by nearly thirty percent. Motor function did not improve, indicating that pathways toward the brain benefit from vitamin B12 while pathways away from the brain do not.

    The results produced are on a par with those produced by drug treatments with the combination of high-dose intravenous cyclophosphamide plus steroids. However, while this drug combination is associated with profound immune suppression and toxicity, no side effects or toxicity exists with high doses of vitamin B12 since it is water soluble and any unused portion passes out of the body in about 6 to 8 hours.

  • Ginkgo Biloba Extract-- The increased levels of lipid peroxides and other indicators of free-radical damage in the central nervous system in patients with MS suggests the need for antioxidant support. Ginkgo bilobaextract demonstrates impressive results as an antioxidant, exerts positive effects on platelet function, improves blood flow to the nervous system, and has been shown to enhance nerve cell functions [Brochet et al. "Double-Blind Placebo-Controlled Multi-Center Study of Ginkgolide B in the Treatment of Acute Exacerbations of Multiple Sclerosis." Journal of Neurology, Neurosurgery Psychology v.58 (1995) p.360-362]. Of course long-term studies need to be conducted, but to date no toxic or adverse effects have ever been reported with ginkgo biloba supplementation.

  • The EFAs (essential fatty acids--omega-3 and omega-6 fats) are nutrients for healthy cellular membrane and neural function.

  • At least three double-blind trials exist where omega-6 (linoleic acid) EFA supplementation was investigated as a treatment for MS. Results indicated that patients with this omega-6 supplementation had a smaller increase in disability, and reduced severity and duration of relapses, compared with controls. [Dworkin, et al. "Linoleic Acid and Multiple Sclerosis: A Reanalysis of Three Double-Blind Trials," Neurology v.34. 1984. 1441-1445]

  • Omega-3 oils are important in maintaining normal neural function and myelin production. The omega-3 oils are incorporated into the myelin sheath, where they increase fluidity and improve neural transmission. Although not validated as effective MS therapy through research, this known neural functionality would indicate the importance of adequate omega-3 when dealing with MS.

  • Many studies have demonstrated a reduced capacity to detoxify free radicals in patients with MS. The key factor appears to be a reduced activity of the antioxidant enzyme glutathione peroxidase (GSH-Px). [V.K.S. Shukla, G.E. Jensen, and J. Clausen, "Erythrocyte Glutathione Peroxide Deficiency in Multiple Sclerosis," Acta Neurol Scand 56 (1977):542-50.] Since GSH-Px is intricatly involved in the protection of cells from free-radical damage, decreased activity level would leave the myelin sheath particularly sensitive to damage. In response to free-radical exposure, lipid peroxides are formed.

  • GSH-Px is found in two forms: a selenium-dependant enzyme and a non-selenium-dependant enzyme. Since low selenium areas often overlap with high-frequency-rate areas for MS, it is natural to speculate that a link might exist between selenium levels, GSH-Px activity, and MS. Studies linking MS to selenium levels have given conflicting results. Initial studies supported the link between MS and selenium levels [Wilkstrom, Westermarck, et al. "Selenium, Vitamin E and Copper in Multiple Sclerosis," European Neurology v.22. 1983. 442-446], but a subsequent study, found that reduced GSH-Px activity was independent of selenium [Szeinberg, et al. "Decreased Erythrocyte Glutathione Proxide Activity in Multiple Sclerosis," Acta Neurology Scandanavia v.60 1980 61-67].

  • This conflict doesn't mean that selenium supplementation is a dead end; it could have resulted because cofactor antioxidant nutrients (vitamin E and copper) were present in the successful link study and were not included in the study that found no coorelation. Also, individual genetic factors play a major role in both low GSH-Px and selenium absorption. One could logically conclude that many individuals may benefit from selenium and cofactor nutrient supplementation, but that others may not have noticable improvements.

    Because of the established malabsorption patterns of MS, the proven association of certain nutrients to certain body functions and to MS therapy, the improvements found from the Swank program, and the absence of risky side effects, it is logical to conclude that nutrient supplementation is a therapeutic option for MS. The following would be our suggestion:

  • Follow the Swank Daily Diet Guidelines stated below.

  • Assist the body with nutrient absorption from foods and supplements by daily including 1000 to 1600 mg of a digestive enzyme formula that contains bromelain, papain, pancreatin, pepsin, betaine HCL, and ox bile (spread throughout the day).

  • Supplement each day with a complete coverage of vitamins, minerals, amino acids, and essential fatty acids (EFAs) for the body to uptake and use in daily function and repair. Do not rely on just food sources since the complete nutrient value of many foods (even fresh foods and vegetables) can not be securely known and would leave a possible door of deficiency open.

  • Include at least 1 Tbsp (approx. 1600 mg) of EFA per day, 200+ mcg Vitamin B12, 800 IU of Vitamin E, 1000+ mg Vitamin C, 100+ mcg selenium, 20 mg zinc, and additional antioxidants like N-Acetyl Cysteine, Lycopene, Grape Seed Extract, Co-enzyme Q10, Quercetin, Bilberry Extract, etc.

  • Include 40-80 mg Ginko biloba extract three times per day.

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Lifestyle Changes

    Here Comes the Sun!
  • A diet including mostly vegetables, eggs, fruits, whole grains, raw nuts and seeds, and cold-pressed vegetable oils (no Crisco, Sun, or other common hydrogenated grocery store vegetable oils).

  • Limit saturated fats and animal , since the processing of saturated fats uses up EFAs and thereby result in a lower available quantity for neural myelin support.

  • Drink at least eight 8-oz glasses of water daily to prevent toxic buildup in the muscles.

  • Eliminate alcohol, caffeine, fried foods, highly seasoned foods, meat, oats, refined foods, last spices, sugar, and tobacco.

  • Get tested for possible food allergies.

  • Avoid stress and anxiety by performing relaxation exercises (deep breathing, meditation, prayer, visualization).

  • Avoid exposure to heat, such as hot baths, showers, sunbathing, and overly warm surroundings, and avoid becoming overheated when working or exercising.

  • Utilize massage, get regular exercise, and keep mentally active. These are extremely valuable in maintaining muscle function and bringing about remission of symptoms. Swimming is the best activity, or other exercises in the cool water, because increased body temperatures can decrease the function of hte nerves involved and make symptoms worse.

  • Dr. Roy Swank began successfully treating patients with his lowfat diet in 1948. His research and clinical work as Professor of Neurology at the University of Oregon Medical School, provides convincing evidence that his dietary suggestions over a long period of time tends to retard the disease process of MS and reduce the number of attacks [Swank, "Multiple Sclerosis: Twenty Years on Low Fat Diet." Archives of Neurology v.23 (1970) p.460-474]. Dr. Swank recommends: A saturated fat intake of no more than 10 grams per day A daily intake of 40 to 50 grams of polyunsaturated oils per day (margarine, shortening, and hydrogenated oils are not allowed) At least 1 tsp of cod liver oil per day, A normal allowance of protein Consumption of fish three or more times per week.

  • A diet low in saturated fats significantly restricts many animal sources of protein or would require very lean sources of animal protein (i.e. baked chicken breast). The patient should derive protein from other sources (legumes, grains, and vegetables). While meat consumption is advised, cold- water fish (mackeral, salmon, herring) are one of the best sources because of the protein content and also the beneficial omega-3 oils they contain.

  • Swank's diet was originally thought to help patients with MS by overcoming an essential fatty acid deficiency. Currently, it is thought that the beneficial effects are probably a result of (1) decreasing platelet aggregation, (2) decreasing an autoimmune response, and (3) normalizing the decreased essential-fatty-acid levels found in serum, erythrocytes, and, perhaps most importantly, the cerebrospinal fluid in patients with MS.

  • Swank's diet significantly reduces the platelet adhesiveness and aggregation that is observed in atherosclerosis as well as in multiple sclerosis. Excessive platelet aggregation and very small clumps of platelets are thought to result in the following abnormalities observed in MS: damage to the blood-brain barrier, alterations in the microcirculation of the central nervous system, and reduced blood flow to the brain.

  • MS patients have been shown to have an abnormal blood-brain barrier, presumably as a result of excessive platelet adhesiveness and aggregation. Damage to the blood-brain barrier may allow the passage of blood components that are toxic to myelin into the cerebral spinal fluid; these components include bacteria, viruses, antibodies, toxic chemicals, and other compounds. Reduced blood flow may also be a contributing factor in demyelination, by promoting both cellular death and the release of self-destructing enzymes.

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    Medical Options and Precautions

  • The effect of diet on platelets is important in MS, but probably more important is the effect that fatty acids have on the activity of the immune system. Immune-suppressing drugs such as adrenal steroids, cyclophosphamide, and methotrexate yield good short-term benefits, but are of limited value in the long run due to their high risk side effects and lack of demonstrable long-run effectiveness. The idea behind using drugs which suppress the immune system in MS is based upon the theory that MS is an autoimmune condition where the immune system is attacking and destroying the myelin sheath. Currently, new immune-suppressing drugs are being tested for use in treating MS. However, considering the lack of toxicity and long-run effectiveness, Swank's dietary approach with stepped up nutritional supplementation to secure adequate nutrient coverage and possibly yield quicker improvements appears to be more appropriate and safer ways of modulating the immune response.

  • Concerned individuals should become knowledgeable about the side effects of any drugs they are taking and with that awareness establish with their health care practitioner a comprehensive treatment program with the lowest possible risk.

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