Alternative and Integrative Therapies for Multiple Sclerosis

Unclear or Conflicting Scientific Evidence:

Colostrum: Colostrum, or bovine (cow) colostrum, is the pre-milk fluid produced by cow mammary glands during the first two to four days after giving birth. Bovine colostrum delivers growth, nutrient, and immune factors to the offspring. Bovine colostrum has been used for multiple sclerosis, although early results do not indicate any benefit. Additional study is needed in this area.

Creatine: Creatine is naturally synthesized in the human body from amino acids primarily in the kidney and liver, and transported in the blood for use by muscles. Approximately 95% of the body's total creatine content is located in skeletal muscle. Results from one randomized, double-blind clinical trial suggest that creatine supplementation does not improve work production in individuals with multiple sclerosis. This was a small study. Large, well designed studies are needed. Creatine may increase the risk of adverse effects, including stroke, when used with caffeine and ephedra. In addition, caffeine may reduce the beneficial effects of creatine during intense intermittent exercise.

Evening primrose oil: Evening primrose (Oenothera biennis) oil (EPO) contains an omega-6 essential fatty acid, gamma-linolenic acid (GLA), which is believed to be the active ingredient. It is theorized that primrose oil may be helpful in patients with MS based on laboratory studies. Limited evidence is available in humans, and a firm conclusion is not possible at this time.

Several reports describe seizures in individuals taking evening primrose oil (EPO). Some of these seizures developed in people with a previous seizure disorder, or in individuals taking EPO in combination with anesthetics. Based on these reports, people with seizure disorders should not take EPO. EPO should be used cautiously with drugs used to treat mental illness such as chlorpromazine (Thorazine ®), thioridazine (Mellaril ®), trifluoperazine (Stelazine ®), or fluphenazine (Prolixin ®), due to an increased risk of seizure. Patients who plan to undergo surgery requiring anesthesia should stop taking EPO two weeks ahead of time because of the possibility of seizure.

Ginkgo: Ginkgo (Ginkgo biloba) has been used medicinally for thousands of years. Today, it is one of the top selling herbs in the United States. Based on laboratory study, it has been suggested that ginkgo may provide benefit in multiple sclerosis (MS). Human research is limited to several small studies that have not found consistent benefit. Additional research is needed. Gingko may cause bleeding in sensitive individuals, including those taking blood thinning medications such as aspirin or warfarin (Coumadin ®).

Magnet therapy: The use of magnets to treat illness has been described historically in many civilizations, and was suggested by ancient Egyptian priests and in the 4^th century BC by Hippocrates. The 15^th Century Swiss physician and alchemist Paracelsus theorized that magnet fields play an important role in Western medicine, including use for magnetic resonance imaging (MRI), pulsed electromagnetic fields, and experimental magnetic stimulatory techniques. Initial studies of electromagnetic field therapy for MS report varied results, with one trial suggesting improvement in spasticity but not other symptoms, and a different study finding improvement in a combined rating for bladder control, cognitive function, fatigue level, mobility, spasticity, and vision (but no change in overall symptom score). Due to methodological weaknesses of these studies, it remains unclear if electromagnetic field therapy is beneficial in patients with MS.

Massage: Initial research reports that massage may improve anxiety, depression, self-esteem, body image, and social functioning in patients with multiple sclerosis. Benefits on the disease process itself have not been well evaluated. Additional research is necessary before a firm conclusion can be drawn.

Vitamin D: Vitamin D is found in numerous dietary sources such as fish, eggs, fortified milk, and cod liver oil. The sun is also a significant contributor to our daily production of vitamin D. Scientists have detected MS rates to be lower in areas with greater sunlight and higher consumption of vitamin D rich fish. Preliminary research suggests that long-term vitamin D supplementation decreases the risk of MS. However, additional research is necessary before a firm conclusion can be reached.

Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Yoga has been described as "the union of mind, body, and spirit," which addresses physical, mental, intellectual, emotional, and spiritual dimensions towards an overall harmonious state of being. There is limited study of yoga therapy in patients with multiple sclerosis. Further research is needed.

Historical or Theoretical Uses Lacking Sufficient Evidence:

Integrative therapies used in multiple sclerosis, and that have historical or theoretical uses but lack sufficient clinical evidence, include acupressure (Shiatsu), acupuncture, Alexander technique, astragalus (Astragalus membranaceus), bee pollen, boswellia (Boswellia serrata), calcium, chiropractic, detoxification therapy, DHEA, healing touch, Kundalini yoga, liver extract, meditation, music therapy, organic food, ozone therapy, phosphorus, qi gong, reflexology, reishi mushroom (Ganoderma lucidum), resveratrol, rutin, SAMe, spiritual healing, tai chi, TENS (Transcutaneous Electrical Nerve Stimulation), therapeutic touch, thymus extract, and vitamin B12.

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