Multiple Sclerosis Centers of Excellence
Complementary and Integrative Health in Multiple Sclerosis
Most people with multiple sclerosis (MS) - between about 50 and 80 percent - use approaches outside of standard medical care. The VA calls these complementary and integrative health, or CIH. They include herbs, supplements, special diets, acupuncture, massage, yoga, tai chi, and visits to chiropractors or naturopaths. Many people like that these feel natural, affordable, or more in their control. Some can help. But some are useless or even harmful with MS, so it is worth knowing what the science says before you spend your money or change your care.
Ask Questions Before You Try Something
Complementary means using a practice alongside your regular medical care. Alternative means using it instead, which carries real risk in MS. Before trying anything new, ask: What does it involve? How well does it work? Is it safe? How much does it cost? And most important, could it affect my MS? Many of these products have little or no science behind them, so a few good questions can save you money and keep you safe.
What May Help
Mind-body therapies. Acupuncture, massage, yoga, and tai chi may ease MS symptoms such as pain, spasticity, bladder problems, and trouble sleeping.
Certain herbs and nutrients. Some may help specific symptoms - for example, valerian for sleep and calm, cranberry to help prevent urinary infections, and psyllium for constipation. Omega-3 fats from fish, walnuts, and flaxseed may support overall wellness.
Vitamin D. Low vitamin D is common in MS and is linked to higher risk and worse disease. Ask your provider about checking your level.
What To Avoid Or Be Careful With
Immune-boosting herbs. Herbs like echinacea, garlic, Asian ginseng, and astragalus stimulate the immune system, which may make MS worse. Be cautious.
Unproven treatments. Therapies such as bee-sting therapy, hyperbaric oxygen, chelation, and removing tooth fillings have not been shown to help MS, and some carry real risks.
Cannabis. Oral cannabis extract may ease spasticity and nerve pain, but it can cause drowsiness and problems with attention and memory that may worsen MS-related fatigue and thinking. Note that VA providers cannot prescribe or recommend marijuana, because it remains against federal law.
How the VA Fits This Together
Using standard and complementary approaches together in a coordinated way is what the VA means by integrative health, and it is offered through the Whole Health program. Services can include acupuncture, chiropractic care, massage, meditation, yoga, and tai chi. The goal is balance: these approaches can add to your wellness and symptom management, but it is risky to drop proven MS treatments in favor of unproven ones. Every VA medical center builds health and wellness into care and can refer you if your site does not offer a specific program.
When to Talk to Your Provider
Tell your provider about any supplements, herbs, or therapies you use or are considering, since some can interact with your MS medicines. Ask your care team or your Whole Health coordinator what your VA offers. The safest path combines the treatments proven to work with the complementary approaches that fit your life.
Based on articles by Heidi Maloni, PhD, APRN, BC-ANP, CNRN, MSCN.
