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Exploring Myelin Repair, Stem Cell Therapy, and Medical Cannabis

By Cherie C. Binns
Cherie-Binns-and-Husband.pngIn part one, we covered mental health comorbidities and the changing landscape of the doctor-patient relationship in MS Care. There was discussion on which medications are safest and how to decide on your disease-modifying therapy as well as looking at lifestyle changes that can affect your quality of life. Now we will take a look at myelin repair, progress in finding a cure for MS, the current status of stem cell therapies, and medical cannabis.

Myelin repair occurs naturally once inflammation has been addressed in the central nervous system. 
  • CNS inflammation must be managed in order for myelin repair to take place therefore, in active disease, a DMT seems necessary for repair to happen.
  • Myelin repair processes are more active in younger individuals and taper off as we age. Possibly because of this factor, the therapies being studied are working best in younger individuals with less CNS damage.
  • Once a nerve is transected or cut, myelin repair of that nerve axon will not be effective.
  • Biotin can be a problem as it causes false readings on many common lab tests. Biotin itself is used in many of the chemicals used in the lab. As a result, false readings will happen in the person taking high doses of this vitamin. We see this particularly with blood glucose and thyroid tests. If your doctor does not know you are on high dose biotin, you may be prescribed medications to treat thyroid conditions or diabetes that do not exist and this could be life-threatening.

Stem Cell Therapies are being refined and bring hope of slowing and even reversing the progress of MS.
  • Adipose stem cell therapies are never prescribed by licensed clinicians. They are bogus, cost thousands of dollars, are not covered by insurance, and have no science to back them up. The FDA has now been awarded oversight of “for profit” stem cell companies in the USA to try and stop this abuse. “Improvement” with these therapies comes from “placebo effect” and not from actual cellular change. This oversight was mandated after reports of four individuals permanently losing their eyesight from these treatments.
  • HSCT (hematopoietic stem cell therapies) use cells harvested from the individual who will be receiving this treatment. They are multiplied in the lab and infused back into the individual after their immune system has been severely suppressed with chemotherapy. The hope is that the immune system will “re-boot” and attacks on the CNS be halted. This procedure comes with very high risks but shows great benefit in young people with quite active disease.
  • ASCT (autologous stem cell therapies) use cells that come from a donor following the process listed for HSCT above.
  • It can be dangerous, even fatal or permanently disabling to go outside the country seeking these therapies as they are not regulated outside the USA and Canada in the same way they are here.

Medical cannabis is now available throughout most of the United States and Canada for a number of conditions including MS. The Canadian MS Society has teamed up with Health Canada in a five-year study looking at the benefits and risks in using products from this source. What we know currently:
  • Cannabinoid products seem to be helpful for many people with MS in pain relief and spasticity reduction.
  • While most people wih MS using these products do not see a reduction in cognitive function, routine testing in these individuals shows the opposite.
  • There is currently no consistency in product potency across states and in most dispensaries. This hampers our understanding of dose/benefit in all individuals. There are a couple of products currently available by prescription that are created in the lab and have accurate dosing so many prescribers may offer to try these for symptom relief before approving a license to use medical cannabis.
  • More research is needed for us to get the most out of these therapies at appropriate dosing.

Real Talk MS did an interview with Dr. Karen Lee, vice president of research with the Canadian MS Society at the recent CMSC meeting. Dr. Lee discusses the topics in this article here. This entire 27-minute podcast addresses the issues of CNS repair, progress toward a cure for MS and Canada’s look at the risks/benefits of medical cannabinoids to treat multiple sclerosis.

Cherie C. Binns RN BS MSCN cherie@msfocus.org for questions or comments related to this article.

Reviewed 1/2024.