Condition

Multiple Sclerosis (MS)

Multiple sclerosis is an autoimmune condition in which the immune system attacks myelin, the protective coating on nerve fibers in the brain and spinal cord, disrupting signals and causing fatigue, weakness and numbness. Among supplements, vitamin D and omega-3 fatty acids have the strongest evidence, rated moderate, while trials of high-dose biotin in progressive MS found no clear difference in symptoms. Most other studies were small, so the evidence is limited overall.

Sources: PMID 33222767; PMID 27589059

Supplements studied: 11
Graded outcomes: 6
Trials: 42
People studied: 8,998

Evidence by supplement

Strong
Moderate
Limited
Very limited

11 supplements

Cannabis

Cannabis: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People
	Cognition Mixed effect				54 people
	Multiple Sclerosis Symptoms	Improves (the measure goes down)		20 studies	3,161 people
Studies that measured multiple sclerosis symptoms Assessment of Efficacy and Tolerability of Medicinal Cannabinoids in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysisJAMA Netw Open · PMID 30646241 Sativex ® as add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in resistant multiple sclerosis spasticity: a double-blind, placebo-controlled randomised clinical trialInt J Neurosci · PMID 29792372 Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosisJ Neurol · PMID 26289497 and 17 more on the Cannabis page
	Sleep Quality	Improves (the measure goes up)		4 studies	900 people
Studies that measured sleep quality Cannabinoids for adult cancer-related pain: systematic review and meta-analysisBMJ Support Palliat Care · PMID 31959586 A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatmentEur J Pain · PMID 24420962 Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trialPain · PMID 17997224 and 1 more on the Cannabis page
	Balance Moderate Detriment	Worsens (the measure goes down)	Moderate effect	2 studies	20 people
Studies that measured balance Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteersClin Pharmacol Ther · PMID 8143398 The effects of orally administered delta 9-tetrahydrocannabinol in man on mood and performance measures: a dose-response studyPharmacol Biochem Behav · PMID 2161109
	Urinary Incontinence Signs	Improves (the measure goes up)		2 studies	765 people
Studies that measured urinary incontinence signs The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS)Int Urogynecol J Pelvic Floor Dysfunct · PMID 16552618 Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosisMult Scler · PMID 20829244
	Depression Symptoms	Improves (the measure goes down)		1 study	1,132 people
	Motor Speed	Improves (the measure goes up)		1 study	14 people
	Fatigue Symptoms	Improves (the measure goes down)			1,186 people
	Irritability	Improves (the measure goes down)			1,132 people
	Sleep Duration	Improves (the measure goes up)			160 people
	Walking Ability	Improves (the measure goes up)			81 people

Panax Ginseng (Korean Ginseng)

Panax Ginseng (Korean Ginseng): outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People
	Cognition Small Improvement	Improves (the measure goes up)	Small effect	9 studies	60 people
Studies that measured cognition Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasksJ Psychopharmacol · PMID 16401645 Improvement of cognitive deficit in Alzheimer's disease patients by long term treatment with korean red ginsengJ Ginseng Res · PMID 23717092 Effects of Korean Red Ginseng on Cognitive and Motor Function: A Double-blind, Randomized, Placebo-controlled TrialJ Ginseng Res · PMID 23717119 and 6 more on the Panax Ginseng (Korean Ginseng) page
	Fatigue Symptoms	Improves (the measure goes down)			60 people
	Quality of Life	Improves (the measure goes up)			60 people

Coenzyme Q10

Depression Symptoms: improves
Fatigue Symptoms: improves
Interleukin 6: improves

Coenzyme Q10: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People
	Depression Symptoms Moderate Improvement	Improves (the measure goes down)	Moderate effect	2 studies	48 people
Studies that measured depression symptoms Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Clin Psychopharmacol · 2026 · PMID 41294251 Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical TrialJ Clin Psychopharmacol · PMID 30106880
	Fatigue Symptoms	Improves (the measure goes down)		3 studies	48 people
Studies that measured fatigue symptoms The effects of coenzyme Q10 supplementation on performance during repeated bouts of supramaximal exercise in sedentary menJ Strength Cond Res · PMID 19644406 Antifatigue effects of coenzyme Q10 during physical fatigueNutrition · PMID 18272335 Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trialNutr Neurosci · PMID 25603363
	Interleukin 6	Improves (the measure goes down)		2 studies	48 people
Studies that measured interleukin 6 Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markersNutr Neurosci · PMID 29298622 The effects of coenzyme Q10 supplementation on cardiometabolic markers in overweight type 2 diabetic patients with stable myocardial infarction: A randomized, double-blind, placebo-controlled trialARYA Atheroscler · PMID 28149310
	Matrix metallopeptidase 9	Improves (the measure goes up)		1 study	48 people
Studies that measured matrix metallopeptidase 9 Coenzyme Q10 supplementation ameliorates inflammatory markers in patients with multiple sclerosis: a double blind, placebo, controlled randomized clinical trialNutr Neurosci · PMID 24621064
	Interleukin 4	Improves (the measure goes up)			48 people
	Multiple Sclerosis Symptoms	Improves (the measure goes down)			48 people
	TNF-Alpha	Improves (the measure goes down)			48 people

Biotin (Vitamin B7)

Multiple Sclerosis Symptoms

Biotin (Vitamin B7): outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Multiple Sclerosis Symptoms No effect		NoneNo effect	4 studies	360 people
Studies that measured multiple sclerosis symptoms Safety and efficacy of MD1003 (high-dose biotin) in patients with progressive multiple sclerosis (SPI2): a randomised, double-blind, placebo-controlled, phase 3 trialLancet Neurol · PMID 33222767 MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study.Mult Scler · PMID 27589059 High doses of biotin in chronic progressive multiple sclerosis: a pilot study.Mult Scler Relat Disord · PMID 25787192 and 1 more on the Biotin (Vitamin B7) page

Melatonin

Heart Rate Variability
Walking Ability: improves
Sleep Quality: improves

Melatonin: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People
	Heart Rate Variability No effect		NoneNo effect	1 study	27 people
Studies that measured heart rate variability 12-week melatonin intake attenuates cardiac autonomic dysfunction and oxidative stress in multiple sclerosis patients: a randomized controlled trial.Metab Brain Dis · PMID 39630381
	Walking Ability	Improves (the measure goes up)		1 study	27 people
Studies that measured walking ability 12-week melatonin supplementation improved dynamic postural stability and walking performance in persons living with multiple sclerosis: A randomized controlled trial.Behav Brain Res · PMID 39122092
	Sleep Quality	Improves (the measure goes up)			27 people

Riboflavin (Vitamin B2)

Anti-Oxidant Enzyme Profile
Homocysteine: improves
Multiple Sclerosis Symptoms: improves

Riboflavin (Vitamin B2): outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People
	Anti-Oxidant Enzyme Profile No effect		NoneNo effect		29 people
	Homocysteine	Improves (the measure goes down)		4 studies	29 people
Studies that measured homocysteine Effect of riboflavin supplementation on plasma homocysteine in elderly people with low riboflavin statusEur J Clin Nutr · PMID 12209373 Riboflavin supplementation and biomarkers of cardiovascular disease in the elderlyJ Nutr Health Aging · PMID 19390751 Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphismCirculation · PMID 16380544 and 1 more on the Riboflavin (Vitamin B2) page
	Multiple Sclerosis Symptoms	Improves (the measure goes down)			29 people

Vitamin D

Multiple Sclerosis Symptoms: improves

Vitamin D: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Multiple Sclerosis Symptoms	Improves (the measure goes down)		6 studies	719 people
Studies that measured multiple sclerosis symptoms Therapeutic effect of vitamin D3 in multiple sclerosis patientsImmunol Invest · PMID 21542721 Effect of vitamin D3 supplementation on relapses, disease progression, and measures of function in persons with multiple sclerosis: exploratory outcomes from a double-blind randomised controlled trialMult Scler · PMID 22354743 Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementationTher Adv Neurol Disord · PMID 22783368 and 3 more on the Vitamin D page

Cannabidiol (CBD)

Pain: improves

Cannabidiol (CBD): outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Pain	Improves (the measure goes down)		3 studies	24 people
Studies that measured pain Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in UruguayTransplant Proc · PMID 29579828 Short-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus VaccinationIsr Med Assoc J · PMID 28457055 A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptomsClin Rehabil · PMID 12617376

L-Carnitine

Multiple Sclerosis Symptoms: improves

L-Carnitine: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Multiple Sclerosis Symptoms	Improves (the measure goes down)		1 study	36 people
Studies that measured multiple sclerosis symptoms Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trialJ Neurol Sci · PMID 14759641

Ginkgo Biloba

Multiple Sclerosis Symptoms: improves

Ginkgo Biloba: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Multiple Sclerosis Symptoms	Improves (the measure goes down)		1 study	116 people
Studies that measured multiple sclerosis symptoms Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trialNeurology · PMID 22955125

Vitamin A

Multiple Sclerosis Symptoms: improves

Vitamin A: outcomes studied for Multiple Sclerosis (MS)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Multiple Sclerosis Symptoms	Improves (the measure goes down)		1 study	101 people
Studies that measured multiple sclerosis symptoms Effect of Vitamin A Supplementation on fatigue and depression in Multiple Sclerosis patients: A Double-Blind Placebo-Controlled Clinical TrialIran J Allergy Asthma Immunol · PMID 26996107

Key findings

CognitionCannabis
Depression SymptomsCoenzyme Q10Improves (the measure goes down)
Multiple Sclerosis SymptomsBiotin (Vitamin B7)

The Multiple Sclerosis (MS) Nutritional Support protocol

2 primary supplements · 7 supporting supplements

Vitamin D4,000–10,000 IU daily (target 40–60 ng/mL or higher per neurologist)
Omega-3 Fatty Acids2–4 g EPA+DHA daily

See the full protocol

Studies cited

1 study from PubMed

Effects of mindfulness-based interventions on cognition in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.Front Psychiatry · PMID 39071226

Evidence by supplement

Key findings

The Multiple Sclerosis (MS) Nutritional Support protocol

Studies cited

Related conditions

Supplement stack for Multiple Sclerosis (MS)