MSM—Joint Health and Beyond
by Jeremy Appleton, N.D.
Methylsulfonylmethane (MSM) is a
naturally occurring sulfur compound
present in small amounts in
many foods and beverages. MSM is also
known as dimethyl sulfone, or DMSO2, a
name that reflects its close metabolic relationship
to dimethyl sulfoxide (DMSO). MSM
is the first oxidized metabolite of DMSO in
the environment and in humans.
MSM is widely distributed in nature. It is
found in selected fruits, vegetables, grains
and beverages. Milk is the most abundant
known source of dietary MSM, containing
between 3.3 parts per million (ppm) to 8.2
ppm. Other dietary sources of MSM include
coffee, tomatoes, tea, Swiss chard, beer, corn
and alfalfa. Trace amounts of MSM have also
been detected in asparagus, beets, cabbage,
cucumber, oats, apples and raspberries. MSM
is found naturally in the human body in
small concentrations.
MSM is a source of dietary sulfur, containing
approximately 34 percent sulfur by
weight. Sulfur is the fourth most abundant
mineral in the body, after calcium, phosphorus
and potassium. A 154-pound human
body contains approximately 200 grams of
elemental sulfur, slightly less than one percent
of the total body weight. The sulfur
component of MSM has been shown to be
taken up by sulfur-containing amino acids
in the body.
Sulfur is a major component of connective
tissues, amino acids and vitamins
required for various enzyme reactions (i.e.,
coenzymes). It is most abundant in skin and
cartilage. Sulfur helps maintain the structure
of intracellular proteins by forming crosslinkages
through disulfide bonds. Sulfur is
also a constituent of glutathione, the most
important and abundant intracellular
antioxidant in the body.
The mechanisms by which MSM exerts its
many effects are not well known. However,
its primary metabolic precursor, DMSO, has
been studied extensively. DMSO has several
pharmacologic properties that it likely shares
with MSM. These include effects on pain
receptors, increase of local blood supply,
action on mediators of inflammation, effects
on collagen and reduction of muscle spasm.
Oral MSM appears to be well absorbed
and may even become incorporated in the
synovial fluid of the joints. Three studies
suggest that intact MSM is incorporated into
human brain tissue. The authors of these
studies found no adverse effects of MSM in
the brain. In fact, MSM’s non-toxicity, combined
with its ability to cross the bloodbrain
barrier, may prove to be beneficial as
neurologic applications for the supplement
emerge.
MSM Clinical Trails in Humans
Most people think of MSM as a supplement
strictly for joint health. However, the first
clinical trial of oral MSM to be published in a
peer-reviewed medical journal evaluated the
efficacy of MSM, not for arthritis, but for seasonal
allergic rhinitis (hay fever). Fifty subjects
completed the open-label study.
Participants consumed 2,600 mg of MSM
(OptiMSM, Cardinal Nutrition, Vancouver,
Washington) orally per day for 30 days. After
one week of supplementation, upper and
total respiratory symptoms were reduced significantly.
Lower respiratory symptoms were
significantly improved after three weeks. All
respiratory improvements were maintained
through the end of the study. No adverse
effects on various laboratory parameters
occurred.
Only one double-blind trial of MSM for
osteoarthritis has been reported to date. In
1998, an abstract appeared in the
International Journal of Anti-Aging Medicine. In this abstract, the author presented the
results of a preliminary study in which
patients suffering from degenerative arthritis
were given either 2,250 mg per day of MSM
(Adaptin, no manufacturer specified). The
author reported “a better than 80 percent
control of pain within six weeks of beginning
the study.” No formal publication of the full
study or follow-up has occurred.
Randomized, controlled clinical trials of MSM
are needed to confirm and extend the results
of this preliminary report.
Intravesicular MSM has also been used by
medical doctors to treat interstitial cystitis, a
painful inflammatory condition of the
bladder.
Stanley W. Jacob, M.D., of Oregon Health
and Science University, conducted a trial of
MSM nasal drops for the control of snoring.
In this study, 80 percent of the subject’s
mates reported the lessening or absence of
snoring in their partners, while 20 percent
reported no benefit.
Dr. Jacob has treated over 18,000 patients
with MSM. A selection of case histories is
available in MSM—The Definitive Guide.
The vast majority of health conditions
treated successfully with MSM are inflammatory
conditions such as rheumatoid arthritis,
repetitive stress injuries (e.g., carpal tunnel
syndrome, tendinitis, bursitis), scleroderma,
lupus, fibromyalgia, myasthenia gravis and
asthma. Anti-inflammatory effects of MSM
have also been suggested in animal studies.
In addition to the conditions described here,
Dr. Jacob has also used MSM with success to
treat chronic pain syndromes and many
lesser-known clinical entities.
Toxicity Research
The first toxicity study of MSM to be published
in a peer-reviewed scientific journal
appeared in 2002. The study assessed both
the acute and subchronic oral toxicity of
OptiMSM in rats. No adverse effects, clinical
signs of toxicity or deaths occurred at the
human equivalent of more than 100 grams, or
about five ounces, per day. Most people take a
small fraction of the amounts used in this
study. A typical dose of MSM as a dieta
Conclusion
Information on MSM in the public domain is
largely unreliable. Retailers and consumers
should be skeptical of extravagant claims,
claims that one form of MSM is more “natural”
than another and of reports of potential
drug and nutrient interactions with MSM.
Published data does not exist to confirm or
refute most of these claims. Nevertheless, scientific
data does exist to support many of the
current uses of MSM for human and animal
health.
Retailers and consumers should be on the
alert for substandard or contaminated MSM,
which has become more prevalent. MSM
should be produced in a dedicated facility that
complies with Good Manufacturing Practices
(GMP) as set forth by the National Nutritional
Foods Association (NNFA). Every batch of MSM
should be distilled for maximum purity and
subjected to the most up-to-date laboratory
analysis for microbiological and heavy metal
contamination. TH
References available upon request. Send a SASE to totalhealth.
Jeremy Appleton, N.D., is a licensed naturopathic physician, writer and educator in the field of evidence-based natural medicine. He is co-author, with Stanley Jacob M.D., of MSM—The Definitive Guide (Freedom Press). Dr. Appleton is nutrition department chair at the National College of Naturopathic Medicine and director of scientific affairs at Cardinal Nutrition. His articles have appeared in numerous journals and newswire services.
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