By Beth W. Orenstein
If you take vitamins and other supplements, you're in good company -- more than half of all adults in the United States do the same, hoping to avoid nutritional deficiencies, stave off chronic disease and improve health overall. Do vitamins and supplements help with multiple sclerosis though? The answer seems to be a resounding "that depends."
One new study found that increasing vitamin D may help reduce the risk for new lesions and active disease in people with multiple sclerosis. The study, published in The Annals of Neurology, and led by Ellen M. Mowry, MD, MCR, an assistant professor of neurology at the Johns Hopkins University School of Medicine, looked at 469 people with MS who were participating in a five-year study at the University of California, San Francisco. Each year, the researchers did blood tests and performed brain MRIs on the participants to look for new lesions and active spots of disease. They found that a low level of vitamin D correlated with more lesions and a more active disease.
Dr. Mowry cautions, however, about uniformly advising people to take vitamin D supplements when they have MS. "As practitioners, we want to make sure we apply the best scientific evidence," Mowry says, "and I don't think we have enough evidence yet to definitively recommend our patients take vitamin D supplements."
Dennis Bourdette, MD, chairman of the Department of Neurology and director of the Multiple Sclerosis and Neuroimmunology Center at Oregon Health and Science University, says that the evidence is strong that having a low level of vitamin D can increase disease activity. "What hasn't been clearly shown is whether normalizing MS patients' level of vitamin D alters disease activity," he points out.
Finding the Right Balance of Vitamin D
Given the available evidence, Dr. Bourdette recommends keeping your vitamin D levels within the normal range, 30.0 to 74.0 nanograms per milliliter (ng/mL). A simple blood test can tell you what your vitamin D level is. "I recommend to my patients that they have a vitamin D level of not less than 30 nanograms and preferably over 40 nanograms," he says.
The recommended daily allowance for vitamin D is 600 to 800 international units (IU) for adults, and the preferred form of vitamin D is vitamin D3, notes Bourdette. Neurologists don't recommend doses that are extremely high because vitamin D, which acts as a hormone, can have toxic effects including nausea, vomiting and muscle weakness.
To naturally increase your levels of vitamin D:
Eat vitamin-D-rich foods such as fish, liver, processed milk, and fortified cereals.
Get moderate amounts of sunlight, 15 to 30 minutes a day. Your body can make vitamin D when skin is exposed to the sun's rays, but remember that increased exposure to the sun's harmful UV rays can lead to skin cancer.
Vitamin D supplements are another option, but talk to your doctor before taking them to meet your needs.
Can Other Vitamins and Supplements Help MS?
Many strategies have been studied in a quest to find nutrition-based relief for a variety of medical conditions, but few have involved people with MS. Of those studied, Bourdette says, none so far has proven to have a significant benefit for people with MS.
Here's what we know about certain vitamins, minerals, and herbs that hold potential because they may help counter the effects of MS on the body or may ease MS symptoms:
Antioxidant vitamins. The body's cells use oxygen to function. When they do, they release unstable molecules known as free radicals that can cause tissue damage. Antioxidants, including vitamins A, C, and E, scavenge for free radicals and can prevent that damage. Antioxidants are readily available in healthy foods -- vitamin A in brightly-colored fruits and vegetables like carrots, squash, cantaloupe, peaches, apricots, and broccoli; vitamin C in citrus fruits, green leafy vegetables, and strawberries; and vitamin E in nuts, seeds, whole grains, vegetable oil, and green leafy vegetables. Aim for two to four servings of fruits and three to four servings of vegetables every day. Although important for overall health, whether antioxidants can improve the course of MS is still under investigation, Mowry says.
B vitamins. Some people with multiple sclerosis believe taking vitamin B6 can help boost their energy levels. Good food sources of B6 include salmon, tuna, pork, chicken, beans, bananas, and many vegetables. However, high doses of B6 can cause symptoms similar to MS. Even doses as low as 50 milligrams may cause nerve symptoms.
Vitamin B12 promotes red blood cell production and nervous system function. Some people with MS tend to have low levels of B12, which can be measured with a blood test. However, there's no evidence to suggest that taking B12 supplements improves symptoms or alters the disease.
Selenium. Selenium is a mineral with antioxidant properties that are found in seafood, legumes, whole grains, low-fat meats, and dairy products. People with MS may have lower levels of selenium than people without MS. However, in animal studies, selenium worsened their MS-like symptoms. Human studies are still needed.
Gingko biloba. An herb with antioxidant effects, Gingko is thought to improve memory. "We completed a large study of gingko biloba comparing it to a placebo, and it did not improve the cognitive performance of people with MS," says Bourdette. On the other hand, a small study showed that it might help with fatigue associated with MS.
Ginseng. Another herb, ginseng, is thought to increase energy and strength. Some people with MS find ginseng helps reduce fatigue. However, Bourdette notes that research has not substantiated this claim. "When we completed a placebo-controlled trial of ginseng for fatigue and MS, we found that both the group taking the placebo and the group taking ginseng reported their fatigue improved."
Valerian. People with MS often have trouble sleeping. One study showed that the herb can help people fall asleep, but participants in the trial didn't have MS. Plus, it comes with a caution: Though it is often well tolerated, valerian may affect some prescription MS medications by increasing their sedating effects.
Probiotics. Often referred to as "good" bacteria, probiotics are found in foods such as yogurt as well as supplements. Animal studies suggest that probiotics may be able to lower the risk for developing the animal form of MS or altering the course of the disease. "Human studies of gut bacteria and probiotics in MS are just starting up," says Mowry.
The bottom line, says Mowry, is that more carefully designed, larger trials are needed before recommendations can be made about which vitamins, minerals, and other supplements may help MS. Since high levels of even essential vitamins and other supplements can be dangerous, talk to your doctor or a registered dietitian experienced in MS about the right amounts for you.
"Can Vitamins and Supplements Help MS?" originally appeared on Everyday Health.
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