Multiple Sclerosis is a disease where the myelin sheath of the central nervous system is attacked by the immune system, whereby the immune system mistakes the myelin cells as a foreign invader and thus tries to destroy it. The attack on the myelin sheath disrupts the communication of messages sent via electrical impulses along the nerves of the central nervous system. It is this interrupted electrical signal that produces the many different symptoms of MS.
MS is such an individual disease where people can suffer from any number of different symptoms. It is due to this individual nature of MS that MS treatment plans need to be individualized for the client and not just the disease alone.
It is due to this individual nature of humans as to why some drugs work well in some people and not well in others. Neurologist and practitioners would be smart to consider the individual needs and nature of a person when considering different MS treatment options.
It is exactly the same theory adopted by natural health care practitioners, where “treat the person and not the disease” is one of the core philosophies considered in any MS treatment plan.
To better understand and treat an individual with multiple sclerosis better and more thorough diagnostic testing needs to be adopted into early consultations. MS treatment plans can best be prescribed when individual pathologies are better understood.
MS Treatment: What Test Should I Have Done?
Pathology testing seems minimal in my experience with MS. I often see clients where testing has been done only to find what I determine as necessary blood tests, have not been done at all. Basic multiple sclerosis diagnostic testing should include at the very least the follow blood tests:
- Hs-CRP (Not just CRP)
- Vitamin D
- Red Cell Essential Fatty Acid Membrane Profile
- Saliva Cortisol and DHEA levels
- HLADQ8 gene & Stool IgA
Is paramount to have adequate testing performed when treating MS.
So What Exactly Are These Tests, And How Do They Help MS Treatment?
hs-CRP is a more sensitive marker for inflammation; you may see that you have had your CRP levels checked which during a relapse will be elevated. However during times of remittance a standard CRP test is not sensitive enough to pick up small levels of inflammation.
Inflammation is a hallmark of multiple sclerosis (MS) and thus a more sensitive test should be used to monitor the inflammatory levels of patients. That is where the hs-CRP test comes in, hs standing for highly sensitive. This test will pick up any inflammatory process, and may be a good indicator to pick up relapses before the physical symptoms manifest. Therefore an effective MS treatment is always based on prevention, and treating the cause.
Vitamin D, as the name suggests, is the standard test for vitamin D levels. Low levels of Vitamin D have been scientifically validated to contribute to MS relapses and as such levels should be monitored regularly, and be part of your MS treatment.
Homocysteine is a sulfur-containing amino acid that is normally present in very small amounts in all cells of the body. Homocysteine is a product of methionine metabolism. Methionine is one of the eleven “essential” amino acids – amino acids that must be derived from the diet since the body cannot produce them.
If you do not get enough B12 and/or folate through diet or supplements, then your body may not be able to convert homocysteine to forms that can be used by your body. In this case, levels of homocysteine in the blood increase.
Several studies have documented the link between elevated homocysteine levels and an increase in mortality. This is likely to be due to the damaging affects that homocysteine has on blood vessel walls and supporting the formation of blood clots. Homocysteine also appears to be a nerve toxin and it may interfere with the micro blood flow of blood through the brain. It is via these two mechanisms that elevated homocysteine levels may play a role in the onset and progression of the MS disease as well as indicating potential problems in the way your body uses B12. B12 and folate are therefore used in some individuals as a supportive MS treatment.
“A severe vitamin B12 deficiency can cause breakdown of the myelin sheath, similar to what occurs in MS,” says Donald W. Jacobsen, Ph.D., director of the Department of Cell Biology at the Cleveland Clinic.
Acquired B12 deficiency, from either low levels in the diet or absorption problems, and faults in the metabolism of B12 are recognized causes of central nervous system demyelination, so a deficiency of B12 in MS would be expected to contribute to progression. Early studies of B12 status in MS produced conflicting results, but improved testing techniques confirmed B12 levels were lower in the CSF of MS patients, if not always lower in the serum.
For more than 30 years, health care practitioners have reported consistent clinical improvements of MS treatment from B12 injections. Many integrative physicians routinely prescribe intramuscular injections of B complex with B12 and folic acid to their MS patients, reportedly with improvement.
Red Cell Essential Fatty Acid Profile
Research done in 1989 found that people with MS had replaced their polyunsaturated fatty acids (the good fats) with saturated fats (the bad fats) in the membranes of their cells. This research has been replicated in several other studies, showing the same results, the purpose of this test is to see what fats are in the membrane of your cells.
Using this test we can monitor how changing your diet and incorporating some key nutritional supplements may improve the fatty acid composition of your cells walls and thus improving your symptoms and reducing further relapses.
The Red Cell Essential Fatty Acids (EFA) Test provides the most comprehensive fatty acid test giving information not only on the EFAs but also saturated and monounsaturated fatty acids. This test is the most ideal option for baseline testing in conditions like MS and enhances any good MS treatment protocol.
Saliva Cortisol & DHEA levels
When one begins an MS treatment plan, it is important to have your saliva cortisol and DHEA levels tested. In Multiple Sclerosis the adrenal glands are often impaired in their ability to elicit a stress response, suggesting that adrenal fatigue may be part of the MS picture. A published study found that in MS patients who experienced a high amount of relapses over a one year period had major fluctuations on their serum cortisol levels which may be suggestive of stress being an aggravating factor in the flare ups of these patients.
In clinical practice I often find abnormalities to saliva levels of cortisol, suggestive of a client being in a chronic stress response. Testing saliva cortisol levels, are also important to rule out adrenal exhaustion as a cause of fatigue, a symptom people with MS experience.
HLA DQ8 & Stool IgA
Surprisingly, a successful MS treatment may begin in your gut. A study conducted in 2004 showed that people with MS showed a higher incidence of gluten sensitivity through increased levels of IgA and IgG antibodies against gluten and gliadin (a protein found in glutenous grains). A large study published by the Journal of the American Medical Association found that people with diagnosed, undiagnosed, and “latent” celiac disease or gluten sensitivity had a higher risk of death, mostly from heart disease, cancer and autoimmune disease.
This study looked at almost 30,00 patients from 1969 to 2008 and examined deaths in three groups: Those with full-blown celiac disease, those with inflammation of their intestine but not full-blown celiac disease, and those with latent celiac disease or gluten sensitivity (elevated gluten antibodies but negative intestinal biopsy).
These findings are significant. There was a 39 percent increased risk of death in those with celiac disease, 72 percent increased risk in those with gut inflammation related to gluten, and 35 percent increased risk of death in those with gluten sensitivity but no celiac disease, the category that people with MS are most likely to fall in.
Most Doctors only look for celiac disease, what we are beginning to see more and more of, and what I see a lot of in clinic, is people have a gluten sensitivity but not full blown celiac disease, and this is often undiagnosed because testing for the presence of gluten sensitivity is mostly inaccurate and not properly done.
You will also see people that suggest that there is no link to gluten and MS are basing this information off the link to celiac disease. As you can see gluten is not just celiac disease but also gluten sensitivity, which is where I feel most people with MS will fall into.
Studies suggest that the most accurate way to test for gluten sensitivity is a stool IgA deaminated AGA antigliadin antibodies (AGA) test. The HLA DQ8 is a genetic test that has now been shown to be linked to a gluten sensitivity and celiac disease even when other tests for the disease are normal. I find in clinical practice it is smart in an MS treatment to rule out any dietary foods that may active an inappropriate immune response. More often than not gluten will elicit this response in MS patients.
MS Treatment: Treating You As An Individual
It is only when the individual nature of the person has been taken into account can effective MS treatment being given. If a person tests positive for a gluten sensitivity then surely removing gluten from the diet will have positive effects on that persons immune function.
Similarly if a person tests with low Vitamin B12 levels then prescribing vitamin B12 will aid in reducing symptoms like fatigue for that patient and give the much needed nutrient for the remyelination process.
It is only when practitioners better consider the individual needs of our clients that we can get the best, most effective and longer lasting results. Surely in the case of good MS treatment protocol all practitioners should better adopt this method.
If you have been diagnosed with multiple sclerosis and you are serious about identifying and treating the real cause(s) and drivers multiple sclerosis and to find out of why you developed the disease in the first place then you need to find a team to support you and to integrate these more holistic approaches into your multiple sclerosis treatment plan.