Dr. Michelle Leary-Chang was the guest speaker for a MS/Cancer conference call that focused on patients with Multiple Sclerosis (MS) and nutrition, including vitamin D. She is studying family medicine at Eastside Integrated Primary Care in Bellevue, WA, and works part-time as a research associate at the Institute of Functional Medicine. The following are highlights from her talk. 

I have MS. What should I do?

1.    Choose an eating plan that is nutrient dense and anti-inflammatory. The Mediterranean diet is the best researched and most practical for most individuals wanting to improve their diet.

2.    Talk to your doctor about making sure you are sufficiently complete in Vitamin D.

3.    Assess your need to fix your gut. Common leaky gut symptoms often match up with the clinical syndrome, Irritable Bowel Syndrome. Make sure you have bowel movements daily.

4.    Get some form of physical activity daily, if possible. This can be seated exercise, standing with a balance support, or high-level activity.

5.    Consider talking to an integrative health care provider about ways to support your health goals.

6.    If you decide to buy supplements on your own, select high quality brands. Brands matter.

Mediterranean Diet

• ·      Relatively easy to follow versus restrictive diets
• ·      High intake of anti-inflammatory foods including olive oil, garlic, onions, and fish.
• ·      Lots of anti-oxidants in the diet through fresh vegetables and fruits 

The following are factors patients with MS should consider in regard to their health. 

Why MS and inflammation matters

• ·      Reduction of white blood cells and proinflammatory molecules crossing the blood brain barrier to potentially activate an immune response in the brain and spinal cord against myelin.
• ·      Reduction in risk factors of other chronic illness such as heart disease and cancer.
• ·      Improvement in quality of life.

Anti-inflammatory foods

• ·      Tomatoes.
• ·      Olive oil.
• ·      Green leafy vegetables, such as spinach, kale, and collards.
• ·      Nuts like almonds and walnuts.
• ·      Fatty fish like salmon, mackerel, tuna, and sardines.
• ·      Fruits such as strawberries, blueberries, cherries, and oranges. 

Immunomodulation

·      When our cells become educated in our lymphoid tissue, which includes the lymph nodes and gut associated lymphoid tissue in our digestive tract, sometimes the immune system gets mis-educated about what tissue of our body is our own, and what tissue is a threat.

·      An immunomodulator is a therapeutic, an example being vitamin D, which can help the immune system make better, more educated choices about what cells are our own (and thus should not be attacked) and what cells are true invaders or threats.

·      It is not the same as an immunosuppressant, which reduces the immune system reactivity to a specific agent, which can have a role in the treatment of MS and other autoimmune diseases.

Environment

Your environment is not only your home and physical environment, although this does play a role.

• ·      Consider your lifestyle environment.
• ·      Evaluate your stress, nutrition, movement, and smoking.

Nutrient Density

Nutrient density compares the amount of nutrients in food (vitamins, minerals, antioxidants) to the calorie content in food. 

Vitamin D

Vitamin D work as an Immune Modulator. Essentially Vitamin D helps to tell immune cells that are associated with proinflammatory reactions to make better educated decisions about who it should go after. It also tells the T cells responsible for educating our immune system about our own self-proteins to make sure the immune cells don’t attack them, according to Dr. Leary-Chang. An ideal level of Vitamin D3 translates to a level of minimum of 40ng/mL. 

Foods high in Vitamin D

• ·      Fatty fish, like tuna, mackerel, and salmon.
• ·      Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
• ·      Beef liver
• ·      Cheese
• ·      Egg yolks

Magnesium in MS

Potential therapeutic roles of magnesium for people with MS include:

• ·      Spasticity: Gives adjunctive support, does not affect the neurological signal that creates spasticity in MS patients.
• ·      Constipation treatment: Magnesium citrate powder with 12 to 16 ounces of water, 250 to1000 mg at night.
• ·      Fatigue

Foods high in magnesium

• ·      Dark leafy greens
• ·      Nuts
• ·      Seeds
• ·      Fish
• ·      Beans
• ·      Whole grains
• ·      Avocados
• ·      Yogurt
• ·      Bananas
• ·      Dried fruit
• ·      Dark chocolate

Calcium

How do you know if you are deficient in calcium? Unfortunately, it is not simple. While calcium can be measured in the blood, it is intentionally maintained at a very precise level in the blood and uses bone calcium to maintain that careful balance 

Foods high in calcium

• ·      Dairy foods
• ·      Sardines
• ·      Tofu
• ·      Pink salmon
• ·      Collard greens
• ·      Spinach
• ·      Kale 

Dr. Leary-Chang’s recommendation for persons without osteoporosis is no more than 600 mg daily of supplemental calcium unless you and your doctor have discussed other reasons for higher. Get a DEXA (bone mineral density) scan.

Vitamin B12

Dr. Michelle Leary-Chang stated that patients with chronic immune reactions or recurrent myelin repair processes might increase the demand for vitamin B12. 

Foods high in Vitamin B12

• ·      Shellfish
• ·      Liver
• ·      Fish
• ·      Crab
• ·      Fortified soy products (tofu, soymilk)
• ·      Fortified cereals
• ·      Red meat
• ·      Low-fat dairy
• ·      Cheese
• ·       Eggs.

Guidelines for selecting supplements

• ·      GMP (Good Manufacturing Practices) Certified (FDA Code of Federal Regulations, Title 21, Part 111)
• ·      GMP Registered by NSF International, a respected independent certification organization
• ·      Therapeutic Goods Administration (TGA), Australian Government Department of Health and Aging for regulation of pharmaceuticals and drug products.

 

 

Dr. Michelle Leary-Chang is a graduate of Bastyr University's Naturopathic Medical Doctoral Program. In fall 2016, she participated in the MS Society's advanced mentorship program, allow for 160 hours of advanced post-doctoral training in northwest MS centers with MS trained neurologists. She is studying family medicine at Eastside Integrated Primary Care in Bellevue, WA, and works part-time as a research associate at the Institute of Functional Medicine. Dr. Leary-Chang has a bachelor's degree in exercise physiology and prior to attending medical school was the wellness director of a cardiovascular and medical rehabilitation center in Maple Valley, WA. She is passionate about integrative care for MS patients and hopes to specialize in working with MS in the future, following her family medicine training.