Multiple Sclerosis: The Perfect Patient for a Doctor of Chiropractic?

I magine with me. if you will, that you arc 44 years old. You should be having the time of your life. You arc running after your children, chasing your career, and enjoying all tliat life 1ms to offer. Now. imagine tliat seven years ago you were diagnosed with multiple sclerosis. In the past seven years, you have gone from being independent and enjoying life to slowly having things that you enjoy plucked from you. Your balance has become less steady, your vision continues to worsen, you lose control of your bladder function, you can no longer drive, and. ultimately, you find yourself in a wheelchair with no hope. This story is all too common for individuals suffering with multiple sclerosis (MS), but hope can be found with chiropractic. There are approximately 250.000 to 350.000 people in the United States diagnosed with multiple sclerosis and the onset often appears between 20 and 40 years of age. ' It is an autoimmune disease in which the immune system attacks the protective myclin sheath around a nerve, similar to stripping the wire off an electrical cord. As the myclin is stripped from the nerve, it causes a decrease in nerve conduction. In response, your body forms scar tissue or "sclerosis" as it heals. It usually is not a fatal condition but can be devastating and can leave people severely debilitated with vision loss, weak and sore muscles, incontinence, pain, loss of motor function, paralysis, and the inability to do the simplest daily activities. The current medical treatment for multiple sclerosis is a myriad of different dnigs and therapies. The dnigs range from immune suppressors, corticostcroids. and chcmothcrapcutics to pain relievers. These dnigs usually have a laundry list of dangerous side effects that require very close monitoring by a medical neurologist. As the disease progresses, stronger and often additional dnigs arc administered in hopes of arresting the symptoms. Researchers are constantly looking for new breakthrough treatments, a difficult task with such a complicated disease process. As doctors of chiropractic, we receive extensive training on the central and peripheral nervous system, nutrition, and spinal adjustments. We also learned how to read and interpret x-rays, blood work, urinalysis. and numerous other diagnostic labs. These tools aid in detennining the cause of the dis-case. which B. J. Palmer believed was "thoughts, traumas, and toxins." If a DC can put these pieces of the puzzle together, it can truly make the most significant difference for these patients. Definite neurological components, as well as nutritional deficiencies and toxins, are often overlooked. Ncurologically: First, the vertebral subluxation is the cor­nerstone of the chiropractic profession. With an individual that already has a compromised nervous system, it is essential to conduct an extensive spinal and neurological examination with special attention focused at the upper cervical region, cranial nerves, deep tendon reflexes, dermatomes. and myotomes. These tests will give a clear picture of how ncurologicallv com­promised these individuals are and will aid in setting up a care plan. This will also provide a baseline to note both progression and regression of each test. There is evidence that past cervical trauma can exacerbate MS symptoms, which would warrant cervical films with flexion/ extension to identify any cervical misalignment or ligament instability. Chiropractic adjustments serve as a vital tool to help maximize neurological function and aid with the side effects associated with MS. In fact, a study conducted in 2004 sug­gested that 91 % of MS patients who received an upper cervical adjustment experienced symptomatic improvement during the course of treatment with no further disease progress noted. 2 Everyone who has MS needs to be adjusted! Nutritional Assessment: The second area of concern should be the nutritional status of the individual. Proper building blocks arc required to maintain and heal the tissues and organs. Adding the right vitamins and nutrients arc essential and will be fundamental in healing. However, nutritional deficiencies can be difficult to identify. While some may give nutritional recommendations based on symptoms or a survey, this should be avoided with an MS patient. One of the most effective in­vestigative tools is diagnostic lab work. The right labs can give a great snapshot of an individual's overall health. In most cases, multiple diagnoses need to be addressed. A full compre­hensive blood panel that encompasses multiple body functions is recommended. A tin raid panel, metabolic panel. A1C. CBC w/diff. CRP. ESSR. lipid panel, iron fcrritin along with vitamin D. and vitamin Br can give great direction for which supplements to utilize. The effectiveness of these supplements can be monitored easily by follow-up lab work. Let's look at the importance of just vi­tamin D. Vitamin D is a strong influence on nerve health and has been linked to nerve impairment \ A study conducted by researchers at the University of Oxford and another conducted at the New Jersey Medical School have suggested that maintaining adequate levels of vitamin D may have a protective effect and lower the risk of developing multiple sclerosis (MS). Another study conducted at Maas­tricht University in the Netherlands and others suggest that for people who already have MS. vitamin D may lessen the fre­quency and severity of their symptoms 1. Most clinical minimums for vitamin D arc 32 ng/nl on the low side, though individuals with MS should strive to get theirs above 50 ng/nl. Interpreting blood work appropriately will give direction for specific supple­ments to use. or for a lifestyle change to recommend. Most supplement companies have information regarding specific sup­plements for abnonnal labs. Contact your preferred company for that information. Toxins: Third, the doctor of chiro­practic should evaluate the MS patient for potential toxicity. Hca\y metals and other toxins surround everything we do and cat. Toxins can wreak havoc on an already compromised nervous system. Experiments at the University of Calgary have shown that low levels of mercury can cause nerve damage. In fact, heavy metal toxicity from mercury can mimic MS symptoms 5. Most amalgam fillings contain mercury. Studies have shown that removing mercury amalgam fillings actuallv increases nerve conduction in MS patients8. Other heavy metals can be found in unsuspected foods as well. The FDA just banned roxarsone. an arsenic-containing ingredient given to chickens. The FDA stated a "study of 100 broiler chickens that detected inorganic arsenic, a known carcinogen, at higher lev els in the liv­ers of chickens treated with the dnig 3-Nitro® (Roxarsone) than in untreated chickens." '' It is clear that even though we may think we arc not being exposed to highly toxic metals, they are all around us and need to be avoided if possible or eliminated. Interestingly enough, most of the symptoms of mercury poisoning arc the same as the symptoms of multiple sclerosis. Heavy metal removal is very important and should be done with care. It is important to be able to monitor the effectiveness through proper lab testing. Doctors Data Lab has two lab tests that work well for this. There arc numerous metal detoxifying supplements and herbs so it is important to find one that responds well with the patient and is effective. Diet Modification: Fourth, and perhaps the simplest change a DC can suggest, is diet modification. There is evidence of an autoimmune component to MS. With any autoimmune condi­tion, it would be recommended to change to a whole food diet free of wheat and gluten. Studies suggest that your body can have an inflammatory immune response to wheat and gluten. This means that every time wheat or gluten is consumed, an in­flammatory immune response is initiated. Since MS is a ncuroinflammatory and autoimmune condition, any possibility of an inflammatory immune response should be taken seriously. Interestingly, individuals with MS have been found to have an increase in IgA and IgG re­actions to gluten and gliadin. which is derived from an inflammatory bowel disease. There is also evidence tliat inflammatory bowel disease can cause lesions in white matter of the brain9, which is a very interesting correlation. Remov­ing wheat, gluten, and processed foods while adding whole foods will maximize healing. Even though there is no cure for multiple sclerosis, it does not mean that a person with MS can't live a very health} and happy life. Following these simple steps has completely transformed a countless number of peoples lives. While each of these components is important, addressing them all simultaneously will give maximum results. Be patient because it requires time for the body to heal. For some patients, just stopping or slow­ing the progression will be a major success. For others, they may have a vast improvement and wildly successful story. It is not uncommon for patients to be able to get off medications, improve vision, increase energy, and resume doing things they liad lost the ability to do. With hope and encouragement, help your patients to stand up to MS! It is time for the chiropractic profession to step up and ad­dress these difficult neurological conditions. Our arsenal of science, art. and philosophy make the doctor of chiropractic the premier provider for any individual with multiple sclerosis. Tnic miracles liappen when your goal is to restore health and function, and not merely treat symptoms of the dis-case. If you do not feel comfortable utilizing all of these techniques, refer patients to a doctor of chiropractic who has that particular skill, or treat them together while utilizing each other's area of expertise and experience. References: 1 .National Institute of Neurological Disorder and Stroke. National Institute of Health website. J Vertbral Subluxation Res. - JVSR.Com. August 2. 2004. Lester. Erin. Textbook of Medical Physiology. Tenth Edition. Guy ton andHall.PS 10-811 http://www.fda.gov/downloads/AdvisoryCommittecs/Com- mittccsMcetingMatcrials/MedicalDeviccs/McdicalDcvic- esAdvisoryCommittcc/DcntalProductsPanel/UCM236379.pdf http://\\ww.fda.go\/AnimalVctcrinan/SafetyHealth/Prod- uctSafctyInformation/ucm258313.htm http://www.mayoclinic.coni/hcalth/vitamin-d-and-ms/ AN()1894/rss=l Robert L. Siblcnid: Eldon Kicnholz. Journal of Orthomo- lccular Medicine Vol. 12. No. 3. 1997 Bansil S. Cook SD. Rohowsky-Kochan C. Multiple scle­ rosis: immune mechanism and update on current therapies. AnnalNeurol 1995;37:87-101. Dr. Oldeiikamp is a 2004 graduate of Palmer College of Chiropractic and recipient of the Virgil Strange Chiropractic Philosophy Award. He currently lives and practices in Glasgow. Kentucky. Feel free to contact him at droldenkainpr/ gmail.com or visit www. standuptoms.com.