PHOSPHATIDYLCHOLINE 2 capsules, 3 times daily after meals.
13. INTENZYME FORTE 5 tablets, 3 times daily between meals and at bedtime ( 3 hours after or 1 hour before meals).
14. BIO-K FORTE -- One capsule daily as a source of Vitamin K2 to rebuild the Myelin Sheath.
FATIGUE IN MULTIPLE SCLEROSIS
As published in TOWNSEND LETTER FOR DOCTORS AND PATIENTS, November 1995
by David Perlmutter, M.D.
David Perlmutter, M.D., is a board-certified neurologist practicing neurology and preventive medicine in Naples, Florida. He hosts the weekly, prime-time television program LifeGuide and is the author of LifeGuide: Your Guide to a Longer and Healthier Life. Dr. Perlmutter can be reached at (941) 649-7400.
Recent advances in the understanding of the pathophysiology of multiple sclerosis (MS) are providing fertile ground for the development of unique treatment approaches. Unfortunately, an air of pessimism remains pervasive in a large segment of MS patients as well as clinicians dealing with this entity. Indeed, the historical descriptions of this disease have been filled with bleak commentary. As Godfried Sonderdank, Court Physician of Schiedam, Holland, reported in the 14th century when describing a disease now thought to represent MS with slowly evolving weakness of three extremities, dysphagia, a variety of sensory disturbances, as well as bilateral visual symptomatology: "Believe me, there is no cure for this illness. It comes directly from God. Even Hippocrates and Gallenus would not be of any help here."
Generalized fatigue seems to be one of the most common complaints of patients with multiple sclerosis. Yet the importance of fatigue in terms of compromising the quality of life in MS patients may not be fully appreciated by healthcare practitioners. When recognized, treatment options are generally few and only minimally effective.
In a recent survey of neurologists it was found that most favored research directed toward understanding the cause of fatigue in multiple sclerosis, while one-third said research should be focused on the development of new medications.2 Medicines most commonly used to treat fatigue in multiple sclerosis include Pemoline and Amantadine.
A recent study demonstrated that in 46 MS patients with disabling fatigue, Pemoline was preferred in 51.2% compared to 46.3% who preferred placebo. Detracting side effects of Pemoline in this study included insomnia, anorexia, headache, irritability, dizziness, and nausea.3 Other investigators have reported a 31% benefit in the treatment of MS-associated fatigue using Amantadine.4 Side effects noted with Amantadine have included nausea, dizziness, light-headedness, insomnia, depression, irritability, hallucinations, and confusion.
With the destruction of myelin in MS, nerve conduction in the demyelinated fibers is slowed, becomes temperature sensitive, and then fatigues rapidly. Myelin, however, may regenerate, but the regenerated myelin is usually ineffective with respect to function.
Recently, Dutch investigators have studied the use of 4-aminopyridine (4-AP) in an attempt to improve multiple sclerosis symptoms.5 4-AP is a potassium blocking chemical which has been demonstrated to increase nerve conduction through areaB??f demyelinization. The study evaluated 70 patients with clinically definite MS ranging in age from 23 to 68 years. Subjects were evaluated using a standardized disability scale (Kurtzke) at 2, 6, 12, 14, 18 and 24 weeks with monitoring of blood levels of 4-AP. The most significant side effect was a one percent incidence of epileptic seizures. The study group clearly demonstrated improvements when compared to the placebo group with respect to various motor skills including ambulatory function.
The main emphasis until now with respect to developing treatment strategies for multiple sclerosis have been either anti-inflammatory or immunosuppressive, designed to limit the extent of an acute attack or prevent exacerbations and progression of the disease, respectively. 4-Aminopyridine, however, approaches MS treatment in a different light, attempting to reestablish function through demyelinative nerve pathways whose function is compromised. 4-AP is inexpensive, available, and thus far seems to demonstrate only minimal side effects. Finally, since fatigue in MS has been thought by some investigators to represent a consequence of defective nerve transmission, the use of 4-AP in this scenario seems quite rational.
Autoimmune Disease and Candida The possible link between various autoimmune diseases and infection with the yeast Candida albicans has been described by well-respected researchers over the past two decades. As Trowbridge recently stated when discussing autoimmune diseases, "They appear to be among the growing number of otherwise unrelated disorders partially caused by inflammation and destruction of cells, tissues and organs by the body's own antibodies (autoantibodies). These disorders belong to the autoimmune classification of diseases.
"Science has not explained why the body should lose the ability to distinguish between substances that are 'self' and those that are 'nonself.' An accumulating stack of evidence is pointing the finger of suspicion directly at Candida albicans, as well as at other parasites or infections. How the yeast organism fosters a compromised normal immune function is the subject of investigation and much speculation by the worldwide scientific and clinical communities."
Because of the frequent association of candidiasis with generalized fatigue and the autoimmune nature of multiple sclerosis, we evaluated ten adult MS patients for the presence of Candida immune complexes and Candida antibodies. The diagnosis of MS was confirmed by history, physical examination, and magnetic resonance brain scanning in these patients. Quantitative serum levels of Candida IgG, IgA, IgM, and immune complexes were assayed using an enzyme-linked immunoassay. (Antibody Assay Laboratories, Santa Ana, California). Candida immune complexes contain IgG Candida antibodies, Candida antigen, and fragments of complement. Immune complexes are present in direct proportion to the Candida load. Candida immune complexes are perhaps the most sensitive test for active Candida-related illness.
Candida antibodies (IgM) are transiently elevated in acute infections. IgA antibodies are elevated in surface infections such as the mucosa of the mouth, gastrointestinal tract, and vagina or urethra. IgG antibodies are present in most adults and may persist long after the infection has been cured; therefore, elevated levels may simply indicate past infection.
Because of the high frequency of gut dysbiosis (a state of disordered bowel flora ecology) in various autoimmune diseases as well as chronic fatigue immune deficiency syndrome (CFIDS), we performed stool analysis on nine adult patients with MS diagnosed by history, physical examination, and magnetic resonance brain scanning. We utilized a Comprehensive Digestive Stool Analysis (Great Smokies Diagnostic Laboratories, Asheville, North Carolina). This study provides a variety of useful data including digestive markers (digestion and absorption), metabolic markers (balance of a variety of short chain fatty acids), bacteriology including normal flora, imbalanced flora, and possible pathogens, ratio of gram positive to gram negative organisms, mycology evaluation including normal organisms and possible pathogens, macroscopic evaluation, as well as a dysbiosis index. In this study we were most interested in mycology, lactobacillus count, and dysbiosis index.
The relationship between Candida activity and chronic fatigue has certainly been well-described by various authors. We believe that these data provide compelling evidence that candidiasis may, at the very least, be a frequent occurrence in patients with multiple sclerosis.
In addition, these data seem to indicate that intestinal dysbiosis may be common in MS patients. Dysbiosis is certainly well-recognized in patients suffering from inflammatory bowel disease (also an autoimmune phenomenon), and it is certainly well known that inflammatory bowel disease is often associated with extra-intestinal inflammatory manifestations such as arthritis, iritis/uveitis, and others. We believe, and these data suggest, that there is a strong likelihood that a relationship may exist between intestinal dysbiosis and multiple sclerosis. In a recent report in The Lancet, the frequency of white-matter lesions in 72 consecutive patients with inflammatory bowel disease, 48 with Crohn's disease, and 24 with ulcerative colitis was investigated. Magnetic resonance imaging studies of the brain were performed on the study group and compared to an age-matched healthy control population. This study found hyperintense focal white-matter lesions ranging from 2-8 mm. in diameter in 20 of the 48 patients with Crohn's disease (42%), in 11 of 24 patients with ulcerative colitis (46%), and in 8 of 50 healthy volunteers (16%).
Interestingly, the authors' report: "The frequency of focal white-matter lesions in patients with inflammatory bowel disease is almost as high as that in patients with multiple sclerosis (65000629."
We now routinely perform serum analysis for Candida immune complexes and Candida antibodies (IgG, IgM, and IgA) as well as a Comprehensive Digestive Stool Analysis on our multiple sclerosis patients.
MS patients who have active candidiasis are generally treated with an antifungal agent, typically fluconazole (Diflucan), in dosages ranging from 100 mg. every other day to 150 mg. per day depending on patient size and disease activity. Typically, fluconazole is continued for four to six weeks or even longer depending on response. Midway through treatment we typically assess liver transaminase function. We utilize a low carbohydrate diet as popularized by Dr. William Crook.
Patients demonstrating an elevated dysbiosis index with deficiencies of lactobacillus are generally treated initially utilizing Ultra-Flora Plus (fructo-oligosaccharides, concentrate of globulin protein from whey, Lactobacillus acidophilus, NCFM, Bifido bacterium infantis [A]), which is a nutritional support program designed for patient suffering from dysbiosis. This program is utilized along with a diet eliminating caffeine, alcohol, wheat, and dairy products.
In addition, it is critically important to recognize the importance of vitamin B-12 metabolism in the pathogenesis of multiple sclerosis. Although we typically continue to assess vitamin B-12 levels, we have been more impressed of late with the usefulness of urine methylmalonic acid in providing more relevant information as to B-12 status.
We generally supplement our multiple sclerosis patients with high dosage vitamin B-12 given by IM injection.
Typically, we will begin treatment with 1,000 mcg. of vitamin B-12 administered IM on a daily basis for a two-week period of time followed by a weekly injection for the following four to six weeks and then continue with 1,000 mcg. IM on a monthly basis. We are frequently able to instruct our patients in self-administration of B-12, thus minimizing inconvenience and cost.
This report demonstrates a significantly increased incidence of elevated Candida-related markers in patients with multiple sclerosis. Our success in reducing fatigue in multiple sclerosis with treatments designed specifically to reduce Candida activity lends further support for the suggested relationship between MS related fatigue and Candida activity.
Further, we suggest that intestinal dysbiosis may play a pivotal role with respect to the actual pathogenesis of multiple sclerosis as an autoimmune disease entity.
We gratefully acknowledge the generous assistance and cooperation of Antibody Assay Laboratories, (1715 East Wilshire, #715, Santa Ana, California 92705, Telephone: 714-972-9979) in providing serum evaluations of Candida immune complexes and antibody levels in our patients as well as Great Smokies Diagnostic Laboratory (18A Regent Park Boulevard, Asheville, North Carolina 28806, Telephone: 704-253-0621) for providing the Comprehensive Stool Analysis for our patients in this study.
1. Medaer, R: Does the History of Multiple Sclerosis Go Back as Far as the Fourteenth Century? Acta, Neurol. Scand., 60:189-192, 1979.
2. MS Quarterly Report Volume 12, #4, February 1994, page 9.
3. Weinshenker, B.G., et at., A Double-Blind, Randomized, Cross-Over Trial of0006oline in Fatigue Associated with Multiple Sclerosis, Neurology 1992: 4268-1471.
4. MS Quarterly Report Volume 13, #4, December 1994, 4-5.
5. Van Dieman, et al., Effect of 4-Aminopyridine on Clinical Science in Multiple Science: A Randomized Placebo-Controlled, Double-Blind, Cross-Over Study. Annals of Neurology 1992:32:123-130.
6. Trowbridge, John M.D., and Walker, Morton D.P.M., The Yeast Syndrome, Bantam Books, New York, 1988, Page 35.
7. Geissler, A., et al., Focal White-Matter Lesions In Brain of Patients With Inflammatory Bowel Disease, Lancet Vol. 345, 1995, 897-8.
8. Crook, Eµ¯?iam M.D., The Yeast Connection, Vintage Books, New York, 1986.
COPING WITH MULTIPLE SCLEROSIS NATURALLY
STEPHEN BYRNES, ND, RNCP
Originally published in Well Being (Australia), Fall 1999; Healthy Living Guide (Canada), Sept. 1999.
THIS ARTICLE IS FROM DR. BYRNES WEB SITE CALLED POWERHEALTH
Multiple sclerosis is a modern disease that affects the central nervous system's ability to communicate with the body. Nerve fibres are surrounded by fatty sheaths called myelin which help conduct electrical impulses along nerve fibres. In multiple sclerosis, these myelin begin to deteriorate and scar tissue replaces what is lost. When the impulse hits the scar tissue, it encounters a "road block" so to speak and the impulse gets interfered with. This disruption leads to tingling and feelings of pins and needles in the hands and feet, vertigo, numbness, muscle incoordination, blurred vision, and difficulty walking. In the advanced stages of the disease, there is severe difficulty in walking, speaking, and performing simple physical tasks. Fatigue is another debilitating symptom as well. The disease is known for its "stop-start" pattern: people may go into remission for varying , lengths of time, only to have the disease suddenly return. Each subsequent attack tends to be more severe than the last.
MS, according to medical science, has no known cause. Natural therapy, however, posits several possible causes. Its important to note here that no two cases of MS are alike and that different factors may be in play for an affected person. Part of any successful treatment approach, then, involve sample detective work into what might be the problem(s). Let's take a look at the more well-known possible causes noted by natural medicine.
Gluten intolerance, in particular, has been cited as a major cause. A tough, elastic protein found in wheat, barley, rye, oats, and sweet rice (mochi), gluten is typically difficult for many people to digest, especially as modern cultures have gotten away from soaking and fermenting their grains, a process that "predigests" the proteins in grains, including gluten, rendering them more easy to digest. Soaking and/or fermentation of grains also effectively breaks up nutrient-blocking phytic acid, found in the bran and hull of all whole grains, as well as legumes and nuts. Nutrition writer Sally Fallon explains, "A diet high in unfermented grains like wheat puts an enormous strain on the whole digestive mechanism. When this mechanism breakdown with age or overuse, the results take the form of allergies, celiac disease, mental illness, chronic indigestion, and candida albicans growth. Recent research links gluten intolerance with multiple sclerosis (Nourishing Traditions, 429). Fallon advises that high gluten grains, such as wheat and rye, always be soaked before cooking and to avoid modern baked goods (even if whole grain) as they are invariably made from non-soaked grains.
How to soak? Simply place your chosen grain in a pot and add some water, enough to cover, and leave for at least seven hours. You can also add either a tablespoon of live yogurt or whey to more strongly initiate the fermentation process.
Celiac and Crohn's disease, both involving food sensitivities, are found in many people with MS (and schizophrenia). Avoiding glutinous grains would be in order if you're experiencing any difficulties.
Though gluten appears to be a major food factor for many with MS, other foods such as pasteurized milk, refined sugar, and corn are also implicated. For any person with MS, then, food allergy testing carried out by a professional is in order
Essential fatty acids are typically lacking in those with MS. Found if high amounts in cold water fish, free range eggs, and flax oil, and in lower amounts in dark green, leafy vegetables and whole grains, these polyunsaturated fatty acids help reduce inflammation and maintain the myelin sheaths, as well as modulate the immune system. EFA's, then, are very standard in approaching MS. Supplements of fish and borage oils are typically employed to great effect. Fish oils are high in EPA and DHA, two omega-3 fatty acids heavily involved in brain and nervous function. Borage oil is rich in GLA, an omega-6 fatty acid usually deficient in MS patients. Bodily utilization of EFA's is greatly inhibited by trans-fatty acids. Avoiding all phony fats such as margarine, refined vegetable oils, and vegetable shortening is paramount.
Other lacking nutrients are zinc, magnesium, selenium, manganese, as well as vitamins B1, B6, and B12. B12, especially, is involved in the maintenance and production of the myelin sheath; it is a standard supplement for MS.
Nutritional deficiencies are often exacerbated by poor digestion, which leads to poor nutrient absorption from the intestines and contributes to food sensitivities and hyper-immune responses. Digestive enzymes are a must with MS. Again, the need for food sensitivity testing is important.
An overgrowth of the yeast fungus candida albicans in the intestinal tract ca sZd to a host of problems, including increased food sensitivities and a weakened digestive system. Since candida toxins can affect the nervous system, causing mood swings, depression, and tingling, an overgrowth can only cerbate MS, or possibly initiate it. Candida overgrowth is caused by several things: excessive sugar consumption (even natural sugars), antibiotic use (which kill the intestinal bacteria that control candida), corticosteroid use, and alcoholism (alcohol is a fermented sugar). Addressing a possible yeast imbalance through dietary restriction of sugar and an antifungal supplement regime (colloidal silver, probiotics, garlic, etc) often improves MS symptoms.
Since MS patients have been found to have high mercury levels in their cerebrospinal fluid, and since mercury is a known poison that affects the nervous system, dental fillings are suspect. If an MS patient (or a person interested in prevention) decides to replace their mercury amalgams, he ors he must be careful of the replacing substance, to be sure it also has no heavy metals in it. Its best, here, to seek out the help of a professional trained in biological dentistry. Typically, mercury removal is followed by a detoxification program in which excessive mercury is flushed out of the body. Professional help, therefore, is needed.
EFFECTIVE HOLISTIC TREATMENT
As stated before, each MS case is different, therefore, each treatment will be different. Seeking out the help of a professional experienced in nutritional medicine and/or natural treatment of MS is strongly urged as MS is a complex disease. Despite the uniqueness of treatment approaches, some general guidelines can be given.
Diet therapy is important. In addition to food sensitivity testing, as well as proper food preparation and a diet of whole, unprocessed foods, avoidance of all trans and processed fats is imperative. Some MS researchers have found considerable success by reducing the amount of saturated fat in their patient's diets. Stopping all refined sugars, food colorings, preservatives, etc is imperative as well. Another substance to be avoided is aspartame, a neurotoxin. Supplements of EFA's, B complex, B12, zinc, magnesium, and other trace minerals are typical. B12, especially, is strongly indicated. Digestive enzymes are a must as well.
Dr. Hans Nieper of Germany had considerable success treating MS using a supplement he developed called Calcium EAP, along with squalene, a compound found in olive and shark liver oil (Nieper also used squalene in his cancer programs). Nieper felt that MS patients were deficient in EAP, a substance required for myelin sheath and cell membrane integrity, as well as nerve impulse transmission. When the supply was restored, myelin sheath break down was halted or slowed.
Lifestyle changes, including stress reduction and cessation of smoking or drinking, are necessary as well. The role of stress in promoting chronic disease is often overlooked. Clinical experience shows that the faster one begins appropriate treatment for MS, the better are one's chances of overcoming it. Unfortunately, most people go undiagnosed until the disease is fairly advanced, making treatment more difficult. Listening to your body, as well as practicing prevention by avoiding phony foods and fats and eating a diet of nutrient-dense living foods, is one's best defense against this perplexing modern disease.
It's All In Your Head by Hal Huggins, DDS; The Multiple Sclerosis Diet Book by Roy Swank, MD, PhD and Barbara Duggan; Nourishing Traditions by Sally Fallon. Check your local bookstores for these titles.
Calcium EAP is available from American Biologics in Chula Vista, California,(619) 429-8200; www.americanbiologics.com.
The National Multiple Sclerosis Society
MS Holistic Healing Web Page