Vitamins, Minerals and Supplements
The Use of Supplements for Multiple Sclerosis
In your search for ways to support your health and alleviate symptoms associated with multiple sclerosis, you might seek options in addition to treatment with a disease-modifying therapy (DMT). Many people report that vitamins, minerals, herbs and other supplements improve their sense of well-being, increase their satisfaction with their healthcare experience, give them a sense of more control over their disease management and help manage their MS symptoms.Keep in mind that:
- The U.S. Food and Drug Administration (FDA), which studies medications, does not test supplements before consumers buy them. But they do require supplement manufacturers to adhere to Current Good Manufacturing Practices (CGMP) to ensure the quality and safety of these products.
- To ensure the quality and safety of a product, look for supplements that have been certified by a third-party testing organization such as NSF, USP, Banned Substances Control Group or ConsumerLab.
- Some supplements (e.g., Echinacea, elderberry), when used regularly, may actually worsen MS by overstimulating the immune system.
- Some supplements may interfere with medications or medical conditions and may not be safe to use.
- Taking high doses of any supplement may cause health issues.
Common Supplements Used by People With MS
- This supplement offers some benefits for MS. Vitamin D3:
- Promotes the absorption of calcium, which is necessary for bone health
- Supports immune response to infections
- Helps limit inflammation and regulate the immune system
Several studies have shown that, among other factors, a low level of vitamin D increases the risk of getting MS. Other studies suggest that low vitamin D may be associated with more MS activity. However, scientists are still trying to figure out the link between vitamin D and MS, and whether a low level can affect the disease course.The best natural source of vitamin D is through exposure to sunlight, but it can be hard to get enough sunlight exposure in certain climates and during certain times of year. You can get some vitamin D through food sources such as:- Beef liver
- Egg yolks
- Fortified foods, such as milk and juices
- Oily fish, such as salmon or tuna
- Pork
- Vitamin B9 (folate) and vitamin B12 (cobalamin) are interconnected and play a role in the proper functioning of the nervous system. Deficiency of vitamin B12 results in folate deficiency. Some studies have found that vitamin B12 deficiency can be more common among people with MS when compared to people without MS. Talk to your doctor about checking your levels of vitamin B12, and two metabolites, methylmalonic acid and homocysteine, to determine appropriate treatment.
- Ideally, you would get the recommended daily allowance of vitamins, minerals and other essential nutrients from whole foods. But it can be difficult to consistently eat a varied and balanced diet. Supplements such as multivitamins are meant to fill gaps in your nutritional needs. If you are taking a multivitamin in addition to other vitamins and supplements, make sure that your total dose of each vitamin and supplement is appropriate.
- Fat is an essential nutrient for the body. While some fats are unhealthy, others, such as polyunsaturated fats, help lower cholesterol and the risk of heart disease.Some studies have suggested that omega-3 fatty acids may have anti-inflammatory and neurological health benefits. Omega-3 fatty acids are found in:
- Certain fatty fish, such as salmon, mackerel, herring and sardines
- Fish oil products
- In smaller amounts, in flaxseed and walnuts
- Make Copaxone®, Avonex®, Betaseron® and Rebif® less effective, but it is unlikely
- Interact with anticoagulant medications such as warfarin (Coumadin®), enoxaparin (Lovenox®), heparin, aspirin and other drugs with aspirin-like effects
- Decrease the effectiveness of insulin, oral diabetes medicine and medications for high blood pressure
- Some studies suggest that lipoic acid may help reduce brain atrophy in people with MS. More studies are needed in order to showcase definitive evidence. Lipoic acid may cause kidney issues. If you take it, be sure your healthcare provider monitors your kidney function. It can also interact with medications and can cause hypoglycemia. Discuss with your doctor before taking to determine benefits versus risks and appropriate dosing.
- Magnesium contributes to hundreds of essential metabolic reactions, including energy production, nerve signal transmission, and muscle contraction. While many whole foods like green leafy vegetables, legumes, nuts and seeds contain magnesium, many people do not get enough magnesium in their diet.Studies suggest that magnesium can help with the management of constipation, may be used topically to help relieve muscle soreness and improve sleep. More robust studies are needed to further support its uses. Talk to your doctor about whether magnesium is right for you and what type and dose would be best.
- Growing evidence shows interactions among the gut microbiome, the immune system and the central nervous system. People with MS have an altered gut microbiome when compared to healthy controls. In a small, randomized control trial looking at the use of probiotics by people with MS, patients reported favorable effects on clinical disability, mood, and inflammatory and metabolic markers. Additional study is needed. Discuss the use of probiotics with your doctor.
Antioxidant Vitamins
- Cranberry fruits are grown for their juice and jelly. Cranberry is sometimes used to prevent or treat urinary tract infections (UTIs). Evidence suggests that cranberry keeps bacteria from sticking to the cells that line the urinary tract. Some studies indicate it may kill bacteria. It has very few side effects, but a few studies suggest it may interact with warfarin, which is used to treat or prevent blood clots. Cranberry should never be taken as a treatment for existing UTIs. Existing UTIs require immediate antibiotic treatment for quick control.
- Ginkgo biloba may improve cognitive function in healthy people and those with dementia. However, it does not appear to have the same effect in people with MS. One small study indicated it may alleviate fatigue in MS. It has antioxidant effects and can decrease the activity of certain immune cells. Studies in the treatment of MS have shown mixed results. Serious side effects include increased risk of bleeding and interaction with many medications.
- Cannabis contains chemicals that act on the central nervous system. Although there are no cannabis-based FDA-approved medications to treat MS or its symptoms, some clinical trials have shown that non-smoked CBD/THC modestly improves reported spasticity and pain in people with MS. Laws regarding accessibility and usage of marijuana vary by state. Make an informed decision with your healthcare provider.
- This yellow flower is often used as an antidepressant. Many but not all studies confirm those effects. However, it may alter the metabolism of certain drugs, including some medications taken by people with MS. Depression is common among people with MS, but it should not be self-diagnosed or self-treated. Seek a professional evaluation and keep in mind that this herb is not suitable for severe depression. People who are on an anti-depressant should not take St. John’s Wort, as it puts one at high risk for serotonin syndrome. This is a very serious drug reaction that can be life-threatening.