by A. G. Maas, MD

Multiple Sclerosis (MS) is a disease of the central nervous system (CNS) and incidentally also of the peripheral nervous system (PNS). The demyelination of the oligodendroglia is the most important pathological anatomical (PA) manifestation. The name of the disease is related to the PA picture of sclerotic scars (plaques) of demyelination, located mainly in the white matter of the CNS. Preferred locations are periventricular, also around the arteries, at the site where they enter the CNS. Xenobiotics are 'body-foreign' foodsubstances, which have to be metabolised as well as regular food. Xenobiotics are present in foods, delicacies, liquids, liquors, candies, artificial food colors, -flavors, -preservatives, see list below.

Clinical aspects of MS.
The multiple locations of the demyelinations may produce a great variety of neurological signs and symptoms.
Most often there are disturbances of the:

The clinical course is characterised by either exacerbations and remissions, or a chronic progressive course with gradual deterioration, or by a combination of both.

The disease MS was first described by Dr. Ch. Charcot in 1869. Because of the inflammatory aspect of the disease, scientists were looking for a micro-organism, a bacteruim or a virus. Bacterial infections, such as typhiod, cholera or spirochaeta were mentioned. Viral infections, comparable to polio-myelitis, postvaccinal encephalitis, measles, or even a slow virus, have been considered and researched.
An infectious agens has never been found.

An inflammation, caused by a micro-organism, is usually accompanied by an elevated sedimentation rate, an increase of leucocytes and a changed haemogram. Such blood changes have never been found in MS.

An allergic manifestation can also cause an inflammatory reaction, as in allergic dermatitis ( urticaria, hives), -rhinits (hayfever), -bronchitis, -gastroenteritis. An allergic reaction usually causes the immunoglobulin (Ig) bloodvalues to increase. During an exacerbation of MS the Ig-G values in the liquor are elevated, in the blood they remain normal.

The neuro-cutaneous relationship has been mentioned before. The CNS-skin connection is clear, as seen from the embryonic developement. In the embryonic stage, the ectoderm forms the neural crest, the neural tube is the result. At least 44 neurocutaneous diseases have been described ( Dr. Gomez). Skin manifestations such as urticaria ( hives) may occur in the CNS as well, the edematous patches during an exacerbation may well be the urticaria of the CNS.

MS and food intolerance.
From the beginning of this century there have been centers where special diets for people with MS were prescribed.
A clinical comparison has not been possible.

Dogs and cocoa.
When dogs consume cocoa products, they become paralysed and incontinent. Heart disease may follow, the dogs soon die. Dr. A. Glauberg, DVM and Dr. P. Blumenthal, MD, in 1983 published their findings concerning the theobromine metabolism in dogs, as compared to the same in humans.
The metabolism of theobromine in dogs was very much slower than same in human beings.

P450 and MS.
Cocoa is an alkaloid, which is metabolised with the aid of the liver-enzyme- system P450 (CYP). This enzyme cannot as yet be determined in the blood. There is a lot of circumstantial evidence that P450 (CYP) activity is abnormal in MS. We have found that if MS patients do not consume certain foodsubstances, the ones normally metabolised with the aid of P450 (CYP), the MS will remain stable.
An antihistamine is useful if an offensive 'xenobiotic' has been ingested. All the antihistamine seems to do in MS is to stop the abundant fluid production in the CNS, remove the edematous patches as soon as possible, prevent CNS damage, scars later on.

The elimination diet for people with MS has nothing in common with alternative medicine. More with phenylketonuria (PKU), where the demyelination of the CNS has been stopped with an elimination diet as well. In PKU there is a deficiency of the enzyme phenylalanine hydroxylase. In MS we have increasing evidence of malfunction of the liver-enzyme-system P450.

Possible causes of the abnormal P450 activity.
Some causes of abnormal P450 activity may include:



All homemade food should be kept frozen, so it will not be wasted, as no
preservatives have been added.

Not allowed:

Sometimes tolerated, sometimes not:
Nuts, cheese, oranges, frozen products, gin, whiskey, beer, and
prepared meats.

It is best to eat regular meals without too much variety, foods you like and can tolerate well. An allergic reaction (MS episode) to an offending food can occur hours or even days later. Find your own allergies, intolerances, with the trial and error method. Try a food or drink and wait three days. If no MS signs and symptoms (s&s) have materialised, you can probably tolerate that particular consumption. If you are not sure, don't eat too much at a time of that food. Don't eat whatever you cannot tolerate, even if it is on the 'allowed' list.
Caution: do not follow different diets simultaneously, unless medically indicated.
Not all your s&s will be due to MS. People with MS are susceptible to the same diseases as everyone else.
Consult your Physician.

MS will not be cured by following the elimination diet, but the MS s&s will be greatly reduced.
An antihistamine should be taken if necessary. It will slow down the fluid production in the CNS, thus resulting in less edema, less pressure, better oxygenation of the highly developed brain tissue, cells.

The elimination diet for MS costs the same as a regular diet. It takes a little more time and effort to prepare, it is an old fashioned way of cooking. Selfmade meals can be stored in the freezer. At least you know for sure no offensive ingredients are included. The antihistamines are not expensive and have to be taken only when needed.

MS is a disease of the CNS and the PNS, marked by demyelination. The edematous patches, placques, in the CNS, may well be caused by an intolerance to certain foodsubstances, the xenobiotics. An elimination diet plus an antihistamine if necessary prevents the formation of new placques.
An antihistamine should be taken as soon as MS s&s appear, or preventative, if a food mistake has been made.
Both the elimination diet and the antihistamine are not expensive, but very effective.

CAUTION: This diet and an antihistamine is not an effective treatment during or after interferon type therapies.

A. G. Maas, MD
L.A.H. Hogenhuis, MD, Neurologist.

Reference Literature
Maas A.G. and Hogenhuis L.A.H. Multiple Sclerosis and possible relationship to cocoa: a hypothesis.
Annals of Allergy 1987; 59: 76-9.

Glauberg A. and Blumenthal H.P. Chocolate poisoning in the dog.
J Am An Hosp Ass 1983; 19: 246-8.

IOCCC Fact sheet 1989.

Soto J., Sacristan J.A., and Alsar M.J. Cerebral fluid concentrations of caffeine following oral drug administration: correlation with salivary and plasma concentrations.
Therap. Drug Monitoring 1994; 16: 108-10.

Dessa Sadovnick A., Yee I.M.L., Ebers G.C. and Risch N.J. Effect of age at onset and parental disease status on sibling risks for MS.
Neurology 1998; 50: 719-24.

Sarkar M.A., Hunt C., Guzelian P.S. and Karnes H.T. Characterization of human liver cytochromes P450 involved in theophylline metabolism.
Drug Metab Dispos 1992; 20: 31-7.

Scadding G.K., Ayesh R., Brostoff J., Mitchell S.C., Waring R.H. and Smith R.L. Poor sulphoxidation ability in patients with food sensitivity.
BMJ 1988; 297: 105-7.

Ullrich D., Compagnone D., Munch B., Hille H. and Bircher J. Urinary caffeine metabolites in man. Age dependant changes and patterns in various clinical situations.
Eur. J Clin Pharmacol 1992; 43: 167-72.

McTaggart L. and Thomas P. Special report. Multiple Sclerosis Poisoning in slow motion.
What Doctors Don't Tell You. 1997; vol 7, No 11: 2-5.

Gomez M.R., Editor. Neurocutaneous diseases: A Practical Approach.
Boston, Butterworth, 1988; pp 1-401.

Speer F. Allergy of the Nervous System.
Charles C. Thomas, Publ. Springfield, Ill., USA. pp 1-258.

Fries J.H. Chocolate: A Review of published reports of allergic and other deleterious effects, real or presumed.
Ann of Allergy 1978; 41: 195.

Dr Anne G. Maas MD has helped many patients live a "normal" life without the
otherwise crippling effects of MS. Her treatment is now accepted by insurance
providers in the Netherlands.
For more information write:
Anne G. Maas, MD.
Langstraat 174
2242 JZ Wassenaar
The Netherlands, Europe.
Or to call (this is an International call, you will be responsible for charges
to your phone bill)