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NCCIH Clinical Digest

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Multiple Sclerosis and Complementary Health Approaches

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December 2015
Nerve cells in the brain

Credit: Barbara Calabrese, UC San Diego

Many people with multiple sclerosis (MS) use complementary health approaches to help reduce relapses or relieve symptoms, such as pain, muscle spasticity, fatigue, cognition and depression. Some mind and body practices, such as yoga, may help ease some symptoms of MS, but there is currently no definitive evidence to suggest that any dietary supplement is effective to reduce relapses or symptoms of MS.

The American Academy of Neurology issued evidence-based guidelines in 2014 on complementary and alternative medicine use for MS and concluded that evidence was available to develop practice recommendations for use of cannabinoids, ginkgo biloba, low-fat diet with omega-3 supplementation, magnet therapy, reflexology, and bee venom therapy. This issue of the digest provides the state of the evidence for these and other commonly used complementary health approaches for MS.

Modality and Summary of Current Evidence

Cannabinoids

Natural Product

Orally administered cannabinoids (cannabis extract, synthetic THC), mucosally delivered cannabinoids (cannabis extract oral spray, nabiximols (trade name Sativex), and smoked cannabis have all been studied for therapeutic effects in MS. Based on available evidence, cannabinoids may relieve spasticity and/or pain in people with MS; however, no marijuana-derived medications are approved by the U.S. Food and Drug Administration to treat MS. There are insufficient data to determine if smoking marijuana ameliorates symptoms of MS. Additionally, the psychoactive properties and other potential adverse effects need to be considered. Sativex is licensed in the UK for use as an add-on treatment for MS-related spasticity when people have shown inadequate response to other symptomatic treatments or found their side effects intolerable.

Read more about the evidence base of cannabinoids for multiple sclerosis

Ginkgo Biloba

Natural Product

There is no evidence to support the use of ginkgo biloba as an effective treatment for cognitive function in people with MS.

Read more about the evidence base of ginkgo biloba for multiple sclerosis

Omega-3 Fatty Acid Supplementation

Natural Product

There is insufficient data to assess any real beneficial effects of omega-3 fatty acid supplementation on MS.

2014 evidence-based guidelines from the American Academy of Neurology concluded that a low-fat diet with fish oil supplementation is probably ineffective for reducing MS-related relapse, disability, or MRI lesions, or for improving fatigue or quality of life.

Read more about the evidence base of omega-3 fatty acid supplementation for multiple sclerosis

Vitamin D

Natural Product

There is insufficient evidence to support the use of vitamin D supplementation for MS. A 2010 Cochrane review suggests clinicians may want to consider relevant guidelines on vitamin D supplementation when advising patients with MS. However, more studies need to be conducted to determine if vitamin D supplementation affects disease course and progression.

Read more about the evidence base of vitamin D for multiple sclerosis

Bee Venom

Natural Product

Based on a few small studies, bee venom therapy seems to have no effect on either MS symptoms or disease progression. There are serious side effects associated with bee venom, including risk of anaphylactic reactions and death, which could limit any efficacy of bee venom therapy for the treatment of MS.

Read more about the evidence base of bee venom for multiple sclerosis

Yoga

Mind and Body Practice

There is some limited evidence suggesting beneficial short-term effects of yoga on fatigue and mood in people with MS, but scientific studies overall had a high risk of bias and definitive conclusions could not be drawn.

Read more about the evidence base of yoga for multiple sclerosis

Reflexology

Mind and Body Practice

There is insufficient evidence to support the use of reflexology for most symptoms of MS, including pain, health-related quality of life, disability, spasticity, fatigue, depression, and others. However, 2014 evidence-based guidelines from the American Academy of Neurology concluded that, based on four studies, reflexology is possibly effective for reducing MS-associated paresthesia over 11 weeks.

Read more about the evidence base of reflexology for multiple sclerosis

Magnet Therapy

Mind and Body Practice

There is some limited, low-level evidence that suggests that magnet therapy may have modest beneficial effects on spasticity outcomes in people with MS, but the studies have been of low methodological quality. There is also some evidence, based on two studies, suggesting that magnet therapy may be useful in reducing fatigue in people with relapsing-remitting MS.

Read more about the evidence base of magnet therapy for multiple sclerosis

Hyperbaric Oxygen Therapy

Mind and Body Practice

Although hyperbaric oxygen therapy is often heavily marketed to people with MS, there is no consistent evidence that supports the use of hyperbaric oxygen therapy for the treatment of MS.

Read more about the evidence base of hyperbaric oxygen therapy for multiple sclerosis

Clinical Guidelines

Scientific Literature

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH's Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

Copyright

Content is in the public domain and may be reprinted, except if marked as copyrighted (©). Please credit the National Center for Complementary and Integrative Health as the source. All copyrighted material is the property of its respective owners and may not be reprinted without their permission.

This page last modified October 24, 2018