Overview: Complementary & Alternative Med Resources for PWMS

Discuss herbal therapies, vitamins and minerals, bee stings, etc. here

Overview: Complementary & Alternative Med Resources for PWMS

Postby jimmylegs » Sun Sep 09, 2018 11:12 am

This topic provides an overview of research and an array of resources related to complementary and alternative (CAM) therapies for people with MS.

STATE OF THE RESEARCH (reverse chronological):

Complementary and alternative treatments of multiple sclerosis: a review of the evidence from 2001 to 2016 (2018)
https://jnnp.bmj.com/content/89/1/34
People with multiple sclerosis (PwMS) commonly use complementary and alternative medicines (CAM), but an understanding of their efficacy is lacking. Here, we quantitatively review the class I and class II studies of treatment efficacy for multiple sclerosis from January 2001 to January 2017, in order to assess the modern evidence for CAM use. The 38 studies included in this review are divided across five CAM types (cannabis, diet, exercise, psychological approaches and other). We found little evidence to support CAM efficacy. The studies contained little replication in intervention, primary outcomes or study design. Six of 16 CAMs included in this review were only researched in a single study. Future work in this area should build consensus around study methodologies and primary outcomes.

Uses of Complementary and Alternative Medicine in Multiple Sclerosis (2014)
https://www.sciencedirect.com/science/a ... 1016302267
Multiple sclerosis (MS) is a chronic, disabling, recurrent demyelination of the central nervous system (CNS). It could affect different regions in the brain and spinal cord, and according to the domain which is affected, it could cause different symptoms such as motor, sensory, or visual impairment; fatigue; bowel, bladder, and sexual dysfunction; cognitive impairment; and depression. MS patients also face reduced quality of life. Drugs that are used in MS are not fully efficient and patients suffer from many symptoms and adverse effects. Today there is an increasing trend of using complementary and alternative medicine (CAM). People are more likely to use this type of treatment. Using appropriate lifestyle and CAM therapy can subside some of the symptoms and could improve the quality of life in these patients. Many people with MS explore CAM therapies for their symptoms. This review is aimed to introduce CAM therapies that could be used in MS patients.

Complementary and alternative medicine in multiple sclerosis (2014)
http://n.neurology.org/content/82/12/e103
WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE?
Although it is sometimes hard to define, complementary and alternative medicine (CAM) refers to health care approaches that are developed outside of mainstream and conventional medicine.1 “Complementary” and “alternative” are often used interchangeably, but there are some differences. “Complementary medicine” generally refers to using a nonmainstream approach together with conventional medicine. “Alternative medicine” refers to using a nonmainstream approach in place of conventional medicine. The boundaries between complementary and conventional medicine can overlap and even change with time. Most CAM therapies are not regulated by the US Food and Drug Administration, which means the quality and purity of CAM therapies may vary significantly.

WHY WERE EVIDENCED-BASED GUIDELINES DEVELOPED FOR CAM THERAPIES IN MULTIPLE SCLEROSIS?
Although there are treatments for the early stages of multiple sclerosis (MS), there is currently no known cure for MS. People are often left with uncomfortable symptoms that can be difficult to manage. Therefore, some people look to CAM therapies to treat MS and its symptoms. CAM use is common in MS: up to 80% of people with MS report use of CAM therapy. With such widespread use, it is helpful for clinicians to understand the evidence supporting various CAM therapies in MS.

WHAT DID THE AMERICAN ACADEMY OF NEUROLOGY EXPERTS FIND ABOUT CAM TREATMENTS IN MS?
As summarized in table 1, the American Academy of Neurology panel found evidence to support the effectiveness of cannabinoids against some MS symptoms.2 Cannabinoids are a group of chemicals related to the active ingredient in cannabis (marijuana). They also found that ginkgo biloba, reflexology, and magnetic therapy may be effective against some MS symptoms. They found several therapies to be either possibly or probably ineffective for treating MS disease activity and a variety of MS symptoms. Perhaps just as importantly, 22 therapies had insufficient evidence to determine whether they were effective or ineffective (table 2).

WHAT DOES THIS MEAN FOR PEOPLE WITH MS?
People with chronic diseases like MS, which has no cure, are often attracted to CAM therapies to treat the disease or relieve symptoms. CAM treatments can include pills, liquids, diets, and exercises—even invasive surgical procedures. Some approaches may have little potential for harm, but others may have side effects, significant risks, steep financial costs, or dangerous interactions with conventional medications. For example, people using cannabis to relieve MS symptoms should talk to their clinician about possible side effects such as dizziness, thinking problems, and psychological problems such as depression. It is important for people to let their clinicians know about all the CAM therapies they are taking. Clinicians use these evidence-based guidelines to help guide their patients to effective and safe treatments.

Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries (2012)
https://www.hindawi.com/journals/ad/2012/841085/
Abstract
Aims. The aim of the study was to describe and compare (1) the types and prevalence of complementary and alternative medicine (CAM) treatments used among individuals with multiple sclerosis (MS) in the Nordic countries; (2) the types of conventional treatments besides disease-modifying medicine for MS that were used in combination with CAM treatments; (3) the types of symptoms/health issues addressed by use of CAM treatments.
Methods. An internet-based questionnaire was used to collect data from 6455 members of the five Nordic MS societies. The response rates varied from 50.9% in Norway to 61.5% in Iceland.
Results. A large range of CAM treatments were reported to be in use in all five Nordic countries. Supplements of vitamins and minerals, supplements of oils, special diet, acupuncture, and herbal medicine were among the CAM treatment modalities most commonly used. The prevalence of the overall use of CAM treatments within the last twelve months varied from 46.0% in Sweden to 58.9% in Iceland. CAM treatments were most often used in combination with conventional treatments. The conventional treatments that were most often combined with CAM treatment were prescription medication, physical therapy, and over-the-counter (OTC) medications. The proportion of CAM users who reported exclusive use of CAM (defined as use of no conventional treatments besides disease-modifying medicine for MS) varied from 9.5% in Finland to 18.4% in Norway. In all five Nordic countries, CAM treatments were most commonly used for nonspecific/preventative purposes such as strengthening the body in general, improving the body’s muscle strength, and improving well-being. CAM treatments were less often used for the purpose of improving specific symptoms such as body pain, problems with balance, and fatigue/lack of energy.
Conclusions. A large range of CAM treatments were used by individuals with MS in all Nordic countries. The most commonly reported rationale for CAM treatment use focused on improving the general state of health. The overall pattern of CAM treatment use was similar across the five countries.

Complementary and alternative medicine for the treatment of multiple sclerosis (2010)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901236/
Multiple sclerosis (MS) is a chronic disabling disease of the CNS that affects people during early adulthood. Despite several US FDA-approved medications, the treatment options in MS are limited. Many people with MS explore complementary and alternative medicine (CAM) treatments to help control their MS and treat their symptoms. Surveys suggest that up to 70% of people with MS have tried one or more CAM treatment for their MS. People with MS using CAM generally report deriving some benefit from the therapies. The CAM therapies most frequently used include diet, omega-3 fatty acids and antioxidants. There is very limited research evaluating the safety and effectiveness of CAM in MS. The most promising among CAM therapies that warrant further investigation are a low-fat diet, omega-3 fatty acids, lipoic acid and vitamin D supplementation as potential anti-inflammatory and neuroprotective agents in both relapsing and progressive forms of MS. There is very limited research evaluating the safety and effectiveness of CAM in MS. However, in recent years, the NIH and the National MS Society have been actively supporting the research in this very important area.

Complementary and alternative medicine for multiple sclerosis (2008)
http://journals.sagepub.com/doi/10.1177 ... 8508092808
We analyzed characteristics, motivation, and effectiveness of complementary and alternative medicine in a large sample of people with multiple sclerosis. A 53-item survey was mailed to the members of the German Multiple Sclerosis Society, chapter of Baden-Wuerttemberg. Surveys of 1573 patients (48.5 ± 11.7 years, 74% women, duration of illness 18.1 ± 10.5 years) were analyzed. In comparison with conventional medicine, more patients displayed a positive attitude toward complementary and alternative medicine (44% vs 38%, P < 0.05), with 70% reporting lifetime use of at least one method. Among a wide variety of complementary and alternative medicine, diet modification (41%), Omega-3 fatty acids (37%), removal of amalgam fillings (28%), vitamins E (28%), B (36%), and C (28%), homeopathy (26%), and selenium (24%) were cited most frequently. Most respondents (69%) were satisfied with the effects of complementary and alternative medicine. Use of complementary and alternative medicine was associated with religiosity, functional independence, female sex, white-collar job, and higher education (P < 0.05). Compared with conventional therapies, complementary and alternative medicine rarely showed unwanted side effects (9% vs 59%, P < 0.00001). A total of 52% stated that the initial consultation with their physician lasted less than 15 min. To conclude, main reasons for the use of complementary and alternative medicine include the high rate of side effects and low levels of satisfaction with conventional treatments and brief patients/physicians contacts.


RELATED RESOURCES (alphabetical):

American Academy of Neurology
Summary of Evidence-based Guideline for PATIENTS and their FAMILIES
COMPLEMENTARY AND ALTERNATIVE MEDICINE FOR MULTIPLE SCLEROSIS

https://www.aan.com/Guidelines/Home/Get ... ontent/642
Overall, for most CAM therapies, there is little evidence that they are effective for treating MS. For some CAM therapies, no studies were available.
For some other CAM therapies, studies showed evidence for effectiveness or lack of effectiveness. (click through for details)

General Concerns for CAM Therapies
Most CAM therapies have not been reviewed and approved by the FDA, and their safety is unknown. There is not enough information to show whether
any CAM therapies interfere with prescription drugs used to treat MS. Most CAM therapies are not covered by insurance. Work closely with your doctor
to decide whether any CAM therapies would be good choices in your situation. If you are already using CAM therapies, talk to your doctor about whether
evidence for those therapies is available.

Cleveland Clinic
Multiple Sclerosis: Alternative & Complementary Therapies

Complementary therapies are alternative therapies used in addition to traditional treatments. Alternative therapies for multiple sclerosis can include acupuncture, massage, and linoleic acid.
https://my.clevelandclinic.org/health/t ... -therapies
What alternative or complementary therapy is recommended for multiple sclerosis (MS)?

Positive attitude: Having a positive outlook cannot cure MS, but it can reduce your stress and help you feel better.

Exercise: Exercises such as tai chi and yoga can lower your stress, help you to be more relaxed, and increase your energy, balance, and flexibility. As with any exercise program, check with your doctor before getting started.

Diet: It is important for people with MS to follow a healthy, well-balanced diet. Ask your doctor what diet is right for you.

MS Society of Canada
Complementary and Alternative Medications & Treatments

https://mssociety.ca/managing-ms/treatm ... dicine-cam
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.

MS Society (UK)
Complementary and alternative therapies

https://www.mssociety.org.uk/about-ms/t ... -therapies
People mean different things by the term 'complementary and alternative therapies' (also known as 'complementary and alternative medicines' or CAMs).
Broadly, they can be defined as health-related therapies and disciplines that are not considered to be part of mainstream medical care.
Click through to view
What are CAMs?
What works
Getting Treatment

Multiple Sclerosis Trust
Complementary and alternative medicine and MS

https://www.mstrust.org.uk/news/views-a ... ine-and-ms
There is growing interest in CAMS in western conventional medicine, but the dilemmas remain the lack of evidence, the quality of the little evidence available and the measurement outcomes used. Multiple sclerosis has been documented since the 19th century and yet conventional medicine has yet to find consensus, or the answers on what it is. Is it time serious consideration be given to possible alternatives that may have a powerful role to play in the outcomes for people with MS? The subjective effectiveness reported by two thirds of those who use CAMS needs to be investigated by rigorous methods and questioned by scientific minds.

National MS Society (US)
Complementary & Alternative Medicines

See what is known about the effectiveness and safety of CAM strategies — and how to integrate complementary or alternative medicines into comprehensive MS care.
https://www.nationalmssociety.org/Treat ... -Medicines
Complementary approaches to taking care of yourself

Food and diet — Although various diets have been promoted to cure or control MS, no diet has been proven to modify the course of MS. MS specialists recommend that people follow the same high fiber, low fat diet that is recommended for all adults.

Exercise — Exercise offers many benefits for people with MS. In addition to improving your overall health, aerobic exercise reduces fatigue and improves bladder and bowel function, strength, and mood. Stretching exercises reduce stiffness and increase mobility. The physical therapist can recommend an exercise plan to fit your abilities and limitations.

Stress management — The relationship between stress and the onset or worsening of MS is far from clear — and different types of stress appear to affect different people in different ways. But none of us feel our best when we’re stressed, so it’s important to find the stress management strategies that work best for you.

Acupuncture — Acupuncture is finding its way into Western medicine, with studies suggesting possible benefits for a wide range of problems.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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jimmylegs
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