Copyright © 1994 by Jack Challem, The Nutrition Reporter™
All rights reserved.
Multiple sclerosis may be the quietest epidemic in the country. It's on the rise, but it garners few headlines. One study showed that the incidence of MS increased sixfold In Switzerland between the 1920s and the 1980s, a rise paralleled in other countries. Today, an estimated 500,000 Americans suffer from MS - considered incurable - and perhaps as many as 2 million people suffer worldwide.
The condition causes weakness, tremors, and visual impairments. People with it may have slurred speech, drag their feet, stumble, and frequently drop objects. These symptoms may remain mild, come and go, or become crippling - but they tend to get progressively worse with age.
MS is caused by an auto-immune, or self-allergic, reaction that eats away at the protective myelin sheaths covering nerve cells in the brain and spinal cord. As myelin degenerates, scar-like plaques form over the damaged areas. These plaques short-circuit, or interfere with, normal functioning of the nervous system.
Although doctors aren't entirely sure what triggers MS, they've got a good understanding of who is more likely to suffer from it. For example, twice as many women as men suffer from MS.
In addition, where you live may influence you risk for developing MS. Dr. C. Hutter of the City Hospital in Nottingham, England, pointed out in Medical Hypotheses (1993;41:93-6) that the incidence of multiple sclerosis generally increases as one moves north or south from the equator-and the annual hours of sunlight decrease.
Essential Fatty Acids
One factor in MS may be the consumption of omega-3 essential fatty acids (EFAs), commonly known as fish oils. In Japan and along the Norwegian coast, where fish consumption is high, the incidence of MS is lower than one would expect based on latitude. "This suggests as one possibility, that marine oils may be protective," Hutter suggested.
Indeed, studies have shown that fish oil supplements, low intake of saturated fats, and high consumption of unsaturated fats tend to reduce symptoms of MS. The omega-3 fish oils are known to reduce inflammation in allergic conditions.
Hutter also believes that longer periods of visible light may release carotenoids, such as beta- and alpha-carotene, in the eye, preventing MS-associated eye damage. In addition, the carotenoids may moderate allergic inflammation.
Abram Hoffer, M.D., Ph.D., of Victoria, Canada, concurs. "Animals and plants living in cold areas, such as Canada, must have more unsaturated fatty acids (such as EFAs) to increase winter hardiness. This is why fish from cold waters, seals in northern Canada, and plant oils, such as linseed oil and canola oil, are richer in omega-3 essential fatty acids than animals living in warm waters and oils from warm-weather plants, such as olive, peanut and coconut oils."
This is also why, Dr. Hoffer believes, people living in cold climates need more EFAs. Yet, he says, studies have shown that modern diets contain only 20 percent of the EPAs provided by earlier diets. While the average person gets by, people genetically susceptible to MS are at greater risk.
"Since winter hardiness is a function of the mass of the body, of which the brain is a minor component, then it is likely the limited quantities of EFA will be sequestered by the tissues most in need of winter hardiness properties, i.e., skin, subcutaneous tissues, muscles and ligaments. Any deficiency is apt to be shown in internal organs, including the central nervous system," explains Dr. Hoffer.
B12 Deficiency
Another factor in MS may be vitamin B12 deficiency. Once thought to be rare, highly sensitive blood tests now indicate that B12 deficiency may be common. Several years ago, E. H. Reynolds, M.D., of King's College Hospital in London, England, was surprised to discover that three of his MS patients were deficient in the vitamin.
Within a year of describing these cases at a meeting of the Association of British neurologists, doctors referred to him seven more B12 deficient MS patients. Of the seven women and three men, eight of the patients were under 40, a rare age for B12 deficiency. Yet none had the traditional signs of B12 deficiency, such as peripheral neuropathy or pernicious anemia.
"In neurology and hematology textbooks, multiple sclerosis is not listed among the neurological complications of vitamin B12 deficiency," Reynolds observed in Archives of Neurology (Aug. 1991; 48: 808-811). Vitamin B12 deficiency is not even recognized as being associated with multiple sclerosis. There is no mention of vitamin B12 in the index of textbooks devoted to multiple sclerosis."
The obvious question, of course, is whether treatment with vitamin B12 helps MS patients. Only two of Dr. Reynolds patients have been followed for more than a year while receiving vitamin B12, and their conditions have not deteriorated - a positive sign in a disease that almost always gets worse.
"It is relevant that for some 30 years, there has been a tendency to treat multiple sclerosis with injections of vitamin B12," commented Reynolds. "Although this is done for placebo purposes, this was not the original intention, and some patients are impressed with their neurologic benefit...the subject should be reawakened."
To obtain a random sampling of B12 levels among MS patients, Reynolds measured B12 and folic acid (another B vitamin) levels in 29 consecutive MS cases. All of the MS patients had lower levels of B12 , and nine of them also had extremely low levels of folic acid, compared with normal patients.
"Our observations suggest that there is a significant association between MS and vitamin B12 deficiency and that vitamin B12 deficiency should always be looked for in MS," Reynolds wrote in a follow-up article in Archives of Neurology (June 1992;49:649-52). He added that "the question may be asked when MS and B12 deficiency coexist, as they clearly do in at least some patients, whether the vitamin deficiency is aggravating the underlying demyelinating disorder or impairing recovery?"
MS patients have many choices when it comes to obtaining supplemental B12. Gastrointestinal absorption of the vitamin is difficult, and conventional vitamin B12 supplements may be of little value unless they contain the "intrinsic factor," a protein needed to transport the vitamin through the gastrointestinal wall. In addition, sublingual B12 tablets, which dissolve under the tongue, are better absorbed than conventional tablets. Capillaries located under the tongue permit the vitamin to directly enter the bloodstream. In addition, and the hydoxycobalamin form of the vitamin appears to be better absorbed than the cyanocobalamin form. Lastly, almost any physician - with a little urging - can administer B12 shots.
Too Much Sugar
Twenty years ago, the Swiss physician Hugo Henzi began exploring the relationship of high sugar and low folic acid intake among patients with MS. Since Henzi's death in 1991, his co-researcher, Dr. R. U. Schwyzer of Switzerland, has continued to investigate the causes and treatments of the disease.
Writing in Medical Hypothesis (Feb. 1992;37:115-118), Dr. Schwyzer described their "methanol hypothesis," in which myelin is permanently damaged by exposure to formaldehyde, a methanol byproduct. According to this hypothesis, the incomplete breakdown of methanol-a natural alcohol abundantly found in fruit pectin-leaves free formaldehyde circulating in the blood.
But why does the formaldehyde build up in the first place? Schwyzer contends that it's the consequence of two events. First, a person must have a high intake of dietary methanol via pectin-rich fruits. All ripe fruits contain some pectin, but it is most abundant in apples, plums, red currants, gooseberries, and cranberries. (Conversely, low-pectin fruits include strawberries, blueberries, raspberries, peaches, apricots, and cherries.)
Second, the body's natural enzyme for breaking down alcohols - alcohol dehydrogenase - fails to completely metabolize the methanol. Since the body also uses the enzyme to break down fructose-found in both fruits and the majority of commercial sweeteners-it may be biochemically re-routed to deal with fructose instead of pectin.
Not Enough Folic Acid
Folic acid may help, according to Schwyzer, by helping the body break down the methanol. The B vitamin is abundant in leafy green vegetables.
The hypothesis may also partially explain why pregnant women with MS sometimes improve temporarily. Most women usually get folic supplements as part of their prenatal care.
Physicians have known for years that pregnancy can suppress some types of immune responses, such as allergies. In the early and mid-1980s, several doctors observed that MS patients had fewer symptoms during pregnancy and post-partum recovery.
So, Henzi placed two female MS patients on a diet restricting their sugar intake and including folic acid supplements. These two patients avoided a flare-up of MS symptoms before becoming pregnant, during pregnancy, and for six months after delivery.
"Those who are able to persist (on the low-pectin, how folic acid diet) gradually start to feel better," wrote Schwyzer. "Within 9-12 months the chronic fatigue disappears and the patient is on the way to becoming a benign case of MS in permanent remission.
But it's not a temporary diet. "For the ultimate benefit long-term adherence to the diet...is essential," emphasized Schwyzer.
Weak Adrenal Glands
Finally, a recent medical report noted the association of enlarged adrenal glands and MS. It's common for an injured or nutrient-deficient organ to grow in size-as if the body compensates for inefficiency with size. For example, an enlarged heart is commonly associated with heart failure and inadequate coenzyme Q10, and liver enlargement is associated with many diseases of that organ.
Anthony Reder, M.D., of the University of Chicago, autopsied 10 MS patients and compared their adrenal glands with three patients with amyotrophic lateral sclerosis and one who died of a heart attack. In all cases, the adrenals of the MS patients were more than one-third larger in size and weight compared with the ALS and heart attack "controls," according to his report in Archives of Neurology (February 1994;51:151-4).
"Adrenal enlargement is likely to be the result of hypertrophy (non-tumor enlargement) of the adrenal cortex. The medulla is relatively constant in size and constitutes only 10% of the total adrenal weight," Reder wrote. "In contrast, cells of the adrenal cortex enlarge and multiply when stimulated. In our autopsy series, the adrenal medulla was always normal, whereas corticol hypertrophy was specifically noted in three to five of the 10 cases."
Reder noted that enlarged adrenal glands are not likely the cause of MS. Rather, he wrote, "many types of stress cause adrenal hypertrophy in rodents. Although difficult to quantitate, inflammation of the central nervous system and the resultant clinical symptoms in MS seem 'stressful.'"
While no one has proved that adrenal supplements or adrenal cortex extract (ACE) injections can benefit MS, there may now be justification to experiment with them.
Since there is official no cure for MS, and because the MS Society focuses largely on coping strategies, patients must ultimately depend on their own resources to battle the disease. Carefully selecting the right foods and adding specific supplements can give MS patients a needed edge against the disease.
This article originally appeared in Health Counselor magazine. The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.