Lifestyle and complementary therapies in multiple sclerosis guidelines: Systematic review
Acta Neurologica Scandinavica 2022 January 17 https://doi.org/10.1111/ane.13574 PDF costs $15
Management of multiple sclerosis (MS) may comprise clinical interventions and self-management strategies, including complementary therapies and modifiable lifestyle factors such as exercise and smoking cessation. Lifestyle modifications and complementary therapies with proven safety and efficacy are essential as part of best-practice MS management, especially when faced with limited access to healthcare services. However, it is unclear to what extent MS clinical practice guidelines and consensus statements address these strategies. A systematic review was conducted, wherein MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, guideline databases and developer sites were searched for guidelines and consensus statements that addressed lifestyle modifications and complementary therapies of interest. Two researchers independently screened articles, extracted data and assessed guideline quality using the Appraisal of Guidelines for Research and Evaluation version II. Thirty-one guidelines and consensus statements were included.
- Quality was high for ‘clarity of presentation’ (77%) and
- ‘scope and purpose’ (73%),
- moderate for ‘stakeholder development’ (56%), ‘
- rigour of development’ (48%) and
- ‘editorial independence’ (47%), and
- low for ‘applicability’ (29%).
Two guidelines, related to
- physical activity and exercise,
- mindfulness,
- smoking cessation, and
- vitamin D and
- polyunsaturated fatty acid supplementation,
scored high in all domains.
These guidelines were two of only four guidelines intended for use by people with MS. High-quality guidelines and consensus statements to guide lifestyle modifications and complementary therapies in MS management are limited. Our findings indicate the need for more guidelines intended for use by people with MS, and a further focus on implementation resources.
VitaminDWiki - Overview MS and vitamin D contains
Clinical interventions have shown that Vitamin D can prevent, treat, and even cure Multiple Sclerosis, at a tiny fraction of the cost of the drugs now used to treat it, and without side effects.
- Fact: Low Vitamin D results in higher risk of getting MS
Increase latitude leads to decreased Vitamin D, which leads to increased risk of MS
Dark skinned people are far more likely to get MS (dark skin people typically have low vitamin D)
Elderly (who typically have low vitamin D) are more likely to get MS
Is there increased risk in people who already have diseases associated with low vitamin D - TB, for example ? ? ?
Women typically have 3X increased MS risk then men (note: women typically have 20% lower levels of vitamin D than men)
Exception: women in very sunny climates and dark-skinned women have the same MS risk as men
Obese are 60% more likely to get MS
Multiple Sclerosis 42X more likely if light brown skin and smoke (both associated with low vitamin D) – July 2020
MS recurrence is much higher in spring - the lowest time of the year for vitamin D
increase in clouds/rainfall (which reduces available Vitamin D) is associated with increased risk of MS (Scotland, Western Washington)
MS incidence has increased 70% in a decade while the incidence of vitamin D deficiency doubled
Less MS in those with outdoor occupations PDF file, not a web page - Fact: MS uses up Vitamin D
- Fact: Lower vitamin D (due to MS using up Vitamin D while fighting the disease) results in many other health problems (such as broken bones), so depleted vitamin D levels must be restored.
- Fact: Vitamin D looks so promising for preventing and treating MS that there were 25 INTERVENTION clinical trials as of Feb 2014
- Fact: Vitamin D reduced the MS relapse rate far better than Fingolimod which is now used for that purpose.
- Note: Fingolimod costs $25,000/year while vitamin D, which works better and has no side effects is 1000 times less expensive.
- Fact: 98% of the genes affected by Interferon are also affected by Vitamin D
- Note: 1 week of Interferon = $4,700, 1 week of vitamin D 10,000X lower cost
- Fact: MS Doctors in Brazil recommending 40-100 ng/mL of Vitamin D
- Fact: Many MS forums are recommending vitamin D to treat MS, with some taking 5,000 to 10,000 IU daily
Observation: Risk of going from pre-MS to MS reduced 68 percent with 7100 IU vitamin D – RCT Dec 2012- This is an observation instead of a fact - it has not yet been confirmed.
- Fact: VERY LARGE doses of vitamin D have CURED 2,000 people of MS in Brazil
- Controversy: UVB fron sunlight or UVB bulb may be BETTER than Vitamin D for reducing the risk of getting MS
- Hypothesis: In addition to Vitamin D there are many other photoproducts produced by UVB that may promote health.
Summary: lack of consensus on how much to prevent, treat, or cure MS.
- Coimbra Protocol (using Vitamin D) is safe and effective for Multiple Sclerosis and Autoimmune diseases – April 2022
- 54,000 IU of vitamin D daily with no Calcium (1,000 IU per kg: Coimbra protocol) – July 2024
- How much Vitamin D to prevent many diseases - such as MS
- How much Vitamin D is needed to treat MS? There is currently no agreement
The recommendations range from 40 to 100 ng - which can result of a dose ranging from 3,000 to 20,000 IU/day - How Vitamin D is needed to Cure MS?: It appears that 20,000-140,000 IU daily may be needed to CURE the disease
You must be under the supervision of a doctor who knows what to watch for in your individual situation.
High doses of Vitamin D cannot be used as a monotherapy.
You will need to adjust the cofactors: Typically increasing Magnesium and Vitamin K2, and reducing Calcium intake.
Your doctor will monitor these and might increase your intake of Vitamins B2, C, as well as Omega-3 - Epstein-Barr virus increases risk of Multiple Sclerosis by 32X - Jan 2022
- Multiple Sclerosis treated by Vitamin D, recommends investigating high dose Coimbra - Oct 2021
- Multiple Sclerosis patients had fewer COVID-19 problems (Note: many MSers take Vitamin D) – April 30, 2021
- Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021
- Multiple Sclerosis relapses cut in half by 100,000 IU of Vitamin D every 2 weeks– RCT 2019
VitaminDWiki - Multiple Sclerosis 32 percent less likely among those with more than 32 ng of vitamin D – Dec 2019 contains
- Overview MS and vitamin D
- An opportunity - use Vitamin D to treat Multiple Sclerosis (has been used for 14 years) - Feb 2022
- Multiple Sclerosis treated when use high doses of vitamin D – meta-analysis May 2018
- Multiple Sclerosis: 10 percent fewer relapses for each 10 ng higher level of vitamin D – Meta-analysis April 2020
- Multiple Sclerosis: number needed to treat with vitamin D may be as low as 1.3 – Meta-analysis Oct 2013
- Multiple Sclerosis more likely if poor vitamin D genes - 22nd study – Aug 2017
- Multiple Sclerosis relapses cut in half by 100,000 IU of Vitamin D every 2 weeks– RCT 2019
UV and Sunshine reduces MS risk
- Multiple Sclerosis 2X more likely if low winter UV – June 2018
- Multiple Sclerosis half as likely if get plenty of sunshine (not a news item) – March 2018
Other things also help
- Multiple Sclerosis treated by 50,000 IU Vitamin D bi-weekly plus Omega-3 – RCT July 2018
- Multiple Sclerosis 40 percent less likely if consume tinned fish (Vitamin D and Omega-3) – Sept 2019
- Resveratrol treats Multiple Sclerosis and other autoimmune diseases – many studies
- Not a single case of multiple sclerosis in 15,000,000 people (plant-based diets)
High Dose Vitamin D and cofactors
- Coimbra protocol using high-dose Vitamin D is safe – April 2022
- The use of high dose Vitamin D (Coimbra Protocol) for multiple sclerosis in Germany – 2019
- Comparing High-dose vitamin D therapies MS and other health problems
Number of MS studies which are also in other categories
- 22 studies in Genetics - genes can restrict Vitamin D getting to the blood and to the cells
- 14 studies in Vitamin D Receptor - gene which restricts D from getting to the cells
- 7 studies in Vitamin D Binding Protein - gene which restricts D from getting to the cells
- 21 studies in Ultraviolet light - may be even better than Vitamin D in preventing and treating MS
- 9 studies in Omega-3 - which helps Vitamin D prevent and treat MS