Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives
Abstract
:1. Introduction
2. Dietary Supplements and Multiple Sclerosis
2.1. Fatty Acids
2.1.1. Omega-6 Fatty Acids
2.1.2. Omega-3 Fatty Acids
2.2. Coenzyme Q10
2.3. Vitamin B7 (Biotin)
2.4. Vitamin A
2.5. Vitamin B12
2.6. Lemon Verbena
2.7. Melatonin
2.8. L-Carnitine and Acetyl-L-Carnitine
2.9. Vitamin D
2.10. Lipoic Acid
2.11. Folic Acid
3. Conclusions
- The evaluation of the composition of the gut microbial load;
- The assessment of the defects of the intestinal immune system;
- The clarification of the role of metabolism of polyphenols and Vitamin D;
- The study the effect of dietary agents, extracts and drugs on the signaling pathways involved in AMPK/SIRT/PPAR cascade or to study the NF-kB transcription factor in the light of the disease;
- The identification of possible interactions between complementary dietary interventions and medication agents taken by the patient with MS.;
- The establishment of a committee to organize a campaign to inform and educate patients about the importance of maintaining a healthy dietary pattern during treatment.
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Dietary Supplement | Study Type | Measured Parameters | Number of Patients and Type of MS | Supplement Administration | Effects | References |
---|---|---|---|---|---|---|
FA | Double-blind control clinical study | Relapse rates | 116 MS | 2 groups received linoleic acid, and 2 control groups received oleic acid | 20 g linoleic acid marginally affected the duration and severity of relapses of MS but had no effect on overall disability | [8] |
Ω-3 FA | Double-blind control clinical study | Kurtzke Disability Status Scale Score | 112 RRMS | 10 g/day of FO and diet or placebo OO and diet | After 2 years, 51% of patients in the FO group and 41.4% of those OO group showed improved or unchanged scores, according to the Kurtzke Disability Status Scale | [9] |
Ω-3 FA | Double-blind clinical study | Qol questionnaire: Neurological status and relapse rate | 31 RRMS | 1 group received a low fat diet (15% fat) with FO and 1 group received the AHA Step I diet (fat 30%) with OO | Decreased fatigue on the OO group at 6 months. Both groups had reduced relapse rates compared to the rates during the 1 year prior to the study | [10] |
Ω-3 FA | Open-label designed clinical study | Immune cell secretion of MMP-9 | 10 RRMS | ω-3 FA for 3 months | ω-3 FA decreased MMP-9 levels, while their immune cell secretion of MMP-9 was considerably reduced by 58% after 3-months and a significant increase in ω-3 FA levels in red blood cell membranes was recorded | [11] |
CoQ10 | Controlled randomized double-blinded clinical study | Inflammatory markers (TNF-α, IL-6, and MMP-9) | 48 RRMS | 500 mg CoQ10/day and or placebo for 12 weeks | CoQ10 supplementation at a dose of 500 mg/day may improve fatigue and depression in MS patients | [12] |
CoQ10 | Controlled randomized double-blinded clinical study | TNF-α levels | 48 RRMS | 500 mg CoQ10/day and or placebo for 12 weeks | TNF-α levels decreased significantly in the CoQ10 group. CoQ10 supplementation also resulted in decreased serum levels of MMP-9 as compared to the placebo group | [13] |
CoQ10 | Controlled randomized double-blinded clinical study | MDA, TAC and antioxidant markers (SOD, GPx) | 48 RRMS | 500 mg CoQ10/day and or placebo for 12 weeks | Decrease of oxidative stress and increase antioxidant enzyme activity in RRMS | [14] |
Vitamin B7 (Biotin) | Uncontrolled, non-blinded proof of concept study | Quantitative and qualitative measures: Visual actuality, magnetic resonance spectroscopy (H-MRS) of the Choline/Creatine ratio, disability and progression in progressive MS. | 23 MS | 100–300 mg/day biotin for a period from 2 to 36 months | High biotin doses exerted a positive effect on disability and progression in this MS patient population | [15] |
Vitamin B7 (Biotin) | Double-blind, placebo-controlled study | (EDSS) score: Reversal of MS-related disability. | 154 PRMS | MD1003 (biotin 100 mg) or placebo orally thrice daily | Reduction EDSS progression and improved clinical impression of change compared with placebo | [16] |
Vitamin A | Controlled randomized clinical study | Relapse rate: (EDSS) and (MSFC) | 101 RRMS | 25,000 IU/dretinyl palmitate for 6 months followed by 10,000 IU/d retinylpalitate for another 6 months | Reduction of progression of disability, upper limb and cognitive functions | [17] |
Vitamin A | Controlled randomized clinical study | Modified fatigue impact scale and Beck Depression Inventory-II (fatigue and depression) | 101 RRMS | 25,000 IU/dretinyl palmitate for 6 months followed by 10,000 IU/d retinyl palitate for another 6 months | Vitamin A improved the depression through the modulation of inflammatory conditions | [18] |
Lemon verbena | Randomized double-blinded placebo-controlled study | Serum levels of C reactive protein and 8 cytokines/ inflammatory markers (IFN-γ, IL-12, IL-23, IL-6, TNF-α, TGF-β, IL-4 and IL-10) | 30 MS | Lemon verbena supplementation (10% w/w verbascoside) | After 28 days, CRP concentrations were considerably lower in SPMS patients compared to the placebo group, IFN-γ levels decreased for all MS-treated groups, whereas reduced IL-12 levels for RRMS patients were noted. Anti-inflammatory cytokine concentrations of IL-4 and IL-10 increased in SPMS patients | [19] |
ALC | Pilot randomized, blind clinical study | Kurtzke Expanded Disability Status Scale (EDSS) and fatigue | 60 MS | A 1 month treatment with either 200 mg amantadine, 2 g ALC, 200 mg modafinil or placebo | The amantadine treatment for a period of 1 month improved fatigue in RRMS patients as assessed by MFIS | [20] |
Vitamin D | Controlled randomized double-blinded clinical study | IL-17 levels | 94 RRMS | Received 50,000 IU vitamin D3/5 days for 12 weeks or placebo | IL-17 levels showed significant change in RRMS patients after receiving high dose vitamin D3 for 12 weeks | [21] |
Alfacalcidol | Controlled randomized double-blinded clinical study | Fatigue Impact Scale (FIS) score | 600 MS | 80 patients received alfacalcidol (1 mcg/) and 78 patients placebo for 6 months | QoL improved in Alfacalcidol-treated patients as compared with placebo. The Alfacalcidol-treated group had reduced number of relapses and higher proportion of relapse-free patients | [22] |
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Tryfonos, C.; Mantzorou, M.; Fotiou, D.; Vrizas, M.; Vadikolias, K.; Pavlidou, E.; Giaginis, C. Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives. Medicines 2019, 6, 95. https://doi.org/10.3390/medicines6030095
Tryfonos C, Mantzorou M, Fotiou D, Vrizas M, Vadikolias K, Pavlidou E, Giaginis C. Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives. Medicines. 2019; 6(3):95. https://doi.org/10.3390/medicines6030095
Chicago/Turabian StyleTryfonos, Christina, Maria Mantzorou, Dimitris Fotiou, Michael Vrizas, Konstantinos Vadikolias, Eleni Pavlidou, and Constantinos Giaginis. 2019. "Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives" Medicines 6, no. 3: 95. https://doi.org/10.3390/medicines6030095