Vitamins & Supplements: An interview with Dr. Brenda Banwell

Following last week’s webcast, Living Well with MS: Lifestyle, Diet and Complementary Therapies, we sat down with Dr. Brenda Banwell, MD, to get answers to your questions about vitamins and supplements that are potentially helpful and harmful for people with MS.

In addition to Vitamin D, what other vitamins or supplements do you recommend taking on a daily basis to help MS?

There really isn’t anything else that’s even close to vitamin D in terms of research support for its use in MS. However, I do a blood test of the serum levels of vitamin B12 to make sure my patients aren’t deficient. Vitamin B12 deficiency has a negative impact on myelin, which is important for neurological function and is a particular target in MS. In fact, B12 deficiency can actually look like MS in some patients, and having low B12 if you have MS can further compromise the brain and spine. That said, healthy people who are eating a regular diet are rarely deficient in B12, and if you have normal levels, taking additional B12 has no proven value. People who are on some extreme diets or don’t eat red meat are more likely to have low levels and should be treated if that’s the case.

There’s really no evidence of a specific role for any particular B-complex vitamin in MS. There’s an ongoing debate about the benefits of omega-3 and other fatty acids. I caution parents of kids I look after about not giving too high a dose of fish oils or other oils – when you put too much oil into your gut you actually absorb other nutrients less well. This can put you at risk of diarrhea and other nutritional problems. I strongly discourage a, “A little bit is good, a lot must be great” philosophy. Very few things in nature are meant to be consumed in excessive amounts. If we step back and think more from a nature perspective, almost every species has what we call, “satiety safety.” In other words, they stop when they’re full – and I think that’s a message that we as humans should not override.

What supplements should people with MS avoid?

There are a lot claims made on alternative remedies that may or may not be biologically accurate. To be fair, there are a lot of medications that are approved for which we don’t fully understand their mechanism either. I recommend avoiding nutritional supplements or holistic remedies that claim to boost the activity of your immune system – these are commonly suggested for people who get a lot of coughs, colds, fevers or illnesses. Theoretically, boosting your immune system would not be something you’d want to do if you have MS. MS is a disorder that is characterized by an exaggerated immune response directed at the brain, spine or optic nerves – and there is a dysregulation or failure to turn down the immune response when it starts attacking your own body. So, to give someone something that boosts the ability of turned on immune cells to act even more would go against what we want to do in MS.

When you seek out advice from alternative care providers, I suggest that you ask the provider what the substance they’re recommending is supposed to do. Ask them why they think that would be effective in MS. Then, ask what they know about MS and its characterizations. If that dialogue leads to the choice of a supplement that he or she believes would help with immune control or with improvement in myelin or nerve regeneration, then I would advocate that you bring that information and the supplement to your primary healthcare provider so that he or she can analyze the substance and whether or not it would have any potential interaction with other medication you may be on.

Do you have any other advice for people who are considering complementary or alternative therapies for MS?

There are so many opportunities on the internet to support, give insight and share ideas – that’s one of the strengths of the internet. The problem is that there’s no filter. So, I think an open, honest and trusting dialogue between people with MS, their well-meaning families and friends and all of their healthcare providers is essential to ensure we’re all on the same page and working together. Where we’re seeing alternate treatments cause harm, is when one healthcare provider doesn’t know what the other is doing.

There seems to be a perception from many people with MS that their healthcare providers aren’t open to complementary and alternative medicine, but I think that’s changing. When we’re able to have an open and honest dialogue, I’ve been able to work with families to agree upon what is reasonable and what is potentially dangerous – and ultimately find a course of treatment we’re all happy with.


Please tune in to the MS Connection blog next week as we chat with Drs. Allen Bowling, Timothy Coetzee and Albert Lo about the roles of diet, exercise and other holistic approaches to living well with MS.
Tags Healthy Living, Research, Treatment      10 Appreciate this
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Brenda

Brenda Banwell, MD

Division Chief, Neurology, Professor of Pediatrics (Neurology), Children's Hospital of Philadelphia, University of Pennsylvania

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    23 Comments

  • Karen m Phillips   Jun 20, 2013 4:48 PM
    Hi, anything for PPMS?? I have had it since 05, my balance is really bad, use a rollater to walk, anything wold help! Thank you Karen
  • mark simmons   Jun 20, 2013 4:49 PM
    Is there any truth to systemic enzymes helping MS symptoms?
  • Gwen Heard   Jun 20, 2013 5:08 PM
    Dr. Branwell I enjoyed the article and you are so right about the B12 defiency.. When I first had symptoms was because of nerve damage due to B12 defiency symptoms mimic MS it was only after I had a migraine which caused them to do a MRI and legions were found which prompt them to diagnose as MS. But the spinal was never positive, so is the legions the factor to suggest MS or can serious B12 cause legions also?
  • Christina Polit   Jun 20, 2013 5:23 PM
    Just wanted to share what I've been on for almost a year and it has helped me with my ms symptoms I've had it for 15 yrs its all natural and it's a nrf2 activator which it up regulates your good cells and down regulates your bad ones. It's backed up by science and there are 15 peer review studies on pubmed.gov. Protandim is what it is and you can only get it from lifevantage distributors which I am because it has a story behind it to why they took it out of retail in 09 no one was educated on it. I became a distributor because how protandim helped me and I want to help others. Please let me know what you think, I would appreciate it. Thank you
  • brigette henik   Jun 20, 2013 8:34 PM
    I found this to be very interesting. Using vitamins for ms therapy if it works would be great
  • catherine parker   Jun 21, 2013 12:30 PM
    Dr banwell did not comit to any real advice, opinion or science. This article is "lite" at best. We are seeking information, not a very weak, already documented statement. The society owes us a better program, and Banwell is not it! Please give us quality not quanity.
  • Derek   Jun 21, 2013 7:49 PM
    As an LMT that hopes to eventually work exclusively with individuals directly effected by MS and as someone who believes in supplementation strongly, I love the fact that you note that not all supplements are created equal for all conditions. As you said, there is no filter on the internet and I believe it often leads to poor decisions when the primary care doctor/neurologist is not included in on the decision with regard to supplementation. Just because it is natural doesn't mean that it can't hurt. Looking forward to reading more.

    Derek Somerville
  • loumauro60  Jun 22, 2013 3:38 PM
    I TAKE DAILY DOSES OF ALL DIFFERENT VITAMINS
  • Kristin Bennett   Jun 22, 2013 9:30 PM
    I'm surprised there is no mention of fish oil or probiotics...have you talked to any Naturopaths focused on MS? I recommend Laurie Mischley or Marco Vespignani if not... <3

    Kristin - Founder of MomsWithMS.com
  • Avatar
    THERESAF  Jun 23, 2013 6:56 AM
    I'M THINKING ABOUT STARTING TO HAVE A GREEN DIET.
    I DON'T LIKE MOST GREENS, BUT IF YOU THINK I SHOULD EAT MORE OF THEM I MIGHT!
  • Sandra Mangum   Jun 23, 2013 3:26 PM
    my Dr quit me and now I cannot find a Dr of any kind wondering if you could
    help me? Ilive in Mooresburg ,Tn.....
  • Peter Fernandes   Jun 23, 2013 5:45 PM
    Dr. Banwell,
    Thank you for sharing your feelings and expertise with us. I have been diagnosed since 1980. I got worse for a while and then started tai chi. I stopped after 10 years for no good reason, which I believe is part of the recent disease progression.
    Thanks again, Peter Fernandes
  • Linda Schimel   Jun 24, 2013 9:30 AM
    I am taking a lot of supplements; in the hopes they are helping. Have you heard of N.A.G? It is acetyl-glutamine. It is supposed to help rebuild the myelin that has been damaged due to MS. I have PPMS so the only treatment available for me are alternative treatments. Thank you for your assistance. Sincerely, Linda Schimel
  • Kathy   Jun 24, 2013 11:22 AM
    sugar or some sweets make my feet and legs tingle Why?
  • JoAnne   Jun 24, 2013 8:55 PM
    I do agree with Derik's comment of June 21. Everything in moderation and not everything suits everyone. Brenda Banwell's comments were very "common sense" and "is good"! don't go overboard on any supplement1
  • LaQuita   Jun 30, 2013 4:41 PM
    cont- live without. The nutrilite Double X, this is a multi-vitamin that's got it all. I started 2 feel better about in 2 weeks after taking it. And the Rhodiola 110!! This energy supplement is the bomb. It's gives me all the energy i need 2 get thru a day. if u want some @ amway.com/Laquitafox
  • LaQuita   Jun 30, 2013 4:44 PM
    This product has no sugars or caffeine. It's all vitamins and food. I would never suggest anything 2 u that I wasn't sure worked. Well it's worked 4 me. I have really bad fatigue and 1 of these gets me through my day.
  • carol sorensen   Jul 1, 2013 6:15 PM
    I have had some hair loss since starting Tysabri. I was on Novantrone prior to this . Does the vitamin Biotin help with this and will it cause any problems with my MS
  • Deb   Aug 1, 2013 6:23 AM
    So many doctors say all different things. when I take a mulitvitamin I have flushing all day and night. I feel best whe I just take B-vit drops under tongue every other day and vit C chewable every other day. do not take M.S. shots or pills for they make me worst in bed all the time and legs and tummy full of knots and lumps from shots. so i try to eay good as i can on SSi and take care of me kid s for i am a single mom 51 yrs old. what can I do for more energy?
  • Shamim   Aug 24, 2013 10:10 AM
    Thank you for the post.Good written
  • Lyn   Aug 26, 2013 7:35 PM
    I've been taking medication for MS since 1994. Started with once a week Avonex injections and last 18 months have been on Gilenya (daily pill). Try to follow new medications. Like everyone else w/MS, take daily dose of Vit D and Vit B. But, also take daily 200 MG tab of Modafinil--it is generic equivalent of Provigil...this medication prescribed by physician at Mayo Clinic in Jacksonville; its helps with fatigue. Also, after my hysterectomy in 1988, my surgeon prescribed estradiol .05 MG per day--hormone replacement therapy. Have continued to take it in patch form now for years as it makes me feel better in general. Now understand that a new 12 month study has just been undertaken to determine
    its impact on MS.
    In general, I find estradiol helps me feel better; it will be interesting to see how the study participants respond.
  • Lyn   Aug 26, 2013 7:35 PM
    I've been taking medication for MS since 1994. Started with once a week Avonex injections and last 18 months have been on Gilenya (daily pill). Try to follow new medications. Like everyone else w/MS, take daily dose of Vit D and Vit B. But, also take daily 200 MG tab of Modafinil--it is generic equivalent of Provigil...this medication prescribed by physician at Mayo Clinic in Jacksonville; its helps with fatigue. Also, after my hysterectomy in 1988, my surgeon prescribed estradiol .05 MG per day--hormone replacement therapy. Have continued to take it in patch form now for years as it makes me feel better in general. Now understand that a new 12 month study has just been undertaken to determine
    its impact on MS.
    In general, I find estradiol helps me feel better; it will be interesting to see how the study participants respond.
  • Frank   Jan 20, 2017 5:08 PM
    so I am researching Protandim. What is your take on this supplement?