Dioscorides’ Materia Medica, c. 1334 copy in Arabic, describes medicinal features of cumin and dill. (Photo credit: Wikipedia)
Since my disease has proven to be extremely difficult to treat (I've always been something of a problem child), I'm quite open to new ideas about possible therapeutic options, as long as they make some scientific sense and don't present too much downside. I recently came across a research study (sent to me by a fellow MSer) that led me to investigate and then start a naturopathic program of medicinal herbal supplements, under the guidance of the terrific naturopathic doctor that is part of the team at my neurologist's clinic, the International Multiple Sclerosis Management Practice here in NYC (click here). Before I get into the details of this treatment regimen, please allow me to first provide a little background.
One of the most intriguing MS drugs now in the approval pipeline is BG-12, an oral drug that has been shown to be quite effective throughout a series of rigorous clinical trials (click here). Developed by biotech company Biogen, makers of Tysabri and Avonex, BG-12 differs from all other approved MS disease modifying drugs in that it does not directly suppress or modulate the immune system, mechanisms of action which are the reason why so many of the current drugs have daunting side effect profiles. Rather, BG-12 works by stimulating the body to produce enzymes that are strong anti-inflammatories and very effective antioxidants, thereby presumably protecting the body against the debilitating effects of oxidative stress, a biologic process that can lead to the damage and death of cells in the central nervous system (as well as other tissues throughout the human body).
BG-12 is a derivative of a natural product (it's an ester of fumeric acid, which is found in some mushrooms, lichen, and moss) that has been used generically in Germany for years to successfully treat psoriasis. I'm not sure how Biogen was able to patent this molecule and make it into what I presume will be a tremendously expensive drug, but we saw the same thing happen with 4-AP and Ampyra. All of this is fodder for a Big Pharma rant that I won't get into now.
Oxidative stress occurs as the result of the natural process of mixing oxygen and nutrients together to produce the energy needed to sustain animal life. One of the byproducts of this process are free radicals, unstable atoms or molecules that can damage or destroy healthy cells in the human body if left unchecked. Free radicals can be likened to the biologic equivalent of the exhaust fumes produced by automobile engines when they combine oxygen and gasoline to produce the energy necessary to propel a car. Just as you wouldn't want to breathe in too much of the exhaust coming out of your car's tailpipe, you don't want too many free radicals banging around inside your central nervous system doing irreparable damage.
Under normal circumstances, the human body has a variety of mechanisms in place to combat the effects of oxidative stress, by mopping up and containing free radicals before they can do much harm. In patients suffering from any one of a variety of neurologic diseases, though, it appears that the levels of oxidative stress become too great for the body's natural defenses to handle, which results, at least in part, to the damage in the brain and spinal cord seen in such diseases as Multiple Sclerosis, Parkinson's, and Alzheimer's. The reasons behind these high levels of oxidative stress remain unclear, but if they could be positively identified we'd likely only be a few clicks away from tremendous advances in effectively combating some horrendous illnesses.
Okay, enough with the scientific mumbo-jumbo, let's get to the good stuff. As I mentioned in the opening paragraph, about six weeks ago an MS friend sent me an e-mail containing a link to a study which showed that a dietary supplement called Protandim was more effective than BG-12 at stimulating the production of the same antioxidant enzymes as Biogen's soon to be approved MS drug, at least when tested in a petri dish (click here). Surprisingly, the study was sponsored by none other than Biogen! I'd never heard of Protandim, but a quick Internet search divulged the ingredients included in each Protandim capsule (click here).
Intrigued, I sent a note containing this info to Dr. Deneb Bates, the naturopathic doctor specializing in neurologic disorders who is part of the treatment team at the MS clinic where I'm a patient. Dr. Bates quickly got back to me, saying that she was a big fan of all of the stuff contained in Protandim, but that the dosages of the individual ingredients in each capsule of Protandim were too small to likely have a therapeutic effect on patients suffering from debilitating neurologic diseases. Dr. Bates suggested that I could try taking each of the ingredients individually, in dosages high enough to perhaps make a difference. First, though, she wanted to consult with my neuro, Dr. Saud Sadiq, to make sure he'd be on board with the plan. Dr. Sadiq checked my files to go over the results of some comprehensive analyses of my cerebrospinal fluid that his research lab had done a few years ago, and found that my markers for oxidative stress were tremendously high, therefore making me an especially good candidate on whom to try this experiment. So, with everyone in agreement, I started on the following program of supplements, beginning about a month ago.
Before I go ahead and detail the treatment regimen Dr. Bates came up with, I must advise anybody who would like to follow a similar treatment plan to first consult with their physician, because many of the following ingredients can interact with the wide variety of medicines MS patients typically take to control their symptoms. For this very reason, rather than start all the supplements at once, Dr. Bates wanted me to begin them a few at a time, so that we could judge which components were causing whatever negative side effects might crop up. With this in mind, on week one I started taking:
♦ Curcumin (500 mg, 3X/day)-Curcumin is a component of tumeric, a spice commonly used in curries and other Asian recipes. Curcumin has long been used for medicinal purposes in Ayurvedic medicine, the traditional medicine that has been practiced in India for about 2000 years. It has many purported beneficial qualities, and has been shown to be an effective anti-inflammatory as well as a strong antioxidant (click here).
♦ Milk Thistle (250 mg 2X/day)-Milk Thistle is a flowering plant in the daisy family that has been shown to have liver protective and antioxidant properties (click here). Before starting Milk Thistle, blood tests showed that my liver enzymes were somewhat elevated, likely because of the pharmaceutical cocktail I take to combat my neurologic symptoms and some other potentially serious health issues I'm dealing with. After only one month on Milk Thistle, my last blood test showed that my liver enzymes had fallen dramatically. Yay, Milk Thistle.
I didn't suffer any ill effects from the Curcumin or Milk Thistle whatsoever, so on week two I started:
♦ Green Tea Extract (250 mg 2X/day)-Green Tea Extract is purported to have antioxidant, anti-inflammatory, and anti-carcinogen properties (click here). Dr. Bates suggested that rather than take Green Tea Extract in capsule form, I could drink 8-10 cups of green tea a day, but I informed her that if I did that I would have to take up permanent residence in my bathroom, as I very likely would never stop urinating. Much better, for me at least, to take the stuff in capsule form.
♦ Bacopa (200 mg 2X/day)-Bacopa is a perennial flowering plant that has long been used in Ayurvedic medicine. Tests have shown it to impact the oxidative stress process, and Bacopa also exerts a positive influence on memory and mental acuity (click here). Tests also suggest that Bacopa may also be neuroprotective against Alzheimer's disease (click here).
I didn't suffer any negative side effects from the Green Tea Extract or Bacopa, so on week three I started the final ingredient, one which Dr. Bates was a little more wary of:
♦ Ashwagandha (500 mg 2X at bedtime, starting out taking only one capsule first to judge the effects)-Ashwagandha is sometimes called "Indian ginseng", because it is used in Ayurvedic medicine much the same way that ginseng is used in traditional Chinese medicine, to treat a wide variety of diseases. Ashwagandha is thought to be an adaptogen, a medication that normalizes physiological functions through the correction of imbalances in the neuroendocrine and immune systems (click here).
Unlike my experience with the previous four ingredients, I did have a hard time with Ashwagandha. Dr. Bates had me start out slowly, taking only one capsule a night, and by the second day I felt extremely sedated and very weak, with many of my neurologic symptoms noticeably ramped up. After consulting with Dr. Bates, we decided I should simply stop taking the Ashwagandha, since the goal of our experiment is to make me feel better, not worse. I was disappointed to have to stop taking the stuff, though, because of its many purported positive qualities. Dr. Bates did single Ashwagandha out to be the most potentially problematic ingredient of the bunch, and I'm glad we saved it for last and started slowly. The scientific name for Ashwagandha is Withania Somnifera, and somnifera means "sleep inducing" in Latin. Boy, in my case at least, they weren't kidding…
It's too soon to tell whether or not this adventure in naturopathic medicine is having any positive neurologic results, although my wife thinks I seem a little bit stronger. As I noted previously, my liver enzymes have come down significantly since I started taking Milk Thistle, so that's one benefit I'll definitely chalk up to the herbal medley. Dr. Bates told me she has several other neuroprotective and/or antioxidant supplements she wants to add to the mix, and I have an appointment with her in a couple of weeks to go over these. I will of course keep everyone updated if more mojo gets added to the brew.
I have to admit I was a little bit skeptical about all this going in, but the liver enzyme results can't be denied. The health of my kidneys has also been of major concern because of some of the pharmaceuticals I have to take, and recently my blood test markers for kidney function have been creeping near or above the normal threshold. Dr. Bates started me on a tincture called "Pellitory of the Wall" (eerily reminiscent of "Eye of Newt"), and after only three weeks my latest blood tests showed that these levels, too, have fallen back well into the normal range, a change so dramatic that my pain management doctor seemed stunned when the test results were faxed to him (I was there when he got them), and repeatedly insisted that he needed to call Dr. Bates to find out exactly what she had given me.
Although all of these herbs and other substances sound like something from a witches brew, I can assure you that to date I've found no evidence that Dr. Bates is a witch. I've had my eyes peeled for signs of black cats, broomsticks, and flying monkeys in her office, but so far my investigations have come up empty. She did once briefly turn me into a salamander, but I got better (apologies to Monty Python).
Again, I don't recommend anybody start this program without first consulting with their doctor, as some of the ingredients may be contraindicated by medications you're taking or some underlying condition you may suffer from. It's easy to think, "Oh, herbal supplements, what harm can they do?", but my experience with Ashwagandha definitely was a negative one, and the effects that herbal remedies have recently had on my kidney and liver enzymes were swift and dramatic. Remember, too, that marijuana and magic mushrooms are also "herbal remedies", and those certainly can pack a wallop. Not that I'd know anything about that…