Ideally we would obtain all our nutritional needs from a well balanced diet rich in nutrients.
Sometimes people are unable to obtain everything they need from their diet. This might be because they find it difficult to maintain and manage a healthy well balanced diet, they may have digestive issues which can make adequate absorption of nutrients difficult, they may have a chronic health condition which warrants higher nutritional content in their diet.
Supplements are generally synthetically manufactured in factories. Where possible it's preferable to select a supplement which is made from foods rather than synthetically produced, however these food-based supplements can be difficult to source -
. Supplements can also contain other additives, so it's worth purchasing a good quality supplement from a reliable source.
If you do choose to supplement, you should speak with a dietitian, nutritionist or GP first.
Following are some of the key supplements people with multiple sclerosis might consider.
Multiple sclerosis occurs much more frequently in areas of the world where people have less sunlight and as a result less vitamin D. The best way to obtain Vitamin D is via sunlight, however modern living can make this difficult and supplementation may be useful.
Fish oil supplements are high in Omega 3 essential fatty acids. They have an anti inflammatory effect and are needed for the nervous system and for the production of myelin. Supplementing with fish oils has a number of general health benefits, plus some specific benefits for people with multiple sclerosis.
The B group vitamins are required for good energy production and a healthy myelin sheath and nervous system.
It is possible to become iron deficient if you are restricting or avoiding meat, especially if you are a pre-menopausal female. Iron deficiency anaemia is experienced by over 14% of pre-menopausal women.
Antioxidant supplements containing beta-carotene, Vitamin A and Vitamin E are cautioned against on the basis of a number of large reliable studies which indicate taking synthetic supplements of beta carotene, Vitamin A and Vitamin E can shorten your life not lengthen it.
Additionally blueberries, broccoli and green tea are full of antioxidants.
[i] Ascherio A, Munger KL, White R, Köchert K, Simon KC, Polman CH, Freedman MS, Hartung HP,Miller DH, Montalbán X, Edan G, Barkhof F, Pleimes D, Radü EW, Sandbrink R, Kappos L11,Pohl C. Vitamin D as an early predictor of multiple sclerosis activity and progression .JAMA Neurol. 2014 Mar;71(3):306-14. doi: 10.1001/jamaneurol.2013.5993.
[ii] Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296:2832–2838.
[iii] Professor G. Jelinek, Overcoming Multiple Sclerosis, p127
[iv] Ponsonby AL, McMichael A, van der Mei I. Ultraviolet radiation and auto-immune disease: insights from epidemiological research. Toxicology 2002;181-2:71-8
[v] Esparaza ML , Sasaki S, Kesteloot H. Nutrition, latitude, and multiple sclerosis mortality: an ecologic study. Am J Epidemiol 1995; 142:733-7
[vi] Oilu-Hanninen M, Airas L, Mononen I et al. 25-hydroxyvitamin D levels in serum at the onset of multiple sclerosis. Mult Scler 2005;11:266-71
[vii] Smolders J, et al. Association of vitamin D metabolite levels with relapse rate and
disability in multiple sclerosis. Multiple Sclerosis 2008;14:1220-1224.
[viii] James E, Dobson R, Kuhle J, Baker D, Giovannoni G, Ramagopalan SV. The effect of vitamin D-related interventions on multiple sclerosis relapses: a meta-analysis. Mult Scler. 2013 May 22. PMID: 23698130.
[ix] Tettey P, Simpson S Jr, Taylor B, Blizzard L, Ponsonby AL, Dwyer T, Kostner K, van der Mei I An adverse lipid profile is associated with disability and progression in disability, in people with MS. Mult Scler. 2014 Nov;20(13):1737-44. doi: 10.1177/1352458514533162. Epub 2014 May 14.
[x] Jelinek GA, Hadgkiss EJ, Weiland TJ, Pereira NG, Mark CH, van der Meer DM. Association of fish consumption and omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis. Int J Neurosci, 2013 Nov; 123(11):792-800
[xi] Kristof Vanschoonbeek et al Fish oil consumption and reduction of arterial disease Nutr. 133:657-660, March 2003
[xii] Jeppesen J et al. Triglyceride concentration and ischemic heart disease: an eight year follow up in the Copenhagen Male Study. Circulation 97.11 (1998):1029-36
[xiii] Sudheera S et al. Prevention of Cardiac Arrhythmia by Dietary (n-3) Polyunsaturated Fatty Acids and Their Mechanism of Action
[xiv] Geleijnse JM et al. Blood pressure response to fish oil supplementation: meta regression analysis of randomised trials. J Hypertension 20.8 (2002): 1493 - 99
[xv] S.C.Larsson, M. Kumlin, M. Ingelman-sundberg, A. Wolk. Dietary long chain
n-3 fatty acids for the prevention of cancer: a review of potential mechanisms. Am. J.
Clin. Nutr. 2004; 79: 935-945
[xvi] Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutr Neurosci. 2015 Apr;18(3):125-36. doi: 10.1179/1476830514Y.0000000117. Epub 2014 Mar 17.
[xvii] Ariel Miller, Maya Korem, Ronit Almog, Yanina Galboiz, Vitamin B12, demyelination, remyelination and repair in multiple sclerosis, Journal of the Neurological Sciences 233 (2005) 93 – 97
[xviii] Mastronardi FG, Min W, Wang H, Winer S, Dosch M, Boggs JM, et al. Attenuation of experimental autoimmune encephalomyelitis and nonimmune demyelination by IFN-beta plus vitamin B12: treatment to modify notch-1/sonic hedgehog balance. J Immunol 2004; 172:6418–26.
[xix] Bjelakovic G, Nikolova D, Gluud LL, et al. Mortality in randomised trials of antioxidant supplements for primary and secondary prevention: systemic review and meta analysis. JAMA 2007; 297:842-57
[xx] Omenn, G.S. et al. Effects of a combination of beta carotene and Vitamin A on lung cancer and cardio vascular disease. New England Journal of Medicine. 334 (18):pp1145-1149; May2, 1996
[xxi] Shekelle, R.B. et al. Dietary vitamin A and the risk of cancer in the Western Electric study. The Lancet 2 (8257):pp 1186 – 1190, Nov 28, 1981