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A New Treatment Protocol for Multiple Sclerosis Based on an Expanded Lens of Disease Etiology



Conventional medicine's current understanding of MS pathology raises more questions about the disease than provides answers. This paper aims to increase the understanding of disease etiology and design an effective intervention based on an increased understanding of causal factors. To do so, it will (1) provide a sample case focusing on the patient's biological, psychological, and social history to illuminate possible causative factors; (2) review medical models beyond the current convention biomedical model to expand our understanding of possible MS etiology; (3) introduce a new treatment protocol that works top-down, addressing first causal factors and lastly the resulting physical and mental symptoms; and (4) recommend particular therapies for each level of the protocol. These therapies will be specific to the sample case, considering culture, preferences, and regional availability of these therapies.
A New Treatment Protocol for Multiple Sclerosis Based on
an Expanded Lens of Disease Etiology
Eva M Clark
Independent Graduate Studies, California Institute of Human Sciences
PSY 680: Consciousness-Based Medicine
Michelle Fauver, PhD
June 11th, 2021
A New Treatment Protocol for Multiple Sclerosis Based on an Expanded Lens of Disease
Multiple Sclerosis (MS) is not a disease of the elderly but adults in their prime. The
chance of developing MS if a family member has the disease is only slightly higher (1-5%) than
the general population (Rolak, 2013). Prevalence depends on gender, culture, latitude,
geographic region, and race (Wallin et al., 2019). The most susceptible are Caucasian women
between the ages of 20 and 40, living in northern gradients of first world countries. This
description does not fit the profile we would associate with illness.
Conventional medicine's current understanding of MS pathology raises more questions
about the disease than provides answers. The etiology is unknown, symptom origins elusive,
environmental factors nebulous, and its progression challenging to explain (Rolak, 2003). MS
might be more than one disease (Rolak, 2003). The current understanding is that T-cells cross the
blood-brain barrier and attack the central nervous system. Both the myelin sheaths as well as the
underlying axons are damaged, leading to disability. What triggers the T-cells to break through
the blood-brain barrier and attack is questioned (Rolak, 2003). Why some patients have only
periodic attacks and then fully recover while others have a slow progression is also a mystery
(Rolak, 2003). Even diagnosing can prove difficult (Polman, 2011). Perhaps because of all these
unknowns, conventional medicine has been unable to find a cure, and current treatments only
hope to reduce the number of exacerbations and slow down progression (Rolak, 2003).
This paper aims to increase the understanding of disease etiology and design an effective
intervention that targets these causes. To do so, it will (1) provide a sample case focusing on the
patient's biological, psychological, and social history to illuminate possible causative factors; (2)
review medical models beyond the current convention biomedical model to expand our
understanding of possible MS etiology; (3) introduce a new treatment protocol that works top-
down, addressing first causal factors and lastly the resulting physical and mental symptoms; and
(4) recommend particular therapies for each level of the protocol. These therapies will be
specific to the sample case, considering culture, preferences, and regional availability of these
Sample Case
Our sample case is a middle-class 50-year-old married Caucasian woman from the
Midwest who currently lives in the San Francisco Bay Area. Cindy (not her real name) was
diagnosed with primary progressive MS (PPMS) two years before the interview. Her primary
MS markers are muscle tension, stiffness, spasticity, issues with gait, incontinence, and balance
difficulties. Unlike 95 to 99% of people diagnosed, Cindy’s paternal grandfather had multiple
sclerosis. Emotionally, Cindy describes herself as anxious and an excessive worrier. She was
depressed when first diagnosed but does not feel overly depressed now. Cindy's symptoms have
caused her to reduce her work hours and move into a less strenuous and more administrative
position. Though not satisfying, the position allows her time to take care of her needs and, she
feels, is more adapted to her disabilities. Besides having PPMS, a rarer form of MS, and a family
member with the disease, Cindy is a standard profile for MS.
Contributing Factors at Onset
Cindy was in her early 40's when she was first diagnosed. She was doing 12-hour shifts
as a nurse working with terminally ill patients. Cindy did not enjoy the hours nor the work. She
feels she takes “on other people's pain" (case, personal communication, May 24th, 2021). The
work was even more difficult for her when her patients were children. Cindy did not have
children of her own, though she had always assumed she would. Now in her 40’s, she had started
to grieve “the choice we made as a couple" (case, personal communication, May 24th, 2021).
Perhaps, she theorizes, she does not have close friends because "everyone else is raising
children" (case, personal communication, May 24th, 2021). Her close relationships include her
husband, sister, and coworkers, though this last group, to a lesser degree.
Her mobility symptoms became evident following a broken leg that seemed to take too
long to heal. She was diagnosed soon after. Before the accident, she experienced dizziness,
bumping into things, and an overactive bladder. These symptoms began following her mother's
death five years before the broken leg. She remembers being angry at her mother for dying the
day before Cindy arrived to say goodbye and stressed about her workload.
Contributing Factors Before Onset
Physically, Cindy had always been in good health. Her only other significant medical
experience was an open-fractured broken arm requiring a month-long hospital stay when she was
seven. Cindy recalls that during this experience, she felt disappointed for worrying her mother,
for needing to rely on others, and for being vulnerable when she was “trying to grow up” (case,
personal communication, May 24th, 2021).
Cindy’s family of origin is not emotionally expressive (alexithymia). Cindy described
how feelings were never shared. Her mother was strong-willed, "not tender" (case, personal
communication, May 24th, 2021), and liked to have things look like she had everything together.
Her father worked a lot and was never home. Cindy's parents divorced when she was thirteen.
There had been "no fighting; it was all passive-aggressive" (case, personal communication, May
24th, 2021). She recalls always being anxious as a child and holding it in her hips. Cindy also
remembers playing her flute for hours to help her cope with her feelings. She describes spending
weekends playing up to six hours straight and then being too embarrassed to clock her practice
hours for music class. She describes herself as very sensitive and highly creative. "I see the
world in colors, sounds, and how it feels to me" (case, personal communication, May 24th,
2021). Despite music being a "huge outlet” and way to cope emotionally, she quit midway
through high school and chose to pursue the science route as a way to "get her shit together"
(case, personal communication, May 24th, 2021).
This shift led her into a career in health care, another significant source of emotional
stress. It was incredibly challenging in her twenties when she worked primarily with critically ill
children. She says she has never fully recovered from that experience. When she began having
MS symptoms, she worked long hours, had recently married, and spent as much of her free time
with her new husband rather than rest from work. Thus, she felt physically as well as emotionally
Current Contributing Factors
Cindy has not been open about her disease or symptoms. Though she has shared her
diagnosis with her father, she has not visited him. Cindy worries he will find her symptoms
upsetting. At work, she has only shared with those that work directly with her. At home, Cindy
has a hard time letting her husband help her. “I try not to burden him with my symptoms and
feelings" (case, personal communication, May 24th, 2021). Cindy is embarrassed to ask for help
and feels like she has somehow failed as a person for getting multiple sclerosis. Also, needing
mobility assistance has been hard on her sense of esteem. Besides shifting to an administrative
position with office hours, Cindy continues to work in a hospital setting. She admits she would
prefer not to work with illness altogether. "I probably would have been happy as a music
teacher," Cindy admits with a shy smile (personal communication, May 24th, 2021). When asked
what she would like to achieve, Cindy talks first about finding another meaningful job to
contribute to society. In regards to MS, Cindy would like to walk without assistance. She
describes herself as "a reluctant caregiver turned patient" (case, personal communication, May
24th, 2021).
Current Treatment Protocol
Cindy’s current treatment is primarily pharmaceutical. She takes Ocrevus infusions for MS,
Vortioxetine for depression and anxiety, and Solifenacin for her overactive bladder. She also
takes 5,000 IU of vitamin D daily. Cindy swims and does exercises she learned from her neuro
physical therapist. She has modified her diet somewhat. Recently, Cindy took a mindfulness
meditation class at the hospital and has begun to meditate. Cindy's neurologist prescribed
medication and high dose vitamin D. The rest of her treatment regime are therapies Cindy has
added. Like many people with a medically incurable chronic disease, Cindy has included various
alternative therapies in her treatment protocol (Harrington, 2009).
Expanded Lens of Disease Etiology – What Causes Multiple Sclerosis?
In this next section, we will review various medical models, from the conventional
biomedical model practiced in the majority of hospitals and health centers in the US today; the
Mindbody medicine’s model and its contributions to our understanding of chronic disease
etiology in the last 50 years; the Tibetan medical model, a complete medical system evolved over
several centuries and still practiced today; and the Consciousness medicine model that extends
our scientific basis to include quantum physics and the primacy of consciousness. We will see
how understanding disease etiology and its treatment is heavily influenced by the lens through
which we interpret physical disease (Lipton, 2015).
Conventional Biomedical Model
Through the lens of the conventional biomedical model (also known as allopathic
medicine, mainstream medicine, orthodox medicine, and western medicine), disease is caused by
mechanical, hormonal, or genetic malfunctions in the body. This model assumes that “disease is
to be fully accounted for by deviations from the norm of measurable biological variables
(Engel, 1977, p. 379). This model aims to find these deviations through diagnosis (blood, urine,
x-ray, or MRI screening) and correct them by pharmacology or surgery (Engel, 1977). This
scientific model was born five centuries ago through the split of science and the church. The
basic principle of this science, are defined by the work of Galileo, Newton, and Descartes. This
science views "body as a machine, of disease as the consequence of the breakdown of the
machine, and the doctor's task as repair of the machine" (Engel, 1977, p.382).
In the biomedical model lens, MS is thought to be caused by an overactive immune
system. In particular, macrophages activate T-cells to attack myelin. These T-cells break through
the blood-brain barrier, destroy myelin sheaths, and damage axons. As this is not a genetic
disease, some unknown environmental factor triggers this activation (virus, toxins, or other;
Rolak, 2003). To diagnose MS, neurologists must first rule out other diseases with similar
symptoms. They then test for abnormalities in antibodies in the central nervous system through a
lumbar puncture or for visible myelin lesions through MRI scans (although 10% of those
diagnosed with MS do not have visible myelin lesions; Rolak, 2003). When the patient has
unusual symptoms or a progressive form of MS, diagnosis can be trickier (Polman, 2011).
Through the lens of this model, there is no cure, and interventions focus on suppressing the
action of the immune system to avoid causing further damage (Rolak, 2013). h
Mindbody Medical Model
The Mindbody medical model has expanded the understanding of the contributing factors
behind disease etiology to include “the social, psychological, and behavioral dimensions of
disease” (Engel, 1977, p. 379). In Mindbody medicine, the mind and body have reunited. The
extent to which each influences the other is debated (Harrington, 2009). Thoughts, emotions,
and stress are now included in etiology but only because we now have the biological proof of
their interference in physical health (Harrington, 2009). Psychoneuroimmunology has
established the molecular basis for emotions as the link between mind and body (Pert, 1999).
The new biology of epigenetics has demonstrated that thoughts and emotions interact with cells’
membranes and activate DNA (Lipton, 2015). The stress-disease connection can now be
explained by the internal physiological changes produced in the body (Greenberg, 2017). Thus,
in the Mindbody medical model, disease is biochemical in nature, though the cause is now
In the case of MS, psychosocial assessments show that people diagnosed with MS have
more negative emotions, anxiety, depression, obsession, phobia, and tense interpersonal
relationships when compared to the general population (Liu, Ye, Li, Dai, Chen, & Jin, 2009).
Those diagnosed also have twice as much alexithymia, an issue described by Cindy in her family
of origin, and more than double the amount of childhood traumatic incidents as the general
population (Briones, Arrufat, Aragones, & Bufill, 2013). Stressful life events (SLE) precede 85
to 90% of relapses, and 20 to 49% of SLE are followed by relapse (Briones et al., 2013).
Moderate SLE increases relapse while extreme SLE decreases them (Briones et al., 2013). In
other words, (1) the vast majority of relapses occur after a moderately stressfully life event, and
up to half of stressful events will lead to a relapse; and (2) high-intensity stressors, such as war,
an accident, childbirth, or divorce, do not cause relapse, they might prevent them. Instead,
moderate stressful life events such as relationship conflicts, the threat of being fired, impossible
project deadlines, moving, or an unfaithful partner increase the chance of a relapse. Social
support, distraction, and positive coping mechanisms mitigate the effects of SLE and reduce the
correlation between stress and myelin lesions (Briones et al., 2013). Through the Mindbody lens,
stress is a significant causal factor in MS. Thus, stress management and treatments that address
trauma, teach positive coping strategies, and increase social support, must accompany the mix-
max of biological interventions (pharmacological and lifestyle interventions).
Tibetan Medical Model
Tibetan medicine also considers disease etiology biopsychosocial in nature. It is a
complete medical system (Bradley, 2013). In Tibetan Medicine, everything in life is energy. The
basic principle of healing in Tibetan Medicine is to rebalance the three principal energies or
humors. When these three humors, rLung (Wind), MKhris pa (Bile), and Bad gen (Phlegm), are
balanced, we are healthy. When they are out of equilibrium, we become sick (Bradley, 2013).
These humors become imbalanced by mental and physical factors, but not to the same degree.
The leading long-term cause of imbalance of the humors lies within the mind. “Mental poison
clouds thinking” and causes “poor choices which ultimately leads to suffering and disease
(Cameron & Namdul, 2020, p. 17). Less detrimental, short-term cause of illness lies within the
body and includes improper diet and lifestyle, seasonal influences, and spirit possession.
The main mental poisons, or ignorances, are desire, anger, and close-mindedness
(Bradely, 2013). These three poisons correspond to the three humors and are calamitous to their
energetic balance. rLung imbalances are “related to greed, unhealthy attachment, and desire”
(Cameron & Namdul, 2020, p. 24). So, for example, if one is not content with one’s life, is
overthinking, worried about the future, anxious, craving what they do not have, and fearing
losing what they do, they could create havoc in this humor. Physically, rLung imbalances affect
movement flow, causing movement disorders, digestion issues, insomnia, spinning thoughts, and
headaches (Cameron & Namdul, 2020). This imbalance can lead to addiction, including the
addiction to work and success. MKhrispa imbalance is related to “anger, hostility, and
aggression” (Cameron & Namdul, 2020, p. 25). High levels of MKhrispa are created through too
much doing, competitiveness, constant stressors, and no time for joy. This imbalance can lead to
isolation and judgment of self and others, and physically, to an imbalance in body heat,
inflammation, and metabolic or endocrine problems. Bad gen is “related to delusion, confusion,
and closed-mindedness” (Cameron & Namdul, 2020, p. 26). Healthy levels of Bad gen allow
thinking and the body to slow down, rest, and enjoy time with family and friends. High levels
produce procrastination, lethargy, and inertia. Bad gen (cold energy) helps balance MKhrispa
(hot energy; Cameron & Namdul, 2020, p. 26).
In Tibetan Medicine, diagnosis is achieved through empathetic active listening and
tongue, urine, and pulse analysis. The main aim of treatment is to rebalance the energy of the
humors. To do so, we must address what is in the mind. Thus, meditation is a big part of Tibetan
medicine (Cameron & Namdul, 2020). In meditation, we can notice our negative thoughts and
learn to say, "this is," rather than judging something as being good or bad or needing to be
different (Cameron & Namdul, 2020, p. 23). We can then figure out the best way forward
(Cameron & Namdul, 2020). Thus, under the Tibetan medical model, the first line of treatment
addresses the mind's poisons, accompanied by lifestyle, and diet. Physical therapies are only
used as a last resort (Bradley, 2013). This medical model emphasizes the need to treat the root
cause first.
Tibetan medicine has already contributed to a clearer understanding of the cause of MS.
Husted and Dhondup (2009) demonstrated, through thermodynamics, that these three humors,
correlate with the three types of myelin lipids - phospholipids, sphingolipids, and cholesterol.
MS is a disease with excessive rLung and deficient Bad gen and high Mkhrispa during
exacerbations (Dhondup & Husted, 2009). Research using the Tibetan model suggests changes
in the structure of these myelin lipids caused by humor imbalance precede their destruction by
the T-cells (Husted & Dhondup, 2009). Thus, Tibetan Medicine helps explain that T-cells break
the brain-blood barrier and attack myelin cells because these cells have become abnormal. One
of the primary functions of T-cells is to kill any cell they recognize as abnormal (Krogsgaard &
Davis, 2005). Thus, the focus of Tibetan medicine would be to regenerate the myelin and avoid
further abnormalities by rebalancing the humors through transforming our thoughts, beliefs, diet,
and lifestyle.
Consciousness Medicine Model
The Consciousness medicine model expands upon Mindbody medicine. It ultimately
concludes, as have Candance Pert and Bruce Lipton, that the mind is the basis that holds
everything else together (including the material world and physical expression; Beauregard et al.,
2014; Pert & Marriot, 2006; Lipton & Bhaerman, 2012). Our bodies reflect what is in our minds.
Though this is the same conclusion achieved in the last century by quantum physics, this concept
aligns with ancient wisdom traditions of thousands of years ago. The root cause can no longer be
seen as an unexplainable biological deviation. Instead, the original wound begins as a distortion
of the mind in our understanding of the world and self that influences our physical expression
and ultimately can result in physical disease and disorders. This expanded model prioritized
consciousness in disease etiology and treatment.
In Consciousness medicine, the goal is not to help the person with MS gain enough
function to return to their previous lives. This model understands that precisely those lives, with
their situations, attitudes, and beliefs, formed the premise of disease. The goal of treatment is to
transform the person beyond the level that created the disease (Edwards, 2010). Treatment
includes releasing resistance due to trauma and negative beliefs; connecting to the authentic self,
joy, a positive frame of mind; and removing roadblocks (unresolved conflicts, toxic situations,
spirit attachment and retrieval, death wishes, and environmental and dietary toxicity; Edwards,
2010, p. 263). This new medical model places our spiritual and psychological health as primary,
though the treatment process continues to be a mix-match of modalities, similarly to Mindbody
Transformative medicine’s 7-level Treatment Protocol
Based on the consciousness medicine model, the transformative medicine treatment
protocol is structured and divided into levels of intervention, from the most influential and life-
enriching to the least sustainable and risky (Fauver, 2021; These
levels coincide with the stages of disease formation – firstly, soul and consciousness, then
emotions and mind, and lastly, the physical (Fauver, 2021). Thus, this protocol turns
conventional treatment upside-down, from matter as central and consciousness a byproduct, to
consciousness considered primary and the first level of treatment, and physical interventions the
last resort if all other levels do not restore health.
The rest of this paper will recommend therapies for Cindy, following this protocol's
levels of treatment.
Level 1 Consciousness
“Whatever the spirits tell you to do, you have to do it” (Madrona, 2014).
The goal of Transformative Medicine at this level is to heal the distortions of
consciousness, including the unresolved and repressed traumas of our ancestors, dead or alive
(Wolynn, 2016), and develop a deep relationship with the divine. Level one interventions include
spiritual community, meditation, prayer, family constellations, and the laying on of hands
(Fauver, 2021). Cindy does not have a spiritual practice, though she has found mindfulness
meditation beneficial. Research demonstrates that mindfulness training can improve quality of
life, depression, and fatigue in patients with MS (Grossman et al., 2010). The study by Grossman
et al. (2010) suggested that regular booster sessions could maintain gains. There was a direct
correlation between consistency and degree of improvement, suggesting meditation should be
continued daily and not for a set time of intervention. The social aspect of the training might also
contribute to the favorable results (Grossman et al., 2010). The study hypothesizes that
mindfulness meditation training may enhance a “sense of control and accuracy of perception
(Grossman et al., 2010, p. 1148). A weekly meditation group could assist Cindy with consistency
and provide her a spiritual community.
Additionally, Cindy seems to be what family therapy calls the 'weak link' of a general
family system (Edwards, 2003). In family therapy, ancestral chains of resistance and trauma
manifest in the most sensitive and vulnerable latter generations (Edwards, 2003, p. 260). Family
constellation therapy, regression therapy, or holotropic breathwork could address those deeper
ancestral wounds Cindy might be unconsciously embodying. This paper proposes Cindy
continue mindfulness meditation, join a weekly meditation group, and work with a practitioner to
resolve the deeper ancestral wounds she might embody.
Level 2 Mental/Emotional
At the treatment level of mind and emotion, Cindy can work through her distortions
about the world and herself, connect to her authentic self, and find her joy. Level two
interventions include individual and group psychotherapy, psychological education, support
groups, and skill-building (Fauver, 2021). Psychological interventions have been shown to
improve both psychosocial and physiological symptoms of MS (Pagnini et al., 2014). In Cindy’s
case, her right-brain dominant creative self was swallowed by a demanding left-brained
dominant career for the sake of financial stability and contribution.
This sacrifice of self is an MS pattern I have repeatedly seen in clinical experience. Once
MS becomes so pronounced that demanding jobs in law, engineering, and medicine becomes too
difficult, a few daring individuals begin to follow their interests in the arts. So that Cindy's MS
does not have to progress to the point of influencing her career choice, music and art must return
to her life as a source of peace and joy. Therefore, this paper recommends art as part of her
psychological intervention. A creative arts program can improve "self-esteem, hope, perceived
social support and self-efficacy in individuals with multiple sclerosis" (Fraser, & Keating, 2014,
Additionally, a systematic qualitative analysis found evidence of the effectiveness of
music therapy on chronic progressive MS (Magee & Davidson, 2004). The analysis found the
therapy to affect "the emotional, physical, interpersonal and expressive self, (and) assist with the
emotional consequences of acquired disability" (p. 39). Within this framework or her family
constellations work, Cindy will need to address her blocks and resistance and recover her sense
of authentic self with therapeutic modalities that do not victimize or re-wound her (Gendlin,
Thus, this paper proposes Cindy utilize alternative therapeutic modalities such as somatic
or focusing-orientated-experiential psychotherapy (using the felt sense in the body as guidance;
Krycka & Ikemi, 2016); or analytical hypnotherapy (where the supra-conscious takes the driver’s
seat and guides the client into areas of their lives that need to be witnesses and transformed;
Barnett, 1989). This paper recommends that Cindy join group music therapy and attend an
alternative one-on-one therapy for this level of intervention.
Level 3 Lifestyle
Level three includes lifestyle interventions such as diet and movement therapies (Fauver,
2012). In comparing different types of movement therapies on the quality of life of people
diagnosed with MS, a systematic review found aerobic exercise and physiotherapy improves
physical, mental, and social functioning (Alphonsus, Su, & D’Arcy, 2019). As Cindy has
difficulty with balance and gait, however, a standard aerobics class might risk injury. Cindy has
worked with a neuro physiotherapist and practices movements that strengthen gait and balance.
Periodic check-ins could continue to support her at each stage of her healing journey.
Physical strength and mobility are not the only goals, however. Cindy must strengthen
her relationship with her body and its needs. The first level of treatment helps Cindy form a
deeper relationship with the divine, the second level with herself, and this third level of treatment
promotes a healthy relationship to her body. In my clinical experience, one common trait in
people diagnosed with MS is a disconnect from the body and its needs. While this form of
dissociation might have been necessary for childhood due to adverse childhood experiences, it
has become part of the blockage that disrupts healthy energy flow (Edwards, 2010). Thus, a more
mindful body practice such as Tai Chi, or somatic and focus-orientated therapy described for
level 2, would be beneficial. A systemic review of Tai Chi research shows this therapy can
improve quality of life, flexibility, leg strength, gait, and pain (Zou et al., 2017). This paper
proposes that Cindy continue with periodic follow-up sessions of physiotherapy along with a
mindful body practice of her choice.
Level 4 Physical Manipulation
Level four interventions are treatments provided through physical manipulation.
Examples include osteopathy, chiropractic, massage therapy, acupuncture, and energy medicine
(Fauver, 2021). Reflexology improves spasticity and urinary symptoms in patients diagnosed
with MS, but the improvements are not sustained (Siev-Ner, 2003). Chinese acupuncture for
progressive MS shows more improvement “inserting acupuncture needles just through the skin
and away from true acupuncture sites” (p. 196) than by individualized Chinese medical
acupuncture that applies needles to specific energy points (Donnellan & Shandley, 2007).
Massage therapy improved pain but no other symptoms of MS (Frost-Hunt, 2020). Exceptional
results have been found using energy medicine, in particular Eden energy medicine (Eden,
2008). Similar to Tibetan medicine, Eden energy medicine understands illness as an imbalance
of energy flow in the body (Eden, 2008). Donna Eden, a prominent figure and trainer in energy
medicine, completely reversed her multiple sclerosis using her method of energy medicine. This
reversal is a testament to the possibilities achieved through energy-based therapy. This paper
proposes that Cindy work with a local Eden energy medicine practitioner to address her specific
energy imbalances and learn daily practices to keep herself in balance.
Level 5 Botanical and Supplements
Level five interventions include herbs and supplements. High-dose vitamin D and biotin
are prescribed in standard care. The correlation seems to show that vitamin D deficiencies
increase the risk for MS, higher disease activity, and poor long-term outcomes (Feige et al.,
2020, p. 1). However, a review of research indicates that elevated doses of the supplement (up to
20,000 IU/day) produce no therapeutic advantage on disability or relapse rate (Feige et al.,
2020). Ultra-high-dose treatments of 50,000 UD/day or above are associated with toxic side
effects that can be partially life-threatening and mimic primary progressive MS symptoms (Feige
et al., 2020).
In the case of biotin, researchers hypothesized high-dose biotin could promote axonal
remyelination and reduce axonal hypoxia (Sedel et al., 2015). The objective of the research on
the therapeutic use of biotin was not to slow down progression but to reduce MS-related
disability in patients with primary and secondary progressive forms of MS. Two studies by
Birnbaum & Stulc and Couloume used 300 mg of biotin for 12 months, showed no
demonstratable long-term effect (2017; 2019). In the third study by Tourbah et al. using 100 mg
of biotin for 24-months, patients decreased disability and slowed progression (2016). However,
MRI examination in the study identified a greater number of new and enlarged MS-specific
myelin lesions in the group taking biotin compared to the placebo group. The paper hypothesized
that this reaction could be a pro-inflammatory response to high-dose biotin (Tourbah et al.,
2016). Thus, we see that, as we continue down the levels of intervention, therapies show an
increase in the risk of adverse experiences.
Tibetan medicine also uses a combination of supplements. These not only influence the
physical body but also rebalance the humors. Padma 28 is a Tibetan medical multi-compound
formula registered for circulatory disorders (Venos, 2013). Padma 28 has decades of research
showing effective anti-inflammatory, antioxidant, and antimicrobial properties (Venos, 2013).
Few trials have studied its effects on MS. Trials on mice with AEA, an animal model of MS,
however, have shown Padma 28 to prolong survival time and decrease death rates (Badmaeve et
al., 1999). These examples are only a sample of the effectiveness of a particular Tibetan
medicine compound on MS and not a recommendation to take Padma 28. Tibetan medicine is a
complete system, and treatment is highly personalized to release the specific blocks and mental
toxins creating an imbalance in a particular person’s energy systems. Treatments for MS are
controlled carefully and modified as the humors rebalance (Dhondup & Husted, 2009). This
paper recommends that Cindy see a Tibetan physician in San Francisco for personalized
treatment as part of her full-spectrum treatment for MS.
Level 6 Pharmacological and Level 7 Surgical Interventions
While this protocol and the consciousness medicine model emphasize the mind, they
embrace the advancements in the understanding of nature and technology achieved by
conventional science and medicine (Beauregard et al., 2014, p. 273). Pharmacological agents and
surgery have improved and prolonged the lives of those affected by chronic diseases.
Nevertheless, isolated, these modalities have failed to cure (Engels, 2012). Not only is it not
possible to cure multiple sclerosis through current chemical or mechanical intervention, but these
reductionistic methods also produce side effects that range from mild to deadly. Side effects are
always a risk as any agent that alters any part of the immune system, proteins, or any body
system will influence all other biological systems that use the same building blocks (Lipton,
2015). For example, when we use a pharmacological agent, such as ibuprofen to relax the tension
in our shoulders, we also apply that same chemical agent to every other muscle protein in the
body, including the heart, the gut, the middle ear, and blood vessels in the brain (2015). This
widespread effect is why other medical models, such as Tibetan medicine and consciousness
medicine, only apply these interventions when symptoms are acute or deadly and as a last resort.
These final two levels, pharmacology agents and surgery, are addressed by Cindy’s
current biomedical team. For ethical reasons, this paper will not include an evaluation of her
current pharmacological interventions nor recommend other therapies at these levels of
Other Considerations
The therapies recommended are not an exhaustive array of possible therapies for each
level, nor can any level be isolated from the levels above or below. Homeopathy, for example,
uses tincture administered orally, a level four intervention that facilitates psychotherapeutic
processes (uncovering mental blocks and repressed emotions; Lester, 2021, video). Ayahuasca
ceremonies and psychedelic therapies are additional sources to uncover blocks, resistance, and
ancestral wounding working at both the spiritual and mental levels also applied orally (Garcia-
Romeu, 2016). Furthermore, hypnosis and guided imagery, considered under this protocol, a
level 2 mental practice, are effective in reducing bowel symptoms, pain, anxiety, and other
physical symptoms directly (Kittle & Spiegel, 2020). We must consider that any intervention at
any level will necessarily affect all other levels due to the interconnectedness of spirit, mind, and
body (Beauregard et al., 2014, p. 273).
Additionally, the protocol emphasizes the healing power of personal responsibility for
one’s healing journey and the need to establish healthy relationships at every level (to the divine,
self, nature, others, and community). These needs are significant factors to regaining health and
wellness (Fauver, 2016, video).
Lastly, we must remember that health is not the absence of disease but rather the
“complete physical, mental and social well-being” (World Health Organization [WHO], 1948).
Creating well-being can override even genetic predispositions (Lipton, 2015). Well-being is not
produced by simple improvements in diet, lifestyle, and stressors. These improvements can
prevent continued deterioration. Health requires that one thrives (Lipton, 2015).
By looking at a diverse range of medical models beyond the conventional model
practiced in hospitals and health centers today, more can be perceived of MS etiology.
Expanding our understanding of the causal chain can increase our ability to design effective
treatments. This paper has recommended specific interventions based on a structured 7-tier
treatment protocol that follows the expanded disease’s causal chain of consciousness medicine.
The protocol recommends beginning with consciousness and spirituality and work down to the
material level of symptomology. The paper only includes the first five levels of intervention,
those not currently addressed by conventional biomedicine. The recommendations are specific
to a particular patient and her specific symptoms, history, culture, and geographic availability of
In summary, the recommended interventions are as follows:
Level 1: Mindfulness meditation, group meditation, and family constellation therapy
Level 2: Group music therapy and individual alternative therapy
Level 3: Physiotherapy, mindful body practices, and body orientated therapy.
Level 4: Energy medicine – practitioner-delivered and self-help
Level 5: Tibetan medicine
All recommended therapies have been shown to have positive effects on MS disease outcomes.
The combination of them applied in the order of greatest influence on causal factors with the
least amount of risk strives to create the groundwork for extraordinary healing without harm. As
Cindy begins her healing journey, the intervention is laid out comprehensively, allowing her to
modify treatments where necessary.
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Full-text available
Background: Multiple Sclerosis (MS) is characterized by degeneration of the myelin sheath of an axon resulting in decreased transmission of nerve impulses. It is an autoimmune disease with periods of exacerbation and remission. Types of MS include relapsing-remitting, acute progressive, chronic progressive attack-remitting, and benign. Symptoms vary from patient to patient. Common symptoms include fatigue, spasticity, swelling, and altered gait. MS is commonly treated with medications that help relieve symptoms and prolong disease progression. Massage Therapy (MT), specifically Swedish techniques, have been effective in treating MS. Objective: To examine the effects of MT on mobility, fatigue, and edema in a patient with MS. Methods: An MT student from MacEwan University's 2,200-hour Massage Therapy program administered five MT treatments over a six-week period to a 58-year-old female diagnosed with MS 11 years earlier. She presented with symptoms of decreased mobility, fatigue, and left ankle edema. Assessment included active and passive range of motion (ROM), myotomes, dermatomes, reflexes, and orthopedic tests. Goals for the treatment sessions were to increase mobility, decrease fatigue, and decrease edema. Assessment measures included the Timed-Up-and-Go (TUG) test for mobility, the Modified Fatigue Impact Scale (MFIS) to measure fatigue, and Figure-8 ankle measurement to measure edema. Techniques used included Swedish massage, passive ROM, manual lymphatic drainage (MLD), and home-care exercises. Results: Little change was noted in mobility. The patient's fatigue level and left ankle edema decreased. Conclusion: The results suggest that MT is effective in reducing fatigue and edema in a patient with MS. Future studies are needed to evaluate the correlation between mobility and massage.
Full-text available
Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system (CNS). In recent years, vitamin D has gained attention, as low serum levels are suspected to increase the risk for MS. Cholecalciferol supplementation has been tested in several clinical trials, since hypovitaminosis D was linked to higher disease activity and may even play a role in long-term outcome. Here, we review the current understanding of the molecular effects of vitamin D beyond calcium homeostasis, the potential beneficial action in MS and hazards including complications of chronic and high-dose therapy. In clinical trials, doses of up to 40,000 IU/day were tested and appeared safe as add-on therapy for short-term periods. A recent meta-analysis of a randomized, double-blind, placebo-controlled clinical trial investigating vitamin D as add-on therapy in MS, however, suggested that vitamin D had no therapeutic effect on disability or relapse rate. We recognize a knowledge gap for chronic and high-dose therapy, which can lead to life-threatening complications related to vitamin D toxicity including renal failure, cardiac arrythmia and status epilepticus. Moreover, vitamin D toxicity may manifest as fatigue, muscle weakness or urinary dysfunction, which may mimic the natural course of progressive MS. Given these limitations, vitamin D supplementation in MS is a sensitive task which needs to be supervised by physicians. While there is strong evidence for vitamin D deficiency and the development of MS, the risk-benefit profile of dosage and duration of add-on supplementation needs to be further clarified.
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The aim of this systematic review was to evaluate the existing evidence on the effectiveness and safety of Tai chi, which is critical to provide guidelines for clinicians to improve symptomatic management in patients with multiple sclerosis (MS). After performing electronic and manual searches of many sources, ten relevant peer-reviewed studies that met the inclusion criteria were retrieved. The existing evidence supports the effectiveness of Tai chi on improving quality of life (QOL) and functional balance in MS patients. A small number of these studies also reported the positive effect of Tai chi on flexibility, leg strength, gait, and pain. The effect of Tai chi on fatigue is inconsistent across studies. Although the findings demonstrate beneficial effects on improving outcome measures, especially for functional balance and QOL improvements, a conclusive claim should be made carefully for reasons such as meth-odological flaws, small sample size, lack of specific-disease instruments, unclear description of Tai chi protocol, unreported safety of Tai chi, and insufficient follow-up as documented by the existing literature. Future research should recruit a larger number of participants and utilize the experimental design with a long-term follow-up to ascertain the benefits of Tai chi for MS patients.
Full-text available
Progressive multiple sclerosis (MS) is a severely disabling neurological condition, and an effective treatment is urgently needed. Recently, high-dose biotin has emerged as a promising therapy for affected individuals. Initial clinical data have shown that daily doses of biotin of up to 300 mg can improve objective measures of MS-related disability. In this article, we review the biology of biotin and explore the properties of this ubiquitous coenzyme that may explain the encouraging responses seen in patients with progressive MS. The gradual worsening of neurological disability in patients with progressive MS is caused by progressive axonal loss or damage. The triggers for axonal loss in MS likely include both inflammatory demyelination of the myelin sheath and primary neurodegeneration caused by a state of virtual hypoxia within the neuron. Accordingly, targeting both these pathological processes could be effective in the treatment of progressive MS. Biotin is an essential co-factor for five carboxylases involved in fatty acid synthesis and energy production. We hypothesize that high-dose biotin is exerting a therapeutic effect in patients with progressive MS through two different and complementary mechanisms: by promoting axonal remyelination by enhancing myelin production and by reducing axonal hypoxia through enhanced energy production. Copyright © 2015. Published by Elsevier Ltd.
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Background: Padma 28 is an herbal formula from Tibetan Medicine, which since 35 years has been registered in Switzerland as a drug for the symptoms of circulatory disorders. Over this time, a large body of scientific literature has accumulated. The aim of this article was to give an overview of the clinical studies. Methods: A systematic literature search was done in PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CCRCT). The clinical trials found were assessed regarding fields of application, efficacy, and safety, as well as methodological quality and level of evidence. Results: 29 trials (1 meta-analysis, 21 controlled trials, 7 open trials) and 3 retrospective case studies were found. They deal with different indications and include a total of 1,704 verum (of these, 697 children), 333 placebo, and 394 untreated or healthy patients. Dropouts and withdrawals were 2.5 and 3.5 times higher in the placebo than in the verum group, respectively. The highest level of evidence for the use of Padma 28 was found in the indication of intermittent claudication (11 trials). Indications of efficacy were also found in other vascular (6 trials) and different inflammatory diseases (12 trials). Conclusions: The results suggest a favorable safety profile for Padma 28, also in the children examined (41% of the study population). Furthermore, the results show a broad field of applications. According to clinical evidence, Padma 28 has shown to be a safe and effective symptomatic treatment option for atherosclerosis-related diseases such as intermittent claudication. It also seems to have a potential for application in certain chronic inflammatory diseases such as recurrent respiratory tract infections, viral hepatitis, and multiple sclerosis. However, further randomized controlled trials (RCT) are needed to confirm these findings.
Background A recent controlled trial suggested that high-dose biotin supplementation reverses disability progression in patients with progressive multiple sclerosis. Objective To analyze the impact of high-dose biotin in routine clinical practice on disability progression at 12 months. Methods Progressive multiple sclerosis patients who started high-dose biotin at Nantes or Rennes Hospital between 3 June 2015 and 15 September 2017 were included in this prospective study. Disability outcome measures, patient-reported outcome measures, relapses, magnetic resonance imaging (MRI) data, and adverse events were collected at baseline, 6, and 12 months. Results A total of 178 patients were included. At baseline, patients were 52.0 ± 9.4 years old, mean Expanded Disability Status Scale (EDSS) score was 6.1 ± 1.3, mean disease duration was 16.9 ± 9.5 years. At 12 months, 3.8% of the patients had an improved EDSS score. Regarding the other disability scales, scores either remained stable or increased significantly. In total, 47.4% of the patients described stability, 27.6% felt an improvement, and 25% described a worsening. Four patients (2.2%) had a relapse. Of the 74 patients (41.6%) who underwent an MRI, 20 (27.0%) had new T2 lesions, 8 (10.8%) had gadolinium-enhancing lesions. Twenty-five (14%) reported adverse event. Conclusion In this study, high-dose biotin did not seem to be associated with a clear improvement in disability.
Humans have used serotonergic hallucinogens (i.e. psychedelics) for spiritual, ceremonial, and recreational purposes for thousands of years, but their administration as part of a structured therapeutic intervention is still a relatively novel practice within Western medical and psychological frameworks. In the mid-20th century, considerable advances were made in developing therapeutic approaches integrating administration of low (psycholytic) and high (psychedelic) doses of serotonergic hallucinogens for treatment of a variety of conditions, often incorporating psychoanalytic concepts prevalent at that time. This work contributed seminal insights regarding how these substances may be employed with efficacy and safety in targeted therapeutic interventions, including the importance of optimizing set (frame of mind) and setting (therapeutic environment). More recently, clinical and pharmacological research has revisited the effects and therapeutic potential of psychedelics utilizing a variety of approaches. The current article provides an overview of past and present models of psychedelic therapy, and discusses important considerations for future interventions incorporating the use of psychedelics in research and clinical practice.
Background Published data suggested high dose biotin improved patients with progressive MS. We wished to determine benefits and side effects of administering daily high dose biotin to patients with progressive multiple sclerosis in a large MS specialty clinic. Methods Forty-three patients with progressive multiple scleroses were prescribed pharmaceutical grade biotin as a single daily dose of 300 mg/day. Brain MRIs were performed at baseline and after one year on biotin. Quantitative neurologic exams (EDSS) and blood work monitoring for biotin toxicity were performed at baseline and every three months thereafter. Results High dose biotin was safe, and well tolerated, with no evidence of toxicity on blood work and no new lesions on brain MRIs. None of the patients’ EDSS scores improved. One-third of patients (38–43%) worsened, most often with increased lower extremity weakness, worsened balance, and more falling, with two patients worsening sufficiently to increase their EDSS scores by 0.5. Several worsened patients improved after stopping biotin. Conclusion High dose biotin was safe and well tolerated, but of no demonstrable long-term benefit. More than one-third of patients worsened while on biotin, most likely due to their disease, but in some patients also possibly due to the inability of their injured central nervous systems to respond to the increased metabolic demands induced by biotin.