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Multiple sclrosis
- 1. 23/09/2012
MULTIPLE SCLEROSIS
A SEMINAR FOR THE MS SOCIETY OF
TORONTO
BY
MORWENNA GIVEN
BA MA (OXON) BSC M.OHA BHG RH
MEDICAL HERBALIST 1 ©©
SEPTEMBER 2012
©
- 2. 2 23/09/2012
WHO AM I?
Iam a medical herbalist, trained in University,
Hospital and clinics
With a practise in downtown Toronto focussing on
Chronicauto immune diseases including MS,
Cancer, Alzheimer's, diabetes, and women's’ issues
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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
InMS 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
Plantshave 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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VIBURNUM OPULUS -
BARK
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ANTI SPASMOLYTICS
Thereare a number of plants which provide anti
spasmolytic actions which can be equally effective
or more than marijuana without the associated
cognitive problems
Theseare 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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THANK YOU
MORWENNA GIVEN
WWW.MEDICUSHERBIS.COM
© 2012