Bottom Line/Health: Getting a diagnosis of MS is bad; living with it can be even worse. The drugs are heavy duty, the side effects can be even worse. But there are things that you can do that can reduce that risk and reduce the side effects.

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m talking to Dr. Brooke Kalanick, a leading naturopathic physician in private practice in New York City, who specializes in women’s hormonal and weight issues. Welcome, Brooke.

Dr. Brooke Kalanick, ND: Thank you.

Bottom Line: All right, in Western medicine, in the Western world, obviously getting a diagnosis of MS is like a slow walk into quicksand, because it’s slowly breaking you down and almost strangling you as life goes on, and you’ve got nowhere to go. There’s no way out of it. Is it really just a drowning, or are there things that you can do to at least slow down that walk into quicksand?

Dr. Kalanick: Any time we have an autoimmune process, once it’s on, we can’t go back and turn it off, but what we can do is try to make the experience of it better. One of the things with MS is that it has the classic flares. There’re times when you’re doing okay, and then there are times when you’re feeling really, really bad. It’s a bit of an up-and-down roller coaster.

There are lifestyle things, nutrients. A lot of naturopathic and alternative medicine really shines in this area, because there are things we can do to make those highs and lows less steep and make the bad days further apart.

Bottom Line: Let’s break that down. Just having the reactions and having it flare up, what is it that’s triggering the flares?

Dr. Kalanick: When you look at an autoimmune disease, we have to understand how our immune system works. It’s constantly interacting with our environment. It’s constantly reading a bacteria or a virus, it’s responding to your own hormones. It’s very fluid. And when you have an autoimmune condition, it’s losing the ability to be more fluid, and instead of getting back to its equilibrium, it sort of stays, like a teeter-totter, stays up on one end or on the other end.

So what we can do with nutrients and lifestyle and managing some of these immune system things is we can help it be a little bit more regulated. We can’t necessarily turn it off and say “you don’t have MS anymore,” but we can do two things: we can make it so that the flares are less severe, and we can protect the tissues that are under attack. In this case, it’s your brain and central nervous system.

We want to literally water the plant. You should take good nutrients for brain and nervous system health, like krill oil and antioxidants – resveratrol really shines here, as does turmeric – and really support those tissues that are under attack.

And then, take a step back and look at all the things we do have control over. We don’t have control over every bacterium. I shook your hand earlier; I may have come in contact with a virus. You can’t control that. However, when we’re talking about our immune system having to react to the food that we eat and the stress that we put it under and our hormonal imbalances, we can have a lot of effect there to regulate your immune system and make the flares less significant, and hopefully over time of doing that work, further apart.

Bottom Line: Let me break that down a little bit. Silly question: there are all sorts of different autoimmune diseases – rheumatoid arthritis, MS, lupus, whatever – do they all have similar triggers, and then it’s just dependent on which disease you have is how it expresses itself?

Dr. Kalanick: Exactly. It’s still, when you step back from the tissues under attack – in MS, it’s the brain and central nervous system; it’s literally attacking the insulation around our nerves. Let’s say it’s Hashimoto’s autoimmune, hypothyroidism; it’s attacking the thyroid. If it’s RA, it’s attacking your joints. There’re different tissues under attack, but the problem is always a disregulated immune system. So when you take the tissue, you can support that tissue that’s under attack, but then you need to step back and balance the immune system.

Bottom Line: What are the key factors to reduce the responsiveness of – I’ll call it the anger of the autoimmune system.

Dr. Kalanick: In the research, we have a couple of compounds that work really well in natural medicine to help modulate that system and make it less reactive. These are things that I would recommend people take on a daily basis with autoimmunity. But when you have those flairs, we can up the doses and help you get through that a little bit quicker.

There are things like having a nice vitamin D level. Above 50 nanograms per milliliter is a must if you’ve got an autoimmune disease.

Bottom Line: The level in your blood, not the quantity to take?

Dr. Kalanick: Not the quantity, exactly. You want to be getting your blood work checked so you know how much vitamin D you need to take. You may have enough. Most people are deficient. So you supplement it to get it to a level, and then you adjust it to keep it at that level.

Another thing that’s very important is using glutathione boosters. We can take things like N-acetylcysteine to try to boost our glutathione level. Glutathione is almost like your bulletproof vest; it’s the thing that allows your body and your immune system to take a hit. So the more adaptive that can be, the easier a time you will have keeping that immune teeter-totter more level. And then turmeric has great research, again, on keeping the immune system more modulated and more even. And then food is very important.

Those are things we can take to keep it more level, but what about all the things we’re doing that push it one way or the other?

Bottom Line: I was just going to say, how about the sleep, how about the stress, all of those sorts of self-care things that you really have to pay attention to when you have these diseases, yes?

Dr. Kalanick: And this is where food comes in. Things like gluten and dairy and soy and things that we know to be immune triggers for a lot of this population. It’s not that everyone in the world is going to get an autoimmune disease if they eat gluten, but if you have one, that’s one of the biggest immune aggravators in our modern diet.

So taking those things out can go a long way towards helping someone have a less reactive system, more good days, and the flare-ups not being as bad.

Bottom Line: So we’ve calmed the system down now; what can be done in terms of the nervous system and trying to heal the tissues or calm the tissues down? You mentioned before resveratrol?

Dr. Kalanick: Yeah, those nutrients calm the attack down, but then, like I said, water the plant. We know the brain and the central nervous system is under attack. Krill oil can be really great antioxidants. Nutrients like acetylcholine to boost neurotransmitters in your brain, 5-HTP. Any support you can give to your brain is usually going to help that tissue that’s under attack. So again, resveratrol and krill oil would probably be two of my favorites to put into a regimen for someone with MS.

Bottom Line: And krill oil as krill oil or krill oil as omegas – again the anti-inflammatory with the omegas? 

Dr. Kalanick: Sometimes we need more omegas than we’re going to get out of krill oil, but krill oil is a little bit special. It has some other components, like phospholipids, that make it sort of – some people call it fish oil on steroids. It’s got a little bit more punch to it. So, most likely, you’re going to need to take krill oil to support the brain tissue, but you might also need to additionally support with other omega-3s.

Bottom Line: If somebody is doing all this so that they’re helping not calm the tissues and also reduce the flares, can they also theoretically do anything that helps with side effects of the medications that they’re taking?

Dr. Kalanick: That gets a little bit trickier, because our medications for autoimmune, especially in the case of MS, they’re very strong. They’re trying literally to suppress your immune system to stop the attack. That’s where really good self-care comes in, managing the side effects as best you can with good sleep and good diet.

But the medications are really significant. They work well in terms of shutting the immune system down for some people, but there are all those other things you can do to keep it a little bit more balanced. And any of those things is going to make your side effects less severe.

Bottom Line: How about the flip side? That the better somebody does the self-care in terms of supporting the immune system and tamping down the inflammation, can that allow them to reduce the amount of medication that they’re on?

Dr. Kalanick: Oftentimes yes. Autoimmune disease has a mind of its own, and your MS is not going to be the same as my MS. I’ll have some patients that you’ll see just fall apart in a matter of 6 months, and other times someone does really, really well for quite a long time. These things move at a very different rate in different people, so it’s important for us not to tell everyone that they can expect miraculous results from going off gluten for 30 days. It is important to know that sometimes this does move faster in some people.

Bottom Line: How about any different strategies for men versus women? I know mostly women get all autoimmune diseases, but there was the famous Meredith Vieira from NBC whose husband had a severe case of MS for years.

Dr. Kalanick: Yeah, women do get these autoimmune diseases mostly, except for one. We get most of them more often than men. Another thing that comes into play here is our hormonal fluctuations. Women go through more surges of estrogen – the first couple weeks of our cycle, we have spiking estrogen; pregnancy is a time of high estrogen; perimenopause into menopause is a time of fluctuating estrogen.

Those fluctuations can also be really tough for the immune system to take and can make some of the flares worse, so that’s where giving really good adrenal support and hormone balance support to a person can be really helpful to managing this overall immune picture.

It gets quite complicated. There’s also how well you’re getting iron and oxygen delivered throughout your blood. That plays a role. Your blood sugar swings. There’s a lot that can be done to help manage this.

Bottom Line: All right. Thank you, Brooke. The bottom line? If you have MS, you have MS. You’re not going to cure it. But you can live a whole lot better with it by supporting your immune system, by talking to somebody who’s trained in naturopathic support that can help you with glutathione, can help you with vitamin D, and can help you with turmeric and other supplements to help your immune system function better. Then you can reduce the extent and the frequency of the flares.

You can also work with somebody that can help you calm down the tissues in MS. There are things like resveratrol and other supplements, omegas, krill oil – that can help calm the inflammation so that the pain and the side effects, the effects of the MS flare-ups, are not so severe. I’m Sarah Hiner with Bottom Line.