Treatment of multiple sclerosis (MS) involves using many approaches simultaneously in an effort to manage your disease and symptoms. Some dietary supplements—specifically, biotin, vitamin D, and omega-3 fatty acids—have shown promise as potentially beneficial in MS because of the role they may play in promoting myelin sheath repair and reducing inflammation.
While supplements may be a sensible addition, they are not a substitute for your current MS therapies. In addition, they can potentially pose a danger of toxicity and interact with MS disease-modifying treatments (DMTs) or your other medications.
Given this, it's important to speak to your doctor if you are interested in incorporating supplements into your care plan.
MS is a demyelinating condition in which myelin, a type of fat that insulates and protects nerves, is diminished. This prevents nerves in the brain, spinal cord, and eyes (the nerves that control vision) from functioning as they should.
Demyelination in MS is thought to occur as a result of an autoimmune inflammatory process in which the body attacks its own myelin. This causes a variety of symptoms, such as weakness, sensory changes, and vision loss.
It isn't completely clear how supplements may affect MS, but they are thought to have an anti-inflammatory effect, a restorative effect on myelin, or both.
The three with the most scientific support for this use are biotin, vitamin D, and omega-3 fatty acids.
Biotin, a vitamin, is involved in energy metabolism and the production of fats in the body. It's found in multivitamins and prenatal vitamins, as well as in products that are promoted for hair, skin, and nail growth.
Researchers have speculated that high doses of biotin could help restore myelin because it is a type of fat. But the effects of biotin on MS have been inconsistent. Several studies have found slight improvements in MS symptoms associated with biotin intake, but many studies have shown no effect, and some have suggested worsening of MS symptoms with biotin.
Overall, these mixed results leave many unanswered questions about biotin and MS.
Keep in mind that this supplement can also alter lab results, especially thyroid lab tests, so you should not take biotin beyond the dose that is already included in a regular multivitamin unless your doctor prescribes it for a specific reason.
Vitamin D deficiency is associated with MS. Vitamin D is found in foods like salmon, cod liver oil, canned tuna, egg yolks, and fortified cereals, milk, and orange juice. Vitamin D levels are generally lower when you lack sun exposure because sunlight helps your body convert inactive forms of the vitamin to its active form.
A research study conducted in Germany, with results published in 2017, reported that supplementation with vitamin D3—at a dose of 18,950 international units (IUs) per week—reduced MS relapses by 50 percent.
Vitamin D has been associated with several physiological effects that may impact MS:
Omega-3 fatty acids have been associated with an improvement of MS symptoms. These fatty acids are a type of polyunsaturated fats, which are considered healthy fats.
Omega-3 fatty acids are present in foods such as:
Omega-3 fatty acids can be broken down into two components, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both of which are believed to have an anti-inflammatory effect.
There is data showing that high intake of omega-3 fatty acids is associated with a lower risk of demyelination, but it has not been shown to reduce MS relapses or slow MS-related disability progression.
Experts recommend trying to get omega-3 fatty acids from food rather than from supplements. However, no health risks have been associated with supplements, and they could be beneficial.
MS is a lifelong disease. Management includes lifestyle strategies as well as medication. A nutritious diet is an important part of maintaining your health in MS, and supplements may be considered a useful addition in this regard.
Be sure to discuss any supplements with your doctor or dietitian, even though they are available over the counter.