MSM is a sulfur-containing compound found in a wide range of human foods including fruits, vegetables, grains, and beverages. Methylsulfonylmethane is a popular dietary supplement promoted for a variety of conditions including pain, inflammation, allergies, arthritis, and the maintenance of normal keratin levels in hair, skin and nails. Despite its popularity, there is little published human data except that it may be helpful in seasonal allergic rhinitis and that it is able to cross the blood brain barrier. Studies in rats show it to have very low toxicity.   

Many dietary supplement formulas for joint health contain one or more of these ingredients
Glucosamine sulfate (from shellfish) is a popular ingredient in many joint health products
Chondroitin sulfate - chondroitin is a popular ingredient in many joint health products.
CMO complex also known as cetyl myristoleate
Boswellia serrata extract is used in Ayurvedic medicine
Cat's claw extract comes from the Amazon jungle Joint Power Rx formula
Devil's claw extract has been studied in arthritis
Grape seed extract is a potent antioxidant
Hyaluronic acid is promoted for joint health

Arthritis treatment
MSM has become a popular dietary supplement for arthritis pain relief, but few studies have been conducted involving actual human patients. Researchers from the Southwest College of Naturopathic Medicine in Tempe, Ariz., and the Arthritis Health Center in Scottsdale, Arizona, gave 3 grams of MSM twice a day to 25 knee arthritis sufferers in a randomized, double-blind trial. The study lasted 3 months. The age of the men and women ranged between 40 to 75 years. The patients taking MSM pill reported significant decreases in pain and improvements in their physical function, compared with a control group taking a placebo. However, no notable differences were found in stiffness or aggregated total symptoms.
   Comments: 6 g of MSM daily is a very high dose, and we suggest using a smaller amount since most people will probably take MSM longer than just 3 months. Also, if MSM is combined with other nutrients and herbs used for arthritis, the dosage would have to be further reduced.

MSM glucosamine combination for arthritis
Glucosamine and chondroitin are often used together arthritis. Now it seems there's another nutrient that could be helpful in combination with glucosamine. This nutrient is known as MSM. In the June 2004 issue of the journal Clinical Drug Investigations, scientists report that although the MSM and glucosamine individually did improve pain and swelling in arthritic joints, the combined therapy was more effective than the single nutrients in reducing symptoms and improving the function of joints. In a clinical trial conducted at Nizam's Institute of Medical Sciences in Hyderabad, India, 118 patients with mild to moderate osteoarthritis were treated three times daily with either 500 milligrams of glucosamine, 500 milligrams of MSM, a combination of both, or an inactive placebo. After 12 weeks of treatment, the average pain score had fallen from 1.74 to 0.65 in the glucosamine -only group. In MSM -only participants, it fell from 1.53 to 0.74. However, in the MSM glucosamine combination group, it fell from 1.7 to 0.36.
   It would seem reasonable for those with arthritis to take this combination. The dose of glucosamine has been established to be 500 mg 3 times a day. We still don't know enough about MSM to determine whether lesser amounts than 500 mg three times a day would still be effective.

Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis.
Clin Drug Investig. 2004.
MSM, the isoxidised form of dimethyl-sulfoxide (DSMO), is an effective natural analgesic and anti-inflammatory agent. The aim of this study was to compare the efficacy and safety of oral glucosamine, MSM, their combination and placebo in osteoarthritis of the knee. A total of 118 patients of either sex with mild to moderate osteoarthritis were included in the study and randomised to receive either glucosamine 500mg, MSM 500mg, glucosamine and MSM or placebo capsules three times daily for 12 weeks. Combination therapy showed better efficacy in reducing pain and swelling and in improving the functional ability of joints than the individual agents. All the treatments were well tolerated. The onset of analgesic and anti-inflammatory activity was found to be more rapid with the combination than with glucosamine alone. It can be concluded that the combination of MSM with glucosamine provides better and more rapid improvement in patients with osteoarthritis.

Brain effect, crosses blood brain barrier
Accumulation of methylsulfonylmethane in the human brain: identification by multinuclear magnetic resonance spectroscopy.
Toxicol Lett 2001. MR Spectroscopy Unit, Huntington Medical Research Institutes, Pasadena, CA  USA.
MSM is a widely available 'alternative' medicine. In vivo magnetic resonance spectroscopy (MRS) was used to detect and quantify MSM in the brains of four patients with memory loss and in three normal volunteers all of who had ingested MSM at the recommended doses of 1-3 g daily. MSM was detected in all subjects at concentrations of 0.42-3.40 mmole/kg brain and was equally distributed between gray and white matter. No adverse clinical or neurochemical effects were observed. Appearance of MSM in significant concentrations in the human brain indicates ready transfer across the intact blood-brain barrier.

MSM for seasonal allergy
A multicentered, open-label trial on the safety and efficacy of methylsulfonylmethane in the treatment of seasonal allergic rhinitis.
Barrager E, Veltmann JR Jr, Schauss AG, Schiller RN. GENESIS Center for Integrative Medicine, Graham, WA, USA.
J Altern Complement Med. 2002.
Seasonal allergic rhinitis (SAR) affects more than 23 million Americans annually, and current epidemiologic studies indicate that its prevalence within the United States is increasing. Numerous clinical observations and case studies have led researchers to hypothesize that methylsulfonylmethane (MSM) may help ameliorate the symptoms associated with SAR. The primary goal of this study was to evaluate the efficacy of MSM in the reduction of SAR-associated symptoms. This study also examined possible adverse reactions associated with methylsulfonylmethane supplementation. Finally, this study attempted to elucidate the method of action by which MSM elicits its effect on allergy symptoms. Fifty-five (55) subjects were recruited for the study. All met the criteria for participation in the study. 50 subjects completed the study. Those subjects completing the study consumed 2,600 mg of MSM orally per day for 30 days. Day 7 upper and total respiratory symptoms were reduced significantly from baseline. Lower respiratory symptoms were significantly improved from baseline by week 3. All respiratory improvements were maintained through the 30-day visit. Energy levels increased significantly by day 14; this increase continued through day 30. No significant changes were observed in plasma IgE or histamine levels. The results of this study are promising. It would be worthwhile to conduct a larger, randomized, double-blind, placebo-controlled study to establish further if MSM would be a useful agent in the treatment of symptoms associated with SAR. The results of this study suggest that MSM supplementation of 2,600 mg/day for 30 days may be efficacious in the reduction of symptoms associated with SAR. Furthermore, few side effects are associated with the use of this compound. Recent acute and subacute chronic toxicologic data on the same source of MSM as used in this study, further validate the safety of this product.

Safety, side effects, caution
We currently don't know the long term effects of taking a MSM tablet or capsule daily for many months or years.

Toxicity of methylsulfonylmethane in rats.
Pharmaceutical Control and Development Laboratory Ltd, Budapest, Hungary. Food Chem Toxicol. 2002.
Methylsulfonylmethane is a popular dietary supplement used in a variety of conditions including pain, inflammation, allergies, arthritis, parasitic infections and the maintenance of normal keratin levels in hair, skin and nails. Despite its popularity, there is little published toxicology data on MSM. The objective of this study was to evaluate the acute and subchronic toxicity of MSM in rats at a dose five to seven times the maximum recommended dose in humans. MSM administered in a single gavage dose of 2 g/kg resulted in no adverse events or mortality. MSM administered as a daily dose of 1.5 g/kg for 90 days by gavage resulted in no adverse events or mortality. Necropsy did not reveal any gross pathological lesions or changes in organ weights. Renal histology of treated animals was normal. It is concluded that MSM is well tolerated in rats at an acute dose of 2 g/kg and at a subacute chronic dose of 1.5 g/kg.

Allergy
Do you have glucosamine and chondroitin without MSM? I am allergic to sulfa and cannot tolerate MSM.
   Glucosamine and chondroitin are widely available as supplements together or separately. We have not seen any reliable studies in regards to MSM allergy.

MSM research review
Researchers from the Nestle Research Center, Lausanne, Switzerland, Laurent G. Ameye and Winnie S.S. Chee, have concluded that of 2,026 human clinical trials evaluating the effects of nutritional compounds on osteoarthritis, only 53 studies provided minimum acceptable evidence and only three nutrients, including methylsulfonylmethane or MSM, showed good to moderate evidence. The research was published in Arthritis Research & Therapy, July 2006. The study did not include evidence for glucosamine or chondroitin sulfates, which are known to have significant research support. Good evidence was found for avocado soybean unsaponifiables. Moderate evidence was found for methylsulfonylmethane MSM. In regards to MSM, the research noted two randomized clinical trials, qualified to be evaluated in this systematic review.
   Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonyl-methane MSM in osteoarthritis pain of the knee: a pilot clinical trial, Osteoarthritis and Cartilage 2006. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane MSM and their combination in osteoarthritis. Clin Drug Invest 2004. According to the best-evidence synthesis, “MSM provides moderate evidence of efficacy for knee osteoarthritis.”

Emails
Q. I am interested in MSM and joint products as I am in very bad pain from arthritis in hip and back. My question is that I am allergic to sulphur based drugs eg. Bactrim an antibiotic that if I use will send me to a hospital emergency ward. Is the sulphur in it the same thing? Have you had any people with this allergy try MSM supplements?
   A. Sulfur is a natural mineral found in the body and we are not aware of allergy to sulfur itself. Some people are concerned that if they are allergic to sulfa drugs they would also be allergic to sulfur. Sulfa drugs are actually sulfonamides and are derivatives of para-amino benzoic acid. When a sulfonamide drug is ingested, it is metabolized in the body and then has the potential of attaching itself to proteins, leading to a larger molecule that could be considered an allergen.

Q. With MSM cream, can one mix Passion Rx herbs or DHEA hormone or other product with it and have it enter the body transdermally.
   A. We've never tested this transdermal route for Passion Rx or other supplements. It is possible DHEA may enter but we doubt herbs can enter easily. Simply, we don't know for sure.

Q. I have been using MSM glucosamine capsules for over 2 years. I have ordered them from in internet company and also found a product of the MSM Emu gel from that same company. As I had success with the capsules, and continue to have success, I have also tried the MSM gels. I suffer from severe nighttime leg pains in the calves and thighs and have suffered with fibromyalgia for years. So far this regime of the MSM capsules and the MSM gel for the topical pain relief is the only things that really helps consistently. Everything else that is being prescribed seems to have such severe side effects, that I don't want to take anything.

Q. I cannot find any information about the Sulfonyl- group in MSM. Nothing has been said about possible allergic responses to it in those people who are allergic to sulfa drugs. I am allergic to sulfa drugs and had a bad allergic reaction to the sulfonylamide in the air while synthesizing it during a college biochemistry class. (It also blistered my skin where a drop of the alcohol solvent touched me). Years later, when I tried MSM combined with glucosamine and chondroitin it made me feel very tired and weary, even though the dual glucosamine chondroitin supplement normally made me and my joints feel much better. I'm wondering if perhaps I was having some kind of allergic response.
   A. Sulfonyl comes from sulfonic acid through the removal of the hydroxyl group. Sulfonyl groups have two double bonds between the sulfur and oxygen. A sulfonyl group is different that sulfa drugs. Feeling tired is not necessarily due to an allergic reaction.

Q. I had an immediate increase in energy upon taking MSM pills. It also has dramatically reduced my IBS (irritable bowel syndrome), and for the first time in two decades I am having solid bowel movements. I was taking 40 mg of Adderall and now I either take 10 mg or I can skip it. This has been consistent for three months. The increase in energy has been extreme to the point where I was having trouble sleeping. I was taking 15 grams per day; I had to back down to 10 grams. My knee which was torn up from wrestling is pain free for the first time in years. MSM truly is my miracle supplement. I am baffled as to what is going on, but I do know that I have experienced chronic illness for 20 years and only now am I starting to feel okay

Q. A year ago I was diagnosed with rheumatoid arthritis and spent 8 months in the most excrutiating pain I have ever experienced in my life. Rheumatoid doctor put me on Celebrex and then prednisone . It did nothing to get major flare-ups under control . On the average I was having a major flare-up 4-5 times a week with significant pain in between . I took glucosamine, chondroitin and msm for 6 weeks and the pain miraculously went away and it's like I never had RA .It's been 3 months now and I feel great. Every thing I have read claims this supplement does nothing for RA. What do you make of this ? I am a 48 year old male that has been healthy and very active all my life.
   A. Congratulations! However, it's difficult for any scientist to get excited about one case report.

Q. Does MSM interfere with proper thyroid function as per it being a sulfur.
   A. We have not seen human studies regarding the role of MSM supplements and thyroid function. It is likely that low dosages would not have much of an influence but it is not clear if higher dosages would have an effect on thyroid function.

I wanted to share with you that MSM tablets have helped with herniated discs in my neck which had caused pain in my right arm. These MSM benefits began after a few weeks.

Q. Was wondering if its okay to put diluted liquid MSM directly on eyes?
   A. We don't have any experience with using MSM placed in the eye. One has to be very cautious placing anything in the eye if it has not been formulated for this purpose. At the least, there is a potential to introduce infectious agents. Allergic reactions could also occur, or irritation or other reactions.

Q. I am 60 yrs old with joint stiffness, I have no problems walking , and I have been doing yoga for four years. I have no arthritis. I remembered pure msm and glucosamine for joint pain so I purchased the Double strength 90 tab. bottle. Could you please tell me how long before I should see any results. I started taking the msm and glucosamine a week ago.
   A. Each person is different on how they respond to arthritis supplements. We are not familiar with the msm glucosamine product you mention. In general, it takes several weeks for these joint pain nutrients to start working.

Can you tell me if MSM (methylsulfonylmethane) contains sodium? I take ten 1,000 mg capsules/day of MSM featuring OptiMSM from a company called Nutraceutical Sciences Institute.
   MSM supplements do not contain sodium, but we do not know how the OptiMSM product is made and they would no for sure.

I'm looking into using your Joint Power Rx and was wondering if you know which method the MSM is processed and purified by, the crystallization or distillation method?
    Sorry we don't know. We just review the HPLC testing to make sure it is pure MSM, we don't go into the details how each ingredient we make available is made. We just want to make sure the final product is pure.

My husband is taking MSM I purchased. Was it manufactured using the distillation process or the crystallization process?
    This is outside our area of expertise.
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