| Conditions:

Multiple Sclerosis

Multiple sclerosis is a disease that affects the spinal cord and brain. The body attacks the protective coverings of nerves. This leads to muscle spasms, numbness, and problems moving.

There is no cure. It is managed with medicine and changes in lifestyle habits. Some people turn to natural therapies to help ease symptoms. They should not be used instead of standard care.

Natural Therapies

Likely Effective

These therapies are likely to ease symptoms:

• Cognitive training is therapy to improve brain function.^{A1, A2} 
• Exercise therapy^B1-B9 
• Pilates is a low-impact exercise aimed at strengthening muscles and improving posture and flexibility.^F1 
• Yoga combines poses with breathing.^E1-E3 

May Be Effective

These therapies may ease symptoms:

• Biotin is a B-vitamin naturally produced by the body and can be taken as a supplement. It is also found in egg yolks, whole grains, and nuts.^C5 
• Cannabinoids are compounds found cannabis.^C12-C17 
• Epigallocatechin-3-gallate is a substance found in tea and some other foods.^C20 
• Estriol is an estrogen hormone produced by the body. It can be applied as a cream or gel.^C4 
• Ginseng is a plant used in teas and sodas to stimulate energy and improve brain function.^C3 
• Lipoic acid is made by the body to help slow damage to cells. It can be taken as a supplement. (Note: It should not be taken by people with diabetes.)^{C7, C10, C20} 
• Mindfulness practices may improve symptoms and quality of life.^{D1, D2} 
• Tai Chi is a form of martial arts that combines meditation and movement.^{G1, G2} 
• Vitamin D is available in a few foods and as a supplement. Your body also makes it in response to sunlight.^{C2, C6, C8, C11, C19} 

May Not Be Effective

Carnitine is a compound that helps the body make energy. It may not be effective.^C24 

Not Enough Data to Assess

• Phenylalanine^C1 
• Polyunsaturated fatty acids^C23 
• Traditional Chinese herbal medicine ^C18 

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse. For example, lipoic acid should not be taken by people with diabetes. It may interact with their medicines.

References [ + ]

A1. Hind D, Cotter J, et al. Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:5.

A2. Rosti-Otajärvi EM, Hämäläinen PI. Neuropsychological rehabilitation for multiple sclerosis. Cochrane Database Syst Rev. 2014;(2):CD009131.

Exercise Therapy

B1. Rietberg MB, Brooks D, et al. Exercise therapy for multiple sclerosis. Cochrane Database Sys Rev. 2005;(1):CD003980.

B2. Pearson M, Dieberg G, et al. Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: a meta-analysis. Arch Phys Med Rehabil. 2015;96(7):1339-1348.

B3. Heine M, van de Port I, et al. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015;(9):CD009956.

B4. Alphonsus KB, Su Y, et al. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med. 2019 Apr;43:188-195.

B5. Amatya B, Khan F, et al. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2019 Jan 14;1:CD012732.

B6. Charron S, McKay KA, et al. Physical activity and disability outcomes in multiple sclerosis: A systematic review (2011-2016). Mult Scler Relat Disord. 2018 Feb;20:169-177.

B7. Sandroff BM, Motl RW, et al. Systematic, Evidence-Based Review of Exercise, Physical Activity, and Physical Fitness Effects on Cognition in Persons with Multiple Sclerosis. Neuropsychol Rev. 2016 Sep;26(3):271-294.

B8. Campbell E, Coulter EH, et al. Physiotherapy Rehabilitation for People With Progressive Multiple Sclerosis: A Systematic Review. Arch Phys Med Rehabil. 2016 Jan;97(1):141-51.e3.

B9. Cruickshank TM, Reyes AR, et al. A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease. Medicine (Baltimore). 2015 Jan;94(4):e411.

Herbs and Supplements

C1. Wade DT, Young CA, et al. A randomised placebo controlled exploratory study of vitamin B-12, lofepramine, and L-phenylalanine (the “Cari Loder regime”) in the treatment of multiple sclerosis. J Neurol Neurosurg Psychiatry. 2002;73(3):246-249.

C2. Jagannath VA, Filippini G, et al. Vitamin D for the management of multiple sclerosis. Cochrane Database Syst Rev. 2018 Sep 24;9:CD008422..

C3. Etemadifar M, Sayahi F, et al. Ginseng in the treatment of fatigue in multiple sclerosis: a randomized, placebo-controlled, double-blind pilot study. Int J Neurosci. 2013;123(7):480-486.

C4. Voskuhl RR, Wang H, et al. Estriol combined with glatiramer acetate for women with relapsing-remitting multiple sclerosis: a randomized, placebo-controlled, phase 2 trial. Lancet Neurol. 2016;15(1):35-46.

C5. Tourbah A, Lebrun-Frenay C, et al. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study. Mult Scler. 2016;22(13):1719-1731.

C6. Zheng C, He L, et al. The efficacy of vitamin D in multiple sclerosis: A meta-analysis. Mult Scler Relat Disord. 2018;23:56-61.

C7. Loy BD, Fling BW, et al. Effects of lipoic acid on walking performance, gait, and balance in secondary progressive multiple sclerosis. Complement Ther Med. 2018;41:169-174.

C8. Berezowska M, Coe S, et al. Effectiveness of Vitamin D Supplementation in the Management of Multiple Sclerosis: A Systematic Review. Int J Mol Sci. 2019 Mar 14;20(6). pii: E1301.

C9. Amatya B, Young J, et al. Non-pharmacological interventions for chronic pain in multiple sclerosis. Cochrane Database Syst Rev. 2018 Dec 19;12:CD012622.

C10. de Sousa CNS, da Silva Leite CMG, et al. Alpha-lipoic acid in the treatment of psychiatric and neurological disorders: a systematic review. Metab Brain Dis. 2019 Feb;34(1):39-52.

C11. McLaughlin L, Clarke L, et al. Vitamin D for the treatment of multiple sclerosis: a meta-analysis. J Neurol. 2018 Dec;265(12):2893-2905.

C12. Allan GM, Finley CR, et al. Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. Can Fam Physician. 2018 Feb;64(2):e78-e94.

C13. Nielsen S, Germanos R, et al. The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. Curr Neurol Neurosci Rep. 2018 Feb 13;18(2):8.

C14. Abrams DI. The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. Eur J Intern Med. 2018 Mar;49:7-11.

C15. da Rovare VP, Magalhães GPA, et al. Cannabinoids for spasticity due to multiple sclerosis or paraplegia: A systematic review and meta-analysis of randomized clinical trials. Complement Ther Med. 2017 Oct;34:170-185.

C16. Whiting PF, Wolff RF, et al. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. JAMA. 2015 Jun 23-30;313(24):2456-2473.

C17. Lakhan SE, Rowland M. Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. BMC Neurol. 2009 Dec 4;9:59.

C18. Song L, Zhou QH, et al. Chinese herbal medicine adjunct therapy in patients with acute relapse of multiple sclerosis: A systematic review and meta-analysis. Complement Ther Med. 2017 Apr;31:71-81.

C19. Hempel S, Graham GD, et al. A systematic review of the effects of modifiable risk factor interventions on the progression of multiple sclerosis. Mult Scler. 2017 Apr;23(4):513-524.

C20. Plemel JR, Juzwik CA, et al. Over-the-counter anti-oxidant therapies for use in multiple sclerosis: A systematic review. Mult Scler. 2015 Oct;21(12):1485-1495.

C21. Amatya B, Khan F, et al. Non pharmacological interventions for spasticity in multiple sclerosis. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD009974.

C22. Kuspinar A, Rodriguez AM, et al. The effects of clinical interventions on health-related quality of life in multiple sclerosis: a meta-analysis. Mult Scler. 2012 Dec;18(12):1686-1704.

C23. Farinotti M, Vacchi L, et al. Dietary interventions for multiple sclerosis. Cochrane Database Syst Rev. 2012 Dec 12;12:CD004192.

C24. Tejani AM, Wasdell M, et al. Carnitine for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2012 May 16;(5):CD007280.

Mindfulness Practices

D1. Grossman P, Kappos L, et al. MD quality of life, depression, and fatigue improve after mindfulness training: a randomized trial. Neurology. 2010;75(13):1141-1149.

D2. Simpson R, Booth J, et al. Mindfulness based interventions in multiple sclerosis--a systematic review. BMC Neurol. 2014 Jan 17;14:15.

Yoga

E1. Cramer H, Lauche R, et al. Yoga for multiple sclerosis: a systematic review and meta-analysis. PLoS One. 2014;9(11):e112414.

E2. Alphonsus KB, Su Y, et al. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med. 2019 Apr;43:188-195.

E3. Green E, Huynh A, et al. Systematic Review of Yoga and Balance: Effect on Adults With Neuromuscular Impairment. Am J Occup Ther. 2019 Jan/Feb;73(1):7301205150p1-7301205150p11.

Pilates

F1. Sánchez-Lastra MA, Martínez-Aldao D, et al. Pilates for people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord. 2019 Feb;28:199-212.

Tai Chi

G1. Taylor E, Taylor-Piliae RE. The effects of Tai Chi on physical and psychosocial function among persons with multiple sclerosis: A systematic review. Complement Ther Med. 2017 Apr;31:100-108.

G2. Zou L, Wang H, et al. Tai chi for health benefits in patients with multiple sclerosis: A systematic review. PLoS One. 2017 Feb 9;12(2):e0170212.

Last reviewed November 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 6/9/2020

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