Ellagic acid supplements found to ease fatigue in MS in small trial
Use of antioxidant over 3 months also eased patients' anxiety, depression
Three months of daily supplements containing ellagic acid — an antioxidant found naturally in many fruits and plants — significantly reduced disability levels and eased fatigue, depression, and anxiety in people with multiple sclerosis (MS), according to a small clinical study from Iran.
Indeed, the researchers noted a “statistically significant reduction” in assessment scores across all measures of these common symptoms of MS.
“[Ellagic acid] appears to significantly alleviate fatigue, depression, and anxiety in MS patients,” the team wrote.
Although larger studies are needed to confirm these findings, an earlier analysis of this same triple-blind study showed that ellagic acid may reduce the levels of molecules that signal inflammation in MS, while increasing the levels of anti-inflammatory molecules. This would be expected to ease symptoms and slow progression of the disease.
The study, “Ellagic acid favorable effects on fatigue, depression and anxiety in patients with multiple sclerosis and moderate disability: A randomized clinical trial,” was published in the Multiple Sclerosis Journal — Experimental, Translational and Clinical.
Investigating ellagic acid supplements for use in MS
In MS, the immune system mistakenly attacks myelin, a protective covering that surrounds nerve cells in the brain and spinal cord. These inflammatory attacks cause a gradual buildup of damage, leading to worsening disability that typically affects a patient’s ability to function in daily life.
While mobility-related symptoms, such as stiffness and problems with balance and walking, are the most common, people with MS also can experience other issues — often fatigue and mental health problems. Such symptoms can be bothersome and take a toll on a patient’s quality of life.
“In humans, the effects of … the demyelination process … in MS patients are known to cause the onset of psychological consequences of the disease, including depression, anxiety and fatigue,” the researchers wrote.
Many individuals with MS consider holistic management strategies that combine a healthy diet, exercise, and complementary treatments in addition to the use of approved medication. One supplement that’s sometimes considered is vitamin D.
Here, the team of researchers sought to learn more about the effects of ellagic acid, or EA, supplements. Ellagic acid is found in certain fruits and seeds, like raspberries, strawberries, red grapes, pomegranates, almonds, and walnuts.
“On the basis of animal models and laboratory studies, EA has been identified as an effective substance for treating chronic diseases such as neurodegenerative diseases,” the researchers wrote.
Earlier studies in mouse models of MS showed that ellagic acid may help reduce inflammation and ease symptoms of the disease. However, no studies have examined the effects of ellagic acid supplements in people with MS.
For this study, the team recruited 58 adults, ages 18 to 55, who had been diagnosed with MS for at least six months. Their scores on the Expanded Disability Status Scale (EDSS), a commonly used measure, ranged from 4.5 to 5.5 points, indicating significant disability with minor limitations in daily activities to disability severe enough to prevent some daily activities from being done independently.
Disability levels seen to decrease significantly with one dose
The participants were randomly assigned to receive either ellagic acid — two capsules taken with meals, totaling 180 mg daily — or a placebo, while maintaining their usual diet and physical activity patterns. The researchers called or texted participants to help them stick to the schedule. At the end of the study, leftover capsules were counted to determine compliance with the treatment protocol.
After three months, the EDSS scores of patients on ellagic acid had decreased significantly, by an average of 1.01 points, indicating a lower disability level. For those on the placebo, there was no significant change in their EDSS score.
We found a statistically significant reduction in [assessment] scores compared to the control group. … The changes achieved are also clinically significant.
Specifically, patients on ellagic acid showed a significant reduction in anxiety, depression, and fatigue after three months, while these symptoms remained virtually unchanged in the placebo group. Similar results were observed for physical, psychosocial, and cognitive fatigue scores.
“We found a statistically significant reduction in [assessment] scores compared to the control group,” the researchers wrote, adding that “the changes achieved are also clinically significant.”
The researchers noted that their study “is the first to investigate the effects of EA … on psychological impairments such as anxiety, fatigue and depression in MS patients.” As a study limitation, however, team noted that only a single dose of the supplement was given. Further, the trial was very small in size. I
“Although additional investigations are needed to determine how to [ease] psychological symptoms in MS patients, mechanisms such as the anti-inflammatory properties of [ellagic acid] can be considered,” the researchers concluded.
About the Author
