Nutrition, Myelin, and Nervous System Health

Myelin is a highly specialized fatty membrane surrounding central and peripheral nervous system neurons. The myelin sheath facilitates rapid information processing. Loss of this protective layer or failure to remyelinate leads to neurodegenerative disorders, including multiple sclerosis (MS), a demyelinating disease. Remyelination is tightly regulated by growth factors, nutrients, and a balance of inflammatory compounds (Adamo 2014).

Specific nutrients support myelin production and function, including long-chain polyunsaturated fatty acids, such as DHA and arachidonic acid, iron, choline, iodine, and B12 (Raymond 2021). Cholesterol is also essential to myelin structure and function.

Cholesterol

Cholesterol is vital to health as it is a functional component of cell membranes and the myelin sheath. It is the most abundant lipid in the brain and the precursor to bile acids and steroid hormones, including glucocorticoids (e.g., cortisol), mineralocorticoids (e.g., aldosterone), sex hormones (e.g., pregnenolone, progesterone, estrogen, testosterone), and vitamin D. Cholesterol facilitates cell signaling, nerve conduction, and intracellular transport (Schade 2020, Huff 2020, Hu 2010, Agranoff 1999, Snipes 1997, Tsoupras 2018, Berghoff 2017).

Cholesterol is the rate-limiting compound required for myelin synthesis—failure to remyelinate leads to the axonal damage observed in multiple sclerosis. Animal research demonstrates how cholesterol restores growth factor balance, supports remyelination, and improves motor learning. Increased serum cholesterol observed during active MS in humans may be a countermeasure to facilitate myelin production and repair (Berghoff 2017).

Glutathione

Glutathione is found in the highest concentration in the brain, especially in the glial cells of the cortex. Glutathione is crucial for quenching reactive oxygen and nitrogen species, facilitating neurotransmission, and supporting myelin maturation. Neurological disorders associated with low glutathione include impaired myelin maturation, neuroinflammation, compromised DNA repair, and neurodegenerative diseases. Glutathione impairment in the brain leads to neuron loss associated with aging and neurological disorders, including stroke, Huntington’s, Parkinson’s, and Alzheimer’s (Iskusnykh 2022).

Gamma-glutamyl transferase (GGT)

GGT is essential for maintaining intra- and extracellular concentrations of glutathione. Increased circulating GGT indicates an increased need for glutathione and antioxidant support (Ndrepepa 2016).

Omega-3 and Omega-6 Fatty Acids

A balanced intake of omega-3s and omega-6s from fish, flaxseed, sunflower seed, hempseed, borage, and evening primrose oils may slow MS progression and disability. This effect is most significant when combined with additional nutrition interventions, including multivitamin mineral supplementation and restricted saturated fat intake (Tredinnick 2020).

Omega-3 fats can downregulate inflammatory marker gene expression, and the long-chain omega-3 fatty acid DHA may substantially improve the Expanded Disability Status Scale (EDSS) (Ghasemi 2022).

An open intervention study of 16 newly diagnosed MS patients revealed a significant reduction in exacerbation rate and significant improvement in mean EDSS scores, with 11 of the 16 subjects showing improvement. Daily supplementation included 0.4 grams of EPA, 0.5 grams of DHA, and multiple vitamins, including A, C, D, E, B1, B2, B3, B5, B6, B7, folic acid, and B12. Additional dietary interventions included a reduction in animal-based saturated fat; limited added sugar and alcohol; coffee/tea limited to 2 cups/day; fish intake 3-4 times per week; 1-2 servings of fresh fruit/day; increased vegetable intake; and incorporation of whole grain products (Nordvik 2000).

Vitamins

B1 (Thiamine)

Thiamine is involved in maintaining the myelin sheath and facilitating nerve impulses. Myelin loss, peripheral neuropathy, and motor and sensory changes are features of dry beriberi, a thiamine deficiency disease (Wiley 2023).

B2 (Riboflavin)

Riboflavin is crucial in the nervous system and myelin formation and may be therapeutic in MS (Zielińska 2022).

B7 (Biotin)

Biotin is essential to fatty acid synthesis and supports myelin repair and neuronal energy production. However, high doses may be detrimental (Zielińska 2022).

B12 (Cobalamin)

Cobalamin is vital to myelin production and maintenance. A B12 insufficiency may be characterized by homocysteine and methylmalonic acid accumulation, especially if serum B12 falls below 406.61 pg/mL (300 pmol/L). Clinical signs of overt B12 deficiency include neuronal demyelination, neuropathy, and megaloblastic anemia.

However, even subclinical cobalamin deficiency (SCCD) may be characterized by inhibition of methylation, infertility, miscarriage, psychosis, memory loss, dementia, and depression. B12 insufficiency can be exacerbated by excess synthetic folic acid in supplements and fortified processed foods (Allen 2018).

Homocysteine may be elevated in MS patients even if B12 levels are not significantly reduced. Homocysteine disrupts methylation, which can cause myelin degeneration, neuritis, and microglial activation. Supplementation with B12 and folate can reduce homocysteine levels (Zielińska 2022).

Vitamin D

Maintaining a serum 25(OH) vitamin D above 40 ng/mL (100 nmol/L) has been associated with a significantly reduced MS relapse risk compared to 20 ng/mL (50 nmol/L). Higher concentrations were associated with lower disability scores, reduced risk of new CNS lesions, and better outcomes (Tredinnick 2020).

However, 25(OH)D serum levels above 150 ng/mL (375 nmol/L) should be avoided. Extremely high levels lead to vitamin D toxicity. They can be associated with hypercalcemia, confusion, apathy, depression, drowsiness, psychosis, abdominal pain, vomiting, pancreatitis, constipation, hypertension, EKG changes, dehydration, and renal failure (Feige 2020).

Diet and lifestyle

In general, a Mediterranean-style diet is recommended, including omega-3s from fish or seafood two or more servings/week, eggs 2-4 servings/week, legumes two or more servings per week, monounsaturated fats from olive oil with each meal, 1-2 fresh fruits/meal, two or more vegetables/meal, 1-2 whole grains/meal, 1-2 servings of nuts/meal, and moderate amounts of red wine, Western-style diets containing excess processed foods, added sugars, and saturated fats should be avoided. Ketogenic and fasting-mimicking diets may be of some benefit but are more difficult to follow and prone to nutrient deficiencies. Combined exercise training incorporating aerobic activity, speed walking, Pilates, etc., is also recommended for MS (Fanara 2021). Maintaining a healthy gut microbiome is also important in

Optimal Takeaways

The myelin sheath is a vital protective coating for neurons.

Loss of myelin leads to debilitating neurodegenerative damage that may not be reversible.

A healthy whole-food-based diet is essential to maintaining the myelin sheath.

Several compounds and nutrients support myelin integrity and function, including:

• Cholesterol
• Glutathione
• Gamma-glutamyl transferase (GGT)
• Omega-3 and Omega-6 Fatty Acids
• B1 (Thiamine)
• B2 (Riboflavin)
• B7 (Biotin)
• B12 (Cobalamin)
• Vitamin D

References

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