4 Complementary Therapies Enhance Your Healing For MS Patients

Darin Ingels, ND

I’m a naturopathic doctor by training. I have been practicing for 24 years, but I developed MS over a decade ago. And so I’m an MS patient myself. And like you, I had to learn several things about my own health, which, of course, I have applied to my own patients to help them achieve optimal health.

Terry Wahls, MD

Okay, there is a bunch of interesting novel therapies that we are going to talk about. So let us start with acupuncture. How is it used and why is it helpful? And we will include this for MS and other people with other neuroimmune conditions.

Darin Ingels, ND

You need to understand that acupuncture, what we would call traditional Chinese medicine, has been around for over 5000 years. And we have got several studies showing the health benefits of acupuncture. Now, here I live in California. Acupuncturists are also trained as Chinese herbalists. So they use Chinese herbal medicine. And again, these are formulas that are mixtures of herbs that have been used for literally centuries to treat all sorts of different maladies. So the combination of acupuncture and Chinese herbal medicine can be incredibly powerful and help for a lot of the different symptoms that people with MS experience. It can help with sleep issues that can help with blood flow, issues that can help with spasticity, and help with mobility. 

I know that the purists will tell you that acupuncture alone would probably not be enough, that they would like you to do the combination of acupuncture with the Chinese herbal medicine. Whenever there is any kind of chemical issue in the body. They like to use herbal medicine because the best way that a medical doctor might use a pharmaceutical, they are using the herbs to instigate change in the body. So I think acupuncture by itself can be helpful. For example, I used to be a terrible sleeper and my ex-wife was an acupuncturist. I got a lot of acupuncture. And it would help calm my nervous system down, help improve my quality of sleep. And Chinese herbs, if you have never taken them, by the way, do not ever ask what is in them. You probably do not want to know. These are formulas that derive from things anywhere from orange peel to ground up scorpion to snake gall bladder and kind of odd things to us. 

But back in the day, these are things that they found to be useful. That combination of herbs that can help so many different aspects of what people with MS are dealing with. I’m not aware of any specific research on Chinese medicine in terms of helping with re myelination. But, the key to MS, first and foremost is you have been teaching and you talk about in your book is you got to get the inflammation under control. And there is so much that can be done with acupuncture and Chinese herbs to really help quell that inflammation.

Terry Wahls, MD

I’m going to take a couple more things about acupuncture. I have the impression that there are wonderful acupuncture devices now and that those magnetic fields can stimulate acupressure sites and that red light therapy can stimulate acupuncture results. Is that correct, or am I in error there?

Darin Ingels, ND

When we talk about acupuncture as a whole, understand that depending on where acupuncture came from, like which country. So acupuncture from China is done a little bit differently than acupuncture from Japan, which is different from acupuncture from Korea. So each country kind of modeled it a little bit differently. And when you are talking about acupuncture specifically there are hundreds of different acupuncture points that they figured out centuries ago. And so the whole idea is that each point is what they call meridians are associated with different organ systems. They didn’t do autopsies back then. It wasn’t nice to cut open bodies. So their understanding of the organ system is a little bit different than the way we understand it in Western medicine. 

So they talk about the kidney meridian or the gallbladder meridian. It may not necessarily be associated with your actual kidney or actual gallbladder. And along these meridians that run really from head to toe, there are multiple points along that way. So when an acupuncturist puts a needle into that point, each point is associated with different activities. So in traditional Chinese medicine, they look at your tongue, they take your pulses, which is different than just measuring your pulse rate, but they’re feeling for different. How deep is your pulse? What’s the texture of the pulse? And this is how they come up with their diagnosis and based on that, that dictates which points they’re going to select to choose to put the needle in. But you do not necessarily have to stimulate the point with a needle. Like you said, you can put a needle in and you can connect an electric current that is called electro-acupuncture. You can use a red light to that point. You can just push on the point. That is called acupressure. So I think the end result is really the same as that.You’re trying to stimulate that specific point to get that effect. And again, I’m not an acupuncturist, so I have a very rudimentary understanding of these points. But, when you look at the organ systems, again, it is so much more complex than what we talk about in Western medicine because these organ systems are associated with the times of the clock. They’re associated with different organ systems. It is fascinating because it is a completely different understanding of the body. But the fact it is evolved over literally millennia, they have really fine-tuned it. And it is just amazing how sometimes acupuncture can pick up on things that we sometimes overlook in Western medicine.

Terry Wahls, MD

Sure. Let’s talk about hyperbaric oxygen.

Darin Ingels, ND

I am a huge fan of hyperbaric oxygen, so I personally use hyperbaric oxygen. I have used it with a lot of my patients, including MS patients. And if you think about the overarching things of what hyperbaric oxygen does, we call it hyperbaric oxygen therapy. There are really two parts to it, though. There is the hyperbaric. What that means is that it applies pressure. When you get in these chambers, it is increasing the pressure on your body. And when you increase pressure, you are therefore increasing oxygenation to your tissue. The other part of this is the hyper oxygen part where you are actually increasing oxygen concentration. So you get dual benefits with hyperbaric oxygen therapy because we are increasing the oxygen by putting oxygen in the chamber or having you wear a mask that concentrates oxygen. And then the pressure that gets applied on to your body also helps drive oxygen in the tissue. 

You know, typically oxygen is carried through red blood cells and there is a capacity to which that is going to happen. When you get in a hyperbaric oxygen chamber, it actually floods the air, the watery parts of your blood with oxygen. So now we are not just dependent on red blood cells carrying oxygen. Now that oxygen and the fluid and it can diffuse into tissues. So we have a way of, you know, if there is air in your body that is not getting enough oxygen, maybe that is your brain. And we need oxygen for self-repair to happen. 

We need it for the mitochondria to function well. So with hyperbaric oxygen therapy, we are able to drastically increase the oxygen content in our tissue. And if you look overall at what hyperbaric oxygen does, I will just kind of rattle off a list. First and foremost, it decreases inflammation. Now, whether that inflammation is in your brain, if you have got leaky gut or gastrointestinal problems and we want to quell the inflammation in your gut, if you are getting joint pain and muscle pain, it helps with all of that. And what’s really cool is that you start getting the benefit at very low pressure. So if you are at sea level, that is called one atmosphere. And the way they measured the buried part of this, how much pressure is you might hear about 1.3, 1.5, 2, 3 atmospheres that tells you how much over sea level the pressure is being applied. But at 1.09 is when you start getting the benefit. That is about equivalent to being in maybe two or three feet of a pool. If you submerge your whole body. So it is very low pressure and it happens within a minute of being at that pressure. So even a very low pressure for a relatively short period of time, we start to get some of these benefits. So we have got a way that we can reduce inflammation, which is critically important for us. We also know that it increases natural stem cells from your own bone marrow, and in fact, it increases that by eight fold. That is huge. Stem cells are these early cells that at least have the potential to become a neuron, a damaged neuron. So we have a way to repair that. 

And so by increasing those natural stem cells, we give our body a better opportunity to heal damaged tissue. We also know it helps reduce certain biomarkers which can make me worse. If you are borderline insulin resistant, pre-diabetic, diabetic, we know that it can reduce your glucose up to 23%. So if you are someone who’s had blood sugar issues and you are following the Wahls Protocol diet and you are doing all the right diet and lifestyle things, but you still struggle, this can be a way to help, you know, bring your blood sugar down. It reduces blood pressure. It reduces oxidative stress. Oxidative stress is associated with pretty much any chronic disease, including MS So if we can bring that oxidative stress down again, we give your body a better opportunity to heal. 

It also increases glutathione peroxidase and this enzyme is very important for the circulation of glutathione. Glutathione is a three amino acid peptide that is very critical for the nervous system. In fact, our brain, our peripheral nerves concentrate glutathione when glutathione levels are low, it is very hard for our nervous system to function the way we want. Glutathione is also a very critical nutrient for detoxification. That is one of the ways we get rid of a lot of junk. And I think a lot of people that have MS are generally poor to detoxify. Anything we can do to improve detox pathways helps them again by improving our glutathione on metabolism. That helps our detox pathways.

Terry Wahls, MD

A lot of benefits from getting first of each bath or hyperbaric oxygen. But how do people get that? You probably can not just walk into your neurologist and say, I really want to have some age body.

Darin Ingels, ND

It would be nice if that was easy. This is a medical device. you do need a prescription for it. There are centers around the country that offer hyperbaric oxygen. The downside is that right now there are only 14 approved conditions for hyperbaric oxygen in which insurance would cover it. MS is not one of them. So this is an off label use of hyperbaric oxygen therapy. Dr. Paul Hart, who’s one of the leading researchers on hyperbaric oxygen therapy at LSU. His wife has MS and I know she states that part of her health and maintaining her health has been because of her use of hyperbaric oxygen. But you would definitely need a doctor who knows about this therapy that either has a hyperbaric oxygen chamber in their clinic or they can recommend one close to where you live. And there are portable hyperbaric oxygen chambers. So if you have a doctor that is willing to give you a prescription, they can give you a prescription for one. I understand these are not cheap. This is something that for some people, unfortunately, comes financially limiting. But some of the companies I work with will actually let you rent the chamber for 2 to 3 months and then if you feel like it is helpful and you like it, whatever you paid in the rental apply towards the purchase price.

Terry Wahls, MD

Okay. So is there a clearance site to identify physicians who are familiar with hyperbaric and use that in their cases? 

Darin Ingels, ND

Yeah, there is the International Hyperbaric Association. I think it is IHA dot org. You can go on there and you can find a doctor who’s trained in hyperbaric therapy and hopefully make a connection.

Terry Wahls, MD

Okay. And would you say that hyperbaric oxygen is helpful for remyelination or is it simply about reducing inflammation?

Darin Ingels, ND

You know, it is a great thing. You know, we do know that there is a possibility of changing gene expression. We know it helps with cerebral perfusion. That means bringing more blood flow to the brain. So again, I have not seen any specific studies on remyelination. However, there are other studies in animals. Take it for what it is worth that it helps repair damaged axons. That is the long part of the nerve cell. I think there is the capacity for remyelination, but even if we get all these other benefits again, if we can stop that inflammation and improve blood flow, I think we give the brain a better chance to remyelinated on its own.

Terry Wahls, MD

Okay, now the next thing that we have got on the list is low dose immunotherapy and sublingual immunotherapy. So can you explain what those terms are? So how we use it, 

Darin Ingels, ND

Immunotherapy as a whole, conventional, a lot of DMT is considered immunotherapy. This is very different from a conventional drug. So sublingual immunotherapy means under the tongue. I mean, immunotherapy is just immunotherapy. So we can use sublingual immunotherapy as a way to help desensitize people against various things that you might be allergic or hypersensitive to. This could be anything from food to mold to pollen, to cat, to dust, to dog, to feathers. And the reason that becomes important with MS is that if your immune system is in balance and you are making a lot of antibodies, you know, these antibodies can react to any number of different tissues. So we are trying to tilt the balance more favorable so that you are not getting this overexpression of antibodies because a lot of that drives allergy. So as we control your allergies, your hypersensitivities we control your mass cells. That is less stuff that potentially can damage the brain. So, we can do various types of testing to help identify what you are allergic or sensitive to. And then based on that, you know, we can do this sublingual in a therapy. So very simply, I mean you probably heard of allergy shots. If you go to an allergist and they find out you are allergic to dust or ragweed, you would go in every week and they will give you an injection of dust and ragweed. And then over time, they keep building the dose until you get to a maintenance dose, and then you are on it often for several years. But it builds that immune tolerance again so that you can be exposed to these things and not have this overreaction. So sublingual immunotherapy essentially is the same concept, but instead of getting the shots, these are drops that you just put under your tongue. 

So there are doctors around the country. Some of them are conventional allergists, a lot of them are environmental medicine doctors. That again, and we will test you, find out what you are sensitive to, and then we make up these extracts in our office so that you can administer them at home. There are almost a thousand studies on sublingual immunotherapy. It is widely used throughout Europe. In fact, it is the preferred method over allergy shots because it is a lot less expensive. But here allergists are incentivized to give you allergy shots. They do not get reimbursed by giving you drops under the tongue. So again, it often becomes another out-of-pocket expense, but it is a very safe way to help, again, desensitize your immune system to whatever these potential triggers that you have.

Terry Wahls, MD

And how would somebody with MS or neuro conditions know that maybe allergies are a component that I should investigate.

Darin Ingels, ND

A lot of it is going to be great based on the kind of symptoms. I mean if you know you are someone with seasonal allergies every time spring hits and you get the typical hay fever symptoms, or if you are someone that goes into a damp basement every time it is humid, every time it rains, I get congested, I start coughing, I get a headache. We get a lot of clinical clues about what your reactive to. But again, there are different ways that we can test people through skin testing, through blood testing and find out very specifically what is aggravating your immune system. 

But again, I like the fact that we got an immune modulating therapy to help. Again, take some of that pressure off the immune system so that you are not in this constant, hypersensitive state. And I think for someone with that disorder, there are a lot of symptoms sometimes that we just attribute to being related to MS and sometimes we find out it is actually not that process. There is something else going on. So if we can retrain your immune system again in a healthy way to not be so hypersensitive again that just quells that inflammation and makes it easier for your tissue to repair.

Terry Wahls, MD

Then the last thing I want to ask you about is back to my favorite topic poop. What about the microbiome and the interest in fecal transplants?

Darin Ingels, ND

Well, we have now got so many studies showing that the microbial diversity in somebody with MS is drastically different than someone that does not have MS We know there is a lot of flavor, bacteria, akkermansia and strep in people that have MS, but they are lacking bacteroidetes, lactobacillus, prevotella, and clostridia. So if we have lost these strains or we have got this overexpression of other strains it is not like we can just take a probiotic and that is going to fix the microbiome. And I think if you go back in your history and look at how many antibiotics have I taken over the course of my life? Have I been on other medication that might impact my microbiome? Have I been eating junk food, processed foods, things of that nature that also impact our gut bugs? So over the course of time we know that these gut bones change and they’re obviously having a negative impact on our brain and seem to be a cause of MS and certainly add to the inflammation. 

Knowing that we can not probiotic our way out of the problem and certainly with dietary intervention, we can increase the diversity of bugs. But I think about some I mean, even myself, I mean, I was an ear infection kid. I was on antibiotics for most of my life from the time I was born till I was five. Gosh, when you lose so much of that early microbiome, do you lose some of those species permanently? We have got so many great labs out there like, you know, biome that can give you this very broad testing of all of your bugs. We can see what’s there, but we do not have enough information about how to fix that. And so this is where I think fecal microbial transplant or FMT has incredible promise because we have the ability perhaps to replace all that stuff that might have been lost earlier in life. 

And yet we talk so much about the bacteria of our gut. It is viruses and it is a fungus and it is parasites. Your gut microbiome is incredibly diverse. And again, I think we are still scratching the surface on what it should entail. Can you find anyone, the United States that is, you know, never had an antibiotic, only eaten organic diet and never been exposed to a chemical that might impact their gut bugs. I’m not sure they exist in the U.S., but there are a few very small studies using FMT, and maybe there was one small study that only involved three patients and all they looked at is motility. 

And of course, chronic constipation is a big problem with MS And then these three patients that had a tremendous impact on their gut motility helped resolve their constipation. It did also help improve their neurological function. Right now, FMT is really only being used in the United States for Clostridium difficile infections and a few other select conditions really under our research, IRB. I’m hopeful that this is going to be the evolution of our FMT is that we are going to start to see it with MS  and other autoimmune diseases because honestly, I think this is really where the future of MS  treatments is headed.

Terry Wahls, MD

I think there will certainly be research studies investigating efforts for a variety of autoimmune conditions. Not that available for people with MS, but I think that that certainly is an area where I’m sure we will have investigations in the future. Yeah, well, Darin, this has been just so fabulous. Are you still seeing patients?

Darin Ingels, ND

Absolutely. We still see people in person. And in the era of COVID, we do a lot of telemedicine as well. So we are available to see new patients.

Terry Wahls, MD

And what is your website? So if people wanted to come check you out.

Darin Ingels, ND

Come to yeah, it is dariningelsnd.com, N as in Nancy D dot com.

Terry Wahls, MD

Okay. Well, excellent. Thank you so much, Darin. This has been absolutely wonderful.

Darin Ingels, ND

Thank you, Terry.