Multiple Sclerosis and Inflammation 

Multiple sclerosis is a common disease of the central nervous system (brain and spinal cord). It an inflammatory condition, which is accompanied by loss of the myelin sheath (demyelination). Myelin is the material that insulates nerves allows the nerves to rapidly transmit its impulses in a smooth and co-ordinated fashion. In multiple sclerosis, the loss of this myelin sheath means that there is a disruption in the ability of the nerves to conduct electrical impulses to and from the brain and this produces the various symptoms of MS. In the places where the myelin is lost little scars (known as plaques or lesions) can appear, which can be seen in brain scans. These multiple scars are described as multiple sclerosis (multiple scaring). 

Symptoms of multiple sclerosis vary from person to person and can change over time in the same person. Most commonly people with MS show signs of fatigue, or muscle weakness, which can also be accompanied by decreased coordination, and eye problems such as blurred, double or hazy vision, with accompanying eye pain. As the disease progresses, symptoms may include muscle stiffness, difficulties thinking and problems controlling urination. 

Evidence suggests that part of the etiology of multiple sclerosis is an inflammatory response in which an immune response occurs to altered myelin basic protein (MBP), an essential protein involved in protecting and maintaining the myelin sheath. Processing of MBP involves methylation of a particular arginine in the molecule, which requires normal levels of folate, methylcobalamin and methionine. If MBP is not properly methylated it leads to MBP with exposed arginine residues. Interaction of these residues with nitric oxide synthase leads to the production of NO, plus the amino acid citrulline. Bouts of MS have now been correlated with increased levels of anti-citrulline-peptide antibodies. Initially it was thought that there was a strong correlation between MTHFR and/or MTRR mutations and the occurrence of MS, however, subsequent studies have not shown this to hold up. In addition there is now significant evidence that there has been an increase in the incidence of MS with the use of high SPF rated sunblock, thereby suggesting a significant role for vitamin D in the development of MS.

Vitamin B₁₂ and Multiple Sclerosis 

Many studies have linked the occurrence of vitamin B₁₂ deficiency with an increased incidence of MS. Elevated homocysteine has been correlated with the severity of MS, the levels of which can be reduced by supplementation with methylcobalamin, vitamin B2 and folate. Whilst it is currently not known why this is, vitamin B₁₂ supplementation has been shown to delay the onset of MS. Prolonged vitamin B₁₂ deficiency can lead to a reduced ability to control of the inflammation associated with MS, thus exacerbating the disease. High doses of vitamin B₁₂ have the potential to reduce the pain and fatigue associated with MS, with minimal side effects. Furthermore, certain analogues of vitamin B₁₂, have been shown to reduce or control inflammation and can provide an energy boost for tired muscles. Vitamin B₁₂ has also been shown to reduce the signs and symptoms of neuritis and as such have the potential to help control the incontinence often associated with advanced MS. The production of normal MBP (see above) also requires normal levels of methylcobalamin, which may also explain the link between MS and vitamin B₁₂ deficiency. Further, the insertion of the correct lipids into the myelin sheath is compromised in adenosyl B12 deficiency.. 

Treatment of Vitamin B₁₂ deficiency and Multiple Sclerosis

By the time a patient develops signs of multiple sclerosis, there has been significant damage to the neurones and vitamin B12 is severely depleted in the liver, but more importantly in the brain and CSF. At this stage standard supplements containing vitamin B₁₂ are not effective in increasing the serum and CSF levels of vitamin B₁₂ and so constant high dose administration of vitamin B₁₂ is required, either by injection of by supplementation with topical B12 oils. Correct supplementation with adenosyl and methyl B12 also involves administration of riboflavin (vitamin B2), folate, Iodine, selenium and molybdenum.   A topical form of vitamin B₁₂ has recently been developed that is a specially formulated preparation that is an easy to apply, needle-free delivery system to the skin of the patient with multiple sclerosis. This pain-free form of delivery greatly increases the patient comfort experienced during the administration of the medication and allows for self-medication without the need for medical staff or any special training. It has recently become apparent that oral supplementation with vitamin B₁₂ does not provide enough vitamin B₁₂ to overcome vitamin B₁₂ deficiency due to the limited uptake capacity of the intestine for vitamin B_12, hence there is a requirement for higher initial doses of vitamin B₁₂ to be supplied either by injection or via the topical vitamin B₁₂ formulation. There are preliminary studies showing some reversal of MS symptoms in individuals using a combination of Adenosyl/Methyl B12 oils, riboflavin, Iodine, Selenium (as selenite), and molybdenum. These have been used in combination with high dose biotin and with a topical curcuminoid, which has known neuroregenerative activity, as well as anti-inflammatory activity.

Further Information on MS

Check out the following sites for further information on MS

http://www.mult-sclerosis.org/whatisms.html

Scientific publications on VB₁₂ and MS