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Thursday, January 26, 2017

Alternative Therapies for MS


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The term alternative therapy, in general, is used to describe any medical treatment or intervention that has not been scientifically documented or identified as safe or effective for a specific condition.

Alternative therapy encompasses a variety of disciplines that range from diet and exercise to mental conditioning to lifestyle changes. Examples include acupuncture, yoga, aromatherapy, relaxation, herbal remedies, and massage.

Complementary therapies are alternative therapies used in addition to traditional treatments. For example, you may have weekly massages to complement your drug treatment.

What is recommended for MS?

Positive attitude. Having a positive outlook cannot cure MS, but it can reduce your stress and help you feel better.

Exercise. Exercises such as tai chi and yoga can lower your stress, help you to be more relaxed, and increase your energy, balance, and flexibility. As with any exercise program, check with your doctor before getting started.
Diet. It is important for people with MS to follow a healthy, well-balanced diet. Ask your doctor what diet is right for you.

What are some alternative/complementary therapy options for MS?

Massage. Many people with MS receive regular massage therapy to help relax and reduce stress and depression, which can exacerbate the disease. There is no evidence that massage changes the course of the disease. It is usually safe for people with MS to receive a massage, but if you have bone-thinning osteoporosis (usually as a result of your treatments), massage may be dangerous. 

Talk to your doctor first.

Acupuncture. Some people with MS report that acupuncture provides some relief of symptoms such as pain, muscle spasms, or bladder control problems. There have been no scientific studies to confirm this or to document that acupuncture is safe for people with MS. Also, keep in mind that there are always risks when a procedure involves puncturing the body with needles, as is done with acupuncture. The main risk is infection. Unless sterile techniques are used, acupuncture could transmit hepatitis or HIV.
Evening primrose oil (linoleic acid). Linoleic acid is also found in sunflower seeds and safflower oil. There is some evidence that taking an oral supplement of linoleic acid may slightly improve MS symptoms.

Diet. It is important for people with MS to maintain a healthy, well-balanced diet to keep them as healthy as possible. Discuss any dietary concerns you may have with your doctor.

Marijuana. The use of marijuana to treat any illness remains highly controversial. Some people with MS claim that smoking marijuana helps relieve spasticity and other MS-related symptoms. However, there is little evidence to date that marijuana really works. Research is ongoing to answer this important question. Until more is known, doctors do not recommend the use of marijuana to treat MS, as the drug is associated with serious long-term side effects such as heart attack or memory loss.

How can I tell which therapies are worth taking?

Alternative therapy can be helpful in many cases, but some treatments can be ineffective, costly, and even dangerous. The best way to evaluate your options is to become educated. 

Ask yourself the following questions:  
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Wednesday, January 25, 2017

Good Question: • Pills, Shots or Infusions for Your MS?

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Oral multiple sclerosis meds appear, more and more, to be the first choice of patients who are just beginning to receive an MS treatment. A recent report by the independent marketing research firm Spherix Global Insights shows that oral disease-modifying therapies captured a significantly higher share of the market at the end of 2016 compared to 2015, with Tecfidera at the top of the list and Aubagio gaining ground. But, final FDA approval of the infusion drug Ocrevus (ocrelizumab) could be a game-changer.

Neurologists and many MS patients are very familiar with Ocrevus. There’s a lot of chatter about it in online MS gathering spots, and many doctors report they intend to use it as soon as it is approved. And, even though most of the “buzz” is about prescribing Ocrevus for PPMS patients, it’s expected that a lot of doctors also are looking at it for those with RRMS. It could push ahead of other infusions, such as Tysabri and Lemtrada. as well as oral meds such as Tecfidera and Aubagio. Spherix reports more than one third of the neurologists it surveyed said they would have been likely to have started patients on Ocrevus, rather than on Tysabri, had it been available.
What drives these drug decisions? According to a Spherix report RealWorld Dynamix™: DMT New Starts in Multiple Sclerosis, the drivers include clinical considerations such as safety and efficacy, as well as non-clinical concerns including patient requests and the policies of the insurance coverage of those patients. Interestingly, it appears that neurologists are becoming more comfortable using high-efficacy DMTs right away for patients with aggressive MS, rather than working up to them from drugs with lower efficacy, but lower risk or cost.
As the patient you should take an active role in your drug selection.

Read more

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Tuesday, January 24, 2017

Endocannabinoid System and Multiple Sclerosis


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COMPLIMENTARY in Nature --- 

The endocannabinoid system (ECS) is a group of endogenous cannabinoid receptors located in the mammalian brain and throughout the central and peripheral nervous systems, consisting of neuromodulatory lipids and their receptors. Known as "the body’s own cannabinoid system",[1] the ECS is involved in a variety of physiological processes including appetitepain-sensationmood, and memory, and in mediating the psychoactive effects of cannabis.[2] The ECS is also involved in voluntary exercise[3] and may be related to the evolution of the runner's high runner's high in human beings and related aspects of motivation or reward for locomotor activity in other animals.[4]
Two primary endocannabinoid receptors have been identified: CB1, first cloned in 1990; and CB2, cloned in 1993. CB1 receptors are found predominantly in the brain and nervous system, as well as in peripheral organs and tissues, and are the main molecular target of the endocannabinoid ligand (binding molecule), Anandamide, as well as its mimetic phytocannabinoid, THC. One other main endocannabinoid is 2-Arachidonoylglycerol (2-AG) which is active at both cannabinoid receptors, along with its own mimetic phytocannabinoid, CBD. 2-AG and CBD are involved in the regulation of appetite, immune system functions and pain management.[1][5][6]

Multiple sclerosis

Historical records from ancient China and Greece suggest that preparations of Cannabis indica were commonly prescribed to ameliorate multiple sclerosis-like symptoms such as tremors and muscle pain. Modern research has confirmed these effects in a study on diseased mice, wherein both endogenous and exogenous agonists showed ameliorating effects on tremor and spasticity. It remains to be seen whether pharmaceutical preparations such as dronabinol have the same effects in humans.[50][51] Due to increasing use of medical Cannabis and rising incidence of multiple sclerosis patients who self-medicate with the drug, there has been much interest in exploiting the endocannabinoid system in the cerebellum to provide a legal and effective relief.[38] In mouse models of multiple sclerosis, there is a profound reduction and reorganization of CB1 receptors in the cerebellum.[52] Serial sections of cerebellar tissue subjected to immunohistochemistry revealed that this aberrant expression occurred during the relapse phase but returned to normal during the remitting phase of the disease.[52] Other studies suggest that CB1 agonists promote the survival of oligodendrocytes in vitro in the absence of growth and trophic factors; in addition, these agonist have been shown to promote mRNA expression of myelin lipid protein. (Kittler et al., 2000; Mollna-Holgado et al., 2002). Taken together, these studies point to the exciting possibility that cannabinoid treatment may not only be able to attenuate the symptoms of multiple sclerosis but also improve oligodendrocyte function (reviewed in Pertwee, 2001; Mollna-Holgado et al., 2002). 2-AG stimulates proliferation of a microglial cell line by a CB2 receptor dependent mechanism, and the number of microglial cells is increased in multiple sclerosis.[53]

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Monday, January 23, 2017

Shared MS Analogy - a patients view


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Provided by James H.

If my body was a car, I would be trading it in for a new model.
I've got bumps, dents, scratches, and my headlights are out of focus.
My gearbox is seizing up and it takes me hours to reach maximum speed
I overheat for no reason, and every time I sneeze cough or laugh,
My radiator leaks or my exhaust back fires.

Having ms is so much fun


MS Patients with Spasticity Needed for Study of Extended-release Baclofen Capsules


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A new clinical trial evaluating the effectiveness of extended-release baclofen capsules in relieving spasticity related to multiple sclerosis (MS) is calling for 135 people with any form of the disease. The study, taking place in six U.S. states, is sponsored by Sun Pharma, the drug’s developer.
Baclofen, an approved MS treatment available in different forms, acts as a muscle relaxer and an antispastic agent. As an extended-release treatment, Baclofen GRS distributes the drug’s active ingredients over time in a patient’s body, possibly allowing for less frequent dosing than is now common.
Spasticity refers to feelings of stiffness, and a wide range of involuntary muscle spasms, and is one of the more common symptoms of MS, according to the National Multiple Sclerosis Society, which spotlights this study on its website.
To take part, patients must be 18 or older and diagnosed with any form of MS, have a known history of spasticity, and may already be using baclofen in its current approved formulations.
Participants should have no clinical history of hypersensitivity to baclofen and no previously treatment with intrathecal baclofen, a method that delivers the drug directly to the intrathecal space (area of the spine) via a surgically implanted infusion pump and catheter.

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High-risk relatives of MS patients show early signs of disease


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Information provided by: Cherie C. Binns RN BS MSCN

Publish date: January 17, 2017
By: Heidi Splete  Frontline Medical News

Key clinical point: Higher-risk asymptomatic female family relatives of patients with MS are more likely to have early subclinical manifestations of the disease and deserve further monitoring.

Major finding: Women at high risk for MS scored significantly higher on a composite of measured outcomes (P = .01) and on a vibration sensitivity test (P = .008), compared with lower-risk women.

Data source: A prospective, cross-sectional, cohort study of 65 adult women at risk for MS.

Disclosures: The National Institutes of Health and the National Multiple Sclerosis Society supported the study. Some of the authors reported receiving awards from the National Multiple Sclerosis Society, the American Academy of Neurology, and the National Institute of Neurological Disorders and Stroke

Asymptomatic first-degree relatives of multiple sclerosis patients at high risk for developing the disease were significantly more likely to show subclinical signs of MS than were family members at lower risk, in the Genes and Environment in Multiple Sclerosis prospective cohort study. The findings were published online on Jan. 17 in JAMA Neurology.

The Genes and Environment in Multiple Sclerosis (GEMS) project is the first prospective study of populations at risk for MS and is the first detailed cross-sectional examination of higher-risk and lower-risk family members to date, according to investigators led by Zongqi Xia, MD, PhD, of Brigham and Women’s Hospital, Boston. Although the totality of evidence put together through neuroimaging and numerous clinical tests in the study indicate that individuals with the highest risk for MS have higher risk for the disease than do those with the lowest risk, simple vibration threshold testing gave the best results, Dr. Xia and his colleagues reported.

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