Multiple Sclerosis

Important Points to Consider: Multiple Sclerosis

• For dark-skinned individuals and those living farthest from the Equator, be sure to monitor 25-hydroxyvitamin D levels and supplement to keep the level near 40 to 50 ng/mL.

• Corticosteroids and immunomodulatory drugs have proven efficacy for treating multiple sclerosis, but they also have potentially serious side effects. The high financial cost of immunomodulatory drugs should also be considered when making recommendations.

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Prevention Prescription

• Eliminate tobacco smoke.

• Practice some form of stress reduction technique regularly.

• Exercise moderately and consistently; do not exercise to the point of fatigue.

• Ensure adequate rest and sleep.

• Get adequate sunlight or at least 800 units of vitamin D daily.

• Consume less than 10 g of saturated fat a day.

• Eliminate trans fat.

• Increase foods rich in omega-3 fats.

• Supplement with docosahexanoic acid at 400 to 600 mg/day.

• Supplement with gamma-linolenic acid at 240 to 320 mg/day.

• Reduce or eliminate gluten from the diet.Eat a whole foods, low-fat, high-fiber, plant-based diet.⁠

Integrative Therapeutic Review

Lifestyle and Nutrition

• Smoking cessation

• Aquatic exercise

• Moderate alcohol intake

• Regular sunshine

⁠Mind-Body Therapy

• Yoga

• Mindfulness meditation

Nutrition

• Limit saturated fat to less than 10 g/day.

• Eliminate trans fats. Increase foods rich in omega-3 fatty acids, or take supplements of docosahexanoic acid,
  400 to 600 mg daily, and gamma-linolenic acid, 240 to 320 mg daily.

• Reduce or eliminate gluten.

Botanicals

• Ginkgo biloba: 120 to 240 mg daily

• Ashwagandha: 1 to 6 g two to three times daily

Supplements

• Vitamin D: 2000 units daily if deficient (keep serum level near 40 ng/mL)

• Calcium: 800 mg daily

• Glutathione: 600 to 800 mg intravenously two or three times weekly

• N-Acetylcysteine: 1 g twice daily

• Alpha-lipoic acid: 600 to 1200 mg daily

• Magnesium: 600 to 1200 mg daily B-complex vitamins: doses vary by preparation.

Pharmaceuticals for Acute Attacks

• Corticosteroids: methylprednisolone (Solu-Medrol), 1000 mg daily for 3 to 5 days, or prednisone, 1250 mg orally daily for 3 to 5 days with no taper

Pharmaceuticals for Relapsing-Remitting Disease

• Interferon beta: Avenox, 30 mcg intramuscularly every week; or Rebif, 44 mcg by subcutaneous injection three times weekly

• Glatiramer acetate (Copaxone): 20 mg by subcutaneous injection once daily

• Natalizumab (Tysabri): 300 mg intravenously every 28 days

Pharmaceuticals for Secondary Progressive Multiple Sclerosis

• Mitoxantrone (Novantrone): 12 mg/m intravenously once every 3 months.

Hormones

• Estriol: 4 mg twice daily topically

• Testosterone: men, 10 to 30mg daily; women, 2 to 5 mg daily

• Dehydroepiandrosterone: men, 10 to 30 mg daily; women, 5 to 15 mg daily