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Be Wary of Multiple Sclerosis "Cures"Stephen Barrett, M.D.Multiple sclerosis (MS) is a degenerative disease in which patches of inflammation and scarring interfere with the function of the brain, spinal cord, and/or the nerves to the eyes. The cause of MS is unknown, but the most attractive theory is that it is an immune reaction to the nervous system. Its symptoms include muscular weakness, loss of coordination, and difficulty with speech and vision. It occurs chiefly in young adults and, like arthritis, can have a very variable course. Some people have only a single attack. Others have only a few attacks in a lifetime, recover from these, and experience no disability except during attacks. Others have frequent attacks from which they don't recover completely, but which cause only partial disability. Still others have a slow progression of disability over a period of 10 to 25 years, which eventually leaves them helpless. When attacks occur, symptoms may come and go suddenly and may even vary from hour to hour. MS's extreme variability makes it a perfect disease for quacks. The only way to know whether a treatment is effective is to follow many patients for years to see whether those who receive the treatment do better than those who do not. Quacks don't bother with this kind of testing, however. They simply claim credit whenever anyone who consults them improves. And since the majority of attacks are followed by complete or partial recovery, persuasive quacks can acquire patients who swear by whatever they recommend. The Therapeutic Claims Committee of the International Federation of Multiple Sclerosis Societies has analyzed more than a hundred alleged treatments and published the results in a book called Therapeutic Claims in Multiple Sclerosis, which is revised every few years [1]. Each analysis includes a description of the method, the proponents' rationale, a scientific evaluation, estimate of risks and/or costs, and the authors' conclusion. The methods are then classified according to plausibility, extent of study, risk, and cost. No cure is known, but a few methods are useful in shortening the duration of attacks, reducing their severity, or helping to deal with the symptoms. Methods that have a plausible rational but have not been sufficiently tested are considered "investigational." I am not listing the useful or investigational methods because I believe that advice about them should be obtained from a qualified neurologist who can thoroughly discuss them. Reliable information is also available from the National Multiple Sclerosis Society. The committee noted that no nutritional deficiency is known to be a factor in MS, and that no special diet or the addition of vitamins or minerals has been proven to alter its course. Polyunsaturated fatty acids (PUFA) have slight immunosuppressive properties, but studies involving sunflower seed oil, evening primrose oil, safflower seed oil, and fish oils, have produced conflicting results. The committee concluded that other than a possible benefit of PUFA-containing oils, there is no evidence that any dietary change affects MS. Methods to AvoidThe methods considered implausible or ineffective are listed below. I believe these methods should be avoided: Adequately tested but ineffective in influencing the course of
MS Implausible and untested or inadequately
tested Implausible and known to have significant risk or side
effects Superesonant Wavenergy (SRWE) Program In the 1980s, Irving Dardik, M.D., a vascular surgeon, devised an exercise program which he claimed would to optimize the body's health patterns and lead to reversal of such disorders as multiple sclerosis. In 1995, New York State medical licensing authorities found him guilty of fraud, exercising undue influence, guaranteeing satisfaction or a cure, and failing to maintain adequate records. Case records indicate that he had charged four MS patients from $30,000 to $100,000 for their treatment. His New York medical license was revoked, he was fined $40,000, and his New Jersey license was subsequently revoked. One of the victimized patients, former TV investigative reporter Ellen Burstein MacFarlane, coauthored a book about her experience [2]. Procarin: A Recent Promotion Procarin is a skin cream that is administered using a patch that enables its ingredients to be absorbed. The treatment is based on a hypothesis that involves histamine and dates back to the 1940s. The primary promoter is Elaine DeLack, a nurse who "discovered" and patented a mixture of histamine and caffeine. Compounding pharmacists prepare the product, which is inexpensive to manufacture but is sold for about $250 for a month's supply. Procarin is promoted with anecdotal evidence and has not been tested in placebo-controlled studies. The National Multiple Sclerosis Society warns that it has not been proven beneficial and lacks a scientifically plausible rationale. If you encounter a pharmacist selling Procarin, complain to the state pharmacy board. Additional InformationReferences
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