Bioidentical Hormone Estriol
Beneficial For Multiple Sclerosis MS
by Jeffrey Dach MD
Multiple sclerosis affects about a million people worldwide. It is an auto-immune neuro-degenerative disorder characterized by demyelinating plaques thought the brain and spinal cord, visible on MRI scans (Magnetic Resonance Imaging) and CAT scans. The demyelinating plaques interfere with neuron function, and cause focal neurologic symptoms which wax and wane over time.
Symptoms include double vision, weakness in the arm or leg, difficulty with balance or walking, tingling, numbness etc. Conventional treatments with anti-inflammatory medications are sometimes useful, however, they come with serious adverse side effects. There is a need for safer and more effective treatments for multiple sclerosis. Previous studies in animals and humans have shown that a from of Estrogen called Estriol, a bioidentical hormone, is a promising new treatment of Multiple Sclerosis. (2-5)
Pregnancy Confers Protection In MS
Dr. Rhonda Voskuhl, a UCLA neurologist, who holds a patent on Estriol for MS (4), has made the observation that pregnancy confers relative protection from relapse in multiple sclerosis patients. Based on this observation, she theorized that the pregnancy hormone, Estriol may be protective agent. Pregnancy Photo courtesy of this page.
50% Reduction in MS Symptoms With Estriol
At a recent neurology meeting, Dr. Rhonda Voskuhl reported on her preliminary findings on her study using the bioidentical hormone, Estriol.(1) She found a nearly 50% reduction in relapse rate in MS patients given Estriol (8 mg day oral pill) (1)
Watch the You Tube Video:
We routinely include Estriol in our HRT program for all women.
This is our approach to natural treatments for multiple sclerosis:
1) Wheat Gluten Could be the Culprit
Firstly, MS is an auto-immune disease, therefore Wheat Gluten sensitivity should be suspected and testing for the anti-gliadin antibody carried out. Wheat gluten ingestion may be causative for the auto-immune process. Many MS patients find that their symptoms improve on a Gluten Free Diet. See my previous article on Wheat Gluten And Autoimmune Neurologic Disease
Left Image courtesy of Medscape: MRI
of the brain in multiple sclerosis showing typical distribution of
periventricular white matter lesions. (shown as white spots). These
fixed lesions correspond to edema, demyelination, gliosis, and axonal
loss.
2) Vitamin D
Vitamin D deficiency is thought to be a causative factor in Multiple Sclerosis. Vitamin D for MS has been extensively studied and benefits reported in the medical literature. A review by Dr. Brown reported that Vitamin D supplementation prevented the development and progression of experimental autoimmune encephalitis, an animal model of MS, in mice. A large, prospective, cohort study found that vitamin D supplementation was associated with a 40% reduction in the risk of developing MS. Four small, non-controlled studies suggested that vitamin D supplementation may decrease exacerbation of MS symptoms. MRI studies of multiple sclerosis lesions show improvement during summer months and worsening during winter months suggesting a Vitamin D link.
Many MS patients report improvement of their neurological symptoms with vitamin D3 supplements. We routinely test Vitamin D3 levels and provide supplements to raise serum levels to the upper third of the normal range. Avoid Vitamin D2, use D3 instead. See more details in my previous article on Vitamin D for Multiple Sclerosis.
3) Vitamin B12
Vitamin B12 deficiency can mimic the clinical presentation of multiple sclerosis, so we test for and supplement with B12 injections in many of our MS patients. See my previous articles:
Vitamin B12 Deficiency and Neuropsychiatric Disorders.
and Vitamin B12 Deficiency Part One.
4) LDN Low Dose Naltrexone
Low dose Naltrexone is an FDA approved drug which has been found very useful for MS patients. We have seen excellent results and routinely recommend it for all MS patients. LDN is obtained as capsules from a compounding pharmacy, which are taken at night before sleep. There are no known serious adverse side effects. See my previous articles on LDN: Low Dose Naltrexone Part One
Header image courtesy of Dr. Rhonda Voskuhl and UCLA Health.org
Articles with related interest:
Vitamin D for Multiple Sclerosis
Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663
http://www.jeffreydach.com
http://www.drdach.com
http://www.naturalmedicine101.com
http://www.bioidenticalhormones101.com/
Links and References
1) http://newsroom.ucla.edu/
Preliminary clinical trial shows great promise for new multiple
sclerosis treatment. Female hormone estriol reduces relapse rate by
nearly 50 percent, UCLA neurologist reports
A study conducted by Dr. Rhonda Voskuhl, a UCLA neurologist, shows that
combining estriol, a female hormone, with Copaxone, a medication
currently used to treat multiple sclerosis, reduced the relapse rate of
MS by nearly 50 percent with only one year of treatment. Voskuhl
presented the results of the preliminary Phase II clinical trial today
at the annual meeting of the American Academy of Neurology in
Philadelphia.
The randomized, double-blind, placebo-controlled trial involved 158 women with relapsing-remitting MS. At 16 sites across the U.S., one group of women was treated with Copaxone, a commonly prescribed, standard-of-care drug for MS, and an 8 milligram estriol pill each day; others received Copaxone and a daily placebo pill. After 12 months of treatment, the relapse rate for the Copaxone-plus-estriol group was 47 percent lower than that of the group that took Copaxone plus a placebo.
2) http://www.jimmunol.org/
http://www.ncbi.nlm.nih.gov/
J Immunol. 2003 Dec 1;171(11):6267-74.
Immune modulation in multiple sclerosis patients treated with the pregnancy hormone estriol.
Soldan SS1, Alvarez Retuerto AI, Sicotte NL, Voskuhl RR.
The protective effect of pregnancy on putative Th1-mediated autoimmune
diseases, such as multiple sclerosis and rheumatoid arthritis, is
associated with a Th1 to Th2 immune shift during pregnancy. The hormone
estriol increases during pregnancy and has been shown to ameliorate
experimental autoimmune encephalomyelitis and collagen-induced
arthritis. In addition, estrogens induce cytokine changes consistent
with a Th1 to Th2 shift when administered in vitro to human immune cells
and in vivo to mice. In a pilot trial, oral estriol treatment of
relapsing remitting multiple sclerosis patients caused significant
decreases in enhancing lesions on brain magnetic resonance imaging.
Here, the immunomodulatory effects of oral estriol therapy were
assessed. PBMCs collected longitudinally during the trial were
stimulated with mitogens, recall Ags, and glatiramer acetate. Cytokine
profiles of stimulated PBMCs were determined by intracellular cytokine
staining (IL-5, IL-10, IL-12 p40, TNF-alpha, and IFN-gamma) and
cytometric bead array (IL-2, IL-4, IL-5, IL-10, TNF-alpha, and
IFN-gamma). Significantly increased levels of IL-5 and IL-10 and
decreased TNF-alpha were observed in stimulated PBMC isolated during
estriol treatment. These changes in cytokines correlated with reductions
of enhancing lesions on magnetic resonance imaging in relapsing
remitting multiple sclerosis. The increase in IL-5 was primarily due to
an increase in CD4(+) and CD8(+) T cells, the increase in IL-10 was
primarily due to an increase in CD64(+) monocytes/macrophages with some
effect in T cells, while the decrease in TNF-alpha was primarily due to a
decrease in CD8(+) T cells. Further study of oral estriol therapy is
warranted in Th1-mediated autoimmune diseases with known improvement
during pregnancy
3) http://www.ncbi.nlm.nih.gov/
Ann Neurol. 2002 Oct;52(4):421-8.
Treatment of multiple sclerosis with the pregnancy hormone estriol.
Sicotte NL1, Liva SM, Klutch R, Pfeiffer P, Bouvier S, Odesa S, Wu TC, Voskuhl RR.
Multiple sclerosis patients who become pregnant experience a significant
decrease in relapses that may be mediated by a shift in immune
responses from T helper 1 to T helper 2. Animal models of multiple
sclerosis have shown that the pregnancy hormone, estriol, can ameliorate
disease and can cause an immune shift. We treated nonpregnant female
multiple sclerosis patients with the pregnancy hormone estriol in an
attempt to recapitulate the beneficial effect of pregnancy. As compared
with pretreatment baseline, relapsing remitting patients treated with
oral estriol (8 mg/day) demonstrated significant decreases in delayed
type hypersensitivity responses to tetanus, interferon-gamma levels in
peripheral blood mononuclear cells, and gadolinium enhancing lesion
numbers and volumes on monthly cerebral magnetic resonance images. When
estriol treatment was stopped, enhancing lesions increased to
pretreatment levels. When estriol treatment was reinstituted, enhancing
lesions again were significantly decreased. Based on these results, a
larger, placebo-controlled trial of estriol is warranted in women with
relapsing remitting multiple sclerosis. This novel treatment strategy of
using pregnancy doses of estriol in multiple sclerosis has relevance to
other autoimmune diseases that also improve during pregnancy.
4) //www.google.com/patents/
Estriol therapy for multiple sclerosis and other autoimmune diseases
US 6936599 B2
Inventors Rhonda R. Voskuhl
The present invention discloses administering steroid hormones to
mammals to treat autoimmune related diseases, more particularly,
Th1-mediated (cell-mediated) autoimmune diseases including: multiple
sclerosis (MS), rheumatoid arthritis (RA), autoimmune thyroiditis and
uveitis. Most preferably the invention is used to treat a patient with a
therapeutically effective amount of estriol of 8 milligrams once daily
via oral administration to treat the symptoms or prevent the onset of
multiple sclerosis.
5) http://www.medscape.com/
Medscape Medical News from the American Academy of Neurology (AAN)
66th Annual Meeting Adding Estriol Reduces MS Relapse Rate
———–
YouTube Video
6) Published on Apr 29, 2014
Female hormone estriol reduces relapse rate by nearly 50 percent, UCLA neurologist reports
A study conducted by Dr. Rhonda Voskuhl, a UCLA neurologist, shows that
combining estriol, a female hormone, with Copaxone, a medication
currently used to treat multiple sclerosis, reduced the relapse rate of
MS by nearly 50 percent with only one year of treatment.
Voskuhl presented the results of the Phase II clinical trial today at
the annual meeting of the American Academy of Neurology in Philadelphia.
<iframe width=”560″ height=”315″ src=”//www.youtube.com/embed/
7) http://www.empowher.com/multiple-sclerosis/content/preliminary-research-estriol-looks-promising-ms-treatment
Preliminary Research on Estriol Looks Promising for MS Treatment By Jody Smith HERWriter
———————
Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663
http://www.jeffreydach.com
http://www.drdach.com
http://www.naturalmedicine101.com
http://www.bioidenticalhormones101.com/
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