Despite the incredible advances in medicine, technology and the pharmaceutical industry, we are powerless against many diseases.
A number of autoimmune, neoplastic or idiopathic etiologies are treated only symptomatically, the main goal is to alleviate the patient’s condition (symptomatic therapy and maintenance therapy, in some forms of cancer palliative treatment is used.
It is often difficult to create an effective therapy as a consequence of incomplete and unsatisfactory understanding of the disease, the factors that cause it and the processes that occur in the body during the disease.
Multiple sclerosis is a typical example of a disease for which there is no definitive treatment, and only means and methods are used to alleviate symptoms, slow progression or control an acute attack.
The hope of many experts in this field is the creation, development and application of effective and safe drugs for the treatment of multiple sclerosis in the next few decades. Dozens of drugs are currently being researched and clinically tested, but the results are not satisfactory enough (either the effectiveness is comparable to any of the drugs used or there is an excessive risk of side effects and complications when using the drug).
What is multiple sclerosis (MS)? What are the typical symptoms and complications?
In essence, multiple sclerosis is an autoimmune inflammatory disease that affects the central nervous system, characterized by characteristic damage to various areas (brainstem, spinal cord) or disseminated.
The disease leads to progressive damage to nerve structures, as a result of which disease-specific manifestations develop. As the processes of transmission of nerve impulses to the appropriate executive organs are affected, depending on the affected areas and structure, a wide range of symptoms is observed.
Often, patient therapy is prepared on the basis of the manifestation of diseases present in a particular patient and according to the occurrence of the disease (relapsing-remitting, primarily progressive, secondary progressive, relapsing, benign, malignant).
Clinical symptoms and signs of multiple sclerosis include some of the following:
- muscle weakness and increased fatigue
- stains, stains, stiffness
- tremor
- nausea (see 90% of patients)
- species damage
- balance disorders
- change in progress
- cognitive impairment
- mood swings, depression, anxiety (every other patient shows a sign of depression)
- Pelvic disorders: constipation (carries the risk of subsequent development of fecal incontinence), difficulty urinating
- sense damage
- neurological manifestations: epileptic seizures, hemiplegia, pyramidal symptoms, hemianopsia, etc.
In some patients, the disease goes unnoticed, with barely noticeable symptoms that become palpable as the process progresses and serious damage to nerve structures occurs. In other patients, the onset of the disease is dramatic, with severe manifestations that are often difficult to control.
The disease is more common in whites, women are twice as likely to get sick, and the first symptoms usually appear between the ages of 15. and 50. years.
The etiological factors leading to the onset of the disease have not yet been fully elucidated, and various theories have been discussed.
Useful information about the characteristic signs, complications, disease progression, methods of diagnosis can be found in the section Diseases :
- Multiple sclerosis
There is no etiological, definitive cure for the disease. Drugs from different groups are used to control symptoms, slow progression, speed up the recovery process and improve patient comfort.
Treatment of multiple sclerosis: a means of controlling acute attacks
Corticosteroid drugs are most often used to control acute attacks, quickly improve the patient’s condition and speed up the recovery process.
Depending on the severity of the attack and the general condition of the patient, different drugs are administered orally (in mild forms) or parenterally (in severe cases).
The most common agents are prednisone in the form of tablets, methylprednisolone in the form of intravenous infusion, in some patients prednisolone, betamethasone, combination drugs and others are used.
The therapy is prescribed by a doctor who is present and monitors the patient with multiple sclerosis, the dose and duration of the course are determined individually.
Corticosteroids are usually administered in a regimen with a gradual increase in dose and, consequently, with a gradual decrease after discontinuation of therapy, or in some patients using alternating courses.
Drugs from this group are very effective and have a strong anti-inflammatory and immunosuppressive effect, they quickly control the inflammatory process in the body and lead to an improvement in the general condition.
However, their use should not be overdone due to the high risk of serious side effects of long-term treatment. For example, short-term courses of therapy usually include sleep disorders, changes in blood pressure, changes in position, fluid retention, increased risk of infection, and more. Long-term therapy has an increased risk of developing Cushing’s syndrome, osteoporotic bone changes, cataracts, peptic ulcer, skin changes, etc.
In the treatment of corticosteroids, the use of other drugs is carried out with caution regarding the risk of adverse drug interactions. Such drugs are, for example, rifampicin, phenytoin, oral contraceptives, phenobarbital, antifungals and others.
Even in the absence of the effect of corticosteroid treatment or in the presence of various contraindications that do not allow the type of treatment to control acute lung diseases, plasmapheresis can be used .
In this method of therapy, the liquid component of the blood (plasma) is separated from the blood cells and undergoes special treatment (usually the cells are mixed with a protein, such as albumin).
It is essentially a therapeutic, invasive method for removing abnormal macromolecules from a patient’s systemic circulation. It is used in acute attacks, because it has a short-term effect.
The main risks of performing the procedure include an acute drop in the patient’s blood pressure (hypotension), hypocalcemia (acute calcium deficiency), nausea, suppression of the immune system and others. People with unstable vital signs, mainly hypotension, anemia, active bleeding, severe bronchial obstruction, etc., have a higher risk of complications.
The procedure leads to the conclusion of a specialist in a certain hospital.
Treatment of multiple sclerosis: drugs to slow the progression of the disease
Different groups of drugs are used to slow the progression of multiple sclerosis (MS) and they have different mechanisms of action. Many drugs have immunosuppressive properties (suppress the patient’s immune system, mainly T and / or B cells), in connection with which long-term therapy carries a serious risk of side effects.
Different drugs are given alone or in combination depending on the severity of the disease and a number of individual characteristics of the patient.
The most commonly used drugs in clinical practice that affect the progression of multiple sclerosis are:
- Interferons : Interferons, especially beta-interferons, are one of the most commonly used agents in the treatment of MS. The most commonly used are interferon beta-1b, interferon beta-1a, peginterferon beta-1a, usually subcutaneously or intramuscularly. Common side effects that occur during therapy include flu-like symptoms, liver damage, injection site reactions, and more.
- natalizumab : The drug is a selective immunosuppressant and is one of the most commonly used agents in multiple sclerosis. Natalizumab prevents and blocks the spread of immune cells that damage the systemic circulation in the structure of the brain and spinal cord. The code of many patients is an easy choice, but it is approached individually (the code of some individuals is used in case of not using other means). Its use carries the risk of viral infections of brain structures, especially progressive multifocal leukoencephalopathy in susceptible patients.
- teriflunomide : The drug is a selective immunosuppressant and the active metabolite is leflunomide. It is most often used to treat relapsing-remitting multiple sclerosis and is applied once a day. It has pronounced anti-inflammatory properties, reduces the proliferation of fast-growing cells, and reduces the number of lymphocytes. The main risks of its use include liver damage, alopecia, neutropenia, headache, allergic reactions, joint and muscle pain, changes in blood pressure and more.
- alemtuzumab : is a monoclonal antibody that slows the progression of multiple sclerosis by suppressing white blood cell counts. It is usually given parenterally in a special regimen, with some of the most common side effects including stomach upsets, sensory impairment, depression and an increased risk of infection. The drug is difficult to detect and is available in a special regimen
- mitoxantrone : Essentially, antineoplastic agents are cytotoxic activity used in the complex therapy of certain malignancies. It is used in some patients with MS only in strict indications and as a last resort in patients with a high risk of side effects, damage to the cardiovascular system and an increased risk of hematological neoplasms.
- Fingolimod : is a selective immunosuppressant, and for the treatment of MS (mostly relapsing-remitting form) it is used once a day or a specific mechanism leads to redistribution of lymphocytes and slows down the progression of MS. Its use is associated with an increased risk of infection (herpes viruses, influenza viruses), species damage, headaches, neurological manifestations, extreme heart palpitations, etc.
- glatiramer acetate : The drug is an immunostimulant (immunostimulant), which is usually administered subcutaneously. Its main effects are to help the immune system block myelin attacks, which in turn slows the progression of MS. It often leads to skin irritation at the injection site, rash, edema, flu-like symptoms, neurological and gastrointestinal problems
Drugs used to slow the progression of multiple sclerosis are used with caution only under medical supervision, because they carry a significant risk of side effects that vary in weight, in the short and long term. Improper use can lead to worsening of the patient’s condition.
Many of these drugs are not available in Bulgaria, which requires imports from other countries.
Numerous drugs have the potential to slow the progression of MS. Clinical trials are being tested around the world, but it is a controversial process (lasting 10 to 15 years on average), expensive and difficult to treat.
Treatment of multiple sclerosis: symptomatic drugs
Often, in order to alleviate the manifestation of multiple sclerosis, the main therapy includes symptomatic agents that are specifically targeted to a particular patient’s symptom.
Individualization of therapy is necessary in connection with the multiple manifestations of the disease and their different prevalence in individual patients.
Depending on the main complaints, a certain group of drugs is used:
- to alleviate depressive episodes and change mood : antidepressants are used . 19459012], such as fluoxetine, sertraline, paroxetine and others, where the dose and duration of the therapeutic course are determined by the pods.
- to relieve nausea : nausea is a symptom that occurs in about 90 percent of patients and in some cases leads to significant impairment of patient comfort, which is why it is necessary to prescribe appropriate drugs from the group of antiemetics . Dopamine agonists (metoclopramine, domperidone), serotonin antagonist (ondansetron) and others are used.
- for relieving muscle cramps : to alleviate the manifestations of spasticity, paresthesia, tingling, muscle cramps and other, often observed in multiple sclerosis, drugs from the group[19] relaxation . Baclofen, tizanidine (central action muscle relaxants) are most commonly used, and in some patients diazepam (a representative of benzodiazepines). They are usually given orally in the appropriate dosage regimen
- for relieving pelvic reservoir symptoms : in urinary incontinence (impossibility or difficulty urinating) preparations such as oxybutynin[194591409] (194591409]) 19459011] tolterodine and others, colitis, intestinal obstruction[19459][19459] , etc.
- for pain syndrome : Some patients experience pain of varying degrees, with the use of appropriate analgesics[195] .
- in cognitive decline : in the presence of memory impairment, concentration, sharpness of mind, various means are used, most often from the group of nootropic drugs[1245][1945] . 19459016], which by various mechanisms leads to the improvement of cognitive functions. In addition, various supplements can be learned to improve memory and concentration.
Depending on the main complaints of a particular patient, other means can be used to alleviate the symptoms and improve the quality of life.
Regardless of the type of symptomatic agent, all medications should be consulted with the attending physician to reduce the risk of adverse drug interactions combined and / or worsening severe disease (diabetes, high blood pressure, high blood pressure, pressure). dysfunction and others). ).
Additional and alternative drugs for the treatment of multiple sclerosis: physical therapy, vitamins, treatment
For the treatment of multiple sclerosis (MS), alternative methods, herbs and some vitamins are often used in conventional medicines.
The purpose is to support the basic therapy, reduce some of the side effects of the used drugs and improve the quality of life of the patient.
Alternative methods and aids do not replace drug therapy and should not serve as the only means of therapy.
When using them, it is necessary to consult a doctor in advance about the possible effect of the effectiveness of some drugs in case of improper use (risk of unwanted interactions between herbs, supplements, vitamins and drugs used to treat multiple sclerosis).
The most commonly used alternative and complementary measures to control symptoms and slow disease progression include:
- Physical therapy : A number of techniques used in physical therapy can be used to alleviate some manifestations of multiple sclerosis. Such are, for example, occupational therapy, training in handling certain technological means to alleviate patient comfort, application of a certain set of exercises to improve muscle tone and others.
- vitamins, minerals and other supplements : the inclusion of appropriate doses is recommended in the complex treatment of the disease vitamin D , coenzyme Q10, omega-3 fatty acids , vitamin A , selenium , magnesium , some vitamin B (B-complex) , probiotics and another choice of preparation taking into account the individual needs of a particular patient
- herbs and medicinal herbs : ashwagandha used to reduce anxiety and stimulate the nervous system, barberry i echinacea can be used to relieve inflammation, ginger leads to the alleviation of stomach upsets, but also has potential anti-inflammatory and neuroprotective functions used ginkgo biloba to improve cognitive status, antioxidant and anti-inflammatory potentials of the root dandelion are used to relieve some symptoms of MS, blueberries , cranberries , cannabis and many other herbs can be drugs to control some symptoms of the disease and improve the neurological, mental and muscular tone of patients
- other alternative methods : treatment with bee venom (apitherapy), reflexology, magnetic therapy and others are used as needed in some patients
The treatment plan and treatment for multiple sclerosis are complex, often time-consuming, and require patient follow-up to see for side effects of medications and treatment methods.
The prognosis varies from patient to patient, with a number of factors. In some patients, it is possible to control the manifestations and long-term remission with standard means, but in others, the lack of effect of various treatment measures and death.
Hopes are focused on experimental medicine and the creation of a new, highly efficient and safe tool for use.
Alternative Remedies for Multiple Sclerosis Symptoms
Multiple sclerosis is a chronic, autoimmune disease of the central nervous system. It mainly affects the brain, spinal cord and optic nerve.
The pathogenetic mechanisms of the disease include damage to the protective nerve sheath (myelin sheath) under the influence of one’s own immune system, which mistakenly recognizes them as a foreign body. Disorder of the myelin sheath, in turn, leads to disorders in the transmission of nerve impulses between nerve cells. The name of the disease comes directly from the presence of many areas of sclerosis, which are areas of demyelination within the human nervous system.
Symptoms of multiple sclerosis range from mild, temporary to severe and permanent disability. They most often include progressive weakness, fatigue, impaired appearance, memory problems, movement disorders, balance and coordination, changes in limb sensitivity (tingling sensation), dysfunction and other disorders.
There is still no cure or method that can completely cure the disease. Treatment is primarily aimed at slowing down the development of the disease and alleviating the already manifested symptoms.
The use of alternative medicines for the symptoms of multiple sclerosis is an increasingly common practice. Many people turn to unconventional methods of treatment when traditional medicine fails to improve symptoms.
Treatment of multiple sclerosis with medicinal plants
Ashwagandha
Ashwagandha is a plant known by various names, including Indian ginseng, asana and Vithania somnifera. Among its useful properties are stimulation of nervous activity, relief from stress and anxiety, improvement of immune function. It is sometimes used for chronic pain and inflammation.
Astragalus
Astragalus is a plant used in traditional Chinese medicine. There are many variants of this plant, but Astragalus membranaceus and Astragalus mongholicus are most often used for medical purposes. There is evidence that astragalus reactions are medically designed to control immune activity, so care should be taken when using them.
Barberry
Barberry is a plant that has long been used in Indian and Eastern medicine as a means of relieving inflammation, fighting infections, treating diarrhea and antacids.
Ginger
Ginger has long been used for medicinal purposes for gastrointestinal problems, nausea, joint and muscle pain. However, some studies have revealed anti-inflammatory and neuroprotective potential. Most people can use ginger in a reasonable amount without any side effects.
Echinacea
Echinacea is a plant that can be found in various forms for use. It is known for its use against colds and upper respiratory tract infections. In people with multiple sclerosis, the study focused on the anti-inflammatory potential of the plant and its ability to improve immune function.
Some people may be allergic to echinacea, so be careful with their use! Apart from the risk of an allergic reaction, it is usually safe.
Ginkgo biloba
Ginkgo biloba is a bull known for its ability to improve memory and mental performance. Ginkgo biloba extract has been shown to be effective in improving memory and thinking, relieving leg pain and overactive nervous reactions. It affects the appearance problem and reduces dizziness.
Turmeric
Turmeric is a popular spice that contains curcuminoids, which have shown neuroprotective properties and the potential to alleviate the symptoms of multiple sclerosis and other autoimmune diseases. However, in order to complement the effect of turmeric on electricity and the development of multiple sclerosis, as well as the correct dose, it must first be studied that it is widely recommended for use in people with multiple sclerosis.
Burdock root
Burdock is known for its ability to improve blood circulation and reduce inflammation. Its antioxidant and anti-inflammatory properties for the potential effects of cancer, diabetes, skin diseases and gastrointestinal disorders are still being studied. There is still a need to investigate its effectiveness in treating multiple sclerosis.
Butter root
Dandelion root is used as a plant to improve general health. Animal studies show that jaundice root can reduce fatigue and improve immune function. Its antioxidant and anti-inflammatory properties can help alleviate the symptoms of multiple sclerosis.
Catnip
Some goodies have used catnip to control the pain of multiple sclerosis. However, it should be borne in mind that catnip has a sedative effect and can worsen fatigue, as well as escape from the effects of drugs has a sedative effect. Studies are lacking in Judyma, but animal experiments are essential extracts that show that it has anti-inflammatory properties and avoids pain.
Red viburnum
Viburnum bark is used to treat muscle cramps. Although research has been done on this disease in humans, it appears to have antioxidant and anticancer effects that can inhibit tumor growth and spread the lesion.
blueberry
Blueberries, also known as Hutzkleberry blueberries, are used as food, and fruits and leaves can also be used to make plant extracts. They are used to treat types of disorders, scurvy, diarrhea and circulatory disorders. Vorovnica is rich antioxidants, has the potential to improve appearance, reduce inflammation and reduce cognitive impairment. These properties make blueberries a reliable tool in the fight against the symptoms of multiple sclerosis.
Cranberry
Cranberry juice (unsweetened, 100% natural) has long been used in the treatment of urinary tract infections. Cranberry juice is a suitable remedy for patients with multiple sclerosis and bladder dysfunction.
Cannabis (marijuana)
Cannabis is a plant known primarily for its narcotic properties, but in recent years the term medical cannabis (medical marijuana) has been increasingly used, which is associated with the use of cannabis and its derivatives to alleviate and treat the symptoms of a number of serious diseases., including multiple sclerosis, cancer, neurodegenerative diseases, glaucoma, heart attack, epilepsy. In many countries, the use of cannabis for medical purposes has been legalized and regulated, but this relationship is still much debated, including in our country.
After research and testing, it was found that the substance in marijuana (cannabinoids) led to a significant alleviation of muscle spasticity, stiffness, pain, bladder problems and tremors in multiple sclerosis. In addition, cannabinoids have certain neuroprotective effects, which is especially important for long-term disease control.
Vitamins and supplements for multiple sclerosis
Coenzyme Q10
Coenzyme Q10 is used because of its ability to slow the development of neurodegenerative diseases. Further andresearch is necessary before it can be applied to people with multiple sclerosis, but it is generally well tolerated and a safe substance.
Docosahexaenoic acid (DHA)
DHA is an omega-3 fatty acid that can be obtained by consuming fish and omega-3 supplements. According to the National Center for Complementary and Alternative Medicine (NCCAM) , docosahexaenoic acid is important for blood flow, muscle activity, digestion, cell growth and brain activity. In patients with multiple sclerosis, the addition of docosahexaenoic acid may help protect the central nervous system and reduce the severity of damage. Side effects are usually mild, but it should be borne in mind that it thins the blood and makes blood clotting more difficult.
Polyunsaturated fatty acids
Polyunsaturated fatty acids can be obtained naturally, through proper nutrition or in the form of supplements. Omega-3 and omega-6 fatty acids may be helpful in reducing inflammation and reducing the severity and duration of recurrence of multiple sclerosis.
Magnesium
Magnesium is essential for many bodily functions. Magnesium deficiency can lead to weakness, fatigue, tingling, cramps, seizures, muscle contractions and more. Some studies suggest that magnesium deficiency may be associated with symptoms of multiple sclerosis, as well as some other chronic, progressive conditions. Magnesium supplements and a diet containing a natural source of magnesium may be helpful in preventing worsening of symptoms.
Selenium
Selenium is an increasingly used mineral to improve health. It has long been used to prevent heart problems and various types of cancer, but there is still limited scientific evidence about these actions of selenium. Some research shows that selenium plays a role in improving eye health and the immune system.
Vitamin A
Vitamin A plays an important role in appearance, reproductive health and immune function. It can be obtained naturally from certain foods (leafy vegetables, meat, fruits and dairy products) or taken as a supplement. Due to the risk of hypovitaminosis with vitamin A, it should not be taken for a long time and in large doses without consulting a doctor! Vitamin A supplementation is associated with growth-related macular degeneration. The antioxidants in vitamin A may be helpful for people with multiple sclerosis, but their relationship has not yet been well studied.
Vitamin B1
Vitamin B1, also known as thiamine, is of great importance for the proper functioning of the brain, for proper metabolism, activity of nerves, muscles and heart. Vitamin B1 deficiency is associated with various neurodegenerative diseases, including multiple sclerosis. Vitamin B1 deficiency can lead to weakness and fatigue. Natural sources are nuts, seeds, legumes, whole grains, eggs and lean meat.
Vitamin B6
Vitamin B6 is a special ingredient for the proper functioning of the metabolism. It is found in some foods, such as lean meats, fish and starchy vegetables. Although vitamin B6 deficiency is rare, its low levels are not uncommon in autoimmune diseases. Vitamin B6 deficiency can be associated with brain dysfunction, depression, confusion and kidney problems.
Multivitamins and multimineral formula
Multimineral supplements and multivitamins can be found in the form of tablets or powders, combining a wide range of vitamins and minerals. It is desirable to get them mainly from natural sources, in a healthy and balanced diet, but for some this is not always possible. There is still controversy among the scientific community about the importance of multiminerals and multivitamins in the prevention of a wide range of health problems. However, there is evidence to suggest that some multivitamins and multiminerals may help prevent eye problems, inflammation of the brain, neurodegenerative problems, fatigue and cognitive impairment.
For some people with multiple sclerosis, multivitamins and multiminerals may be helpful in preventing deficient conditions.
Probiotics
Probiotics are live bacteria that are considered to be useful for the body and intestinal microflora. Probiotics can be found in the form of capsules, powders or milk. A small number of studies have shown that they can be useful in preventing malabsorption. Goody’s disease is multiple sclerosis. On the other hand, probiotics can have anti-inflammatory properties, stimulate immune function and improve nerve health.
Apitherapy for multiple sclerosis
Apitherapy includes any treatment based on bee products, such as honey, bee venom, royal jelly, propolis and bee pollen.
Bee venom
Treatment of bee stings is also classified as apitherapy (bee venom is also known as apitoxin). In bee venom therapy, live bee stings are used as a “tool” to inject venom into a patient’s body to relieve pain, muscle weakness and coordination. Unlike many other herbs and supplements used to treat multiple sclerosis and its symptoms, bee venom has been specifically studied for its effects on multiple sclerosis in several clinical trials.
Apamine is a component contained in bee venom that is believed to have the ability to improve the transmission of impulses between nerves. Adolapin and melittin are poisoned by bee venom, which scientists believe will cause a natural weakening of medicinal poisons to reduce aches and pains. This is the basis of hope that bee venom can be used to help people with multiple sclerosis.
Bee pollen
Bee pollen is brich source of minerals, vitamins, enzymes and nutrients. It is more often used in the form of a dietary supplement. Although its properties are still being studied, it seems to have some antioxidant and antimicrobial properties. It is extremely rich in minerals and vitamins, trace elements, proteins and amino acids. It is used to accelerate wound healing and stimulate the immune system, to relieve constipation and to improve endurance. Other suggestions suggest that bee pollen is useful for stimulating the immune system and fighting chronic diseases.
Apitherapy is used to treat high blood pressure, brain damage, cerebral hemorrhage and memory impairment.
It can only be used as an adjunct therapy and in no way can it replace all the treatments prescribed by the doctor! Persons suspected of having an allergic reaction to bee stings, bee pollen or honey should avoid all forms of treatment.
Magnetic therapy
Magnetic therapy is a form of energy medicine and uses magnetic force. It is believed that this force improves the functioning of the body. Some studies suggest that it can reduce fatigue, but there is still no clear evidence that this therapy will help treat the symptoms of MS.
Reflexology
Reflexology is a therapy that involves pressing the legs, arms or ears. These points are believed to be the centers of the organism and organ systems, and the impact on these points improves their functioning. There is little evidence that reflexology helps treat paresthesia (spotting or other unusual skin changes), but research is still needed to determine if reflexology can help alleviate other MS symptoms.
Training
Exercise offers many benefits for people with multiple sclerosis. In addition, it improves general health, muscle strength, reduces fatigue and improves bladder and intestinal function. Exercise reduces stiffness and increases mobility. In order to achieve maximum efficiency and avoid potential complications, the exercise plan should be prepared and implemented by a specialist.
Stress management
The link between stress and the exacerbation of multiple sclerosis is well known – different types of stress seem to affect each case differently. It is important for everyone to find a stress management strategy that suits them best. Suitable for this purpose are meditation, acupuncture, Reiki therapy.
The listed plant and method of therapy do not cover the full list of options for alternative treatment of multiple sclerosis symptoms. The article offers a brief overview of some of the most common diseases, supplements and methods discussed as useful for people with multiple sclerosis. An adjunct to treatment, as a technique and method, can cause drug interactions or complications if used improperly. Before using any supplement, alternative or complementary therapy for the treatment of multiple sclerosis, talk to your doctor about all the potential benefits and risks!
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Probiotic for Multiple Sclerosis Enterosan MS +€15.50 -
Selenium in capsules sale€9.00
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Coenzyme Q10 COQ10 sale€17.00
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Curcumin capsules saleProduct on sale€21.00
