I am often asked what supplements I should take if I have multiple sclerosis (MS). In this blog, I’ll discuss the nutritional issues for people with MS and chronic health problems and my health journey, as well as provide a few suggestions for where to begin when it comes to what supplements you should take for MS.
Nutritional Issues for People with Chronic Health Problems
We need better nutrition than people who are healthy and have ideal body weights, healthy mental health, and optimal blood pressure. That is because our cells are not conducting the biology of life optimally. We have too much inflammation. Our mitochondria are probably not generating an optimal amount of energy or adenosine triphosphate (ATP). Furthermore, we probably have some cell structures that have been damaged by the inflammation and oxidative stress from poorly functioning mitochondria. Our immune cells need to come in and dissolve the damaged molecules and rebuild with correctly made molecules. Imagine having to repair your home after a storm damage or a fire. It takes more resources to haul away the damaged parts of your home and then more resources to do the repairs. The same is true for our bodies. It will take significant resources to repair the damage and create healthier tissues.
People with MS
We know that people with MS, when compared to people who do not have MS, have diets that are nutritionally inferior.1 Compared to healthy controls, the people with MS had lower intakes of 31 nutrients. They had less intake of calcium, magnesium, iron, zinc, copper, and potassium; and less intake of Vitamin A, E, C, B1 (thiamin), B2 (riboflavin), B3 (niacin), B6 (pyridoxine), B9 (folate), and B12 (cobalamin). Total antioxidant capacity was lower in people with MS as compared to controls, and people with more severe MS had more serious nutrient insufficiencies.
Overweight and Mental Health Issues
Most people with MS are overweight. Many have symptoms or a diagnosis of anxiety and/or depression. These two groups of people are likely to also have nutritional insufficiencies as a result. Likewise, people who are overweight have more nutrient requirements and are more likely to have insufficiencies of vitamins C, D, K, and the B vitamins.2,3 People with mental health issues are also more likely to have insufficiencies of multiple minerals, B vitamins, omega-3 fatty acids, and protein.4 Both groups are2,4 more likely to consume more added sugar, more cereals, pastas, and breads, and significantly fewer vegetables than healthy controls. Antibiotics before the age of 3 markedly increase the risk of dysbiosis, overgrowth of sugar-loving yeasts and bacteria, and higher rates of anxiety and depression later in life.5 For those children with early antibiotics and mental health issues, adding more fiber to the diet and probiotics has reduced anxiety and depression.6
My Journey
I followed a low-fat vegetarian diet for 20 years. I ate a lot of legumes and whole grains, lots of vegetables, and became steadily worse after I was diagnosed with MS.I adopted the Paleolithic diet two years after my MS diagnosis. The following year, I needed a tilt/recline wheelchair. That is when I began to read the basic science studies about the animal models of MS. I would decide that poorly functioning mitochondria were the drive of disability. I would create a supplement cocktail for mitochondria. I used a multivitamin/multimineral supplement, B vitamins and Co-enzyme Q. I could tell I felt much more fatigued if I skipped my supplements. I would eventually add a vitamin D supplement and fish oil. Then, I discovered the Institute for Functional Medicine and took its course on neuroprotection and had a longer list of supplements. The real magic happened when I restructured my Paleolithic diet to maximize the key brain nutrients. That is how the Wahls™ diet plans were born. I continued to take the supplements, but I was now also taking a much more focused diet to maximize the intake of these nutrients. The combination of my highly structured Paleolithic diet and supplements led to remarkable improvement in energy and mental clarity, and progressive improvement in strength. Keep in mind I was also doing intensive physical therapy and electrical stimulation of muscles.7
First Step – Improve the Diet
The most important first step is to improve your nutrition by improving your diet. Reduce or eliminate added sugars and flour-based cereals, bread, and pasta. Talk to your family about what foods to add and what foods to reduce or eliminate. The modified Paleolithic diet or Wahls ™ diet has the largest effect size when comparing the various diets that have been studied in a randomized controlled side study (ketogenic, low fat, plant-based low fat, Mediterranean, intermittent fasting, anti-inflammatory, calorie restriction and usual diet).8
Key Supplements to Support People with MS
Supplements that were most helpful to me in the beginning include vitamin B12 and a B complex, multivitamin and multimineral, vitamin D with vitamin K2, and fish oil. I have struggled with depression since I was a teenager. That is probably why multivitamin/multimineral has been very helpful to me. The top three supplements are multivitamin/multimineral, vitamin D with a vitamin K2 and a fish oil. The next thing to add is a B complex. Because the body must activate the B vitamin before it can use the B vitamins, it is helpful to take an activated form of B vitamins. That way you bypass any genetic vulnerability you may have in how you handle your B vitamins. Minerals are co-factors for how the vitamins work to facilitate the chemical reactions in our cells. That is why I want everyone to take a multivitamin/ multimineral. Most people have insufficient magnesium intake. And many have insufficient intake of multiple other minerals. You need the minerals for the various vitamins to work properly.
Because many with MS also have mental health or weight issues and are likely to have multiple mineral insufficiencies, a multivitamin/multimineral is really critical in that circumstance. Most people with MS have some level of anxiety and or depressive symptoms. As I noted earlier, if someone was given antibiotics before the age of 3 or has had multiple courses of antibiotics, they are more likely to have a microbiome that is making the mental health symptoms worse. Many of my patients with mental health issues have candida overgrowth and an unhealthy microbiome or dysbiosis.
I tell my patients with a history of antibiotics before the age of 3 or multiple rounds of antibiotics, to follow a lower carbohydrate diet and add an herbal supplement to help suppress the excessive levels of candida. I also have them add a high-dose probiotic with lactobacillus and bifidobacteria strains and lactobacillus paracasei lcp-37.
As people improve their nutrition and begin adding targeted supplements, often they observe their energy improves, mood improves and it is easier to get along with others. Often, blood pressure improves, blood sugar improves, and mood improves. That is why if you are on any prescription medication, tell whoever prescribed that medication that you are improving your diet and adding some vitamin supplements. They need to follow along and adjust your medications so that you are not over-medicated if how your cells conduct the biology of life improves.
Often people experience significant improvement in chronic health conditions and see their health improve, and the need for prescription medication declines. I tell my patients to work with their personal medical team as they improve their diet and add supplements.
The rest of the family also often experiences significant improvement in health issues as well. Children do better in school. There are fewer meltdowns. Grades improve. Everyone’s mood often improves as nutrition improves. Because we often have a big nutritional hole that our previous diet and chronic health problems have dug for us, adding supplements can often be very helpful in filling our nutritional tank. I still take supplements. I plan on thriving to 120 and beyond. Having great nutrition is part of my plan. Is it part of yours for you and your entire family?
References
- Armon-Omer A, Waldman C, Simaan N, Neuman H, Tamir S, Shahien R. New Insights on the Nutrition Status and Antioxidant Capacity in Multiple Sclerosis Patients. Nutrients. 2019;11(2).
- Gropper SS. The Role of Nutrition in Chronic Disease. Nutrients. 2023;15(3).
- Ojo O. Nutrition and Chronic Conditions. Nutrients. 2019;11(2).
- Kris-Etherton PM, Petersen KS, Hibbeln JR, et al. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021;79(3):247-260.
- Lepri A. Gut Microbiota and Mood Disorders: How Bottom-Up Techniques Can Improve Mental Health. Psychiatr Danub. 2024;36(Suppl 2):83-85.
- Slattery J, MacFabe DF, Frye RE. The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood. Clin Med Insights Pediatr. 2016;10:91-107.
- Reese D, Shivapour ET, Wahls TL, Dudley-Javoroski SD, Shields R. Neuromuscular electrical stimulation and dietary interventions to reduce oxidative stress in a secondary progressive multiple sclerosis patient leads to marked gains in function: a case report. Cases J. 2009;2:7601.
- Snetselaar LG, Cheek JJ, Fox SS, et al. Efficacy of Diet on Fatigue and Quality of Life in Multiple Sclerosis: A Systematic Review and Network Meta-analysis of Randomized Trials. Neurology. 2023;100(4):e357-e366.
