Ask the Experts: Treatment/Complementary Questions
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A: Melatonin is an immune stimulator with an effect on interleukin receptors. Whether it has any actual clinical effect in autoimmune disorders or in MS is not known. You might review the short section in Wikipedia on this subject which appears timely and accurate.
Arthur Safran, MD
Q: I have been hearing claims and anecdotal accounts of the benefits of flavonoids for many ailments, including MS. I have not been able to find any credible information to substantiate that flavonoids are beneficial for people with MS. I did review the Society's brochure, "Vitamins, Minerals, and Herbs in MS: An Introduction" and follow the brochure's recommendation of using moderation. Since the FDA has no position on how much one should take, I am in somewhat of a quandary. Flavonoids seem to be relatively safe, but when used in the concentrations suggested by some of the health supplements, I wonder. Is there anything I should be aware of before I try this?
A: Flavonoids are present in our diet, more notably in vegetables and red wine. In the proverbial "test tube," they have been shown to have anti-inflammatory, anti-oxidant, and anti-platelet aggregation effects that may be beneficial in a number of diseases, including atherosclerosis and cancer. Unfortunately, these potential beneficial effects have not been demonstrated in a human system (what we call in vivo). Theoretically, some of these effects may benefit MS patients. But there are potential downsides. For instance, some flavonoids may interfere with enzymes that metabolize other drugs. At high doses, they have even appeared to be mutagenic, pro-oxidants and interfere with hormone metabolism. All of these effects are potentially quiet harmful and there are reports of harm with high dose human consumption.
In the absence of clinical evidence of benefit with high dose, or even low dose flavonoid supplementation, and the potential for harm, it remains best to follow the path of common sense and moderation. To this end I advise my patients to eat a well balanced diet that includes many different vegetables and drink, in moderation. There is evidence that this prescription is effective for overall health.
R. Philip Kinkel, MD