Multiple Sclerosis

[Rajjpuut]

Hello,

My name is Bob, I'm a health educator from Centennial, Colorado, a Denver suburb. Six years ago my now ex-wife was diagnosed with MS. About 3-4 months back my girlfriend also was told she had the disease. I found myself, once again, reading everything I could find on the internet and in libraries, etc. about Multiple Sclerosis

In the process, I raised six questions that I'd wondered about back in late 2001 and then added a few more. I would appreciate any experienced or expert or experiential comments you'd like to make.
Thanks.



13 Vital Questions about MS:

1. Why is Colorado the highest incident U.S. state?
2. Why is Colorado Springs the highest incident large city in the highest incident state?
3. Why do women suffer from MS at a rate roughly 2-4 times as great as men?
4. Why is MS less prevalent on the coasts?
5. Why is MS far more prevalent in urban settings than in rural areas?

6. Central Nervous System Dilators pioneered as an MS treatment during the 1950’s by Bayard Horton of the Mayo Clinic were apparently quite successful with few or no side effects in relieving acute attacks promptly and often prevented progression? Why?
7. MRI examinations today frequently depict a lack of correlation between symptoms and lesions in MS (often called the “clinico-radiological paradox). What’s going on? If demyelination is the fundamental essential lesion in multiple sclerosis, why is there often no correlation?
8. Trials of sex hormones show they improve lesions as well as symptoms and L-arginine, zinc and magnesium supplements also seem to lesson symptoms. Why?
9. What role do deficiencies of endothelial and neuronal nitric oxide and elevated levels of inducible nitric oxide play in MS? Is this symptomatic or causal?
10. Is better detection the only reason MS incidence has risen so dramatically in the last 40 years, or is some environmental factor exacerbating the situation?

11. What about the “brain leak” theory of MS? That theory says free hemoglobin scavenges nitric oxide avidly, which may create deficiencies especially in the central nervous system, with its greater vasodilator tone. Could depletion of endothelial nitric oxide shift blood from the arterial circulation to the venous circulation in MS sufferers as in diabetics? Could multiple sclerosis result from too little blood in arteries and arterioles leading to vasospastic symptoms? Meanwhile could too much blood in veins and venules lead to blood-brain barrier leakage and lesions?
12. Is there any logical reason for continued loyalty by many to the idea that MS is an anti-immune condition?
13. Is there one over-arching theory that might explain all these factors?


The more I read, the more certain I become that these factors need to be explained and understood.

An obvious main or, at least, exacerbating factor seems to jump out from the first six questions: OXYGEN! The clearest correlation for Question #1 is that higher altitudes = lower oxygen levels. Colorado is the state with the highest average altitude among the 50 states. As far as Question #2, Colorado Springs, the 49th largest city in the country, is easily the highest large metropolitan area in the country roughly 750 ft. (14%) higher than “Mile-High” Denver.

Question #3, Women’s bodies and their unique chemistry may make them far more vulnerable than men to MS for any number of reasons. Exploring the OXYGEN HYPOTHESIS among women more deeply . . . women tend to be smaller and society until recently encouraged female physical fitness far less than it did male activity so generally speaking females are less efficient VO max processors than men. Additionally, hemoglobin and iron are more problematical in females during their menses which makes females more likely prey for anemia again potentially lessening oxygen-use efficiency.
A factor which I've also noticed and which may not have any bearing on the issue is that females are about eight or nine times more likely than man at any given moment to be engaged in dieting, skipping breakfast and sometimes fad dieting that is just plain nonsensiscal healthwise . . . which could spark nutrient deficiencies. I've seen nothing about dieting, eating 3-5 regular meals daily, good nutrition, or having a good breakfast in the MS literature, but common sense says, good habits are important amd could play a role.

Question #4, the coasts, are by definition, found at sea level hence, lower than 99.99% of the inland areas of the country with more oxygen available. Additionally, coastal diet is far more likely to include fish with its attendant fish oil (deficiencies implicated in Alzheimer’s, high blood pressure and heart attacks) which aids in oxygen processing.

Question #5, people in rural areas are less likely to face high levels of air pollution (smog) than city dwellers. In particular: diesel fumes, ground level ozone contamination and INHALED nitric oxide contamination are brutal every day facts of life in our largest cities. (By the way: INHALED nitric oxide is confusing in many respects to the layman. A. it is NOT nitrous oxide (laughing gas) once used as anesthetic. B. Our bodies naturally create nitric oxide and it is one of the most important gases found in our blood stream (as reflected in the Nobel Prize for Medicine awarded to Dr. Louis Ignarro) which we will discuss later as it relates to MS. C. Many people realize that nitric oxide is also an important negative component of tobacco smoke. In any case, the obvious effect of air pollution is less oxygen allowed to reach the lungs, heart, brain and every cell of the human body than one would expect from clear, pure country air.

Question #6 is way beyond the scope of this stumbling/bumbling comment. Peter Good’s thought-provoking website on nitric oxide and MS seems to indicate that there was great success with the
CNS vasodilator histamine diphosphate during the late 40's, the 50's and 60's. Today’s “fashion” calls for different meds with greater potential for dangerous side effects. CNS vasodilation with histamine not only consistently relieved a disease now thought to be incurable, it thereby demonstrated that its fundamental lesion may be something entirely different from demyelination???

Having said that let's examine Question #12, Is there any logical reason for continued loyalty by many to the idea that MS is an anti-immune condition? As a result we regard MS today as incurable because its primary lesion is thought to be relatively irreversible disintegration of myelin sheaths in the brain and spinal cord. That thought pattern has been in place for roughly 50 years. Neurologists who successfully treated MS with vasodilators thought the lesion was REVERSIBLE because the underlying cause – a diminished blood supply in the brain and cord (leading to oxygen lack there) was treatable. Because of the autoimmune assumption, workable theories and workable treatments (and cures?) have been relegated to the trash heap.

Question #7, since MRI results seem NOT to show continued and progressive demyelination as the fundamental and unvarying effect of MS and they don’t rule out oxygen as a key factor, we can continue to keep an open mind toward blood and oxygen as the fundamental truth of the disease. Lest anyone decide that I’m seeking oversimplification of a complex problem . . . Siblerud and Kienholz (1994) compared red blood cell concentrations and hemoglobin levels of MS patients who had their mercury amalgam dental fillings removed against blood values of MS patients who retained their amalgam fillings:

MS subjects with amalgams were found to have significantly lower levels of red blood cells, hemoglobin and hematocrit compared to MS subjects with amalgam removal.... The MS amalgam group had significantly higher blood urea nitrogen and lower serum IgG.... A health questionnaire found that MS subjects with amalgams had significantly more (33.7%) exacerbations during the past 12 months compared to the MS volunteers with amalgam removal. Obviously, while we’re still talking about the blood’s ability to deliver oxygen . . . every indication is that a wide variety of toxins and negative effects might stimulate that same over-arching undesirable effect. The specific trigger may vary from case to case, but the indications are that oxygen and blood might well hold the key to understanding MS.

Just as in AIDS, the possibility that the immune system is responding to an agent like a virus is countered by the reality that no such agent has ever been identified, and once identified, then transmitted to any animal or human in clinical experiments. Retrovirus, where art thou????? In truth, endogenous retroviruses have not yet been proven to play any causal role in this disease. According to PO Behan and A Chaudhuri of Glasgow University, together with BO Roep of Leiden University (2002) contend there is little support for contemporary views that multiple sclerosis is an immunological disease. And not surprisingly, according to them, there is little benefit from treatments based on this misconception. In any case, since no "smoking gun" for MS has ever been found, isn't it a little short-sighted to uncritically say that it must be an autoimmunity problem?

Question #8, again brings up questions of gender. Women, who typically undergo puberty earlier than men, get MS more often and earlier and its path is less likely to be predictable and progressive compared to male victims. Some success has been had treating with either or both male and female hormones. L-arginine creates nitric oxide in the blood which dilates blood vessels. Zinc and magnesium are under-appreciated nutrients which play vital roles in human health. Again, The specific trigger for MS may vary from case to case, but there are no indications here that oxygen and blood do not hold the key to understanding MS and certainly there is no outright refutation for that idea to be found in this question.

Question #9 and 11 are best answered and best understood together through the insights of Peter Good: “Two signs that endothelial nitric oxide may be chronically depleted in multiple sclerosis are that patients tend to be very heat-sensitive, and their platelets are sticky. Sensitivity to stress may reveal depletion of the parasympathetic transmitter neuronal nitric oxide. Other reasons to suspect endothelial nitric oxide depletion in multiple sclerosis are apparent deficiencies of sex hormones, magnesium, and zinc. Estrogen, testosterone via estrogen, and magnesium all utilize endothelial nitric oxide, the primary endogenous vasodilator, to relax vascular smooth muscle. The (most simple and straightforward explanation) of multiple sclerosis might be that too little blood in arteries and arterioles leads to vasospastic symptoms, while too much blood in veins and venules leads to blood-brain barrier leakage and lesions.”

Question #10, is easily dealt with, in principle the last 40 years have seen a precipitous rise in all manner of environmental toxins. Polluted foods (steroids in meats, for example), side effects of certain pharmaceuticals, residential toxins (such as arising from carpet liners, asbestos, etc., etc., ad nauseum), and just plain stress all could easily be regarded as potential triggers setting in motion the conditions leading to diminished blood and oxygen to the brain and spinal cord.

Question #13 (Is there one over-arching theory that might explain all these factors?) In answering the previous 12 questions we have laid the groundwork for open mindedly considering that “Yes, there could be, perhaps not . . . but maybe . . . and for now the overarching theory that holds the key to understanding MS seems to be: a theory of diminished blood and oxygen.

Good health and happiness to ALL,

RPV