There I said it.  It was always going to happen. I’m ok, thanks for asking.  This week we had a case of a woman diagnosed with MS in her late 20s. That was 5 years ago and she’s been medicated ever since with an immunosuppressant and she is understandably very nervous about taking any complementary medicine that would pull against this medication, interfering with its actions.  Her concerns extended to zinc supplementation in spite of her plasma zinc being 7 umol/L.  That’s right, 7. Zinc STAT, right?  But slow up there everyone, her apprehension is not necessarily unfounded.

The top nutritional research topics in MS are: Vitamin D (for der…we all knew that, right?), Vitamin A and Zinc.  The fan-mail for the first two, as key immuno-modulators in both prevention and in established conditions, is almost at stalker level. 

In contrast Zinc attracts both fan and hate mail.

Although the jury is far from in, there’s growing concern that while extracellular levels of Zinc may appear low in MS (that includes of course plasma/serum values) the same individual may actually have elevated levels inside their cells and more specifically inside their CNS. Gulp.  But wait there’s more. There is a hypothesis that Zinc dysregulation may be a pathophysiological driver in MS. Double Gulp. My (nutritional) soul mate has shown a potential dark side finally and is sitting under a cloud of suspicion.  So what do we need to do differently?

If you’re seeing MS patients you need to be up on the sizeable pile of research into CM in this condition.  A brilliant place to start is this very readable review of ‘Vitamins in MS’.  

And specifically in regard to Zinc status in your MS patients?  Well my advice is don’t rely on a plasma/serum Zinc alone – but couple this with an rbc Zn to ensure there is no sign of intracellular accumulation at play before you make a decision about treatment. Not a perfect solution, but while we’re unlikely outside of research to ever be able to measure CNS zinc concentrations, a reasonable approach. An unchecked zinc deficiency is in no-one’s interests either, including your MS patients – so it’s about gathering the best quality information you can to walk that fine line of adequacy not excess. And if you’re still reeling at the very thought that Zinc has a dark side – remember I did warn you…in Mastering Micronutrients – which is essentially a series of truth-bombs one of which, is every nutrient has a sting in its tail, a U-shaped dose response and a dark side.  We need to get to know them all.

Mastering Micronutrients – An Upskilling Opportunity for Old and New Hands

Let’s make sense of the over-arching nutrition principles, that will profoundly change your understanding and application of this modality  Truly understanding the ‘big’ concepts, so often overlooked, or incorrectly taught, ensures you get the critical ‘small’ detail in your nutritional prescriptions right. In this 4 hour recording, together with key clinical tools, we talk about the tough stuff: dose-response curves, active versus passive stores and excretory pathways and ooh lah lah…the myth of taking ‘activated vitamins’.  Even those who feel satisfied with their original training – will find a lot in this critical review that is new, insightful and truly practise-changing!

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