by Jillian Kubala, MS, RD
Medically Reviewed by:
Alana Biggers, M.D., MPH
by Jillian Kubala, MS, RD
Medically Reviewed by:
Alana Biggers, M.D., MPH
Research suggests certain nutrients, such as omega-3 fatty acids, vitamin D, and CoQ10, may improve fatigue, depression, and other symptoms of multiple sclerosis.
Following a balanced, nutrient-dense diet can help you take care of your body and feel your best when you live with multiple sclerosis (MS).
However, when you have MS, it can be harder to meet your nutritional needs through diet alone.
People with MS are more likely to develop nutrient deficiencies, which can flare MS symptoms and impair overall health. Plus, research suggests that certain dietary supplements could help boost the nutrient levels of people with MS, thereby decreasing inflammation and fatigue and improving quality of life.
This is why many healthcare professionals recommend people with MS take certain dietary supplements, such as omega-3 fats, B vitamins, and vitamin D.
Be sure to consult a qualified healthcare professional, like a primary care doctor, pharmacist, or registered dietitian, before adding any dietary supplements to your regimen.
The omega-3 fats docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have powerful anti-inflammatory and immune-supporting properties and may offer specific benefits to people with MS.
According to a 2023 review, studies show that people with MS tend to have lower levels of omega-3 fats in their blood than people without MS.
Having low levels of omega-3 fats may promote inflammation in the body and contribute to MS progression and symptoms. Maintaining higher levels of omega-3s could help reduce inflammation and improve functioning in people with MS.
A 2021 review of seven studies concludes that supplementing with omega-3 DHA and EPA effectively reduces inflammatory markers and relapse rates and improves the quality of life for people with MS.
A 2013 study also suggests that omega-3 supplements can effectively lower inflammatory markers and improve functioning in people with MS.
Another 2013 study that included 1,493 people with relapsing-remitting MS found that those who consumed more fish and those who took omega-3 supplements had significantly better quality of life and less disability than people with MS who didn’t consume fish or omega-3 supplements.
Having low levels of omega-3 fats may promote inflammation in the body and contribute to MS progression and symptoms.
Although these results are promising, more research is needed to understand exactly how omega-3 supplements, and at what dosage, achieve these results.
Omega-3s are considered safe, but they may have blood-thinning properties when taken in high doses.
If you’re interested in trying omega-3s, speak with your doctor for specific dosing and product recommendations.
Coenzyme Q10 (CoQ10) is an antioxidant compound your body naturally produces. It plays an important role in energy production and protects cells from oxidative damage.
People with MS, especially those with more severe MS, tend to have lower blood levels of CoQ10 and higher levels of oxidative stress than the larger population. Oxidative stress can lead to tissue and cell damage.
Since oxidative stress is also a driver of MS progression, supplementing with compounds that help protect against oxidative damage may help improve MS disease activity.
CoQ10 may also support healthy energy production and help reduce fatigue and depression symptoms in people with MS.
A 2019 study that included 60 people with MS receiving treatment with interferon beta1a found that taking 200 milligrams (mg) of CoQ10 daily for 3 months was associated with reduced oxidative damage to cells and DNA. It also promoted a more anti-inflammatory environment in their blood than treatment with interferon beta1a alone.
CoQ10 supplementation was also associated with reductions in disability, fatigue, depression, and pain.
CoQ10 may support healthy energy production and help reduce fatigue and depression symptoms in people with MS.
According to a 2015 study, higher doses of CoQ10 — up to 500 mg per day — may also be effective in reducing depression and fatigue in people with MS.
CoQ10 is generally well tolerated but may cause side effects such as diarrhea, headache, nausea, insomnia, and skin rashes in some people.
Because it may cause sleeping issues, experts usually recommend taking CoQ10 earlier in the day, such as in the morning or early afternoon.
From regulating inflammation to supporting a healthy immune response, vitamin D plays a critical role in health. However, vitamin D insufficiency and deficiency are common.
Due to its important role in regulating inflammation and immunity, low vitamin D levels are suspected to increase the risk of MS and may worsen disease activity in people living with MS.
While it’s known that high dose vitamin D supplements can help increase blood levels of vitamin D, which can benefit and improve overall health, it’s currently unclear how vitamin D supplements benefit MS symptoms and MS disease progression specifically.
Some studies show that high dose vitamin D supplements may reduce disability and inflammatory markers in people with MS, especially in those with very low vitamin D levels.
For example, a 2019 review of 10 small studies found that vitamin D supplementation improved disease markers to a greater extent in participants with MS who had lower baseline vitamin D levels.
According to a 2020 review, studies haven’t found high dose vitamin D supplements helpful in reducing disability and relapse rates in people with MS.
However, another 2023 review of five studies did find that vitamin D supplementation was associated with a significant reduction in fatigue in people with MS compared with control treatments.
The only way to tell whether you’re low or deficient in vitamin D is to have your doctor test your blood. If you have low or deficient levels, your doctor will recommend an appropriate dose and treatment plan based on your levels.
What’s more, a 2023 study shows that lower dietary intake of antioxidant vitamins, including vitamins A and C, is associated with a poorer outlook in people with MS.
Multinutrient supplements, such as multivitamins, B-complex vitamins, and multimineral supplements, are products that contain more than one nutrient. Taking a multinutrient supplement may help improve overall health and disease severity.
A 2020 study with 46 people with MS found that those who took a multivitamin and mineral supplement every day for 3 months experienced improvements in fatigue and in the inflammatory marker interleukin 4 (IL-4) compared with a control group. Larger studies are needed to confirm this effect.
Multinutrient supplements often provide an array of vitamins and minerals important for overall health. They may be more convenient and affordable than taking multiple single-nutrient supplements.
However, more targeted supplement regimens may be more helpful and appropriate for people who need more specific nutrition support.
Because supplementation needs depend on factors like dietary intake and nutrient deficiencies, it’s best to develop a personalized supplement regimen with your doctor.
In addition to those listed above, there’s some evidence that the following supplements may be helpful for people with MS.
Commonly known as vitamin B7, biotin is a B vitamin involved in metabolism, cellular signaling, and gene regulation.
Research findings suggest that long-term, high dose biotin supplementation may help improve some mobility parameters in people with MS.
However, high dose biotin supplements can interfere with laboratory test results, including thyroid tests. If you’re interested in taking biotin, it’s important to clear it with a healthcare professional first.
Melatonin is a hormone your brain produces to help control your circadian rhythm.
Research suggests melatonin supplements may help improve sleep disturbance, a problem that affects more than 50% of people living with MS.
In a 2021 study, 30 people with MS took between 0.5 and 3 mg of melatonin per night for 2 weeks. On average, they experienced significant improvements in total sleep time compared with people who took a placebo. They also had smaller improvements in insomnia severity, sleep quality, and fatigue.
Amino acids play a critical role in energy production. Specific ones may help improve some MS-related symptoms.
For example, a 2019 review of 40 studies shows that L-carnitine supplements may help improve fatigue severity in people with MS.
Plus, a 2023 case study with a 57-year-old female with MS found that combined supplementation with essential amino acids and vitamin D for 24 weeks improved her body composition, strength, and exercise tolerance.
This list is not exhaustive. Other supplements have also been linked to positive outcomes in people with MS.
Research investigating the effects of dietary supplements and other natural treatments on MS symptoms and disease progression is limited, and larger, high quality studies are needed to better understand how supplementing with vitamins, minerals, and other substances may influence the health of people with MS.
Because there are so many supplements to choose from, it can be helpful to work with a healthcare professional to develop a supplement routine based on your specific needs, medication regimen, and overall health.
Medically reviewed on January 02, 2024
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About the author
Jillian Kubala, MS, RD
Jillian Kubala is a registered dietitian based in Westhampton, NY. Jillian holds a master’s degree in nutrition from Stony Brook University School of Medicine as well as an undergraduate degree in nutrition science. She runs a private practice based on the east end of Long Island, NY, where she helps her clients achieve optimal wellness through nutrition and lifestyle changes.