Complementary and Alternative Medicines and Multiple Sclerosis

Complementary and alternative medicines — sometimes collectively referred to as “CAM” — include a wide variety of interventions from diets and supplements to meditation and tai chi. They come from many different disciplines and traditions. Most are considered to be outside the realm of conventional medicine, although others, including vitamin D, exercise, acupuncture and cooling strategies, for example, are gaining recognition in comprehensive care through scientific study and clinical trials.

When used in combination with conventional medicine, these interventions are referred to as “complementary.” When used instead of conventional medicine, they are referred to as “alternative.” In the United States today, many people use a form of complementary or alternative medicine to help manage their multiple sclerosis, most often in combination with their prescribed MS treatments. 

Many people seek alternative or complementary medicine because they believe that anything sold online or over-the-counter at a pharmacy or health food store is healthy and harmless. But many products that claim to be safe and beneficial may not be. Unlike conventional medical treatments that are thoroughly tested and carefully regulated by the U.S. Food and Drug Administration (FDA), most supplements have undergone very little — if any — scientific study to evaluate their safety and effectiveness. 

This means that some forms of alternative or complementary therapies may be completely safe for a person with MS while others may actually pose significant risks — by producing significant side effects, over-stimulating the person’s immune system or interacting negatively with other medications a person is taking. Some may provide benefit for a person with MS while others offer no benefit at all.

The American Academy of Neurology released a guideline on the use of complementary and alternative medicine in MS. The guideline was developed to address the following questions:

1. Do complementary and alternative therapies reduce specific symptoms and prevent relapses or disability?
2. Can their use worsen MS or cause serious adverse effects?
3. Can alternative or complementary medicines interfere with MS disease-modifying therapies?

Although these are all very important questions, the authors found very few published studies of sufficient quality to provide helpful answers about most of the CAM therapies that are being used by people with MS.

Carefully-designed clinical trials are the best way to determine the safety and effectiveness of a particular treatment. Here’s 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 if a treatment is effective is to test it against a placebo or an already established treatment, in a large study group.
• 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 study group over a sufficient period of time.

Questions to consider:

• What does the treatment involve?
• How and why is it supposed to work?
• How effective is it?
• What are the risks associated with its use?
• How much does it cost or is it covered by your insurance plan?
• Will it interact with your other therapies?
• How reliable is your source information?

Keep your healthcare provider informed about everything you are taking (vitamins, herbs, etc.) or doing (acupuncture or exercise). Not sharing this important information is like asking your healthcare provider to treat you blindfolded. Also, knowing everything you are taking will allow your provider to alert you to possible side effects or drug interactions.

Discuss any changes in your treatment plan with your healthcare team. You and your healthcare team have developed a comprehensive plan to manage your MS. Adding, stopping or switching one of your treatments can affect the others. Have a conversation with your healthcare team prior to making changes 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).

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 heart-healthy, high-fiber, low-fat diet that is recommended for all adults. Some other medical conditions — such as high blood pressure and cardiovascular disease — may be associated with MS worsening, so a heart-healthy diet is very important.

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. A physical therapist can recommend an exercise plan to fit your abilities.

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 and studies suggest possible benefits for a range of MS symptoms such as pain, spasticity and fatigue.

• Clear Thinking About Alternative Therapies — Download the Society’s guide to alternative therapies, which includes tips, checklists and government and professional resources. 
• National Center for Complementary and Integrative Health (NCCIH) — Find information about complementary health practices and products from the NCCIH, an agency under the National Institutes of Health (NIH).