Both Wahls diet and Swank diet were found to have favorable impact on MS symptoms in this new study. A new study comparing the efficacy of the Swank and Wahls diet for reducing MS-related fatigue is underway and will include an analysis of diet quality.Note: This study uses the newer version- WahlsElim diet which is a low lectin version of her original Paleo diet. Has added fermented foods and excluded gluten free grains, legumes and nightshades.
New Book “Solving the Brain Puzzle: A Complete Layperson’s Guide to Achieving Brain Health”, By Bill Code, MD; Karen D. Johnson M.D., Teri Jaklin ND. Helps you understand how to take control of your health, the latest research including various treatments that can enhance your recovery quickly (oxygen therapy, microbiota therapy, photobiomodulation therapy, venous angioplasty, cannabis) and much more. Dr.Bill Code is an MD, trained in integrative medicine, researcher and received the diagnosis of MS.
Exercise & Physio
How often should you exercise ? Of course, should be adjusted for each person, but generally speaking these are the current guidelines for people with MS (updated in 2017): Aerobic exercise 2-5x/week, for 10-40 minutes each session; Resistance training 2-3 x/week 1-3 sets, rest for 2-4 minutes, 4-10 exercises; Flexibility 7x/week stretching to the point of feeling tightness or mild discomfort. 10-15 minutes.
Complementary therapies need to be included in the management of MS, according to this extensive systematic review and meta-analysis (based on studies from 1990 to 2017). Specifically they refer to aerobic exercise and physiotherapy, both found to improve physical, mental and social functioning.
Exercise training can improve central nervous system integrity and function, according to this new systematic review (technical: showing a positive effect on modulation of blood‐brain barrier (BBB) permeability markers and BDNF).
Aquatic exercise/ therapy can be helpful in the management of MS, according to this study that found improving markers of inflammation IL-12, IL-17 in the participants who exercised compared with the control group.
A case report showing improvements (in static balance, lower extremity strength, and decrease in objective fall risk) from using resistance and balance training for 12 weeks.
Two devices for foot drop (in this case report, the foot drop was associated with PPMS) : WalkAide functional electrical stimulation (FES) device and an ankle-foot orthosis (AFO) show promises to improve walking, and could be great addition to physio treatments.
Virtual reality training can improve gait function in CNS -movement disorders related, based on this new review/meta analysis. If you wonder how it works, here is a quick video
Physiotherapy targeting vestibular rehabilitation can help stability function in those with RRMS according to this new randomized controlled trial.
Pulsed low-frequency electrostatic field (as a physio modality) in highly effective and well tolerated, according to this study, for managing RRMS (as well as asthma, cystic fibrosis, scoliosis).
Vitamins/ Herbs/Natural Supplements For Managing MS Symptoms
Vitamin D. The benefits of vitamin D for MS debated in this study. While studies provide “fairly conclusive evidence that vitamin D deficiency increases susceptibility to MS”, a recent Cochrane study that didn’t find enough evidence that supplementing with vitamin D could help manage MS. I think is totally worth correcting vitamin D deficiency. D supplements are extremely safe and cost effective, so if you look at benefits vs risks, vitamin D is a clear winner over any FDA approved drug for MS. Re: vitamin D, I look beyond studies, at the physiological effects of vitamin D. It will be a long article on this topic.
CoQ10. CoQ10 supplementation in those with MS treated with interferon-β1a is helpful. Supplementing with coQ10 not only decreased several markers of inflammation and boost antioxidant levels, but also improved disability and depression scores as well as fatigue and pain, according to this new study.
Omaga fatty acids. Three new studies. The benefits of omega 3 fatty acids are evaluated in this review of scientific literature. Conclusion: “The effects of omega-3s on the nervous system have been observed, with enhancement on neuroprotection in the treatment of neurodegenerative diseases”. Anti-inflammatory properties have also been seen that act systemically and centered on the nervous system. Omega fatty acids (the phospholipid form Docosahexaenoic acid (22:6n‐3) was found to ameliorate the onset and progression of MS (animal model) in this new study.Another study explores the potential benefits of erucic acid (omega 9 fatty acid and a ligand of PPAR-δ). Likely works by blocking neurone death, reducing neuroinflammation and /or inducing myelination.
Hesperidin. The benefits of hesperidin (a plant derived flavonoid) are described in this new review study, which included both animal and clinical studies. Overall, hesperidin was found to be protective against neurodegeneration. Clinical trials showed that hesperidin can significantly improve cerebral blood flow, cognition, and memory performance.
Apigenin. Two new studies. The health effects of apigenin (plant derived flavonoid) for neuroinflammation and other chronic conditions, and its impact on modulating the immune system are explored in this new research paper. Here is the second study on apigenin, focused on the anti-inflammatory actions of flavonoids against chronic illnesses such as cancer, diabetes, cardiovascular diseases, and neuroinflammation.
Oligomeric proanthocyanidins (a class of polyphenols found in a variety of plants) show potent therapeutic effect in animal model of MS in this study(technical: reduces demyelination, increases expression of MBP and expression of O4+ oligodendrocytes in the corpus callosum, reduces the numbers of B and T cells and more).
Prevotella histicola, a human gut bacteria was found as potent as Copaxone® in an animal model of MS, in this new study. Treatment with P.histicola plus Copaxone was not more effective than using P. histicola or copaxone alone. Note: There are several studies on P. histicola and how is linked with inflammation and autoimmunity. MS is associated with lower levels of these gut bacteria.
Melatonin found to have a positive influence on brain metabolism and on remyelination, according to this new study (animal model of MS).
D-Aspartate, an amino acid available as a dietary supplement, was found to improve synaptic plasticity in animal models of progressive MS in this research paper.
Short-chain fatty acids (SCFAs) have immunomodulatory effect, and this study, conducted in animal model of MS explores the benefits of SCFA pentanoate.
A combination of hemp seeds and evening primrose oil has beneficial effects on the repair of myelin, according to this new study (animal model of MS).
Other Natural Therapies & More News
Ayurvedic treatment for MS found effective. This is a case report of a 24 year old person with MS treated with ayurvedic medicines—Ashwagandha, Yastimadhu, Vata Vidhvansha, Agnitundi, etc. He showed marked improvement in clinical signs and symptoms. MRI reports showed a decline in lesion and reduction in size of some lesions within a period of six months. Note: I wrote about Ashwagandha here and about Ayurvedic medicine here and here. Yes, I see a lot of potential in this form of medicine.
Reflexotherapy could help manage MS, according to this new review of scientific literature.
Psychotherapy in the form of Acceptance and commitment therapy (ACT) and logotherapy (LT) help relieve symptoms of anxiety, depression and stress in women with RRMS, according to this new randomized controlled trial.
Hopefully, cognitive rehabilitation and exercise training will become standard care for treating MS. The researchers of this study reviewed extensive research (systematic reviews and meta analyses) supporting the benefits of both cognitive rehab and exercise training.
Is MS progression primary driven by age ? 2 studies with pros and cons. I agree with the second theory.
Diet & The Gut Microbiome
The microbiota-gut-brain relationship could play a key role in the development of neurological diseases like Alzheimer, Parkinson and MS, suggests this new study.
Another new study looks at dietary changes as a way to improve gut microbiome linked with neuroinflammation.
Genetics
Genetic variants related to lipids and lipid levels are associated with significantly increased disability progression in MS, according to this new study. Five lipid polymorphic (rs2013208, rs9488822, rs17173637, rs10401969 and rs2277862) and one BMI polymorphism (rs2033529) were associated with disability progression.
Why people do not respond to natalizumab? This study suggests the genetic factor may play a role. Study found poor response to natalizumab associated with rs2304166 CC genotype in MS patients.
MS Conventional Therapies & Drugs (Including Side Effects)
Cladribine has comparable efficacy when compared with disease modifying therapies (DMTs): fingolimod, natalizumab, alemtuzumab and ocrelizumab, according to this study.
Drug-induced MS (Iatrogenic MS) explored in this study. Vaccines, tumor necrosis factor (TNF)-alpha inhibitors and checkpoint inhibitors are the most frequently cited inducers of CNS inflammation/ demyelination.
Alemtuzumab. New Warning for the Multiple Sclerosis Drug Alemtuzumab- FDA added a black box warning for alemtuzumab stating that the drug, used in the treatment of RRMS, may cause ischemic and hemorrhagic stroke and cervicocephalic arterial dissection, rare but serious adverse effects.
Alemtuzumab. A case of anaphylaxis from Alemtuzumab use- a case report.
Alemtuzumab- Immune thrombocytopenia (ITP) occurs in approximately 2% of patients treated with Alemtuzumab, according to this new review- study.
Alemtuzumab- 2 cases of diabetes type 1 developed after Alemtuzumab use- 2 cases.
Teriflunomide: Psoriasis-like skin lesions related to teriflunomide use for MS- a case report
