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MARCH 2018 MS NEWS- Neurotransmitter Deficiencies, MS Gut Microbiome, Herbs & Supplements Work, Best Anti-Spasticity Treatment

 

New study on neurotransmitter deficiencies : Dopamine and norepinephrine deficiencies associated with MS. Both neurotransmitters appear to have an inhibitory effect on T17 cells (which are abnormally high in MS) [1]. I wrote about norepinephrine and dopamine deficiencies in MS, along with ways to boost dopamine and norepinephrine levels.

The link between hepatitis B vaccine and MS is not new.

This study looked into the database and the cases reported to the Vaccine Adverse Event Reporting System (VAERS). According to this study, MS cases were up to five times more likely to be reported after a hepatitis B vaccination than after any other vaccination. Another finding: the development of MS following hepatitis B vaccination were more likely to occur from outside the USA and to be reported before 2000 than those associated with other immunizations [2].

Is it safe to discontinue MS therapy after age 60? It looks that is very safe to discontinue MS therapy as you get older. This study evaluated 600 individuals with MS on DMT (disease-modifying therapy- immunomodulators). Almost 30% (178) of them discontinued MS therapy, and only one MS relapse had been recorded [3].

I do have a question this study didn’t look at- if it’s so safe to discontinue MS therapy after age 60……how about after 50, or a couple of years after the therapy started ?

Diet, Supplements & Alternative Therapies

 

 

 

 

 

 

 

 

 

 

 


The Best ways to treat MS related spasticity? Based on a review study (including 23 randomized controlled trials and 2720 patients) found that Cannabis based treatments (Cannabinoids) and botulinum toxin are effective (significantly better efficacy than placebo) for managing spasticity. Other treatments included tizanidine, baclofen and transcutaneous electric nerve stimulation (TENS). The researchers suggest botulinum toxin as a first choice, followed by cannabinoids and TENS [15].

Quick note: be aware that botulinum toxin may be effective, but is not the safest option- it is one of the most potent neurotoxin out there. Even the purified form (as in prescription drug) has serious side effects. More serious side effects are recorded from used it therapeutically (as in MS) compared with cosmetic botox injections, and include: swallowing problems, breathing problems, generalized muscle weakness, necrotizing fasciitis (rapid spreading infection, can be lethal), sarcoidal granuloma (a form of tissue inflammation), a form of gangrene called Fournier gangrene and also death [16].


A phase I clinical study evaluated the stem cell therapy for treating MS (autologous, bone marrow-derived mesenchymal stem cells) [17]. We will see more research on stem cells for MS in the next decade. I think the treatments will get safer in the future. However, at this point I see more risks than benefits for using these therapies.


The Importance Of Gut Microbiome in MS

Obesity, leptin levels, gut flora and MS: Higher levels of leptin are found in individuals with MS compared with healthy controls, based on a systematic review and meta-analysis [18].

A second study shows that impaired gut microbiota and elevated leptin levels seem to correlate with an increased risk of developing MS in obese individuals [19]. Quick note: Leptin is a hormone produced by fat cells and other cells in the body. It has many beneficial effects, the problem occurs when leptin levels are higher than normal.  Increased leptin levels correlate with inflammation, increased body weight, fatigue and much more. Luckily, there are natural ways to decrease leptin levels- for example fasting, exercise, or correcting some neurotransmitter deficiencies (ie dopamine, norepinephrine). 

Gut flora (microbiome) play a key role in MS- another study supporting this idea. Impaired gut microbiome is more often seen in MS than healthy people. In those genetically predispose to MS, the alteration of gut microbiome leads to inflammation and demyelination in the brain/spinal cord. Bacterial products can directly influence the blood brain barrier, the neurons and other cells can activate T cells [20]. 

Note: Let’s remember Dr. Fasano’s research and how autoimmune diseases develop.  There must be 1. A genetic predisposition 2. Certain triggers (ie infections, stress) and 3. Increased intestinal permeability aka leaky gut (which correlates with altered gut microbiome). By reducing the triggers and address gut inflammation, one can reduce the symptoms and even reverse the autoimmune condition. Intestinal inflammation activates the kynurenine pathway causing serotonin deficiency; serotonin is the precursor of melatonin and a down-regulation of serotonin-melatonin pathways may contribute to several symptoms of MS, including depression [21].

More details about tyrptophan -serotonin-melatonin and kynurenine pathways in my article and how to correct serotonin deficiency here.

Great research papers discussing the changes in MS gut microbiome, along with solutions such as dietary changes and probiotics [DIET_MS MICROBIOME_2018],  [22]-more details about this research paper and MS microbiome in this article

Fecal incontinence associated with MS could be treated by stimulating a nerve that controls certain muscles in the leg (posterior tibial nerve) [23].

It is worth getting a sleep test to see if you have restless leg syndrome (RLS). RLS is common in MS, and correlates with sleep quality, fatigue, and overall quality of life. It appears that individuals with more adipose tissue (fat) are more likely to have RLS [25].

 

 

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