Complementary and Alternative Medicine (CAM)

• Canadian Health Network – From the home page, click on Complementary and Alternative Health

• Natural Health Products Directorate - From the Health Canada home page, click on Drugs and Health Products, then on Natural Health Products

• Eating well for healthy living: Examining the role of supplements

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.

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.