We try different things every few days but are running out of ideas. Your information has been so valuable. I read your column every day in our local newspaper. Any suggestions?

DEAR READER: For readers who may not fully understand multiple sclerosis, this disorder occurs when the body’s immune system attacks itself, destroying the protective sheath that covers the nerves. This may result in deterioration of the nerves over time and, unfortunately, the condition isn’t reversible. However, there are a number of things your son can do to remain active both mentally and physically.

Symptoms can occur at any age but are most common in people between the ages of 20 and 40. Women are more susceptible than men. Family history plays a large role, as well. For example, if a parent or sibling has the disorder, the other children of the affected parent or the siblings of the affected individual have up to a 3 percent chance of also developing it. This compares with one-tenth of a percent without a family history. Patients may have tremors, weakness or numbness in one or more limbs, occurring on one side of the body at a time, double vision, fatigue and more. In the beginning stages, there may be partial or complete remission that can reverse suddenly.

Bowel and bladder difficulties and depression are common in those with MS. I suggest he speak with his physician regarding the use of warm prune juice daily or my “colon cocktail,” which consists of equal parts prune juice, applesauce and bran. The specifics can be found in my Health Report “Compelling Home Remedies” and is one I have found to be effective when treating patients in nursing homes.

Your son should be eating a more healthful diet with fiber. Poor diet is linked to constipation, and diets low in fiber are known to increase the possibility for producing stools that can be difficult to pass. Because his diet is so limited, he should begin slowly — perhaps with whole-grain cereals and breads. He should drink plenty of fluids daily. Gradually add fresh fruits and vegetables, broiled fish and/or chicken and other appealing foods.

Many medications carry the unwanted side effect of constipation. He should speak with his prescribing physician to determine whether any of his drugs are contributing to his problem. If so, he should request another drug be ordered in its/their place.

His depression must be addressed. I don’t know how limited your son is in terms of walking, riding a stationary bike, listening to the radio, working on model cars or airplanes, having a stamp collection or using the Internet. It’s hard to make recommendations without knowing his age, general health and physical status, etc., but something between speaking with a therapist, a trip to the local park or a rousing game of checkers or chess with a friend on a regular basis might be just what the doctor ordered. He should also contact the MS Society to find the nearest support group.

As mentioned above, I am sending you a copy of my Health Report “Compelling Home Remedies.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Multiple sclerosis is an autoimmune disease that occurs when the body’s immune system destroys the protective sheath covering the nerves. This, in turn, interferes with signals between the brain and the remainder of the body, resulting in nerve deterioration.

Symptoms vary from person to person but can include an inability to speak or walk, dizziness, tremor, unsteady gait, double or blurred vision, weakness on one side of the body at a time or on the bottom half of the body. Increases in body temperature can worsen symptoms.

The disorder can affect anyone at any age but commonly begins between the ages of 20 and 40, with Caucasians at the top of the list. Women are more likely to develop MS than are men. Heredity plays an important role except in the case of identical twins. Should one twin be diagnosed with MS, the second has only a 25 percent to 30 percent chance of developing it. People also appear more susceptible if they have other autoimmune disorders, such as type 1 diabetes, a thyroid disorder or inflammatory bowel disease.

Diagnosis can be difficult because other disorders with similar symptoms must be ruled out first. A spinal tap, MRI or electrical testing might be considered. A spinal tap can show abnormal levels of white blood cells or proteins. The MRI can detect lesions of myelin loss caused by MS. Electrical testing can trigger the brain to respond to outside stimuli. An MRI may not provide proof-positive results, however, because the lesions detected could be caused by other conditions, including lupus and Lyme disease.

While there is no cure, there are medications, such as corticosteroids to reduce inflammation, and glatiramer, which protects the myelin (the fatty substance that covers nerve fibers) and prevents it from being attacked. Another procedure patients might consider is interferons (proteins that protect against vital infection), which appear to slow the progression of MS. The downside is that interferons can cause liver damage. Then there’s physical therapy, obtaining sufficient rest, avoiding extreme heat, and eating properly. Because mental stress can accompany MS, counseling and support groups are endorsed.

Herbal remedies are a long shot but could include omega-3 fatty acids, such as is found in freshwater salmon, and bromelain, a substance extracted from pineapple that is thought to control pain and inflammation. Before trying either of these remedies, I would recommend your relative speak with her physician to obtain his or her opinion. Your daughter-in-law should be under the care of a specialist who can guide her through this ordeal. Many people do not require any treatment in the early stages, while others will fare better with a more aggressive approach.

To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Multiple sclerosis is generally considered to be an autoimmune disease that affects the central nervous system. From your brief note, it is my guess that your friend has had the condition for some time. Therefore, I must interpret her symptoms are related to one of the following: dehydration with inadequate daily fluid intake; antithyroid medications; neurological disorders; or sinusitis and postnasal drip. Saving the most likely cause for last, I feel she is, in a sense of the word, “overdosing” on B12, because many supplements contain a recommended daily value of 200 percent.

I was diagnosed with Multiple Sclerosis (MS) in 1982. I have the relapsing/remitting type. There was no treatment for MS in those days and I had to wait many years before one was available. In 1997, I started taking Betaseron. I only had Medicare so I was able to get the medication directly from the manufacturer at a discounted rate.

Then when Medicare part D took over, I could no longer get it at the discounted rate and it was still very expensive. I was frantic to find a solution. Then during one of my regular MS support group meetings, a woman came to talk about LDN.

She told us that naltrexone was approved by the FDA for drug addicts and alcoholics, but that 25 years ago, Dr. Bernard Bilhari discovered that in low doses it helped MS sufferers. He was a neuropsychiatrist from New York. I have also heard that it is now being used successfully to treat other autoimmune disorders like Crohn’s disease.

I started the medication in May 2006. I don’t know how it works but I can say that I have experienced improvement since starting it. The cost is minimal and it’s a pill, not injection or infusion like most of the other MS treatments. There are no side effects except it cannot be taken with any opiates (Vicodin and others). Most neurologists are hesitant to prescribe it because there have not been any clinical studies done on its effectiveness. Also, it needs to be made up by a compounding pharmacist, not a regular pharmacist.

I recently changed to a new neurologist who is quite renowned and is very supportive of the LDN therapy. My general practitioner who prescribed the medication thought that I should write to you so that this information could get out there even more.

DEAR READER:
Multiple Sclerosis is thought be an autoimmune disorder that causes the body to attack the central nervous system (brain, spinal cord and optic nerves). Myelin is a substance which covers nerve cells in the body. In those with MS, the myelin is attacked as a foreign substance which then leaves the nerves vulnerable to damage.

There are four types of the disorder. The most common is Relapsing-Remitting (RR) MS. 85% of sufferers are initially diagnosed with this type which is characterized by flare-ups followed by periods of improvement.

Primary-Progressive (PP) MS affects approximately 10% of all MS diagnoses. It is a slow, progressive form in which there are no significant periods of worsening or improvement. In some there may be plateaus, periods of time which there is little or no change, that are followed by worsening symptoms.

Secondary-Progressive (SP) MS is similar to PP. In this case, however, it is secondary because it follows the RR type. Some may experience flare-ups followed by minor recovery, flares without recovery, or plateaus. Before disease-modifying medications were available nearly 50% of all RR sufferers would develop SP within 10 years.

The final form is Progressive-Relapsing (PR) MS. This is a relatively rare type in that it only accounts for about 5% of those diagnosed. As the name suggests, it is characterized by steady worsening of neurological function as well as clear attacks of elevated symptoms.

In general, some of the most common symptoms of MS include fatigue, numbness, pain, depression, cognitive function changes, vision problems, bladder dysfunction, gait abnormalities, coordination problems, and more. Each case of MS is different so it becomes increasingly difficult to base diagnosis on symptoms alone. For instance, itching, tremor, seizure, swallowing problems, headaches, hearing loss and more may also be (less commonly) symptoms of MS as well.

Thankfully there are many treatments available today.

According to the National Multiple Sclerosis Society (www.NationalMSSociety.org) there were/are several clinical trials on a variety of medications. Two involved completed human trials of low-dose naltrexone. One small study (40 participants) done in Italy showed significant improvement in fatigue and depression in those suffering from the primary-progressive type of MS. Sleep disturbances, urinary tract infections, mild agitation and transient liver enzyme increases were the most common side effects.

The second was slightly larger with 60 participants and looked at the effect of LDN on quality of life. Improvement was seen in self-reported cognitive function, mental health and pain. No impact was seen on physical aspects such as visual function, fatigue, sexual satisfaction or bowel and bladder control. The only adverse effect seen during the trial was vivid dreaming during the first week of treatment.

It must be understood that these were small clinical studies. Further research is needed using larger groups of sufferers. However, it does appear that LDN treatment is potentially beneficial with few side effects.

Then my mother had two weeks of non-stop agonizing migraines. She had an MRI that showed an unknown type of growth in her brain causing double vision and the smelling of things that weren’t there. The growth is twice the size of a golf ball and doomed to kill her without surgery. She’s scheduled for an operation in two days.

The point of this letter is not for your help or anyone’s sympathy. It is to tell people that things aren’t always what they seem. Those readers with constant migraines should see a doctor. Don’t attempt to cover up the pain, get checked out. If pain killers don’t work, try an anti-inflammatory. And see a doctor. What’s keeping my mother pain-free isn’t pain killers. It’s medications to keep the swelling of the growth down.

Please, please print this.

DEAR READER:
You are very articulate for your age. I’m quite impressed with your knowledge and common sense view of two complex situations that never should befall a family the age of yours.

MS is a neurological disease that affects the nervous system and regulates an individual’s ability to move, speak, see, and hear. It often begins with weakness in one limb, pins-and-needles sensations, blurred vision, or difficulties with speech. It may take years for the diagnosis to be confirmed. Even then doctors do not know how symptoms will advance and whether progressive disability will result.

Patients should eat a well-balanced, nutritious diet and get adequate rest. Physical and emotional stress or fatigue should be avoided. It is critical to exercise regularly to keep muscles functioning properly. The disease is non-contagious and non-hereditary. It cannot be cured or prevented but exercise, counseling, psychotherapy, self-care, and medication can be of assistance, allowing patients to remain as independent as possible.

Headaches are not generally related to a serious condition, such as your mother experienced. In fact, only about 1% of all headaches are caused by a serious condition such as tumor, stroke or meningitis.

The classic ocular migraine often begins with a warning sign or aura, accompanied with flashing lights, colors or temporary loss of peripheral vision. Pain can occur on one or both sides of the head. Common migraines generally begin more slowly, last longer and are not preceded by an aura.

Fortunately, your mother had an MRI and the tumor was found. I hope the surgical results were extremely favorable and your family life can settle down. Let me know what happens.

To give you related information, I am sending you a copy of my Health Report “Headaches”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.