Complementary and alternative medicine (CAM) includes a variety of interventions—from exercise and dietary supplements to stress management strategies, biofeedback, and acupuncture. These therapies—which come from many different disciplines and traditions—are generally considered to be outside the realm of conventional medicine. When used in combination with conventional medicine, they are referred to as “complementary;” when used instead of conventional medicine, they are referred to as “alternative.” In the United States today, approximately 75% of people with MS use one form or another of CAM, generally in combination with their prescribed MS treatments. For more information about complementary and alternative medicine , please watch these two short videos. Part 1 & Part 2
Are CAM Therapies Safe to Use?
Many people use CAM because they believe that anything sold over-the-counter at a pharmacy or health food store is healthy and harmless. However, unlike conventional medical treatments—which are thoroughly tested and carefully regulated by the U.S. Food and Drug Administration—most CAM therapies have undergone very little, if any, scientific study. So some may be completely safe while others may actually pose significant risks—for example, by producing serious side effects or interacting negatively with other medications a person is taking.
Fortunately, a greater effort is now being made to find ways to evaluate the safety and effectiveness of various types of CAM.
Why are Controlled Clinical Studies So Important?
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.
Recommended Guidelines to Follow
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 good, 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 to track your prescription and over-the-counter treatments. (.pdf)
Check out These Complementary Approaches to Physical Health and Emotional Well-Being
- 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.
- 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. The physicial therapist 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.
- Acupuncture—Acupuncture is finding its way into Western medicine, with studies suggesting possible benefits for a wide range of problems.
Some Complementary Approaches to Avoid
- 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.
What Do We Know about Cannabis (Marijuana)?
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. Read more on cannabis.
Low Dose Naltrexone
Naltrexone is approved by the FDA for the treatment of addictions to opioids and alcohol. At the full recommended dose, Naltrexone blocks opioid docking sites on cells. At significantly lower doses, it has been prescribed as a treatment for a variety of diseases, including various types of cancers, HIV/AIDS, Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), emphysema, as well as MS and other autoimmune diseases. There has been limited clinical study of low dose Naltrexone (LDN) to treat MS, but in spring 2010, results from a pilot clinical trial were published. Read more about LDN and MS.