Complementary and alternative medicine (CAM) is a term to describe approaches that come from a variety of traditions and practices, such as exercise, natural health products, herbs, homeopathic medicine, vitamins, acupuncture, massage, meditation and spirituality. Many Canadians use CAM as a way of managing their MS in addition to enhancing their overall wellness. A practice is generally considered complementary if a person uses it in addition to taking other medications or therapies. It is considered alternative if a person uses this healthcare approach exclusively.
Historically, CAM treatments have not been well-supported by scientific evidence; however, this is changing. Many CAM treatments are now being studied in well-controlled clinical trials. Over the last several years, for example, we have seen a significant increase in research studies and clinical trials involving vitamin D and the benefits of exercise.
People are encouraged to maintain open and ongoing discussions with their MS healthcare team when exploring disease management options.
People who are considering using a CAM therapy should ask the following questions:
- For what is it recommended?
- Has this therapy been evaluated for safety and efficacy in people with MS?
- What are the expected benefits?
- Are there known side effects or risks?
- What amount is recommended, by whom or what source?
- Should people with a certain condition or disease (such as MS) avoid the use of the product?
- How much does it cost?
The answers to these questions can help a person considering a CAM therapy to weigh the benefits against the risks.
Side effects and adverse or unintended interactions between combinations of therapies can occur with any type of medication including herbal preparations and those known as natural health products. Coming from a natural source does not mean that a product is necessarily safe.
Tell your health care team about any medication you are taking.
It is important for people with MS to let their doctors and other health care professionals know if they are using any other kinds of medications or products (including over-the-counter medications) along with their prescribed medications.
The treatments your doctor prescribes for you have been tested in carefully-designed clinical trials and accepted by the MS medical community as safe and effective therapies. So stay with your prescribed treatments even if you decide to add CAM to your regimen.
Carefully-designed clinical trials are the best way to determine whether a treatment is safe and effective. Here are the reasons why:
- The only way to determine the safety and effectiveness of a treatment is to test it on a large number of people over a sufficient period of time.
- The effectiveness of a new treatment can only be proven by comparing it to a placebo or to another treatment that has already been shown to be effective.
Keep a health journal.
Keep a detailed log of what you take or what is done and any changes you experience. Use this form to track your prescription and over-the-counter treatments and vitamins, herbals, dietary supplements.
Approaches for Physical and Emotional Wellness
Diet and Supplements
People with MS sometimes wonder whether they should take dietary supplements. Clinical trials involving people with MS have not provided any evidence to support vitamin supplementation, with the exception of vitamin D. The effects of diet on MS treatment and progression are uncertain. Although a topic of interest for the MS community, conclusive evidence supporting dietary claims is scarce. Research investigating the effect of dietary manipulation on MS is challenging, as these types of studies are difficult to design and control for.
Aside from its role in promoting calcium absorption and overall good bone health, vitamin D has also been shown to have a direct effect on the immune system. As a result, researchers are determining the relationship between inadequate vitamin D and risk of MS, as well as the effect of vitamin D intake in treating MS . Vitamin D can be obtained from fish products, supplements and exposure to sunlight. It is a good idea to consult your doctor or a nutrition specialist before making dramatic changes to your diet or vitamin intake.
Exercise and Physical Activity
Historically, individuals living with multiple sclerosis were advised to avoid physical exertion for fear that physical activity will make them feel worse. Over the past few decades, new research has uncovered considerable benefits associated with increased physical activity, and perceptions among the MS community have shifted toward encouraging a more active lifestyle.
In MS, cannabis is generally used to manage MS pain and spasticity. Although cannabis is not an approved medicine or treatment in Canada, Health Canada has granted access to dried marijuana for medical reasons to individuals who are supported by their prescribing physicians. In addition, Health Canada approved the use of the cannabis-derived drug Sativex® (GW Pharmaceuticals) to treat MS-related pain.
Large well-controlled studies are ongoing to determine if there is a role for cannabis or its chemical derivatives in the treatment of MS-related symptoms. For more information about medical cannabis visit Access to Cannabis for Medical Purposes Regulations (ACMPR).
Acupuncture, an ancient form of Chinese medicine that involves inserting needles into the skin at specific points on the body for a therapeutic effect, is finding its way into Western medicine, with studies suggesting possible benefits for a wide range of conditions.