This Is MS Multiple Sclerosis Knowledge & Support Community

I began with the following information:
Dr. Wendy Warner was the fourth and last of the Functional Medicine doctors appearing on this episode of The Dr. Oz Show; in the following video she is discussing weight gain in menopause. Belly (or visceral) fat not only secretes estrogen, but cytokines (a.k.a. adipokines), especially interleukin-6. Dr. Oz's animation of the weight gain flowchart (about .30 in the video) explains the cycle that I think we are dealing with in MS:
http://www.doctoroz.com/videos/dr-oz-s- ... tives-pt-6

I have tried unsuccessfully to reduce insulin levels with diet. Now I will target the other stages in the cycle – visceral fat (specifically, fatty liver) and inflammation. Indirectly, that should eventually reduce insulin production.
Visceral fat produces cytokines, which lead to more insulin, which leads to more inflammation, which produces more visceral fat… and round and round it goes.
Or Visceral fat => Cytokines (Adipokines, especially IL-6) => Insulin=> Inflammation=> Visceral fat…

And thanks to cheerleader we have this article on elevated liver enzymes and MS: http://www.ncbi.nlm.nih.gov/pubmed/17030771

And thanks to JackD: Biol Res Nurs. 2011 Nov 14. [Epub ahead of print]

Psychological Stress and Cytokine Production in Multiple Sclerosis: Correlation With Disease Symptomatology.
Sorenson M, Janusek L, Mathews H.

Department of Nursing, DePaul University, Chicago, IL, USA.

Objective: Psychological variables such as perceived stress appear to play a role in symptom onset or disease exacerbation in multiple sclerosis (MS). The authors sought to determine if perceived stress is indeed associated with the expression of pro-inflammatory cytokines and disease symptoms in individuals with MS. To do so, the authors examined the relationships among disease symptomatology, perceived stress, and cytokine production from peripheral blood mononuclear cells in 42 outpatients with MS and 36 normative controls. Method: The authors drew peripheral blood from all subjects prior to the completion of a series of psychological instruments. The authors measured stress using the Perceived Stress scale and negative mood with the Profile of Mood States. Disease symptoms were measured using the Multiple Sclerosis Symptom Checklist. Cytokine production was induced separately by lipopolysaccharide and a combination of phytohemagglutinin and phorbol-12-myristate-13-acetate.

Results: In MS subjects, the induced production of interleukin (IL)-6 and IL-10 positively correlated with psychological stress, mood disturbance, and disease symptomatology.

n contrast, psychological stress in control subjects significantly correlated with level of tumor necrosis factor-alpha (TNF-α), and mood disturbance correlated with levels of TNF-α and interferon-gamma. As well, compared to controls, MS subjects exhibited a significant fourfold increase in the production of IL-12.

Conclusion: There is, in those with MS, a pattern of IL-6 and IL-10 production that correlates significantly with perceived stress and disease symptomatology.

PMID: 22084401 [PubMed - as supplied by publisher]


From The Belly Fat Cure by Jorge Cruise, page 3:

Researchers at the Washington University School of Medicine in St. Louis confirmed that visceral belly fat (the kind that wraps around your internal organs, not the kind you can pinch) releases inflammatory molecules called interleukin-6; higher levels of these molecules are connected to increased levels of C-reactive protein, which in turn, is connected to chronic inflammation. Scientists in London substantiated this link by declaring visceral fat a "key promoter of… chronic inflammation." Even though inflammation starts out as our bodies way to protect itself, when it becomes chronic, its causes cellular damage that ages our tissues and organs and can eventually lead to arterial stiffness and heart disease.

And in the recent AARP Bulletin article, "Battling Belly Fat": http://www.aarp.org/health/healthy-livi ... y-fat.html

I think the MS symptoms are the result of the insulin in the above cycle; I think Dr. Terry Wahls' diet is detoxifying the liver (kale, Swiss chard, dark green leafy vegetables), reducing visceral fat, and ultimately reducing insulin levels. I will investigate detoxifying the liver next; any suggestions in that project will be appreciated.

hi lyndacarol, please don't take it that this article is meant in anyway to take away from what you are doing. that would be the furtherest from the truth. we are all "fishing" trying to figure things out. we are all different yet with a sameness. the article i'm posting makes a person wonder-if our livers need fixing as you point out--or are the anti-rejection drugs playing a part in her recovery? whatever came into play here the womans doing good. lots of ???????????? maybe you're onto something. you'd think the ms researchers would be looking at this.



Remission of multiple sclerosis post-liver transplantation.
Yoshida EM, Devonshire VA, Prout AJ.
SourceDivision of Neurology, the Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

Abstract
BACKGROUND: The effect of liver transplantation on pre-existing multiple sclerosis (MS) has never been reported. We report the three year post-transplant neurological outcome of a patient with MS.

CASE REPORT: A Caucasian woman with MS received an urgent liver transplant for fulminant liver failure at the age of 59. Her Extended Disability Scale Score (EDSS) pretransplant was 5.0 and clinically she had cerebellar and brainstem dysfunction. Post-transplant immunosuppression consisted of tacrolimus, mycophenolate mofetil and tapering corticosteroids that were discontinued after 1.5 years. Post-transplant her EDSS decreased to 2.0 and after three years she is clinically asymptomatic with only very mild dysarthria on neurologic examination. Long-term maintenance immunosuppression consists of low dose tacrolimus.

CONCLUSIONS: Combination immunosuppression with tacrolimus may have a beneficial effect on MS although an effect of donor allograft itself can not be excluded.

PMID:15595263[PubMed - indexed for MEDLINE

I have not looked at any liver detox protocols and although they may have a beneficial effect, I doubt the description of their action is accurate.
We do not have the capability for any direct actions on the liver, they are all the result of reactions to our dietary intakes, physiological (exercise) & psychological (emotions) inputs, so excluding the latter two with the assumption that you are endeavouring to exercise appropriately and applying appropriate mental health measures, that leaves diet.
So this requires an analyis of liver functions and I am not an expert, but one of the prime functions dietary wise is the conversion of excess sugars to fat for storage, so this would suggest restriction of simple sugars, particularly fructose.
Another important function is breakdown of toxins, this includes alcohol, caffeine, medications, artificial sweeteners, flavours, etc. so exclusion of everything that does not qualify as natural food.
It is also the manager of Cholesterol, this involves the recycling process and disposal of cholesterol remnants, through the bile, which also is how it disposes of most of the toxins it removes from the blood, for bile to be discharged it requires gut stimulation by the presence of fats, so reasonable & healthy fat consumption is essential.
The metabolism of protein is another essential function in the liver, so control of excessive protein intake is required to minimise liver workload. only as much protein (good variety) as required for normal body maintenance should be present in the diet.
Overall a reduction of calorific intake below that of expenditure can result in the removal of excess fat, be it Visceral or Subcutaneous, therefore some control on volume of intake of macronutrients (carb's, fat & protein) is required whilst at the same time adequate micronutrients (vitamins & minerals) must be maintained & slightly enriched.
To do this properly, this will not be a 10 day fix, I would expect 2-4 weeks of adaptation and then a further period for the full clean out, this may be a month or a year or more.
The reason I believe the extended time frame is because the only way your body can remove the excess fat is to burn it and to do this effectively, unless you are already keto adapted, means your body will need to build more mitochondria and rebuild other fat burning mechanisms, this will not happen overnight as they say.
I want to add more, but am running late.
Just a bit of food for thought, I looked at a lot of the cleansing and healing diets a while back, most had a significant low calorie vegetable input,
One thing to consider is that solouble fibre, resistant starches & complex carbohydrates are fermented by bacteria in the lower intestine, not to sugars, but to Short Chain Fatty acids, so is this a carbohydrate intake or a fat intake??
BTW fat digestion bypasses the liver processes as well, so i think a large part of these cleansing protocols involve the body going into Ketosis.

previous liver chats

The MS Liver (3 pages)
http://www.thisisms.com/forum/general-d ... c6906.html

I appreciate the comments from you all, blossom, CaveMan, and jimmylegs. My philosophy is "What do I have to lose?" As many of us do, I continue to search or "fish" for some solution that will work for me.

With the premise of the above-stated cycle of visceral fat/cytokines/insulin/inflammation, I now recommend the following scans or tests, in addition to the long-standing "fasting blood insulin test":

Visceral fat: H magnetic resonance spectroscopy (H MRS)
Description (two-minute video):

According to the following article, "For a long time, fatty liver or hepatic steatosis was considered as a benign manifestation. However, recent data indicate a wide spectrum of clinical and pathological manifestations that subjects with nonalcoholic fatty liver disease develop,…"

"The best method for frequent, repetitive, and highly specific estimation of the hepatic fat in vivo is localized H MRS (H magnetic resonance spectroscopy)."

"… women who, in fact, have higher prevalence of nonalcoholic hepatic steatosis than men. (27)" 27. Angulo P 2002 Non alcoholic fatty liver disease. N Engl J Med 346:1121-1231. This fact could explain the higher prevalence of MS in women than men!

The following URL is for the article from Journal of Clinical Endocrinology & Metabolism. Title of the article is Hepatic Steatosis, Insulin Resistance, and Adipose Tissue Disorders: http://jcem.endojournals.org/content/87/7/3019.full


Insulin: fasting serum insulin test – ideal results are 3 UU/ML or less

http://www.mercola.com/nutritionplan/index2.htm
Factor # 1 : Your Insulin Level
Insulin is absolutely essential to staying alive, but the sad fact is that most of you reading this have too much floating around, and it is pushing you towards chronic degenerative illness and increasing the rate at which you age.
Most adults have about one gallon of blood in their bodies and are quite surprised to learn that in that gallon, there is only one teaspoon of sugar! You only need one teaspoon of sugar at all times -- if that. If your blood sugar level were to rise to one tablespoon of sugar you would quickly go into a hyperglycemic coma and die.
You body works very hard to prevent this by producing insulin to keep your blood sugar at the appropriate level. Any meal or snack high in grain and sugar carbohydrates typically generates a rapid rise in blood glucose. To compensate for this your pancreas secretes insulin into your bloodstream, which lowers your blood sugar to keep you from dying.
However, if you consume a diet consistently high in sugar and grains, over time your body becomes "sensitized" to insulin and requires more and more of it to get the job done. Eventually, you become insulin resistant, and then diabetic.
If you have high cholesterol, high blood pressure, type 2 diabetes, or are overweight, it is highly likely that you are eating too many grains -- yes, even unrefined whole grains -- as this is the most common culprit causing your insulin level to become abnormal.
Compounding the problem, when your insulin levels rise due to an excess of carbohydrates, they send your body a hormonal message telling it to store fat while holding on to the fat that is already there. So not only will excess carbohydrates make you overweight, they will effectively hamper your weight loss efforts too.
Your Fasting Blood Insulin Test
To find out your insulin levels, you need to get tested by your doctor. The test you need to ask for is a fasting blood insulin test, The test is done by just about every commercial laboratory and is relatively inexpensive.
Facts about Your Fasting Insulin Test:
• This test is profoundly useful. It's one of the least expensive tests in traditional medicine, yet it is one of the most powerful. A normal fasting blood insulin level is below 5, but ideally you'll want to be below 3.
• You can safely ignore the reference ranges from the lab as they are based on "normals" of a population that has highly-disturbed insulin levels.
• This is a great test to do BEFORE you start your program as you can use it to assess how well you are progressing in the program.
• If your level is above 5 you will want to consider significantly reducing most sugars and grains, even whole wheat grains, until you lower your level. Once you've normalized your insulin level you can reintroduce grains into your diet at a lower level to optimize your health.
• Exercise is of enormous benefit in improving the sensitivity of your insulin receptors, and help normalize your insulin level far more quickly.

Inflammation: CRP test (or hs-CRP test specifically for heart inflammation; hs = "high sensitivity")

Demonstration of test and explanation of results:
http://www.doctoroz.com/videos/best-new ... sease-pt-1

http://www.foxnews.com/health/2012/07/1 ... -diseases/

http://online.wsj.com/article/SB1000142 ... 90070.html

i kinda do want to forewarn anybody doing the liver cleanse at least this was my experience. i had been going to a dr. that treats all natural. "one of my fishing trips". i did the intervenous chelation after having mercury removed. we decided to do a liver cleanse. i followed to the t. it's been quite a while back but i recall apple juice and then that evening i took the ingredients. it did say it could cause nausea---well nausea was a mild word---i really recall no other nausea that bad except when my appendix were ready to burst. the upside after what i thought was a near death experience was it lasted an hr. or 2 and subsided. maybe it was just me but just putting it out there. i was not near as bad ms wise then and i was barely able to keep my head up to breath through all this and i was alone. if you're gonna try the cleanse and it warns nausea i'd highly suggest someone is with you especially if you're at a stage that is pretty limited mobility. if i was to try that now and i had that reaction i feel strongly that strangulation or suffication would do me in. ---- but, it's good to try to keep the liver good. don't know how efficient but i take milk thistle. i've been on many fishing trips and keep fishing with hopes of catching the trophy. i appreciate the shareing of info. here. what seems maybe even a little offkilter to some might just be the answer to some.

lyndacarol,
Not sure what dietary approaches you have used to try to manage insulin levels, so we may well end up covering old ground here.
Like Blossom has said any type of extreme cleansing protocol should be approached with caution as there can be considerable shocks applied to the body.
My inclinations are a slow and steady approach to dietary changes, restriction of calories via short fast protocols (16-36hrs) and support with electrolytes, like salty bone broths during these fasts, your body has to metabolise the fats and this will require Ketosis, which if not approached properly will result in fatigue, brain fog, lethargy etc. If your body is not adjusted progressively this may result in both physiological and emotional traumas of deprivation (starvation feeling) & it doesn't need to be that way, when you are better adapted to metabolising fat, the feeling of hunger for most people is more of a gentle reminder rather than the ravenous response to the insulin rollercoaster.

These are my opinions from my own personal experience & reading, I recently started looking more deeply into the Ketogenic diet and feel that there are a lot of common factors that bring on Ketosis to some degree in the wide range of healing protocols, not suggesting the full Keto diet, just the low carb/sugar aspect with a healthy compliment of Veg. Enough on that bent.

I also looked into the Cortisol:Visceral fat & stress connection, something triggered by Skydog's post on page 1 of Liver thread, there seems to be a significant connection as per this explanation, which also has link to study:
http://nextpharmaceuticals.com/nextword ... onnection/
The gist of the information I read is, when we are exposed to stress Cortisol goes u and one of the responses is to build up stores of Visceral fat, rationale is it is much better positioned with good blood supply and can be metabolized much quicker during strenous exercise (running from Lion), but in our modern life, we get the stress and build the Visceral fat, but never burn it because the opportunity never arises. So it is part of the Fight or Flight response mechanisms.
In that regard I imagine the resolution would be twofold, one, stress management to minimise excessive response, and two, strenuous exercise occassionally beyond muscle Glycogen stores to stimulate fat metabolism.

CaveMan – I feel that we are on the same track. My approach has been to restrict calories, eliminate sugars (or any sweeteners), eat virtually a no carb diet (EXTREMELY low carb, at least), and attempt a modified ketogenic diet. I have not tried, nor do I intend to, any "cleanse" – other than a two or three day fast, as some programs recommend.

I am NEVER hungry; haven't been for years – I attribute this to my chronically high insulin levels. With no difficulty, I have only tea for breakfast – green tea or oolong. Lunch is usually avocado, an egg, cheese (Gouda, Edam, Jarlsberg – for the vitamin K2 especially), more tea. Dinner is a form of protein (fish, chicken, beef or pork), and veggies (usually kale, Brussels sprouts, or sweet potato), and tea again. I used to eat three or four servings of fruit per day, but have cut back (to reduce any fructose) to an occasional half cup blackberries now and then. Pretty dull and routine! I welcome any suggestions on diet you may have.

I do not identify stress in my life; there is no elevated cortisol to blame for visceral fat. (Thanks for Next Pharmaceuticals link.) Although I have had no scan for visceral fat, I am sure it is there (as waistline would indicate – I am NOT fat otherwise). My lifestyle is too sedentary, I know; I will work on increasing exercise.

Thanks again, folks, for your input.

Alright, got it.
So you are basically doing low to moderate carb diet and have been for a while now, which is textbook recommendation to manage blood sugar & insulin.
You are basically already doing the 16/8 fasting protocol, ie no food until lunch, so there would already be some ketosis occuring during this period.
I don't know what degree of exercise you do, one of the key points to stimulate the process is vigorous exercise to burnout the Glycogen stores in your muscles, particularly during the fasting period in the morning. When you do this, you use up some of the available blood sugar and stimulate the liver to replenish this from it's own Glycogen stores and also via Glucogenesis by converting Triglycerides to Glucose. Burning out the Glycogen stores in the muscles stimulates them to build more mitochondria & associated fat burning mechanisms, the exercise needs to be high intensity bursts, so you get the burning feeling in the muscles, rest between, then repetitions. Obviously you need to build up in the process and I really have no personal experience with MS so you will know what approach is most appropriate for you. I don't think the type of exercise is critical, could be exercise bike, treadmill, I have worked out a pretty tough routine in water, just using the resistance of the water and easy to vary just by adjusting speed of movement pushing my arms & legs through water.
The other benefit may well be the production of lactate, I have recently been reading up on this and it appears to be much more than the enemy of the athelete, a couple of points I found out:
*Lactate appears to be the prefered fuel for both the brain & the heart.
*Brain Injury healing is accelerated by providing an ample supply of lactate, work done by George Brooks, though limited because of the moral issue of doing trials in these difficult circumstances.
*Red blood cells do not have mitochondria and rely on lactate pathway for their own metabolism, so they are net producers of lactate at all times.
*Muscles also produce lactate all the time even at rest
*Sometimes gut flora imbalances cause production of the mirror molecule D-Lactate, which the body cannot use, and this has been found in association with CFS, symptoms last 3 days after carbs have been withdrawn from diet, there may be some association between disease pathways in other autoimmune diseases.
I need to spend some more time looking at this, but feel it may have some relevance to good health management.

Didn't see Yoghurt mentioned in your diet, I assume it is ok for you as you do plenty of cheese.
I am very interested in the Hyperinsulinemia thing, amongst other stuff, and will do some scouting around.

As for the fasting I have read of some sucess with calorie restriction by eating on alternate days, may be worth a look into.
I have also seen some references that some women do not respond to fasting as well as men, so something to keep in mind.

I just came across this fasting thread on a health & fitness forum I visit,
The site is occupied by a variety of individuals from fit and wanting more, through to various individuals dealing with obesity, diabetes, gastro ilnesses, eating disorders, autoimmune diseases etc., I know there is atleast one MS'er there.
I stumbled on the Part 3 thread, and have read a few pages of discussions, the originator of the threads seems to know his stuff, so there may be some info & tips in there for you,
In part 3 he is basically talking about going from the 20 hour fast (eating once per day) to the 40 hour fast and feels that this range is quite safe within health issues, anything over that needs more attention with the potential of metabolic issues.
http://www.marksdailyapple.com/forum/thread27894.html
http://www.marksdailyapple.com/forum/thread28459.html
http://www.marksdailyapple.com/forum/thread29011.html
You can open links in seperate page by holding Ctrl when you click on it.
I still need to go back to read part 1 & 2 so can't comment on those, I am currently doing the 16 hour fasting, but want to go up to a weekly 40 hour fast.
This angle may not be what you are looking for, but may give you some tips & things to be aware of if you decide to do any fasting protocols.

Interesting article on the dangers of visceral fat – the last section has a new take on uric acid:

http://fitness.mercola.com/sites/fitnes ... artTest_A1

Now, in an effort to reduce visceral fat, it seems that raspberry ketones may help due to adiponectin:

http://www.doctoroz.com/videos/miracle- ... ner-bottle

And the written article: http://www.doctoroz.com/videos/rasberry ... ience-says