(A Preliminary Correspondence)
By Ronald M. Lawrence, M.D., Ph.D.
Assistant Clinical Professor U.C.L.A. School of Medicine
Los Angeles, California
Methyl-Sulfonyl-Methane (M.S.M.) is an organic sulfur
compound which is a metabolite of dimethyl-sulfoxide (D.M.S.O.).
It is a white, odorless, slightly bitter tasting, crystalline
substance, which contains 34 percent elemental sulfur.
It is easily soluble in water. Its chemical formula is
(DH3)2SO2. It has been suggested by Lovelock and his associate's
(1) that M.S.M. and its related compounds D.M.S.O. and
D.M.S. (dimethyl-sulfide) provide 85 percent of the sulfur
found in all living organisms.
The cycle of these naturally occurring sulfur compounds
begins in the ocean where microscopic plankton release
sulfur compounds called dimethyl-sulfonium salts. These
salts are transformed in the ocean into the very volatile
compound D.M.S. which escapes from the water as a gas
which rises into the upper atmosphere. Exposed to ozone
and high energy ultraviolet light the D.M.S. is converted
to D.M.S.O. and M.S.M. Both the D.M.S.O. and M.S.M. are
very soluble in water and they return to the surface of
the earth in rainwater. Plants then take up the two compounds
into their root systems concentrating them up to one hundred
fold. M.S.M. (sulfur) is incorporated into the plant structure.
Through the process of plant metabolism the M.S.M., along
with the other sulfur compounds it has spawned, are ultimately
mineralized and transported back to the ocean and the
sulfur cycle begins again.
M.S.M. is found naturally in the human body. It occurs
in the blood and in other organs and has been detected
in normal human urine (2). The level of M.S.M. in the
circulatory system of an adult human male is about 0.2
parts per million (3). Normal human adults excrete from
four to eleven milligrams M.S.M. per day in their urine.
Experiments using radiolabled sulfur (S35) in M.S.M. have
shown that after ingestion the sulfur in M.S.M. helps
form the essential amino acids methionine and cysteine
(4).
M.S.M. is rated as one of the least toxic substances
in biology, similar in toxicity to water (5). The lethal
dose (LD50) of M.S.M. for mice is over 20 grams per kilogram
of body weight. Hundreds of patients have been treated
at the Oregon Health Sciences University (6) with oral
M.S.M. at levels above two grams daily for many years
without serious toxicity. Since sulfur is found to be
needed for the formation of connective tissue, M.S.M.
has been studied for its use in treating arthritis of
various types (7). Sulfur concentration in arthritic cartilage
has been shown to be about one-third the level compared
to normal cartilage (8). In addition, the amino acid cystine
has been noted to be diminished in arthritic patients.
Personal communication with Stanley Jacob, M.D., Gerlinger
Professor, Department of Surgery, Oregon Health Sciences
University, Portland, Oregon, substantiated his personal
experiences using M.S.M. in the treatment of patients
with degenerative (osteoarthritis) arthritis.
Study Design
M.S.M. was provided in a crystalline form (LIGNISULmsm)
which we encapsulated in a clear gelatin capsule providing
750 mgms of LIGNISUL MSM per capsule. The placebo substance,
which was also placed in clear gelatin capsules, consisted
of sugar (sucrose) to which a small amount of quinine
sulfate was added to create a slightly bitter taste. This
was done in case the capsule was opened and tasted, Since
M.S.M. also has a slightly bitter taste.
A total of sixteen patients were studied over a period
of four months. Initially twelve patients were admitted
to the study and subsequently (two months later) additional
four patients were added to the study group. The initial
twelve patients were divided as follows. Eight were given
the M.S.M., while four received the placebo. Later, the
additional four patients were divided into two on M.S.M.
and two on placebo. Totally, therefore, we had ten patients
on M.S.M. and six patients on placebo.
Criteria for Selection
Patients ranged from age 55 to age 78. All patients had
x-ray evidence of degenerative joint disease (degenerative
arthritis). All patients had pain in the involved area
ranging from four weeks to six months. Most of the patients
had tried non-steroidal anti-inflammatory drugs or aspirin
type compounds. None had taken steroids either orally
or by injection. All non-steroidal anti-inflammatory drugs
or other anti-arthritic medications or non-sterol alternative
health remedies were stopped a least three days prior
to their entering the study.
Patients were randomly chosen by lot and assigned to
either the active (M.S.M.) group or the placebo group.
The treating physician did not have knowledge as to which
patient received which agent until after the completion
of the study. Records were kept by an independent evaluator
until the study was terminated. Both the patients and
the physicians were blinded.
Of the eight patients on LIGNISULmsm, two had osteoarthritis
in their hands, three had lumbar degenerative joint disease,
two had degenerative arthritis in their knees, and one
had arthritis in the shoulder.
Of the six patients who received the placebo, two had
degenerative arthritis in the knees, two had lumbar degenerative
joint disease, one had degenerative arthritis in the hip,
and one had osteoarthritis in the neck.
Dosage
Patients were instructed to take two capsules on an empty
stomach in the A.M. after arising and one capsule before
lunch. This constituted a 2250 milligram dose of LIGNISULmsm
daily and zero dose of M.S.M. on the placebo.
Measurement
Each patient was administered a visual analog scale (V.A.S.)
which consisted of a 10-cm line anchored at one end by
a label of "no pain" and at the other end a label of "pain
as bad as could possibly be." The scoring is accomplished
by having the patient mark the line indicating pain intensity,
and the line is then measured to the mark on a 1 -100
scale (9).
RESULTS
The V.A.S. was completed by each patient at the four
week and at the six week visit. Records were measured
by an independent evaluator.
At the four week visit, the patients on the LIGNISULmsm,
showed a 60 percent improvement on average, while at the
six week V.A.S. evaluation the patients showed and 82
percent improvement in pain on average. Those on
the placebo showed an improvement of 20 percent on average
at four weeks and an 18 percent improvement on average
at six weeks.
ABSTRACT
This preliminary simple study was performed to initially
evaluate 16 patients suffering from degenerative arthritis
as to the effect of using LIGNISULmsm to control their
pain. Eight patients, randomly chosen, were treated with
2250 mgms of M.S.M. per day. Six patients received placebo
capsules. Results indicate a better than 80 percent control
of pain within six weeks of beginning the study, while
only two patients showed a minimal improvement (less than
20 percent) on the placebo. Although this was only a simple
preliminary study, it appears that a more intensive investigation
of M.S.M. is warranted. A larger group of arthritic patients
and additional measurement evaluation (such as range of
motion, etc.) should be utilized in such a future study.
LIGNISULmsm may offer a significant new nutritional substance
for the control of arthritic pain as a safe, non-toxic
method.
REFERENCES
1. Lovelock, J.E. et al. Nature, Vol.
237, p452, 1972
2. Williams, K.I.H. et al. Arch Biochem Biophys, Vol.
113, p251, 1966
3. Jacob, S.W. and Herschler, R., Ann NY Acad Sci, Vol.
411, pxii 1983
4. Richmond, V.L., J Nutrition, Vol. 116 NO. 6, June,
1986
5. Deichman, W.B. & Gerarde, H.W. "Toxicology of Drugs
& Chemicals, 4Ih Edition, Arcadia Press, 1969
6. Jacob, S.W., Oregon Health Sciences University, Portland,
Oregon, Personal communication
7. Jacob, S.W., Oregon Health Sciences University, Portland,
Oregon, personal communication
8. Rizzo, R. et al. Jour Exp Zool, 1995 September, 1,273(l):82-6
9. Carlson, A.M. Pain, 16:86, 1983
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