Multiple Sclerosis Centers of Excellence
Complementary and Alternative Medicine in Multiple Sclerosis
Heidi Maloni PhD, ANP-BC, CNRN, MSCN
National Clinical Nursing Director
Multiple Sclerosis Center of Excellence, East
Veterans Affairs Medical Center
Not a day goes by without hearing or seeing information about nonconventional drugs and treatments. From green tea extract to vitamin D to mindfulness, the information highway is speeding along with the latest and greatest way to stay well, get well, and maximize physical and mental potential. Nonconventional drugs and therapies are not always tested, nor are they regulated. Caution for the safe and effective use of nonconventional therapies is of chief concern. This article discusses CAM safety and potential used by people with multiple sclerosis.
Over 40% of Americans and 50% to 75% of people living with multiple sclerosis (MS) integrate one or more nonconventional therapies into their health care regimen. Collectively nonconventional therapies are considered complimentary or alternative medicine (CAM). Complimentary refers to therapies in addition to conventional medicine and alternative refers to therapies used instead of conventional medicine. These health practices include nutritional supplements, herbal medicine, special diets, acupuncture, massage, spiritual healing, mind-body modalities and practices such as naturopathy, homeopathy, and chiropractic therapy.
When surveyed, those living with MS say they use CAM to treat symptoms and to treat overall physical and psychological health. Cam may be chosen as users may feel CAM therapies are more effective, natural, and less harmful than conventional medicine. Concern arises when proven effective therapies are dismissed in lieu of a therapy that may not have proven effect, may lack product standards (contain contaminants, uneven potency, toxic substances), may interact with other medications, is costly, has false claims of benefit and under reports side effects.
Conventional treatments exist because evidence from research clinical trials supports its use. The Federal Drug Administration (FDA) approves conventional medicine. This oversight body regulates drug practice, and assures drug safety and efficacy.
Because CAM products are commonly used, there is interest in understanding if claims are true. The truth finding body is The National Center for Complementary and Alternative Medicine (NCCAM), created as a branch of the National Institutes of Health to understand the efficacy, safety and benefit of CAM to the public. NCCAM is involved in information sharing about CAM products and conducts CAM clinical trials.
Use of CAM in MS has been addressed in small clinical trials that aim to assess efficacy and safety. When considering a complimentary therapy talk to your healthcare provider about what is known of CAM safety and effect in MS. Ask yourself and/or provider the following questions:
- What does the treatment involve?
- How and why is it supposed to work?
- How effective is it?
- What are the risks?
- How much does it cost?
CAM safety is as important as CAM expected effect. Unlike FDA approved drugs, many complementary and alternative therapies have little or no rigorous scientific study or randomized, placebo controlled clinical trials (RCT). RCT is considered the “gold standard” of scientific testing. There are randomized clinical trials of CAM in MS. A holistic approach to MS symptom and disease management demands a discussion of CAM. CAM therapies with potential for impacting MS disease, helping with symptoms and improving quality of life has a place in MS care.