Intended for healthcare professionals

Practice A Patient’s Journey

Multiple sclerosis

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4470 (Published 26 November 2009) Cite this as: BMJ 2009;339:b4470

Drs looking for Solutions

Dr Leedham correctly states that "it's the role of Drs to look for
solutions" and that we "should seek the best possible for our patients".
It is worth noting the work of Prof Jelinek, an Emergency Physician, who
is doing interesting work in this area. He reminds us that 20 years ago
Swank published a paper that showed following a low saturated fat diet
dramatically reduced the rate of progression of the disease. Almost 40
years after Goldberg proposed his Vitamin D hypothesis we have had the
first RCT of Vitamin D supplementation which showed a marked reduction in
relapse rates.

There continue to be calls for the routine supplementation
of MS patients with Vitamin D. Jelinek suggests combining these dietary
changes with lifestyle changes such as meditation. We know from Ornish's
work that such changes can benefit CHD and prostate cancer and it has been
shown that psychological methods can endogenusly modulate levels of
interferon (refs 44 and 45 in jelineks primary care paper).
It is of great reassurance to MS patients that these promising areas are
finally being combined and followed up.

Refs:

Jelinek G & Hassed C. Managing multiple sclerosis in primary care: are
we forgetting something?

Swank RL, Dugan BB. Effect of low saturated fat diet in early and late
cases of multiple sclerosis. Lancet 1990; 336:37-39

Vitamin D rct was presented at American Academy of Neurology 2009 and is
in submission (personal contact with author):http://www.webmd.com/multiple
-sclerosis/news/20090428/high-doses-vitamin-d-cut-ms-relapses

Ornish (et al) Can lifestyle changes reverse coronary heart disease? The
Lifestyle heart trial- Lancet 1990 Jul 21 ; 336(8708):129-33
and intensive lifestyle changes may affect the progression of prostate
cancer - J Urol 2005 sep; 174(3)1065-9

Competing interests:
I have MS and have benefited from the changes suggested by jelinek.

Competing interests: No competing interests

06 December 2009
sam gartland
Gp
Salford m6 5qq