Supplements for Autoimmune Health: Functional Medicine vs. Conventional Approaches

This article examines the different roles of conventional medicine subspecialists like neurologists and autoimmune experts compared to the role of functional medicine in your healthcare journey. Both fields can be important components in your plan of care.

I will also provide a few tips for optimizing your nutrition and incorporating key supplements to support improved brain health and longevity.

What is the Difference Between Conventional and Functional Medicine?

Neurologists and other autoimmune specialists are conventional medicine (CM) experts. These doctors are usually the ones who diagnose MS, and their treatment plans often include FDA-approved drugs for the management of autoimmune diseases. These plans are referred to as disease modifying treatments (DMTs).

There are (DMTs) that can be highly effective at reducing the number of new lesions and/or relapses for people with MS. DMTs can also slow disease progression, delaying the need for a scooter or wheelchair by up to five years.

Additionally, numerous effective DMTs are available for systemic autoimmune diseases that present with neurological or psychiatric symptoms such as pain, fatigue, anxiety or depression. I often urge patients with more severe disabilities or disease burdens (the impact of a disease on finances, quality of life, etc.) to use DMTs to help stabilize their condition while we work on optimizing nutrition and environmental factors.

A functional medicine (FM) practitioner has extensive training in the environmental and lifestyle factors that can influence autoimmune diseases and symptoms, and how to begin addressing or modifying these factors.

Environmental factors include gut health (the ability to digest and absorb nutrients), toxin exposure and detoxification processes, mitochondrial health, and the microbiome composition in the mouth and bowels.

Lifestyle factors include stress reduction, exercise and movement, nutrition, sleep, social connection, emotional resilience, and spiritual or religious practices.

The FM practitioner can assist with the evaluation and optimization of these modifiable lifestyle and environmental factors.

You Don’t Have to Choose: You Can Do Both Functional & Conventional Medicine!

Both approaches have value in a comprehensive MS treatment approach. You could use an FDA-approved DMT to treat autoimmunity, combined with a functional approach to address the environmental and lifestyle factors that most CM neurologists and autoimmune subspecialists don’t have time to discuss.

For a list of practitioners trained in The Wahls Protocol® for MS and autoimmune diseases, visit the Health Professionals Directory on my website.

Nutrition for a healthier brain

Hopefully your CM specialist and primary care team are working with you to improve your nutrition—but what about specific recommendations to support better brain health?

Here are my top two additions (and one reduction or elimination) to discuss with your family. For most people, adding foods or swapping one food with another is much easier than reducing or eliminating.
meals.

Eat more non-starchy vegetables and berries, particularly those that are deeply colored.

Pigments are markers for polyphenols (antioxidants)—so the deeper the color, the richer a food is in these nutrients. Diets rich in colorful vegetables and fruits are anti-inflammatory, antioxidant-rich, and rich in polyphenols. They provide excellent nutritional support for people with a wide range of autoimmune disease states.^1,2

Have more potatoes, yams, squashes and beets.

Again, look for deeply pigmented options (like purple potatoes). The deeper the color, the richer it is in antioxidants.

Reduce your intake of ultra-processed foods like sugar-sweetened beverages and flour-based cereal, bread, and pasta.

Research links ultra-processed foods to higher rates of obesity,⁴ metabolic syndrome, prediabetes, diabetes,⁵ and high blood pressure,⁶ all of which may worsen autoimmune disease progression. Diets high in these foods have also been associated with cognitive decline,⁷ mental health problems,⁸ and more severe MS outcomes.⁹

For these reasons, I recommend minimizing sugar-sweetened beverages and opting for starchy vegetables as healthier alternatives to flour-based products.

What Your CM Specialist May Not Know About Vitamins D And K

You may have heard that vitamin D is important for people with MS because of the support it provides in reducing new lesions and/or relapses, and slowing disability progression.^10,11
But many CM specialists may not know that vitamin D is best taken with vitamin K2, which enhances bone density,^12,13 tooth mineralization,¹⁴ and remyelination.¹⁵ Vitamin K2 levels tend to be much lower in people with MS than in healthy controls.¹⁶

I advise my MS and autoimmune patients to take vitamin D and vitamin K2 together, like D3K2 5000 iu. When and where possible, I also suggest getting enough sunlight exposure to get a tan without getting a sunburn.

Why Additional Targeted Supplements May Be Helpful For MS And Autoimmune

Repairing damaged cell tissue in the brain, spinal cord, and cranial nerves requires more nutrients than maintaining healthy tissue in the first place. That’s because your body needs to remove the damaged proteins and structures before it can create and rebuild healthy ones.

In addition to the nutritional recommendations above, taking targeted supplements can help ensure your immune cells and brain cells have the necessary nutrients to do the work of rebuilding healthier tissue. That is certainly my goal for myself.

Next, I’ll cover several supplements that help support better immune health for people with MS and systemic autoimmune disease.

Fish oil

Supplemental fish oil has been extensively studied in the setting of MS and has been associated with fewer new enhancing lesions on MRI, fewer relapses, and less disability progression.¹⁷ Fish oil supplements were also helpful for reducing severity of the psoriatic plaques and reducing inflammatory biomarkers.¹⁸ In people with rheumatoid arthritis, fish oil supplementation was associated with reduced pain¹⁹ and inflammatory biomarkers.²⁰

Acetyl-l-carnitine and alpha lipoic acid

Carnitine levels are lower in fatigued MS patients compared to those without fatigue.²¹ Supplemental acetyl-l-carnitine combined with alpha-lipoic acid enhances mitochondrial fatty acid utilization, increasing adenosine triphosphate (ATP) production.²² Although the brain accounts for only 2% of body weight, it uses 25% of all ATP, making improved mitochondrial ATP generation particularly beneficial for individuals with brain-related symptoms.²³

Coenzyme Q

Coenzyme Q is an essential component of a mitochondrial protein involved in ATP production.²³ Supplementing with coenzyme Q has been linked with reduced fatigue, depressive symptoms,²⁴ and inflammatory biomarkers in people with MS.²⁵ For people with fibromyalgia or rheumatoid arthritis, taking coenzyme Q was linked with reduced pain and inflammatory biomarkers.²⁶

N-acetylcysteine

N-acetylcysteine (NAC) is a sulfur-containing amino acid commonly used to support a wide range of neurological disorders including multiple sclerosis, mild cognitive impairments, Parkinson’s, and Alzheimer's.²⁷ It is also used as an adjunct therapy for psychiatric disorders including anxiety and depression, which frequently occur alongside MS.²⁸ NAC has been shown to reduce anxiety, depression, and oxidative stress, improving mitochondrial efficiency.²⁹

Phosphatidylserine

Phosphatidylserine (PS) is a lipid that is part of the myelin sheath around the wiring between brain cells. As we age, the content of PS within our cell membranes declines, which is why supplementing with PS is often recommended for people with neurological disorders.^30,31

Broccoli seed extract

Broccoli seed extract is metabolized to make sulforaphane, a bioactive compound that activates Nrf2 pathways to reduce inflammation and boost detoxification pathways.³² Sulforaphane has been used as adjunct therapy for Parkinson’s, Alzheimer’s, MS,³³ anxiety, depression and cognitive impairment.³²

Summary

In summary, the question of conventional vs. functional medicine is not an either/or. Work with your CM specialists to understand how DMTs fit into your treatment plan and look into FM-guided treatments for your MS or systemic autoimmune disease.

Regardless of the practitioner(s) you choose to work with, everyone should try to optimize the lifestyle and environmental factors that are within their control. Improve your nutrition at a pace that you and your family can manage. Add targeted supplements to support how your cells will engage in the chemistry of life to rebuild a healthier brain.

Below you’ll find the three most common supplements that I often recommend to my MS and autoimmune patients. And for those who are healthy and want to thrive to a 100 and beyond, these same three supplements are terrific for longevity.

It is my goal to thrive to 120 and beyond. I hope that is your goal as well.

Supplements I recommmend:

These are some of multi-faceted supplements in the Wahls Protocol® Supplement Line:

Brain Protect combines acetyl-l-carnitine, alpha lipoic acid, coenzyme Q, N-acetylcysteine, phosphatidylserine, and broccoli seed extract into one supplement. It is a convenient way to take the six supportive nutrients for brain health that I reviewed in this blog post.

D3K2 5000 iu has 5000 IU of vitamin D and 90 mcg of vitamin K2mk7. I advise my patients to follow their vitamin D levels and adjust the amount of vitamin D that they are taking to get their vitamin D level into the top half of the reference range.

Mono Absorp 1300 Omega has 600 mg EPA and 260 mg DHA. The dose of fish oil that has been studied in clinical trials ranged from 1 to 4 grams. Work with your medical team to know which dose is right for you

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