multiple sclrosis

MULTIPLE SCLEROSIS A SEMINAR FOR THE MS SOCIETY OF

TORONTO

BY

MORWENNA GIVEN BA MA (OXON) BSC M.OHA BHG RH

MEDICAL HERBALIST SEPTEMBER 2012

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23/09/2012

WHO AM I?

I am a medical herbalist, trained in University,

Hospital and clinics

With a practise in downtown Toronto focussing on

Chronic auto immune diseases including MS,

Cancer, Alzheimer's, diabetes, and women's’ issues

23/09/2012

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MS : causes Genetic

Unknown environmental

Traditional aetiology. Most research has been

concentrated on genetic factors as patenting drugs

in this area is much easier since the Americans

patented part of the human genome

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BUT

In my practise

Careful case history taking has universally shown

the possible cause is viral infection plus deficient

nutrients leading to an immunocompromise in the

patient.

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Current Research on

Causes It is now being admitting that there is considerable

evidence to show the initiator of MS is an infection

This maybe viral or bacterial Trigger, pathogen or bystander: the complex nexus linking Epstein Barr

virus and multiple sclerosis Owens GP et al Mult Scler 2012 June 8

Is the treatment of multiple sclerosis headed in the wrong direction? Kadoch MA Can J NeuroSci 2012 May 39(3)405

Active intrathecal herpes simplex virus type 1 and human herpes virus -6 infection at the onset of multiple sclerosis. Ferro MT et al J Neurovirol 2012 May 19 epub ahead of print.

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Environmental –

diseases of excess

MS has long been associated with northern climes

and temperate zones…..i.e. the western diet heavy

on meat/potatoes/grains

As the BRIC countries consume western processed

diets in favour of their own high vegetable diets

the incidence rate for MS is rising.

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Pathology –

simplistically speaking

The initial process of MS starts with inflammation

( i.e. your immune system responding to a

pathogen ) via T lymphocytes which recognise

myelin derived antigens on the surface of the

microglia ( nerve cells ) which then starts an

inflammatory cascade resulting in the destruction

of the myelin sheath, within the central nervous

system

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CONSEQUENCES OF PATH

This results in acute and chronic plaque formation

within the CNS, oedema and auto immunity in the

immune system

Changes occur in the HPA axis which affects the

thyroid and all metabolic function and sexual

function in the body as well as musculo/skeletal

function.

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RESULTS OF

PATHOLOGY PROCESS Removing the myelin sheath from neuronal fibres

means that the signals can jump from fibre to fibre and thus get muddled up or not delivered. Signals (neurotransmitters) are molecules which depend on an electrochemical gradient – ions. If there are any nearby molecules which attract ions ( positive and negative charges) the normal signal transduction may not take place.

I compare this to:

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THE EFFECT

Is like a plug which is not earthed

Resulting in a blown fuse – replace the fuse but if

the plug is not earthed another bulb will go!

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MS SYMPTOMS – some

Optic neuritis, facial palsy

Relapsing and remitting sensory symptoms e.g.

tingling in the hands

6th cranial nerve palsy (eye movements)

Tingling on the spine ( Lhermitte’s syndrome )

Spasticity, pain, ataxia, fatigue, bladder and

impotence issues

Sub acute patterns of symptoms over time

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Conventional approach Diagnosis: By exclusion

Imaging & CSF examination

Drugs: Interferon Beta ( not effective in early MS does not inhibit

progression)

Azathioprine

Immunoglobulin

Monoclonal antibody no proven overall efficacy delays progression increases likelihood of cvs events and hypothyroidism ( Oxford seminar)

physiotherapy

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SYMPTOM/ DRUGS

Spasticity – baclofen

Ataxia - clonazepam

Pain - gabapentin

Urinary – cathertization and anti cholinergics

Fatigue – amitriptyline

Impotence – viagra

All the above have significant side effects with

implications for MS

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SURGERY

Does not treat the cause

Venous angioplasty in Multiple Sclerosis: neurological outcome at 2 yrs in a

cohort of relapsing – remitting patients. Salvi F. et al Funct Neurology 2012 Jan

–Mar 27(1):55-9

Veins and arteries are often comprised entirely due to inappropriate diet

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WHAT IS

A MEDICAL HERBALIST A person who treats medical disease

‘wholistically’ on an evidence based basis with whole plant extracts

A person who has trained in University, hospital, clinic environments

A person who treats the cause of the problem not just the symptom

We are specialists in the use of medicinal plants and their ability to resolve disease

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HOW AM I TRAINED?

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PHILOSOPY MEDICAL HERBALISTS LOOK AT THE

PATIENT AS A WHOLE NOT AS A SPECIFIC CONDITION OR PART OF A BODY

MEDICAL HERBALISTS TREAT NOT JUST TO RESOLVE AN ISSUE BUT ALSO TO OPTIMISE HEALTH INCLUDING PREVENTION

THE BODY IS LIKE A JIGSAW IF ONE PIECE IS MISSING THE REST IS OUT OF SYNC

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HOW DO I TREAT?

I review all aspects of the health of the person

Diet, exercise

Drugs, supplements

Co-existing conditions – obesity, diabetes, pcos &

other women’s issues, impotence, constipation etc.

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HOW DO I TREAT?

You may remember there was no mention of

exercise or diet under the conventional approach

This is the first step to review – especially as those

with auto immunity are normally nutrient deficient

Being nutrient deficient pre-disposes to immune

disorder

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Diet

Linoleic acid levels are abnormally low in MS patients – diet should be rich in fatty acids

COD LIVER OIL!

FLAX SEEDS! ( helps constipation too !)

Identification of naturally occurring fatty acids of the myelin sheath that

resolve neuro-inflammation Ho PP et al Sci Transl Med 2012 June 6;4 (137) :137ra 73

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DIET

Gluten intolerance may be a factor

Hybridised grains and overconsumption

Poor nutrition – lack of key vitamins, minerals in immunocompromised patients directly relates to poor function

Inflammation mediated memory dysfunction and effects of a ketogenic diet

Kim do et al Plos One 2012 7(5) 35476

High glucose levels affect the HPA

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Vitamin D Deficiency

Ontario is well known for its lack of vitamin D in

the population – it is recognised to be endemic

Reduced vitamin D is associated with the

geographic incidence of MS

Loss/Lack of vitamin D affects bones, muscles,

thyroid, liver etc.

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Is Lack of Vitamin D

a co-factor?

Yes, in making MS symptoms and long term

health worse

No, in direct causation

Vitamin D deficiency is not associated with early stages of thyroid auto

immunity Effraimidis G et al Eur J Endocr 2012 Apr 19

Vitamin D reduces remission Neurology. 2012;79:208-210, 254-260, 261-

266, 267-273

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Sugar Like all diseases of excess sugar plays a key role in

destabilising the body’s normal mechanisms including brain function

Excess sugar is derived from an inappropriate diet i.e. one high in grains

Insulin resistance a hall mark of MS co morbidities e.g. PCOS

High circulating levels of glucose affect the brain

J.Physiol 2012 590:2485-2499 Gomez-Pinella

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Exercise Exercise – improves brain function

Makes tissues work better – import and export

Improves cardiovascular function

Erickson KI et al Exercise training increases the size of the hippocampus

and improves memory. PNAS 31 Jan 2011epub ahead of print.

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Review existing

medications Statins - Inhibits the formation of cholesterol, but the

myelin sheath is made from cholesterol, causes diabetes

Impairs the immune system

Bisphosphonates

Cytotoxic to new red blood stem cells in bone marrow

Proton pump inhibitors – inhibits the bodies’ immune system and first line of defence against pathogens

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Review MS symptoms

as expressed by the patient

Such as:

Sleep issues

Excretion issues

Sexual issues

Review these in conjunction with the thyroid and

vitamin D consumption

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Sub clinical

hypothyroidism Iodine, selenium, zinc

Directly impacts on the immune system, responsible for all metabolism in the body outside of the CNS

Vitamin D

Endemic in Ontario not available in our local soils

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Review the Patient’s

other symptoms

Spasticity

Movement

Cognitive function

And so on and then select appropriate plants to

alleviate, reduce symptoms

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Plants

I choose the plants that offer the medical

therapeutics that patients need in combination to

maximise synergy of the biochemicals based on

published scientific evidence

In MS we have two outstanding plants

Curcuma longa

Scentella asiatica

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Curcuma Longa &

Scentella Asiatica Recent Pat CNS Drug Discov. 2012 Jun 21. Curcuminoids in Neurodegenerative

Diseases. Kim DS, Kim JY, Han Y.

Curcumin has bright prospects for the treatment of multiple sclerosis.Xie L, Li XK, Takahara S.Int Immunopharmacol. 2011 Mar;11(3):323-30.

Neurol Sci. 2012 Aug 4.

Centella asiatica attenuates the neurobehavioral, neurochemical and histological changes in transient focal middle cerebral artery occlusion rats.Tabassum R, et al.Neurotoxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, 110062, India.

Evid Based Complement Alternat Med. 2012;2012:946259. Epub 2012 May 14. Centella asiatica (L.) Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential. Orhan IE.

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Plants

Withania – adaptogens

Astragalas – anti inflammatories

Nervines to modify dopamine vs. serotonin e.g.

Passionflower and St John’s Wort

Milk Thistle – hepatics

Hypoglycaemics – Cinnamon

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HOW THEY WORK

Plants have many chemicals in them which work

at many levels of the bio-chemical pathways of the

body in a synergistic fashion.

Conventional drugs in order to be patented can

only work in one way with one key chemical – it is

this direct action which causes many of the side

effects.

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Medical marijuana I am not a supporter of the use of this plant as the

cannabinoids alter brain function over the long term

Synthetic versions cannot be the same as in Cannabis sativa and may either not produce the result desired or worse

Marijuana relieves spasticity but affects cognitive function Corey-Bloom

J.et al. CMAJ May 14 2012

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ANTI SPASMOLYTICS

There are a number of plants which provide anti

spasmolytic actions which can be equally effective

or more than marijuana without the associated

cognitive problems

These are normally given as part of the treatment

protocol by a Medical Herbalist

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SUPPLEMENTS

There are some specific supplements beneficial in

MS such as pure Cod Liver Oil

Retail supplements are not allowed by law to have

a medical effect and thus the doses suggested

maybe inappropriate

Always consult your professional practitioner first

before purchasing

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CAUTIONS PLEASE NOTE: IT IS ADVISED, THAT ANY PLANTS

MENTIONED IN THIS TALK, ARE ONLY USED UNDER PROFESSIONAL GUIDANCE.

BOTANICAL MEDICINE AS COMPOUNDED BY A PROFESSIONAL IS NOT AVAILABLE OVER THE RETAIL COUNTER.

It is not advisable to self treat

A professional: will recognise all the issues within the body ;

Select herbs that will impact positively on these issues without causing problems in order to co exist with orthodox drugs,

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References

www. Pubmed, Science direct

I have a full list of references for those who are

interested – if you would like either to email me or

put your name down tonight I will send them to

you. It is several pages!

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multiple sclrosis

Health & Medicine