Table 1 Assessing the alternatives

Helminthic therapy

Patients are infected with a parasitic helminth worm.

The worm uses an immunomodulatory mechanism to control autoimmune responses and suppress MS symptoms.

Preliminary studies show some promise but there is no conclusive evidence of effectiveness.

Severe infection if not properly monitored, nausea, vomiting, diarrhoea, fatigue, flatus, epigastric pain, and topical rash at site of inoculation.

US$3,000–7,800

Stents

A stent or balloon is inserted into blocked blood vessels in the brain to improve drainage.

In chronic cerebrospinal venous insufficiency (CCSVI), irregularly formed blood vessels in the brain are said to prevent proper blood flow from the brain and spinal cord; the blockage may be a factor in the nervous-system damage in MS.

Some positive effects have been reported, primarily in relapsing–remitting MS. But research into CCSVI is preliminary, and there is no conclusive evidence that CCSVI is linked to MS.

Surgical complications and potentially death.

US$10,000–15,000

Chelation

EDTA, a crystalline acid, is injected into the bloodstream over several hours. It binds to heavy metals, which are then excreted by the kidneys.

The theory is that MS and some other diseases are caused by an accumulation of heavy metals in the bloodstream.

There is no evidence that the accumulation of heavy metals causes MS. The FDA deems this a worthless treatment for anything other than excessive heavy metals in the bloodstream.

Kidney damage, anaemia and death.

US$3,000–4,000

Removal of mercury-based fillings

Silver and mercury amalgam dental fillings are removed from the teeth and replaced.

Mercury leaks from the fillings are said to cause a variety of health problems, including MS.

There is no evidence linking mercury fillings to MS. Heavy metals can cause nervous-system damage, leading to tremors and weakness like those seen in MS, but the mechanism of nerve damage is different.

The procedure can be painful and might cause dental problems.

Removal costs US$100–400 per tooth. If a crown is needed, $700–1,100 per tooth.

Tai chi

The patient uses patterns of movement to bring the body and mind into harmony.

Advocates claim the practice alleviates the symptoms of MS.

There is evidence that tai chi may lower stress, promote relaxation, relieve fatigue, and improve balance.

The exercises are safe.

The only costs are a class or purchasing an instructional video.