Alternative Medicine and Multiple Sclerosis: An Objective Review from an American Perspective

Abstract

The use of complementary and alternative medicine (CAM), or unconventional medicine, may be challenging for health care providers in the United States. There are several definitions of CAM, and therapies that are considered alternative in one country may be conventional in other countries. Unconventional medical practices may be used instead of, or in addition to, conventional medical therapy. It may be difficult for people with multiple sclerosis (MS) to obtain reliable MS-relevant CAM information, and there may be conflicts between the values of patients and those of health care providers. These issues may create problems in the clinical decision-making process. The relevance to MS of some commonly used CAM therapies is discussed: herbal medicine, vitamins and minerals, marijuana, and a histamine and caffeine transdermal gel patch. Current information about the efficacy and safety of CAM therapies is extremely variable. Some therapies appear promising, others are unsafe or ineffective, and nearly all need to be studied further.In the United States, complementary and alternative medicine (CAM) are increasing in popularity 1 and appears to be widely used by multiple sclerosis (MS) patients. 2,3 However, there are limitations to the MS-relevant CAM information that is currently available. In addition, addressing issues raised by patients interested in CAM may be particularly challenging for mainstream health care professionals.This review article discusses CAM issues that are important to health professionals who are specialized in MS care. CAM therapy is defined, and the demographics of CAM users are discussed. The clinical decision-making process is considered as it applies specifically to MS patients. Differing and potentially clashing value systems of MS patients and health care providers are highlighted. Information provided in this article is limited to CAM therapies and selected MS-relevant information. More detailed information may be found in the literature about CAM, [4][5][6][7]8 and dietary supplements. [9][10][11][12][13][14][15][16] Definition Controversy and confusion surround alternative medicine, and even the definition itself is controversial. Alternative medicine (also known as unconventional or unorthodox medicine) is often defined by what it is not: It generally refers to medical therapies that typically are not taught in medical schools or are not readily available in community hospitals. 1 According to this definition, the term means one thing in the United States, another in Germany, and something completely different in China. In the United States, the definition is a "moving target," since increasingly alternative medicine therapies are provided in hospitals and alternative medicine courses are offered in medical schools. 17 To define alternative medicine by what it is, the National Institutes of Health (NIH) has developed a classification system for alternative medicine (Table 1) Alternative use means that they are used instead of conventional medicine, while complementary use ...

Dendropanax morbiferus leaf extract facilitates oligodendrocyte development

“…The reported functions of phytochemicals of DM leaf on inflammation and cell protection as well as our current finding of DM leaf function in myelination indicate that DM leaf extract can be considered as a candidate for relieving the symptoms of progressive multiple sclerosis, even as a complex. Medicinal plants used in multiple sclerosis care report their benefits in relieving spasticity, pain, tremor and depression [67] and enhancing fatty acid metabolism and lymphocyte function [68,69]. However, to our knowledge, no study has explored the function of medicinal plants on OL differentiation/myelination, which is a critical step for remyelination in multiple sclerosis, and our result that DM leaf extracts affect OL development is the first observation as far as we know.…”

Current complementary and alternative therapies for multiple sclerosis

“…It is important for conventional healthcare providers to recognize that, because treatment options may be limited, people with MS may be willing to make treatment decisions with limited information [4]. Also, it is important to acknowledge that, like some unconventional therapies, some conventional MS therapies and practices have limitations and may not be entirely evidence-based.…”

“…However, some of the information that is available to people with MS is biased, inaccurate, and not evidence-based. One survey of 50 lay books on CAM found that MS was sometimes defined incorrectly, five or six therapies, on average, were recommended, no books had the same recommendations, and few books discouraged the use of any CAM therapies [4]. Vendors of CAM products may exaggerate claims, CAM practitioners and product vendors may have limited MS-specific information and experience, and, by definition, most conventional health care providers have little or no knowledge of, or experience with, CAM therapies.…”

“…One definition of unconventional medicine is that it refers to forms of medicine that are not taught widely in medical schools or generally available in hospitals [3•]. The National Institutes of Health has proposed a classification scheme for unconventional medical practices that includes biologically based therapies, alternative medical systems, mind-body interventions, manipulative and body-based methods, and energy therapies [4].…”

Mind the Gap! Lay and Medical Perceptions of Risks Associated with the Use of Alternative Treatment and Conventional Medicine

“…Despite the widespread use, studies on risks associated with the use of CAM still remain sparse, and a need for more research that enables patients to make informed treatment decisions has been emphasized by several authors [14][15][16][17][18][19][20][21][22][23][24]. The existing literature shows that benefits and low risk are associated with some specific CAM treatments used by MS and cancer patients when implemented properly [e.g., 14-16, 19, 25-27], while other treatments are considered unsafe or ineffective [e.g., [14][15][16]18]. In general, increased CAM use has been interpreted as a result of both a positive attitude toward CAM and a somewhat negative attitude toward conventional health care.…”