MS: Probable Cause and Best Bet Treatment

BEST BET DIET BOOK
Scientific Papers

"MS: Probable Cause and Best Bet Treatment" Dr. Ashton Embry © 1996
Section 17: Other Environmental Factors and Potential Treatments
	SUB-SECTIONS: Introduction, Inhalants, Viruses and Bacteria, Heavy Metals, Vaccinations, Beta-interferon Drugs, Copaxone, Myloral and Bovine-Brain Supplements, Other Drugs, Alternative Treatments.
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Introduction
I believe it would be naive to think that every single case of MS had the same cause and that most cases have only a single cause. MS is basically "an effect", a chronic inflammation and demyelination of the CNS, and it seems to me a number of environmental factors can in combination, result in such a condition. For example, it is known that a bacterial infection can cause chronic inflammation and demyelination but, because the cause is known, it is called Lyme Disease rather than MS. Furthermore, in rare cases, measles vaccination has also resulted in chronic demyelination and once again, because the cause is known, it is not referred to as MS but rather as chronic rubella encephalitis. Thus MS is basically a catch all term for chronic demyelination of unknown cause. As I have discussed in the first part of this essay, dietary factors are most probably the main (but not the only) cause of most (but not all) cases of MS. Given this, it is essential to find out through testing if indeed your MS is caused mainly by food hypersensitivities and high saturated fat intake. If you avoid dairy, cereal grains, eggs, yeast, legumes and other hypersensitive food and follow a low fat diet with supplements and the progression of MS is not abated, then it is likely your MS is mainly caused by another environmental factor. The factors discussed below are other likely contributors to MS and, although in most cases they are subsidiary to hypersensitive foods, they may be major factors in some cases.
Inhalants
Another possible cause of immune reactions which damage the BBB and possibly activate T-cells are hypersensitivities (type I, III, IV) to inhalants. IgE, immediate sensitivity reactions to inhalants seem relatively rare in persons with MS (Oro et al., 1996) but IgG reactions may be more common and problematic. Once again a blood-allergy ELISA or RAST test which measures IgE and IgG4 production on antigen challenge for a variety of inhalants is a reasonable way of determining if this is a major contributing factor to your MS. If the test is positive for a number of inhalants then once again it is essential to avoid or greatly lower the exposure to these substances. This maybe more difficult than for foods but allergists should be able to advise on various methods of avoidance and reduction. Extreme measures such as moving to another part of the country may be necessary in rare cases.
Viruses and Bacteria
As discussed earlier common viral and bacterial infections undoubtedly can affect the BBB and activate T-cells against the CNS. It is very doubtful if common viral and bacterial infections are the main cause of MS onset and progression as revealed by the epidemiological data but, in a few cases, such occurrences may play a major role in progression. In regard to a bacterial cause of MS the reader is referred to the website, "ourworld.compuserve.com/homepages/GShannon". Strong antibiotics are useful in cases where bacteria play a significant role in MS. In general, strategies to avoid infections should be adopted and any common bacterial infection should be treated with standard antibiotics as soon as possible. Minerals such as zinc and selenium, which strengthen the immune system, may well have value in warding off viral infections (Macknin et al., 1996). It has also been suggested that herbs such as goldenseal and echinacea have value in strengthening the immune system (Balch and Balch, 1996). One problem with these herbs is that they may cause hypersensitivities (goldenseal is closely related to ragweed) and questions still remain concerning the wisdom in taking these herbs over a long time period. I would suggest caution in their use for MS treatment with echinacea perhaps being the safest herb to use to ward off viruses.
Heavy Metals
Heavy metals can be very toxic to the CNS and thus, in some cases, may play a significant role in MS onset and progression. One of the most obvious sources of heavy metal toxicity is mercury in dental fillings. Currently there is considerable debate on this point and it is difficult to separate the data from the hype. Replacement of mercury amalgams is very expensive and may itself cause problems. However there is enough theoretical and anecdotal data available to indicate that mercury fillings may contribute to MS progression. If diet revision does not result in an effective halt of MS progression then it may well be worth the trouble and expense to have the fillings replaced. An interesting and insightful study of the effect of toxins on the CNS concerns the response of 26 women with failed, silicone breast implants (Shoab and Patten, 1996). "All patients had evidence of disseminated CNS lesions" and 80% had oligoclonal bands (IgG antibodies) in their spinal fluid. All the women had "systemic, inflammatory, autoimmune disease with CNS involvement" which was "triggered by the foreign material (silicone) in their body". This example clearly indicates that foreign, "antigenic" material can cause BBB failure and demyelinating immune reactions. It is worth having a blood test and perhaps even a hair analysis for levels of heavy metals (see appendix). Chelation therapy can be valuable for detoxifying when anomalously high levels of heavy metals are detected.
Vaccinations
Poser (1986, 1993) has stated that vaccinations may be an important factor in MS onset and progression. Given the fact that vaccinations cause immune reactions it is clear that they may well affect the BBB and cause CNS inflammation (not necessarily an exacerbation). Poser (1986) provides references for a number of incidences where vaccinations resulted in MS. The most reasonable explanation of such occurrences is that the vaccination provided the final stress on an already embattled CNS. Overall I would suggest that vaccinations (including the flu shot) be avoided unless they are absolutely necessary.
Beta-interferon Drugs
Currently three different, but very closely related, drugs which consist of beta-interferon, a protein (cytokine) secreted by immune cells, are available for MS therapy (Betaseron, Avonex, Rebif). Clinical trials have demonstrated that these drugs reduce the number of exacerbations and lesion forming activity and thus are beneficial for treating MS. A number of immediate side effects (flu-like symptoms, site reactions) are often associated with these drugs but in most cases are not intolerable or dangerous. Depression can be a troublesome side effect and notably 3% of the study group on betaseron attempted or committed suicide whereas no one in the placebo group attempted or committed suicide. One major concern in the use of these drugs is that up to 40% of those taking them for up to 3 years develop neutralizing antibodies to the injected beta-interferon (Thompson and Noseworthy, 1996). The immediate result of this is that the drug no longer will have any beneficial effect. Of more concern is the possibility that the produced antibodies will cross-react with and neutralize the individual's natural beta-interferon. If this happens the individual's immune system will be severely compromised with likely catastrophic results. There have been no confirmed reports of such disastrous cross reactions having occurred. Thus the decision to take these drugs is a bit of a gamble and I suggest that the pros and cons be thoroughly considered before deciding to accept such drug therapy.
Copaxone
The latest drug available for treating relapsing- remitting MS is copaxone which is a synthetic chemical (amino acid copolymer) that resembles myelin basic protein. It was in development for about 30 years. It is not certain how the drug works to reduce the number of exacerbations and lesion activity but the most likely explanation is that it acts as a "decoy" for the T-cells and antibodies which are activated against myelin. Thus, instead of attacking the myelin, many immune cells react against the copaxone (Wolinsky, 1995). The drug seems to be most effective in individuals in the early stages of MS (minimum disability). A clear understanding of the short and long term side effects of copaxone has not been achieved. Initial data indicate the side effects and risks are less than those for the beta interferon drugs.
Myloral and Bovine-Brain Supplements
Recently the concept of oral tolerance has been suggested as the basis for MS treatment (Weiner et al., 1993). The main concept is, that by eating CNS proteins of bovine derivation, an individual desensitizes the immune system to CNS proteins and causes the development of suppressor immune cells which inhibit immune action against CNS proteins. Presently, a Phase III trial, which is testing this treatment, is going on and the results are expected by mid-1997. The "drug" which is currently being tested is refined bovine CNS proteins (including myelin basic protein) and is called Myloral. In reality Myloral is nothing more than a food supplement which has been patented. To me this therapy, like other suggested supplements such as grape seed extract, holds promise because it likely has few side effects and helps to offset the immune reactions associated with the ingestion of offending foods. The most serious potential side effect is a hypersensitivity reaction (i.e. oral tolerance is not achieved) to the Myloral. Obviously immune reactions against ingested myelin proteins which pass into the circulatory system will likely result in substantial damage to the CNS. Clearly it will not solve the problem on its own but is a useful addition to the suggested dietary revisions and other supplements. It is worth noting that two non-patented, bovine brain products are currently available, Sphingolin and Ora-brain. Given the above theoretical basis it might be worth taking one of these products although optimum dosage is not known. As a caution I suggest you make sure you are not hypersensitive to this substance. Also there might be a remote possibility of disease transmission (Creutzfeld-Jakob?) by them. Overall the oral myelin therapy may turn out to be a very beneficial therapy in fighting MS for many people and would be complimentary to diet revision.
Other Drugs
The one therapy method, for which MS societies, MS clinics and many neurologists provide reasonably up to date information, is drug therapy (Carter, 1995; Bansil et al., 1995; Van Oosten et al., 1995). A variety of immunosuppressive drugs is being used to fight MS although results are mixed. Cladribine and possibly Methotrexate appear to hold some promise for CPMS. For those who prefer drugs to diet revision and supplements I suggest you discuss the options and the various side effects with a neurologist.
Alternative Treatments
Numerous "alternative" therapies have been suggested to relieve MS symptoms and to alter the progression. These are all listed and discussed in Graham (1989) and Thomas (1995). Much anecdotal data are available to indicate that various alternative therapies have value and are worth investigating. Of course common sense approaches to health such as adequate rest, exercise and a reduction of stress are undoubtedly very beneficial.
End section 17.