Many of you have been asking me about what supplements and vitamins are best for people with MS. These types of questions can be the trickiest ones for me to answer, because there really is no way to give a “one-size-fits-all” answer. What I can do is give a general overview, but keep in mind that everyone is different and that you should ALWAYS ALWAYS ALWAYS consult your personal physician before starting anything new.
Vitamins, minerals, and supplements fall under an category that we call “complimentary medicine”. Your disease modifying drugs are like that little black dress, and the complimentary medications are the accessories that really tie the whole look together. There are a few key things to know and understand about these complimentary medications:
MS damage is caused by an overzealous immune system, so in general things that ramp up your immune system are bad. DMD’s most often aim at suppressing immune function, so taking a bunch of super-immune-boosting pills on top of your DMD doesn’t make much sense.
You can have too much of a good thing. It’s actually not that difficult to overdo it with vitamins. Some vitamins in large amounts can actually mimic MS symptoms like fatigue, numbness, tingling, and headaches. Other supplements can alter the actions of common medications like blood pressure pills and antidepressants. That’s why we stress consulting your doctor before starting anything new. Taking a daily multivitamin instead of a bunch of individual supplements is a good way to make sure you don’t overdo it.
Complimentary medications are not as tightly regulated as prescription drugs, so exercise caution when it comes to brand, dosage, etc…Manufacturers of these medications also are under no obligation to prove that their product actually works, and most have not been well researched.
A lot of this good stuff can be obtained through a healthy diet instead of taking extra pills, we will go more into that!
All of the following information comes directly from the National MS Society, but you should always use your own personal doctor as your #1 source of information because new research emerges all the time. So without any further disclosures, let’s look at the big players!
Your doctor can check for a vitamin D deficiency by doing a simple blood test. If your level is very low they will give you a prescription strength supplement for a few months and then have you take 1,000-2,000IU’s daily after that. The exact recommended dosage is dependent on your blood levels, so it is important to know your number before you start supplementing.
Biologically speaking, calcium and vitamin D are best friends. Without enough vitamin D calcium can’t be absorbed and used properly by your body. Calcium is also highly recommended for women, especially after menopause, because it helps to keep your bones strong and prevent osteoporosis. It is also especially important for women with risk factors such as frequent and prolong steroid use (sound familiar?), hyperthyroidism, and a family history of osteoporosis. Calcium can be found in dairy, eggs, and leafy green vegetables. The recommended daily dosage of calcium is 1,000-1,200mg per day.
B12 plays a key role in the production of blood cells, and in the normal functioning of our brain and central nervous system. This is why very low levels of B12 can mimic MS symptoms like fatigue, numbness, and tingling. Many people with MS have low levels of B12. Like vitamin D, we can measure you B12 level through a simple blood test. Based on that level your doctor can tell you if you need supplements or not. Many patients claim it helps with fatigue levels, but that hasn’t been proven by research yet. The recommended dose of B12 is 2.4mcg per day. The best dietary sources of B12 are dairy, eggs, meat, shellfish, and poultry.
Some evidence suggests that vitamin C can be useful in preventing urinary tract infections in people with MS. The evidence is fairly weak though and does not really support it’s use in people with MS. Doses greater then 1,000mg/day have also been shown to cause kidney damage and diarrhea.
Vitamins A, E, and C are antioxidants and fight damage done by free radicals. This sounds great and all, but there really isn’t any evidence that says it helps with MS. Antioxidants also ramp up the immune system which is potentially harmful, although no scientific evidence has shown that these particular vitamins cause harm. The general recommendation is that it is probably best to stay away from taking these as individual supplements, and to get moderate amounts via a multivitamin or your diet by consuming 2-4 servings of fruit and 3-4 servings of vegetables a day.
There is so much conflicting data on probiotics right now, it’s hard to say whether they are good or bad for MS. Right now the general consensus is that you should avoid them if you are on an immunosuppressing medication.
All of these have been shown to have mixed effects for people with MS. Some can exacerbate MS symptoms, and some can have bad side effects when mixed with certain prescription medications. These supplements MUST be discussed with your doctor before you consider adding them to your daily regimen, especially if you have other health problems like heart disease, high blood pressure, depression, or problems with blood clots. Not all of them are contraindicated in people with MS, but they can have complex interactions with the immune system, bleeding factors, and other medications. Therefore they need to be supervised by a medical professional.
So now what?
As a general rule of thumb taking a daily multivitamin is the best way to go. It will contain a little bit of everything you need without going overboard on the dosage which you could easily do by buying each vitamin and mineral individually. The most common side effect of multivitamins is stomach upset and nausea, but I have personally found that the gummy vitamins solve that issue for most people. The only extra vitamins that most people with MS need is vitamin D, and potentially B12. And don’t forget, eating a healthy diet will go a long way in ensuring that your body has all of the nutrients it needs to perform at its best!