Complementary & Alternative Medicines for Multiple Sclerosis - updated
Overview
Complementary and alternative medicine (CAM) includes a wide variety of interventions — from diets and supplements to meditation and T’ai Chi — which come from many different disciplines and traditions. Most are considered to be outside the realm of conventional medicine, although others, including vitamin D, exercise, acupuncture and cooling strategies, for example, are establishing their role in comprehensive care through scientific study and clinical trials.
When used in combination with conventional medicine, these interventions are referred to as "complementary"; when used instead of conventional medicine, they are referred to as "alternative." In the United States today, the vast majority of people incorporate one form or another of CAM as part of their MS management, most often in combination with their prescribed MS treatments.
Safety & effectiveness
Many people use CAM because they believe that anything sold online or over-the-counter at a pharmacy or health food store is healthy and harmless. But many products that claim to be safe and beneficial may not be. Unlike conventional medical treatments that are thoroughly tested and carefully regulated by the U.S. Food and Drug Administration (FDA), most CAM therapies have undergone very little — if any — scientific study to evaluate their safety and effectiveness. So some forms of CAM may be completely safe for a person with MS while others may actually pose significant risks — by producing significant side effects, over-stimulating the person’s immune system or interacting negatively with other medications a person is taking. Some may provide benefit for a person with MS while others offer no benefit at all.
The American Academy of Neurology released a guideline on the use of complementary and alternative medicine (CAM) in MS. The guideline was developed to address the following questions:
- Do CAM therapies reduce specific symptoms and prevent relapses or disability?
- Can CAM use worsen MS or cause serious adverse effects?
- Can CAM use interfere with MS disease-modifying therapies?
Although these are all very important questions, the authors found very few published studies of sufficient quality to provide helpful answers about most of the CAM therapies that are being used by people with MS.
The importance of clinical trials
Carefully-designed clinical trials are the best way to determine the safety and effectiveness of a particular treatment. Here’s why:
- Because the course of MS is variable, and each person’s symptoms tend to come and go in an unpredictable way, the only way to determine if a treatment is effective is to test it against a placebo or an already established treatment, in a large number of people.
- Because every treatment carries with it the risk of anticipated and unanticipated side effects, the only way to evaluate a treatment’s safety is to evaluate it in a large number of people over a sufficient period of time.
Guidelines for considering or using CAM
Questions to ask when considering CAM:
- What does the treatment involve?
- How and why is it supposed to work?
- How effective is it?
- What are the risks associated with its use?
- How much does it cost or is it covered by your insurance plan?
- Will it interact with my other therapies?
Keep your healthcare provider informed about everything you are taking (vitamins, herbs etc.) or doing (acupuncture or exercise). Not sharing this important information is like asking your healthcare provider to treat you blindfolded — and knowing everything you are taking will allow your provider to alert you to possible side effects or drug interactions.
Discuss with your healthcare team before changing your treatment plan. You and your healthcare team have developed a comprehensive plan to manage your MS. Adding, stopping or switching one of your treatments can affect the others. Have a conversation with your healthcare team prior to making changes to your treatment plan.
Document the experience. Keep a detailed log of what you take or what is done and any changes you experience. Use this form to track your prescription and over-the-counter treatments (.pdf).
Complementary approaches to taking care of yourself
Food and diet — Although various diets have been promoted to cure or control MS, no diet has been proven to modify the course of MS. MS specialists recommend that people follow the same heart healthy, high fiber, low fat diet that is recommended for all adults. Some other medical conditions – such as high blood pressure and cardiovascular disease may be associated with MS worsening, so a heart healthy diet is very important.
Exercise — Exercise offers many benefits for people with MS. In addition to improving your overall health, aerobic exercise reduces fatigue and improves bladder and bowel function, strength, and mood. Stretching exercises reduce stiffness and increase mobility. A physical therapist can recommend an exercise plan to fit your abilities.
Stress management (.pdf) — The relationship between stress and the onset or worsening of MS is far from clear — and different types of stress appear to affect different people in different ways. But none of us feel our best when we’re stressed, so it’s important to find the stress management strategies that work best for you.
Acupuncture — Acupuncture is finding its way into Western medicine, with studies suggesting possible benefits for a wide range of symptoms, such as pain, gait.
Information source: #TheNationalMultipleSclerosisSociety
Multiple Sclerosis Risk Significantly Associated With Vitamin D Deficiency
Vitamin D deficiency represents a significant risk factor for multiple sclerosis (MS), necessitating the need for greater public outreach and interventions to improve vitamin D levels in the population, according to a case-control study published in Neurology.
Investigators performed a prospective nested case-control study using patient data from the Finnish Maternity Cohort, in which approximately 1.8 million serum samples from 800,000 women were recorded. The researchers included 1092 women with MS who had at least 1 serum sample taken prior to their diagnosis. In 511 subjects, ≥2 samples were collected, and 3 controls (n=2123) were used to match each patient according to geographic residence and age.
High Vitamin D Levels Associated with Low MS Disease Activity -
By By Jackie Syrop | October 21, 2013
Higher levels of 25-hydroxyvitamin D are correlated with less multiple sclerosis (MS) disease activity and progression, according to a study presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2013 meeting in Copenhagen.
Alberto Ascherio, MD, MPH, a professor of medicine at Brigham & Women’s Hospital and Harvard Medical School, presented data on 251 patients with 25-hydroxyvitamin D levels below 50 nanomoles per liter and 213 MS patients who had a higher level of 25-hydroxyvitamin D. Ascherio used the records of participants in the BENEFIT study, since the researchers from that trial collected data on baseline 25-hydroxyvitamin D for one year.
Patients were an average of 31 years of age and more than 70 percent of the study population was female. At baseline, patients with low 25-hydroxyvitamin D levels had a median of 20 T2 lesions, compared to the median of 15 lesions found in those who had higher levels of 25-hydroxyvitamin D.
According to Ascherio, every 50 nmol/L increment from the average serum 25-hydroxyvitamin D levels seen at baseline translated into a 57 percent lower rate of new and active MS-defining lesions (P = 0.0009). He also found that higher baseline differences in 25-hydroxyvitamin D levels were associated with:
- A 57 percent lower MS relapse rate
- A 25 percent lesser increase in T2 lesion volume
- A 0.41 percent lower yearly loss in brain volume from 12 to 60 months
- Fewer active lesions on MRIA lower increase in T2 lesion volume
- Less brain loss
- Decreased disability as demonstrated by a -0.17-point reduction in the Expanded Disability Status Scale score during the subsequent four years.
Ascherio said he was unable to determine if the lower levels of 25-hydroxyvitamin D were caused by the patients’ lifestyles or the disease itself, which can influence lifestyle choice. Nevertheless, he concluded that “higher serum 25-hydroxyvitamin D levels early in the course of MS robustly predicted a lower degree of MS activity, MRI lesion load, brain atrophy, and clinical progression over five years.”
The study was sponsored by Bayer HealthCare.
- Source for this article: HCP LIVE
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COMPLEMENTARY AND ALTERNATIVE MEDICINE
Vitamin D could be simple solution for multiple sclerosis
About the Swank Low-Fat Diet for the Treatment of MS
THE DIET
Multiple Sclerosis and Nutrition
Is there a diet recommended for people with MS?
No conclusive data exists that favors a particular diet for multiple sclerosis (MS). But maintaining a healthy diet is a key part of your overall health. What is considered a healthy diet? For most adults, it is an eating plan that is low in fat and includes a variety of nutrient-rich, high-fiber foods like grains, fruits and vegetables, as well as some high-protein foods like lean meats, fish or low-fat dairy.1
Always talk to your doctor before starting any diet or nutritional program.
Strategies for healthy eating
Some helpful tips for managing your diet:
Keep a food journal. Then, compare what you eat with the U.S. Department of Agriculture's MyPlate food guide recommendations. This can help you identify changes you can make in your diet.
Control your portions. It takes 20 minutes before you start feeling full, so try taking smaller portions at first and eating slower.2 You may find that by giving your body a chance to register food intake, the smaller amount of food on your plate may actually be enough!
Make low-fat substitutions. Choose fresh fruit or yogurt instead of ice cream, turkey instead of ham for a sandwich, and precut veggies or pretzels instead of potato chips.
Don't forget the fiber. Eat fiber-rich foods such as whole grains, fruits and vegetables. These foods can help you feel full, which decreases the desire to eat more.3
Avoid foods high in saturated fats, sugar and other sweeteners, including refined "white" grains. They may offer empty calories that fill you up but don't offer the nutritional value your body needs.4 For example, choose brown rice instead of white rice, whole wheat bread over white bread.
Stay hydrated. Water helps maintain a normal body temperature. For some people, a rise in body temperature may temporarily exacerbate symptoms or lead to fatigue.5
Plan ahead. Eating a healthy snack before going to a party or other social events can help curb your appetite and limit indulgence in more high-calorie foods.
Start slow. When changing your diet, it's best to start slow. Diet plans that involve dramatic changes are harder to start and maintain.
Understand the connection between eating and emotions. For instance, sometimes people eat too much or too little when they are stressed. If you notice changes in your eating habits related to your mood, talk to your doctor.
Setting goals
Changing ingrained eating habits can be difficult. It can help to set small, easily attainable goals. Here are a few suggestions:
Try a new healthy food or recipe once a month.
Cut out dessert with meals once or twice a week.
Visit a farm stand if there is one in your area. Locally grown food is often fresher and tastier than a lot of produce you might find in your large grocery store chains, because locally grown food often gets to the consumer more quickly. It may travel less or spend less time in between distribution centers.
If you drink a lot of soda, try cutting out one or two servings a week.
Think of goals that will work best for you. You can also ask your health care professional for additional ideas.
Source:http://www.mslifelines.com/pages/wellness-and-ms/nutrition