Medications are often a must for the roughly 400,000 Americans with multiple sclerosis (MS). Powerful disease-modifying drugs (DMDs) can reduce the development of new brain and spinal cord lesions that lead to symptoms…prevent relapses…slow the disease’s progression…and delay disability.

THE BIG MISTAKE: For the majority of patients with MS, drugs are the only therapy used.

In my own experience treating thousands of people with MS, I have found that an integrative approach—a treatment plan that combines conventional medicine with science-supported nondrug strategies such as diet, nutritional supplements and exercise—is a much more effective way to manage symptoms and improve quality of life than medications alone.

NEW EVIDENCE: In a one-year study published in Journal of the American College of Nutrition, an integrative approach including a healthy diet, stretching, meditation and self-massage eased depression, anxiety and fatigue in people with MS and helped prevent mental decline.

Additionally, starting a healthy lifestyle when MS is diagnosed (typically between the ages of 20 and 50) can help prevent chronic, lifestyle-associated medical problems, such as obesity, arthritis, heart disease and diabetes, that may worsen disability and quality of life in those with MS.

Here are the most reliable, safest and cost-effective integrative treatments for MS patients…


I advise my MS patients to stay away from (or at least minimize) processed foods…avoid overeating…and consume a plant-based diet. This simple advice may make a huge difference in their health, especially over the long-term.

WHAT NOT TO DO: I find that extreme diets—for example, a strict Paleolithic diet or strict gluten-free diet—may be difficult to follow and may not actually be healthy for people with MS. They don’t provide the variety of foods that support good health.

BOTTOM LINE: There is no one diet that is best for MS. But the worst diet for MS is the standard American diet, loaded with processed foods, fatty meats and sugar. Eliminating those foods and ingredients goes a long way toward maintaining good health.


There are two common nutritional deficiencies that I have found in people who have MS—vitamin B-12 and vitamin D. I test my patients for these two deficiencies and advise supplements if necessary, customizing the dose to the patient. A multivitamin may be considered for those with an unhealthy diet, but it is preferable to change the diet.

RECENT SCIENTIFIC RESEARCH: Dozens of studies show that low vitamin D levels or low vitamin D intake increases the risk for MS and, in those with MS, increases risk for attacks, disability progression and new brain lesions. Also, there are studies that a subgroup of people with MS are at risk for vitamin B-12 deficiency—this is of concern because many of the symptoms of vitamin B-12 deficiency are the same as those of MS.

BEWARE: There is a lot of hype about nutritional supplements for MS. Watch out for products asserting that a single nutritional supplement can treat many different diseases, including MS…touting one or more “secret” ingredients…or relying heavily on customer testimonials as evidence of effectiveness.


Research shows that regular exercise can reduce the fatigue, muscle weakness and walking difficulties common with MS. Other symptoms that exercise may ease include anxiety, anger, depression, bowel and bladder difficulties (such as constipation, incontinence, urgency and frequency), pain, sleeping difficulties, stiffness in the arms or legs (spasticity) and cognitive decline. Exercise may even slow the progression of the disease.

NEW SCIENTIFIC RESEARCH: In a six-month study of 35 people, published in Multiple Sclerosis Journal, researchers found that twice-a-week resistance-training slowed the rapid shrinking of the brain common in MS. Some areas of the brain even started to grow.

MY ADVICE: In addition to twice-weekly strength training (such as wall squats with or without hand weights, lunges and wall push-ups), I urge my patients to do aerobic exercise (30 minutes of medium–intensity exercise, such as stationary cycling, dancing or walking, twice weekly). Aerobic exercise has many benefits for MS patients including improved cardiovascular fitness…better bowel and bladder control…and less fatigue and depression.

ALSO HELPFUL: Hydrotherapy (water exercise such as swimming and water aerobics) may be especially well-suited for people with MS who have leg weakness. And yoga is particularly good for easing spasticity. In a recent study published in the journal Medicine & Science in Sports & Exercise, eight weeks of water exercise or yoga improved fatigue, depression and tingling and numbness in women with MS, compared with a group that didn’t exercise.


Emotional health is a crucial but often-neglected component in the treatment of MS.

NEW SCIENTIFIC RESEARCH: In a study of more than 1,000 people with MS, published in Neurology, 44% reported their emotional well-being was worsening due to fatigue, trouble concentrating and bladder/urinary problems.

WHAT I RECOMMEND: To improve emotional well-being, I counsel my MS patients to identify their difficult emotions—and to talk about those feelings with a spouse or friend. I have found that patients who do this not only feel happier but also dramatically reduce their feelings of stress.

ALSO HELPFUL: Listening, creating or moving to music stimulates feelings and facilitates emotional processing. A professional music therapist can suggest an approach geared to your specific situation. A study published in the journal Expert Review of Neurotherapeutics found that music therapy improved self-acceptance and eased depression and anxiety in MS patients. To find a music therapist near you, consult the American Music Therapy Association at