B.S., C.N.C.

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It may be best, before I mention dietary and lifestyle changes concerning MS, to give a little background on the disorder and discoveries that have been made.

The blood brain barrier is made up of tightly bound capillary cells within the central nervous system. This prevents most substances from passing out of the capillaries into the central nervous system tissue. Certain proteins – such a collagen and fibrin make up the “glue” to hold these cells together. There are certain cells in the immune system which can dissolve the extracellular “glue”. This is a beneficial process when allowing white blood cells to access an area of infection. However, when these cells release their chemicals in the capillaries of the central nervous system, there results a breakdown of the blood brain barrier, leading to an MS lesion. An example of one such “glue dissolving” process is the metalloproteinases (MMP’s). These MMP’s are not readily active, but must be converted to an active form by other enzymes in order to act on the collagen or fibronectin. It has been found that flavonoids have an affinity for joining themselves to enzymes. If they were to join with the MMP’s or their activators, they would be able to block this process – preserving the blood brain barrier and preventing an MS lesion. Inhibiting the activity of these enzymes or activators may offer a therapeutic approach in the development of inflammatory demyelinating diseases. Studies have found that flavonoids may also become part of the cellular matrix – or at least adhere to it. They have receptor sites which tend to grab on to enzymes which would otherwise attack the matrix. The flavonoids become “sacrificial lambs” so to speak – maintaining the integrity of the matrix. Flavonoids are potent anti-oxidants. Anthocyanosides have been found to neutralize free radicals so quickly that they don’t have time to act on the collagen, thus – again – protecting the blood brain barrier from damage and preventing MS lesions. In addition to having anti-degenerative actions, anthocyanosides also have been found to have a strong anti-inflammatory action. This action would enable flavonoids to not only reduce the number of attacks on the myelin, but also reduce the severity, since much of the damage caused to nerve cells is due to inflammation. In other words, flavonoids have been found to not only strengthen the blood brain barrier, but simultaneously reduce inflammation. Oligomeric proanthocyanidins are better anti-oxidants than anthocyanosides, but anthocyanosides are better anti-inflammatory agents. The best therapy might be to use flavonoids high in anthocyanosides (blueberries, cherries, grapes, or bilberry) and OPCs (pycnogenol or pine bark).

When the immune system is stimulated or overactivated, white blood cells called T4 lymphocytes are produced. During an attack, the T4 lymphs attack the myelin sheath, causing inflammation followed by scar tissue. The blood brain barrier is adept at keeping the T4 lymphs away from the myelin sheath. Therefore, theoretically, no matter how stimulated the immune system might be, if the blood brain barrier is intact, the lymphocytes will not be able to attack the myelin. Studies have shown that the problem may very well be a weakened blood brain barrier, not an immune system that is sensitized to the myelin. In light of this, therapy could be aimed at protecting the blood brain barrier and healing it, and not necessarily to lower the immune system. This is important, since lowering the immune system creates the risk of contracting other diseases that the immune system would normally keep at bay. Strengthening the blood brain barrier is not a cure. People with sensitized, overactive immune systems may always be AT RISK of an MS attack. However, if the blood brain barrier is kept healthy and effective, the attacks should be minimal or none. Research has found that degradation of the blood brain barrier may be caused by nutritional deficiencies or a viral attack. This can be compounded many times over by the addition of stress to the system. This could be physical, emotional, or mental stress. Stress is one of the primary causes of oxidation in the body.

In addition to stress and a compromised blood brain barrier, studies have found a strain of herpes virus – HHV6 – may play a role in the development of MS. The virus infects most people in the first few years of life and patients with the most common form of MS(relapsing/remitting) have shown an increased immune response to it. The herpes virus is known to infect nerve cells and HHV6 proteins are expressed in MS lesions. Herpes also tends to re-activate. The same factors associated with MS exacerbations have been linked to herpes virus reactivation (stress, poor diet, allergies).

Another pathway on the road to the initiation of MS concerns the thyroid gland. Clinical studies have shown that men and women suffering from multiple sclerosis may have low serum T3 concentrations coexisting with normal T4 levels, which may indicate a changed peripheral conversion pathway of the thyroid hormones. Thyroid dysfunction is common in people with MS – both hyper- and hypo-thyroidism. Antithyroid antibodies have also been found in people with MS. Many immune disorders are related to underlying thyroid disease. There are controversies concerning the use of steroids in the reduction of MS attacks. In some cases, steroids have been shown to lower thyroid hormone production and have a depressive effect on the pituitary-hypothalmic system as well as adrenal cortex insufficiency...in a sense, antagonizing the multiple sclerosis. Interferon treatment has been associated with thyroid disease. It can induce antithyroid antibodies and thyroiditis. It would greatly benefit you to ask your doctor to run a thyroid panel on you. This would include TSH, Free T3, Free T4, TRH, Reverse T3, and thyroid antibody test. It would also be a good idea to check your basal body temperature. Hypothermia is a known and medically accepted symptom of hypothyroidism. This is done using a basal thermometer(purchased at a drug store - preferrably mercury or another liquid). Shake it down before bed and set if on the night stand. Set your alarm for 10 minutes earlier than usual. When your alarm goes off, without moving too much, place the thermometer in your underarm area. Hold it tightly under your arm for 10 minutes. Take the reading 3 consecutive mornings. A temperature falling below 97.5 degrees denotes hypothyroidism. A low temperature accompanied by a normal (.3-3.0) TSH level may indicate faulty T4-T3 conversion. In that case, T3 therapy may be recommended. If the TSH is high ( above 5.5), then therapy using the natural thyroid extract (Armour thyroid) is usually best.

The keys to combating MS are halting the activation of the immune system and healing and strengthening the gut, the blood brain barrier, and the immune system. With that in mind, nutrition and lifestyle changes follow:

When considering vitamins, herbs, and supplements, it is best to remember that you can't (or shouldn't) use everything at once. Work with a knowledgable practitioner and devise two to three different regimens. Decide what you would like to focus on first, and utilize that regimen for at least a period of 6 months. It is never beneficial to utilize the same supplemental regimen for an indefinite period of time. The body tends to become resistant to it, and you either have to continually take more of the supplements to get the same results or, the body just doesn’t recognize it at all and it becomes ineffective. Try to change your regimen every 6 months or so, even if it means going back to what you took a year ago. It may also be a good idea to only take your supplements and herbs Monday through Friday, and let your system reset itself on the weekend. That way, the body will freshly accept them on Monday. It will also give you a break, and makes it a little more financially feasible. When first starting a protocol, however, it is always best to take the supplements everyday for at least a week or two. That will get all the supplements into your system readily.

Nutrition and lifestyle changes can be incorporated gradually or as quickly as you wish. My recommendation would be - "the quicker the better".

Women with MS need to make sure their hormones are in balance. Excess estrogen or ERT (estrogen replacement therapy) has been found to cause MS (auto-immune ) symptoms or the disease itself. Women with MS who have had a hysterectomy or are going through menopause may have an increase in, or more severe, symptoms. This is due to the fact that studies have found that a failure to ovulate may be linked to adrenal insufficiency, hypothyroidism, auto-immune disorders or poly-glandular failure, an increased susceptibility to osteoporosis and increased risk of developing cardiovascular disease. Natural progesterone cream is known to balance out estrogen dominance. Progesterone therapy has also been found to be beneficial for men with MS. An imbalance in hormones happens very frequently in anyone with MS. This is due to the exposure to the extremely strong environmental estrogens (xenoestrogens) and an imbalance of other hormones in the body. Hormone imbalance has a cascading effect in the body. The additional benefit of using progesterone cream is with the risk of hormonal cancers in the body. In men it is the risk of prostate cancer. Progesterone balances estrogen dominance, increases the activity of the thyroid hormone, and is known to build bone density.

Following is a list of beneficial vitamins and supplements you may want to include: