Diet Tips for Multiple Sclerosis

Multiple sclerosis is an autoimmune disease. It develops when the body’s immune system mistakenly attacks its own central nervous system.

Nerve fibers in the body are usually coated with a layer of myelin, a substance that protects the nerves and helps to transmit electrical signals.

In patients with multiple sclerosis (MS), the myelin is damaged. Areas that have less myelin do not transmit signals effectively, meaning that commands from the brain do not reach the targeted muscles as quickly as they should.

MS is the most common disabling neurological disease of young adults.

Dietary factors appear to have some impact on the condition. Understanding the role of diet may lead to a person with MS having fewer relapses and a better quality of life.

Role of diet and nutrition for people with MS

Gut bacteria
A 3D model of gut flora, which are important for digestion. A person’s health may be affected without them.

A study published in Clinical & Translational Immunology notes that gut health appears to play a role in many diseases.

The intestinal flora, or gut flora, is a highly complex system of microorganisms that live in the intestines. In humans, these are largely bacteria.

The bacteria are responsible for breaking down food and nutrients, and they play a key role in digestion and in the health of the immune system. Healthy gut flora thrives in the intestine when there is ample fiber in the diet.

The lack of a healthy gut flora may contribute to a range of immune disorders.

Foods that are good for people with MS

Multiple sclerosis is a disorder of the immune system, so it is important to eat a diet that supports a healthy immune system. A diet that promotes beneficial gut flora might help to achieve this.

Probiotics

The authors of a study published in Nature Communications suggest that adjusting the gut flora using probiotics may be helpful for people with MS. Probiotics may help to boost levels of beneficial bacteria in the gut, helping to strengthen the immune system.

Probiotic bacteria are available in supplements and also in a range of fermented foods. Yogurt, kefir, Kim chi, sauerkraut, and kombucha, or fermented tea, all contain good levels of lacto-bacteria, which is one type of beneficial bacteria.

Prebiotics

As well as filling the gut with good bacteria, it is important to feed them. Foods that nourish probiotic bacteria are called prebiotics and they are mainly fibers.

Foods containing good levels of prebiotics include:

  • Artichoke
  • Garlic
  • Leeks
  • Asparagus
  • Onions
  • Chicory

Individuals should aim to get at least 5 to 7 grams of prebiotic fiber each day.

Fiber

High fiber diet
A high-fiber diet helps to nourish the gut bacteria.

Fiber is found in plant foods, such as fruits, vegetables, nuts, seeds, and legumes. It helps to promote optimal health through nourishing the gut bacteria, encouraging regular bowel movements, and keeping the heart healthy. Fiber is also a filling food source.

Vitamin D

Vitamin D is important for everyone, but it may be especially beneficial for people with MS.

Vitamin D may regulate the growth and differentiation of different cells. In an article posted to European Neurological Review, researchers found that people with MS might benefit by increasing their intake of vitamin D.

There is evidence that vitamin D has protective qualities for people with MS. Most of the body’s vitamin D is made through exposure to sunlight. Studies have associated a higher level of sun exposure and increased intake of vitamin D in the diet with a lower risk of developing MS.

Biotin

Biotin is a form of vitamin B, which has also been called Vitamin H. It is usually found in foods, such as eggs, yeast, liver, and kidney. Recent evidence suggests that high-dose supplements of biotin may benefit some people with MS.

While more research is needed to determine exactly who may benefit, adding biotin to the diet has not been linked with any serious safety issues.

Polyunsaturated fatty acids (PUFAs)

There is mixed evidence as to whether diets rich in PUFAs will help with MS symptoms directly, but they are known to support a healthy body and control inflammation. PUFAs appear to boost functions, ranging from the ability to think to cardiac health. Foods that contain PUFAs include fatty fish, such as salmon and mackerel, and some plant-based oils.

Foods people with MS should avoid

Saturated fats and processed foods

A healthy gut affects the well-being of the immune system, so it is important to avoid foods that contribute to poor gut flora. People with MS should avoid processed foods, especially those that contain high levels of saturated fats and hydrogenated oils

Sodium

Research has found that people who have MS and have a moderate to high sodium intake in their diet are more likely to relapse, and are at greater risk of developing a new lesion than those with a low sodium intake.

The study, published in ASN Neuro, also suggests avoiding sugar-sweetened drinks, excessive quantities of red meat, fried foods, and low-fiber foods.

Considerations for people on special diets

Anyone who is on a specific diet needs to be sure that they are consuming all the required daily nutrients. A person who eliminates a particular food or food group from their diet should ensure that the nutrients contained in the eliminated food are replaced by other foods.

Gluten-free diet

Research has not shown a link between gluten and MS, but many people with the disease opt for a gluten-free diet and say they feel better. A gluten-free diet is acceptable for people with MS as long as they replace the fiber that they would have got from the wheat by eating other fiber-filled foods.

Paleo diet

The Paleolithic, or paleo diet, is based on the idea that our bodies have not evolved to eat the highly processed foods we now consume.

The diet advocates switching to foods that were probably eaten by hunter-gatherers. The first step is to choose natural foods over processed foods, with an emphasis on meat and plant-based foods, but not grains.

Very small studies have shown that people with MS who follow a paleo diet may see improvements, but it is important to note that the participants also introduced lifestyle changes, such as stretching, massage, exercise, and meditation.

Swank diet

The Swank diet started in the 1970s, and it was used to treat MS patients for several years. It reduces saturated fat intake to below 15 grams a day and recommends limiting unsaturated fats to between 20 and 50 grams a day.

People on this diet are not allowed to eat processed foods or dairy fats at any time. They are forbidden from eating red meat during the first year but are allowed to eat as much white fish and shellfish as they want. The Swank diet also recommends an individual eats two cups of both fruits and vegetables every day. Eating whole grain pasta is also encouraged, and cod liver oil and multivitamins should be taken daily.

Followers of the Swank diet say it has helped them, although it is now considered dated. Researchers note that some people who follow this diet may become deficient in vitamins A, C, E, and folic acid.

How do the diets compare?

pre packaged processed food
Studies suggest that any diet was chosen that may impact MS should avoid processed foods and saturated fats.

A paper published by the National MS Society in the United States reviewed a number of diets and their impact on MS. It concluded that there is not enough evidence to recommend one diet over another. It also pointed out that most of the diets agree on the same food items that should be cut out of the diet.

Foods to avoid are those that:

  • Are highly processed
  • Have a high glycemic index (GI)
  • Are high in saturated fat

In general, the diets tend to recommend eating less fatty red meat and more fruits and vegetables.

Lifestyle changes that may help

Supporting the immune system may be the most important aspect of a healthy diet for a person with MS. As vitamin D is an important factor in MS, increasing sunlight exposure each day can help to increase the levels of vitamin D in the blood.

Exercising is also important for the immune system. Aerobic exercise helps flush the body of toxins, increases circulation, boosts the metabolism, and increases levels of “feel good” hormones in the brain. Anybody considering making major changes to their diet or lifestyle should talk to a doctor first.

Symptoms of MS

MS can affect any part of the body.

The most common symptoms include:

  • Changes in thinking, such as attention problems, memory loss, forgetting certain words, and problems with abstraction.
  • Vision problems, such as blurred or double vision, red-green color distortion, and partial or whole blindness in one eye.
  • Muscle problems, such as weakness, numbness, and difficulty with coordination and balance. In severe cases, MS can result in partial or complete paralysis.
  • Sensory feelings, such as tingling, prickling, or a “pins and needles” sensation. Some people also experience pain.

Because the central nervous system is affected, many other symptoms are possible.

Anyone who is experiencing new or increasing symptoms should seek medical advice.

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Biotin: Health Benefits, Recommended Intake

Biotin, also known as vitamin H or B7, and often grouped with the B-complex vitamins, is a water-soluble vitamin that can be produced by bacteria in the body and which is present in numerous foods.

Recommended intake of biotin

The Adequate Intake (AI) for biotin is 30 micrograms per day for adults over 18 years of age. Biotin deficiency is rare in humans due to its wide distribution in foods and the ability of gut bacteria to synthesize biotin typically in excess of requirements.

The most common cases of biotin deficiency that have been reported are in pregnant women, patients receiving prolonged parenteral (intravenous) nutrition, infants consuming breast milk containing low amounts of biotin and in patients with impaired biotin absorption due to an inflammatory bowel disease or other GI tract disorder.

Biotinidase deficiency is another cause of biotin deficiency. This autosomal recessive metabolic disorder means that the body does not produce sufficient amounts of the enzyme required to release biotin from proteins in the diet during digestion or from normal protein turnover in the cell.

Around 1 in 60,000 newborns have profound (less than 10% of normal enzyme activity) or partial (10-30% of normal enzyme activity) biotinidase deficiency.

Long-term use of anti-seizure medications such as phenobarbital, phenytoin, or carbamazepine can also reduce blood levels of biotin.

Biotin supplements are available, and those with biotinidase deficiency are usually given a starting dose of 5-10 mg a day. For those without this genetic condition, it is usually preferable to try to first obtain sufficient biotin from the diet as this can also help enhance the intake of other beneficial nutrients which work alongside biotin.

Isolating specific nutrients in supplement form does not provide the same health benefits as consuming the nutrient from a whole food that also contains a variety of other nutrients. As such, it makes sense to focus on obtaining daily biotin requirements from foods and to only resort to supplements as a backup where necessary.

Possible health benefits of consuming biotin

Biotin is an essential nutrient for the metabolism of fats, carbohydrates, and protein. It is a coenzyme for carboxylase enzymes, which are involved in the synthesis of fatty acids, isoleucine, and valine (amino acids), and in gluconeogenesis.

Healthy pregnancy

Mild biotin deficiency is often seen during pregnancy and poses a risk for abnormal development of the fetus. Since folic acid supplementation is recommended both before and during pregnancy, it is sensible to obtain a multivitamin with at least 30 micrograms of biotin per day in addition to folic acid to decrease the risk for deficiency.

Strong nails

Biotin has been shown to improve nail strength and durability of fingernails in several small-scale studies. One study showed a 25% increase in thickness and a decrease of splitting with biotin supplementation.3 Another trial reported an improvement in nail strength for up to 91% of participants.4

Lower blood glucose

Promising results have been seen in several studies testing biotin’s ability to lower blood glucose in both type 1 and type 2 diabetics. In animal studies, biotin was shown to stimulate the secretion of insulin from the pancreas and subsequently lower blood glucose. More studies need to be conducted before biotin’s effects on blood sugar can be confirmed.

Biotin may also help reduce the risk of nerve damage in people with diabetes. This is because it is necessary for the activity of pyruvate carboxylase, without which high levels of pyruvate and aspartate may arise, adversely affecting nerves.

Foods sources of biotin

boiled eggs at breakfast
Eggs are rich in biotin – one large egg contains 13-25 micrograms.

Foods that are rich in biotin include baker’s yeast, wheat bran, organ meats, eggs, and oysters.

Care should be taken, however, with the consumption of raw eggs as these contain a protein called avidin that inhibits the absorption of biotin. Excessive consumption of egg whites has been known to cause biotin deficiency.

  • Liver, cooked: 27-35 micrograms
  • Egg, large, cooked: 13-25 micrograms
  • Salmon, 3 ounces, cooked: 4-5 micrograms
  • Raspberries, 1 cup: 0.2-2 micrograms.

Many foods, such as fruits and vegetables, contain a small amount of biotin.

Potential health risks of consuming biotin

Large doses of biotin have no known toxic effects.

Can Biotin Help Treat Multiple Sclerosis?

Multiple sclerosis is an autoimmune disease in which the immune system affects the central nervous system, including the brain and the spinal cord. The cause is unknown, but it may involve a combination of genetic and environmental factors.

Many people with multiple sclerosis (MS) use diet to help manage their symptoms, and vitamins are an essential component of this.

One important group of vitamins are the B vitamins, which help the body turn food into energy, support the nervous system, and keep the skin, hair, eyes, and liver healthy. They are very important during pregnancy.

Biotin, sometimes referred to as Vitamin B7 or Vitamin H, is one of the B-complex vitamins and is essential for human health. Biotin is found in brewer’s yeast, nuts, egg yolks, Swiss chard, liver, and many other foods.

The United States Food and Nutrition Board has not set a recommended daily allowance (RDA) for biotin, but the board has established an adequate intake (AI) level of 30 micrograms per day for adults.

How might biotin work and how is it used?

Nuts
Amongst other foods, biotin can be found in nuts.

Biotin is very useful in cases of progressive MS because it supports nerve cell metabolism.

MS develops when myelin, a substance that protects the nerve cells, is damaged. Biotin activates key enzymes and helps the body to produce more of this the nerve-protecting substance.

When levels of myelin are at healthy levels in the body, the nerve cells are able to communicate with each other more easily. This communication between the nerve cells can reduce the level of disability in people with MS.

Producing more myelin may also slow the progression of the disease.

Current research on the use of biotin with multiple sclerosis

Several studies have found that high doses of biotin, up to 10 times the typical daily intake, can reduce symptoms in people with progressive MS. In addition, people who took these high doses of biotin did not develop any significant adverse reactions.

Several studies on the use of biotin as a treatment for people with MS have shown positive results.

One study found that people with MS who had taken high doses of biotin reported reduced pain and improved energy levels.

A French study showed that people with MS who had been treated with biotin found that their vision had improved.

Scientists in Canada also documented an improvement in vision as well as a reduction in partial paralysis. In another study, 91 percent of participants showed clinical improvement.

It is important to note that these are preliminary studies and that not every person who took part in the studies saw the same degree of improvement.

However, several studies do show that of those people who have been treated with high levels of biotin, some have seen a slowdown in the progress of the disease and an improved quality of life.

Other health benefits and precautions of biotin

Biotin pills
Large doses of biotin appear to reduce the symptoms of MS but may affect tests for other conditions.

In standard doses, biotin is associated with promoting healthy skin, hair, and nails. When taken in large doses, biotin appears to reduce symptoms of MS without causing serious side effects.

However, biotin can interact with other elements, and this may skew the results of important medical tests. This has led to unreliable readings in some individuals who are taking biotin supplements.

For example, biotin has been known to interfere with thyroid testing, suggesting that some people had Graves’ disease, a serious thyroid condition, when they did not.

Reports in The New England Journal of Medicine have suggested that taking biotin supplements could lead to falsely high measurements of:

  • Free T4
  • Free T3
  • Testosterone
  • Estradiol
  • Progesterone
  • DHEA sulfate
  • Vitamin B12

The reports also noted that biotin could lead to false in tests for:

  • TSH
  • PSA
  • PTH
  • Luteinizing hormone
  • Follicle stimulating hormone

However, in order to ensure accurate readings, a person being treated with biotin should stop taking it 3 days before having a blood test.

Causes and symptoms of MS

MS is a progressive disease, which means it gets worse over time. It attacks myelin, a substance that wraps around nerve cells to protect them and facilitates communication between them.

When MS attacks myelin, it damages this layer and the nerves underneath. Scar tissue develops, which slows or stops the nerves transmitting signals to each other. This interferes with communication between the brain and rest of the body, resulting in the nervous system problems that are characteristic of MS.

Risk factors may include age, as the disease tends to appear between the ages of 20 to 40 years, family history, tobacco use, and the presence of another autoimmune disease.

Women are around twice as likely to have MS as men, and it is more common among white people and those living in cold climates.

Symptoms

Doctor and patient in discussion in his office
People who are diagnosed with MS may have to work closely with a healthcare professional to find a treatment that works for them.

MS affects people in different ways. Some individuals may experience only mild symptoms, while others may eventually lose the ability to walk or communicate. The rate of progression also varies between individuals.

Symptoms include:

  • Problems with vision, coordination, and balance
  • Weakness in the hands and feet, or on one side of the body
  • Fatigue
  • Pain
  • Hearing loss
  • A tingling sensation or numbness

People with MS may also develop emotional and cognitive difficulties, such as depression, forgetfulness, loss of concentration, and poor judgment.

Current medical treatments

Although there is currently no cure for MS, researchers are hopeful that techniques such as stem cell therapy and myelin repair might offer a solution.

Current treatment programs aim to relieve symptoms, help patients recover after flare-ups, and slow or stop disease progression.

Steroid medications can help when symptoms spike. If medication does not work, plasma exchange is another option.

For patients whose symptoms develop steadily, no treatment is currently available. For those whose disease progresses in fits and starts, some disease-modifying drugs can help in the early stages. These drugs can have unwanted side effects, however.

Patients with MS need to work closely with their physician to find an appropriate treatment.

Physical therapy, muscle relaxers, antidepressants, and other medications targeted at specific symptoms can help to manage the symptoms of MS.

Self-care practices, such as exercising, getting plenty of rest, and trying to reduce stress can also help people to live with the disease. Eating a balanced diet, especially one containing healthy oils rich in omega-3 fatty acids, can also help people manage the symptoms of MS.