Some people with MS may elect to turn to complementary
and alternative medicine (CAM) as a way to manage the effects
of multiple sclerosis. CAM includes a broad range of approaches
that often include natural health products, herbs, homeopathic
medicine, vitamins, acupuncture, massage, meditation and
prayer.
Generally a practice is considered complementary if
a person uses it in addition to taking conventional medicine
or therapies. It is considered alternative if
a person uses this health care approach exclusively.
The Canadian Health Network, a website of the Public Health
Agency of Canada, estimates half of Canadians use some
type of complementary and alternative health care for wellness
purposes. Several of the Canadian MS Clinics have reported
up to 70 percent of their patients use various kinds of
complementary and alternative medicines, although the types
used vary widely and individuals often switch from one
therapy to another.
Because of this widespread use and the possible risks associated
with a given CAM – as well as adverse or unintended
interactions between combinations of therapies – it
is important for people with MS to let their doctors and
other health care professionals know if they are using
other kinds of medications or products along with their
prescribed medications. This includes, as well, over-the-counter
drugs such as cold, sinus medications or pain relievers.
In addition, side effects can occur with any type of medication
including herbal preparations and those known as natural
health products. Coming from a natural source does not
mean that a product is necessarily safe. When investigating
the use of complementary and alternative medicines, some
questions to ask are:
For what is it recommended?
What are the expected benefits?
Are there known side effects or risks?
What amount is recommended, by whom or what source?
Should people with a certain condition or disease
(such as MS) avoid the use of the product?
How much does it cost?
Fortunately, there is a steadily increasing amount of information
available about CAM. Health Canada has established a Natural
Health Products Directorate to regulate natural health
products, including homeopathic medicine. A good source
for information and links about CAM is on the Canadian
Health Network, a
web-based resource with information from the Public
Health Agency of Canada, Health Canada and national and provincial/territorial
non-profit organizations, as well as universities, hospitals,
libraries and community organizations. Please see below
for resources and links:
Carefully-designed clinical trials are
the best way to determine whether a treatment is safe and
effective. Here are the reasons 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 the effectiveness of a treatment
is to test it on a large number of people.
Because most people—regardless of the disease
they have—will have a positive response to any new treatment
they receive (even if it’s an inactive substance
or placebo),
the effectiveness of a new treatment can only be proven
by
comparing it to a placebo or to another treatment that
has already been shown to be effective.
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.
People who are considering using a CAM therapy should ask
the following questions:
What does the treatment involve?
How and why is it supposed to work?
How effective is it?
What are the risks?
How much does it cost?
The answers to these questions can help a person considering
a CAM therapy to weigh the benefits against the risks.
For those who decide to go ahead with the CAM therapy,
here are some, common sense recommendations:
Keep your physician informed about everything you
are taking. Not sharing this important information is like
asking your
physician to treat you blindfolded—and knowing
everything you are taking will allow your doctor to alert
you to possible
side effects or drug interactions.
Don't abandon conventional therapy. The treatments
your physician prescribes for you are the ones that have been
evaluated in controlled clinical trials or accepted
by
the MS medical community as safe and effective therapies.
So stay with your prescribed treatments even if you
decide to add CAM 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 (.pdf) to track your prescription and over-the-counter
treatments and vitamins, herbals, dietary supplements.
Check out These Complementary Approaches to Physical Health
and Emotional Well-Being
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
high
fiber, low fat diet that is recommended for all adults.
In addition, people with MS sometimes wonder whether they should take
extra vitamins
or food supplements. There is no scientific evidence that
they will make a difference with one exception. Researchers are now looking
carefully at vitamin D as a way to possibly reduce the
risk of MS
developing in the first place. In terms of food supplements,
people with MS should avoid those that claim to boost the immune system.
That could be a problem in MS, which results because of
a misdirected
immune attack on myelin within the central nervous system.
As mentioned, vitamin D – whether delivered through sunlight,
fish such as salmon or tuna, milk, or in pill form – may play
a role in preventing MS. Many physicians now suggest that people
with MS themselves might benefit from taking a daily intake of 1,000-2,000
IU of vitamin D because some people may be vitamin D deficient.
If you do change your diet radically or increase your intake of
vitamins, it is a good idea to consult your doctor or a nutrition
specialist. You could also contact the nutrition service of your
community health service or provincial health ministry. In addition,
the MS Society’s Healthy
Eating: A guide for persons with multiple sclerosis examines
what makes up a healthy diet.
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.
See the publication, Everybody
Stretch. The
physiotherapist can recommend an exercise plan to fit your
abilities and limitations.
Stress management
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. See the publication, Taming
Stress.
Acupuncture
Acupuncture is finding its way into Western medicine,
with studies suggesting possible benefits for a wide range
of problems.
Removal of amalgam fillings
There is no scientific evidence
to connect the development or worsening of MS with dental
fillings containing mercury, and therefore no reason to have those
fillings
removed. Although poisoning with heavy metals-such as mercury,
lead, or manganese-can damage the nervous system and produce symptoms
such as tremor and weakness, the damage is inflicted in
a different
way than occurs in MS and the process is also different.
Bee sting therapy
In spite of long-standing claims about the
possible benefits of bee venom for people with MS, a
24-week randomized study showed no reduction in disease activity,
disability,
or fatigue,
and no improvement in quality of life.
Based on the studies to date—and the fact that long-term use
of cannabis may be associated with significant, serious side effects—it
is the opinion of the Society's National Clinical Advisory Board
that there are currently insufficient data to recommend marijuana
or its derivatives as a treatment for MS symptoms. However, research
is continuing to determine if there is a possible role for marijuana
or its chemical derivatives in the treatment of spasticity and pain.
In the meantime, Health Canada, the drug regulatory agency for Canada,
has approved the use of the cannabis-derived drug Sativex® (GW
Pharmaceuticals) to treat MS-related pain.
