According to a new phase III study, presented at the 2016 AAN Annual Meeting, biotin at a dose of 300 mg daily seemed to reduce the rate of disease progression in both primary and secondary progressive MS. About 13% of the patients also showed an improvement in EDSS or timed 25-foot walk at month 9, which was maintained at month 12, compared to no patient in the placebo arm.

A widely used preparation called Women’s Hair, Skin, & Nails contains biotin, selenium, and zinc. Biotin is available over-the-counter, but highest dose is 10 mg. Thus, an MS patient would need to swallow 30 pills a day at a cost of about $30 a month. Several of my patients have located compounding pharmacies who will prepare a 300 mg pill at a cost of $70 to $100 per month.

Other recent studies regarding supplements for MS have shown benefit using lipoic acid 1200 mg a day, proprionic acid 1 gram a day, and a probiotic preparation termed VSL#3, double strength sachets, 3600 billion CFU/day.

Older studies strongly support the use of vitamin D. Melatonin 10 mg 1 to 2 hours before bedtime has not been rigorously tested in MS patients but may have anti-inflammatory effects. Studies about omega-3 fish oils are conflicting, as are studies with statins.

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