Natural Remedy Dos and Don’ts for Multiple Sclerosis

More and more people with multiple sclerosis (MS) are looking for natural remedies and complementary therapies to incorporate into their treatment plan.

But caution is necessary, because even some supplements that appear to be helpful have actually been shown to be harmful when tested in clinical trials.

“Talking to your doctor is certainly the first step before trying any supplements,” says Ellen M. Mowry, MD, professor of neurology and director of the MS Experimental Therapeutics Program at Johns Hopkins Medicine in Baltimore.

“I think sometimes people get frustrated that doctors aren't more ‘positive’ about supplements, but as a neurologist, I expect to see the same high-quality data for a supplement as I would expect for any medication I prescribe before recommending it,” Dr. Mowry says.

The U.S. Food and Drug Administration (FDA) doesn’t require that kind of evidence for supplements to be sold, which means that something may be advertised as helping with MS but have little to no evidence to back it up.

The American Academy of Neurology (AAN) published its first-ever guidelines for complementary therapies in MS in 2014. And while the academy has not yet published an update to those guidelines, “We do know more about the effectiveness of different complementary therapies since those guidelines were released,” says Vijayshree Yadav, MD, professor of neurology and director of the Multiple Sclerosis Center Oregon Health and Science University in Portland.

So what does the evidence say about which supplements are worth exploring and which ones you should avoid? Here are some natural remedy dos and don’ts for people with MS.

Do Discuss Vitamin D With Your Doctor

There is evidence that maintaining the recommended level of vitamin D may lower the risk of developing in MS, especially in women, according to Mayo Clinic. Some studies also suggested people with MS could benefit from taking vitamin D, and in the past, providers often recommended supplements for people whose blood levels weren’t at the high end of the normal range, says Dr. Yadav.

“That has changed,” Yadav says. “Although there is still evidence that vitamin D is important, high levels may not be as important as we once thought. We are no longer recommending that people with MS should be in the higher range of normal. We are recommending that they be to the mid-to-lower range of normal, and that is a big difference.”

Although vitamin D is generally safe, Yadav adds, too much of it can be a problem, leading to vitamin D toxicity and serious side effects, including nausea, vomiting, and constipation.

It’s best to take any vitamin D supplement under the supervision of a medical professional who can monitor your blood levels.

Ginkgo Biloba May Not Improve Cognitive Function

Ginkgo biloba is an extract produced from the leaves of the ginkgo tree. It’s typically taken to improve brain function and memory, although clinical trials of ginkgo have not consistently shown these benefits.

To date, scientific evidence supporting its effectiveness in treating memory loss associated with MS is limited, with multiple studies producing mixed results.

“At the present time, based on current evidence, we don’t recommend ginkgo biloba for cognitive function in people with MS,” says Yadav.

On the plus side, a study in which people with MS were given 240 milligrams (mg) per day of the herb for a four-week period showed that ginkgo did provide significant reduction in fatigue symptoms compared with the effects of a placebo.

Ginseng May Have Benefits for Fatigue

Ginseng, an herb that’s been used in China for medicinal purposes for more than 2,000 years, has been found in some clinical studies to reduce fatigue, although how it works remains unknown.

A three-month randomized, controlled trial, published in 2013 in the International Journal of Neuroscience, found that ginseng was superior to placebo in helping reduce fatigue in women with MS.

An earlier study, published in the Multiple Sclerosis Journal, found that giving American ginseng extract to people with MS in increasing daily doses of 100 mg, 200 mg, and 400 mg for the first three weeks of a six-week period failed to show any benefit. Worse, some of the study participants experienced insomnia, particularly while on higher doses.

There haven’t been any more recent studies to support the use of ginseng in MS, says Yadav. She adds that while smaller doses of ginseng extract — less than 2 grams (g) per day — appear to be safe, doses of more than 3 g per day have been linked with side effects, such as high blood pressure, insomnia, rash, and diarrhea.

Do Drink Green Tea

A study published in May 2014 in the journal Multiple Sclerosis International found that deficiencies of certain antioxidants in the blood of people with MS may contribute to worsening symptoms. Green tea is rich in antioxidants as well as epigallocatechin-3 gallate (EGCG), a compound that may boost the immune system as well as help to prevent cognitive dysfunction, per a review of studies published in International Journal of Molecular Studies.

People who drink black and green tea, coffee, and nonalcoholic beer may be less likely to develop MS, according to a study published in March 2023 in the Journal of Health, Population, and Nutrition.

Although studies of the benefits of green tea in people already diagnosed with MS have yet to yield conclusive results, small amounts are perfectly safe and may help you feel better.

Green tea supplements, on the other hand, are not without risk, says Yadav. “There was some evidence of a risk of liver damage in a small pilot study published in the Journal of Neurological Sciences,” she says.

In that study, participants took two capsules of polyphenon E, a green tea extract, twice a day. Although N-acetyl-aspartate (a marker of neuronal metabolic health) increased by 10 percent after six months, the study was discontinued because the majority of participants had elevated liver enzymes.

“Because of these findings, people with MS should be cautious about how much green tea extract they are consuming,” says Yadav.

Do Think About Taking Coenzyme Q10

Coenzyme Q10 is an antioxidant that is naturally produced in the body, where it’s used to help convert the food you eat into energy. A study published in March 2016 in the journal Nutritional Neuroscience found that a supplement containing 500 mg of coenzyme Q10 given once a day for 12 weeks reduced the symptoms of fatigue and depression in people with MS compared with those who didn’t use it.

But Yadav says these findings need to be repeated in larger studies before clinicians can draw specific conclusions.

In a study published in November 2020 in the Journal of Molecular Histology, researchers used animal models and found that CoQ10 helped with oxidative stress and inflammation. Researchers concluded that the supplement had potential to enhance remyelination (the natural repair mechanism of demyelination) in people with MS, but that further study in humans is needed.

Even though there hasn’t been any new evidence on coenzyme Q10 in people with MS, Yadav is part of a new placebo-controlled trial that is studying a compound similar to CoQ10 called mitochondrial cofactor (MitoQ) to see if it can improve MS fatigue. “We will know the results of that study in about a year,” she says.

Do Consider Lipoic Acid Supplements

Alpha-lipoic acid is an antioxidant that is both made by the body and naturally present in some foods, including red meat, organ meats, and brewer’s yeast.

Lipoic acid supplements are available in both oral and IV forms, and they may be of interest to people with MS.

In a small pilot study published in September 2017 in Neuroimmunology and Neuroinflammation, people with secondary-progressive MS who took 1,200 mg per day of a lipoic acid supplement had 66 percent less brain atrophy compared with participants taking a placebo, and had a significant preservation of brain volume over a two-year period.

A new trial is currently underway that is trying to replicate those results, says Yadav. “Early findings in this current study have shown that there is a rare risk of having autoimmune kidney disease in subjects that are taking lipoic acid,” she says.

When people stopped taking the supplement and were given supportive therapy, the disease went into remission, according to the findings.

That risk — and any benefits — are being observed and the study is set to be completed by the end of next year, she adds.

Before taking lipoic acid, it’s important to talk with your provider about the potential risks involved, as well as the possibility of drug interactions.

Do Discuss Your Diet With Your Doctor

There is a lot of interest and research on diet and how it may impact MS, says Yadav. A new meta-analysis of 12 trials published in October 2022 in Neurology found that diet, particularly paleo and Mediterranean diets, could be helpful for improving quality of life and fatigue in people with MS. The studies included in this review were small and of short duration, and so more research is needed, the authors concluded.

Research presented at the 2023 American Academy of Neurology Annual Meeting found a significant association between eating a Mediterranean diet and cognition: Those who more closely followed the diet were about 20 percent less likely to develop problems with memory and thinking skills compared to those who did not.

In 2016, Dr. Yadav published a year-long study that found that people with MS who ate a very low-fat vegan diet significantly improved fatigue. The participants lost an average of 20 pounds, and their cholesterol and insulin levels fell. A later study that allowed participants to include lean sources of animal proteins had similar results, although participants didn’t lose quite as much weight.

Do Include Your Doctor Before Trying Any Natural Remedies for MS

“We should be looking at each individual’s MS and their overall health to determine the best complementary therapies to achieve optimal health,” says Yadav.

In addition to any natural remedies, Yadav recommends adopting habits like regular physical activity (provided it’s approved by your doctor) and managing any other health conditions. “People with MS who are in generally good health tend to do better, and there are many ways to get to that goal,” she says.