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What is MSM?


Stanley W. Jacob and Robert Hersehier

Department of Surgery Oregon Health Science University Portland, Oregon


MSM, an odorless essentially tasteless, white crystalline chemical demonstrates usefulness as a dietary supplement in men and lower animals. Our research suggests that a minimum concentration in the body may be critical to both normal function and structure. Limited studies suggest that the systemic concentration of MSM drops in mammals with increasing age. This may be due to dietary habits where one ingests foods with lower MSM potential with maturity or possibly there is a change in the renal threshold. Healthy juvenile rabbits maintain a level at or above 1 PPM body weight, with milk being the dominant food and source. Cow's milk normally contains between 2 and 6 PPM MSM, dependent on source and freshness. In an adult man, the circulating concentration varies but may average about 0.2 -0.25 PPM. We have no estimate of total body concentration as yet, but suspect that MSM is banked in some of the organs, other than the adrenals. Based on radiolabel (35 S) studies, the residence time of a single challenge in mammals may be several weeks with gradual dumping via the renal system. Daily output of urine contains several milligrams of MSM. This possibly is not the dominant excretory route. The following abnormal conditions seen in the clinic have responded to oral MSM generally administered at dosage levels of 250-270 mg/day.
Response to allergy: Oral MSM moderates diverse allergic responses as to pollen and foods. Anti-allergy medication and, dissemination methods may be sharply reduced.

Control of hyperacidity: Subjects that are chronic users of various antacids and histamine H 2 receptor antagonists prefer.

Hypersensitivity to drugs. Subjects demonstrating drug hypersensitivity to aspirin, several non-steroid anti-arthritic agents (naprosy, Indocin, Motria), and oral antibiotics, were drug tolerant when MSM was given within an hour before or concurrent with the sensitizing drug.
Control of constipation. Particularly in the older population seen in our clinic, chronic constipation can be a medical problem of concern. To date, over 50 subjects presenting chronic constipation have gained prompt and continuing relief by supplementing the diet with 100 to 500 mg of MSM per day.

Improving lung dysfunction: We have seen some individuals with severely restricted lung function. Of these, only a few cooperated in vital function assessments. All cooperated in endurance measurements. Limited objective and strong subjective evidence suggests that MSM is a useful dietary supplement to reduce lung dysfunction.

Anti-paracitic action: In vitro and in vivo tests suggest MSM has an activity against a variety of medically important parasitic tracts, MSM, for example, is active against Giardia, Trichomondads, and round worms. MSM surface, presenting a blocking interface between host and parasite. We are at present evaluating the action of MSM with a variety of abnormal or medical problems to determine whether any are responsive to a diet supplemented by MSM.

We are intrigued the fact that MSM is a contestant factor in all normal dies of vertebrates and somewhat mystified by the seeming need of the body of adults for a concentration level above that available from a diet presumed as normal. We hope soon to have data defining any specific interacting role that MSM may have with the water-soluble vitamins, particularly Vitamin C, which like MSM is reportedly banked in the adrenals. It is not possible to directly compare DMSO and derivative MSM, though of the same chemical family. Each is unique unto itself MSM is a dietary factor derivable from most natural food. It is conveniently taken alone or in foods. Taken by mouth, there is no bad breath. DMSO has certain unpleasant attributes not possessed by MSM. While MSM is a dietary factor, DMSO is not. DMSO readily penetrates the dermas and less complicated membrane systems while MSM does not. Each contributing to the well- being of mankind, but in differing ways. Both have important implications.

By Ronald M. Lawrence, M.D., Ph.D.
Daniel Sanchez, D.C., C.C.S.P.
Mark Grosman, D.C.

Twenty-four subjects (both male and female) were seen in a clinical office setting. The subjects suffered from acute injuries (under 30 days) sustained during the course of athletic endeavor. The patient's were selected on a random basis to receive either a placebo or MSM (Methylsulfonylmethane) in addition to routine chiropractic manipulation, ultrasound and muscle stimulation at each visit. All patients were treated with similar therapy and all patients received unmarked capsules of either a placebo or MSM. Patients were discharged from care once all their symptoms were resolved. Of the twelve patients who received placebo four of the twelve graded their results as excellent or good, while of the twelve patients on MSM seven of the twelve graded their symptom reduction as excellent or good. This represented a 58.3% of symptom reduction on MSM, versus 33.3% on placebo. Of greater significance, however, was the fact that patients on MSM had 3.25 visits on an average, while those on placebo had 5.25 visits. This means that patients on MSM had 40% fewer visits to the office before reaching a recovery phase. This represents sizable economic advantage.
This paper discusses the chemical nature of MSM; the possible mechanisms involved in treatment of such sports injuries and the implications for future usage of this phytonutrient for the treatment of short term athletic injuries.

Methylsulfonylmethane (MSM) was first discovered in the late 1970's by researchers at Oregon Health Sciences University in Portland. It is a metabolite of DMSO (Dimethyl sulfoxide). By 1965, more than one thousand five hundred studies had been conducted on DM50 involving about one hundred thousand patients. DMSO is used for a host of problems, primarily musculoskeletal inflammatory conditions. However, by 1978, the FDA approved DMSO only as a prescriptive treatment for interstitial cystitis. When DMS0 enters the body, approximately 15% of it is converted to MSM, its major breakdown component. MSM is in reality DM50 2 (dimethyl sulfone). MSM has had widespread use since the late 1970's in veterinary medicine where it has been used to treat inflammatory conditions, including muscle and bone disorders. (1, 2, 3, 4, 5)
In 1998, one of the authors of this paper, Ronald M. Lawrence, performed a double-blind study using patients with degenerative arthritis. This study showed an 82% decrease in symptomatology after six weeks of usage on a three-times-a-day dosage. (6) It has been postulated that MSM takes anywhere from three to six weeks to produce significant changes in regard to the treatment of arthritic disorders, but to date there has been no study that has evaluated it for acute short-term injuries.

R. D. Moore and J. I. Morton studied the effect of MSM in inflammatory joint disease in MRL/1pr mice. (7) In addition, R.D. Moore and Morton studied the effect of 3% water solutions of dimethyl sulfone (DM SO 2) in P1w mice and found a diminishment in death due to lupus nephritis. (9) B. V. Siegel and J. Morton studied the effects of dimethyl sulfone on murine autoimmune lymphoproliferative disease and explained the benefits of this compound.
(9) Since one-third of the DMS0 2 molecule is composed of sulfur, a relationship to sulfur metabolism has been postulated. Several papers have been written about sulfur and it's roles in such disorders of the musculoskeletal type. (10,11) For this reason, and because of the effective results noted in the treatment of degenerative arthritis, this study was undertaken to evaluate the potential effects of DMSO 2 (M SM) in athletic injuries involving muscles, tendons, and ligaments.

Twenty-four subjects were examined in a clinical practice setting (the practice of Daniel Sanchez and Mark Grosman). This practice deals with a large number of athletic injuries on a daily basis. The first twenty-four subjects who came in with complaints of acute injury were admitted into the study and the subjects were divided in a random fashion into two groups (A and B). The twelve subjects in group A received a container labeled "A" which had a thirty-day supply of capsules, while the twelve in group B received a contained labeled "B". The doctors and patients involved were not privy as to whether they received placebo or actual MSM. The code, which defined whether bottle A or bottle B contained placebo or active substance, was not broken until after the completion of the study.

Nine of the twelve patients taking bottle A had diagnoses of sprain/strain injuries, one had an acute episode of bilateral chondromalacia patellae, one patient had a right lateral epicondylitis (right elbow), and one patient had a radicular syndrome (bilaterally) in addition to a lumbar strain syndrome. In the group taking bottle B, ten subjects had a sprain/strain diagnosis, while one subject had a radiculopathy involving the left lower extremity along with a lumbar sprain syndrome and one patient exhibited a lateral epicondylitis involving the right elbow.
Each patient received chiropractic manipulation in a standard fashion, ultrasound (five watts for ten minutes) and muscle stimulation (applied in a standard fashion for five minutes). Each subject took the material in either bottle A of bottle B three times a day with meals. The only differential between treatment given to each group was the administration of either the placebo or the phytonutrient MSM.
All patients were examined in a similar fashion for angle of motion of the part or parts involved and this was duly recorded. Patients were also quizzed as to subjective complaints at the time of each visit. In addition, palpatory findings in regard to the musculature in the involved area was recorded on the basis of zero to four plus, with zero being the absence of any type of muscle spasm beyond that of a normal resting state, while four-plus represented extreme muscle spasm based on the rigidity of the muscle involved. This information was recorded at each visit as well. In those injuries involving the upper extremities a Jamar Hand Dynamometer evaluation of grip strength was recorded at each visit. In those exhibiting lower extremity or low back injuries, straight-leg raising testing was performed at each visit and the degrees of elevation from the horizontal were noted and recorded.

Those patients in the aliquot, which consumed the MSM, on average, reported a faster reduction of symptomatology than those on the placebo. Four of the subjects taking the MSM reported the "Disappearance" of symptoms after taking the capsules for a very short period of time. (We shall discuss this below). Symptom resolution and evaluation also consisted of the objective findings noted by the examining doctors at each visit. Response of the patients in regard to their symptoms were graded on a scale of zero to ten with ten being the severest pain and zero representing an absence of pain. This evaluation of the symptom level of pain was performed at each of the visits. Therefore the patients were evaluated objectively by the doctor at each visit and there was a subjective evaluation in regard to the patient's own perception level of pain.

Since we were dealing with very small study groups the excellent and good categories were combined in arithmetic fashion and the satisfactory category and poor category were grouped together, again for purposes of statistical evaluation in using this small group of subjects. Seven out of twelve in the A category showed excellent to good results (58.3%). Those in the B category showed four out of twelve having excellent to good results (33.3%). In the satisfactory to poor categories, the total for the "A" group was five of twelve (41.66%) versus eight of twelve in the "B" category (66.66%).
Since economic considerations are very important, we determined the number of visits for each group. The number of visits, on average, for group A was 3.25 versus group B which was 5.25 visits. This represents a 40% reduction in visits. The economic advantages of reduced number of office visits were clearly noted with patients on MSM. This is also reflected in reduced disability time.
One patient in group A (who had an acute flare-up of bilateral chondromalacia patellae) noted complete resolution of her pain within two visits. Past episodes of this problem had usually taken up to four visits to resolve and up to two weeks to clear. This patient had resolution of her problem in less than one week. One patient who had a diagnosis of left ankle sprain/strain of a severe type noted a complete resolution of her problems within three visits over a period of one week, with a reduction of plus-four swelling of the ankle joint, resolving within two days after beginning the test substance ("A"). One patient in group A with a diagnosis of moderate cervical strain with associated radical syndrome of the right upper extremity noted complete relief of her discomfort within one week. Another patient with an episodic flare-up of lumbar radicular syndrome involving the left lower extremity noted a 70% improvement in five days (category A) where typical flare-ups in the past required approximately ten to fourteen days to resolve. One patient with left elbow medial collateral ligament sprain (grade I) needed only two visits and five days of taking bottle A to resolve her symptomatology. One patient with a lumbar strain diagnosis eventually was diagnosed with a herniated nucleus pulposus (ruptured disc) and substance A did not produce a resolution of his symptomatology within thirty days. A male, age sixteen, who fell while playing softball and injured his right elbow (diagnosed with right elbow strain, medial collateral ligament grade 1 strain) noted a disappearance of symptoms within two days and the examining doctor found full range of motion (which had been impaired by 25%) after two days on bottle A. One patient with lumbar sprain syndrome and associated pyriformis syndrome went from severe to slight within two days after starting bottle A.

In this small study using MSM versus a placebo (both administered in a similar capsule form and both capsules appearing exactly the same to the examiners and the patients) it was discovered that those taking substance MSM had a level of significant recovery from short-term injuries or flare-ups of previously induced athletic injuries. From the economic point of view, we were particularly gratified to see a marked reduction (40%) in the number of visits usually required to treat these injuries. It is postulated that MSM has an anti-inflammatory action based upon increased blood flow to the injured part (dilation of blood vessels and enhanced blood supply), reduction in muscle spasm and change in cellular membrane potentials involving sodium-potassium transfer. (12)
Since MSM, a phytonutrient, has been shown to have a very low level of toxicity (comparable to water) and since the substance has also been widely used in veterinary medicine without showing any toxic results as well, the use of MSM to treat human sprains, strains and athletic injuries appears to be very beneficial based on this small but intensive study. A larger study involving several hundred subjects is being planned and these subjects will be taken from a sports medicine practice.
It is felt by the authors that MSM, in view of it's low toxicity, inexpensive costs, and ease of administration, should be considered as an invaluable addition for treatment of short-term athletic injuries of the type that were involved in this study. It was previously shown in a double blind study that MSM had a high rate of effectively in a chronic painful condition involving osteoarthritis, the physiologic actions of MSM are apparently similar in producing an alleviation of symptoms in both chronic and acute conditions.

The present study demonstrated the effectiveness of a natural substance MSM on acute athletic injuries, such as muscle sprains and strains, with a negligible level of toxicity and, of even greater importance, a significant reduction in visits necessary to the doctor's office or treatment facility.

1. 1Jacob, S. W., E .E. Rosenbaum, and D. C. Wood. Dimethyl Sulfate (Basic Concepts), New York; Marcel Dekker, Inc. 1971.
2. Jacob, S. W., ed. Biological Actions ofDim ethyl Sulfoxide, Volume 243. New York New York Academy of Sciences, 1975.
3. Jacob, S. W., R. J. Herschler, and H. Selimellenkamp. The Use of DMSO in Medicine, Munich: Springer Verlag, 1985.
4. Jacob, S.W., and J. G. Kappel. DMSO, Munich: Springer Verlag, 1988.
5. Tarshis, Barry. DMSO - The True Story of a Remarkable Pain-Killing Drug. New York: Morrow, 1981.
6. Lawrence, R.M. "Methylsulfonylmethane (MSM): A double-blind study of its use in degenerative arthritis." International Journal of Anti-Aging Medicine, summer 1998, I (I); 50.
7. Moore, R.D., and J. I. Morton. "Diminshed inflammatory joint disease in MRL/1pr mice ingesting dimethyl sulfoxide (DMSO) or Methylsulfonylmethane (MSM)." Federation of American Societies for Experimental Biology, 69 Th annual meeting. April 1985, p.692.
8. Morton, Jane I., and R. D. Moore. "Lupus nephritis and deaths are dimished in BIW mice drinking 3% water solutions of dimethyl sulfoxide (DMSP) and dimethyl sulfone (DMSO (2). "Journal ofL eukocyte Biology, 1986, 40 (3); 322.
9. Morton, Jane I. And Benjamin V. Siegel. "Effects of oral dimethyl sulfoxide and dimethyl sulfone on murine autoimmune lymphoproliferative disease." Proceedings of the Society for Experimental Biology and Medicine, 1986,183:227-30.
10. Moss, Jeffrey. "A perspective on sulfur - Is it the most ignored, misunderstood essential trace element." The Moss Nutrition Report, August 1997, Hadley, M.A.
11. Osterberg, E. E., et al. "Absorption of sulfur components during treatment by sulfur baths." Archives Dermatol. Syphitol, 1929,20:156-66
12. Jacob, Stanley, and Robert Herschler. : Pharmacology of DMSO: Crybiology, 1986, 23.

A Preliminary Correspondence
By Ronald M. Lawrence, M.D., Ph.D.
Assistant Clinical Professor UCLA School of Medicine Los Angeles, CA

Methyl-Sulfonyl-Methane (MSM) is an organic sulfur compound, which is a metabolite of dimethyl-sulfoxide (DMSO). It is a white, odorless, slightly bitter tasting, crystalline substance, which contains 34 percent elemental sulfur. It is easily soluble in water. Its chemical formula is (CH3) 2S02. It has been suggested by Lovelock and his associate's (1) that MSM and its related compounds DMSO and D.M.S. (dimethyl-sulfide) provide 85 percent of the sulfur found in all living organisms.

The cycle of these naturally occurring sulfur compounds begins in the ocean where microscopic plankton release sulfur compounds called dimethyl sulfonium salts. These salts are transformed in the ocean into the very volatile compound D.M.S., which escapes from the water as a gas, that rises into the upper atmosphere. Exposed to ozone and high-energy ultraviolet light the D.M.S. is converted to DMSO and MSM. Both the DMSO and MSM are very soluble in water and they return to the surface of the earth in rainwater. Plants then take up the two compounds into their root systems concentrating them up to one hundred fold. MSM (sulfur) is incorporated into the plant structure. Through the process of plant metabolism the MSM, along with the other sulfur compounds it has spawned, are ultimately mineralized and transported back to the ocean and the sulfur cycle begins again.

MSM is found naturally in the human body. It occurs in the blood and in other organs and has been detected in normal human urine (2). The level of MSM in the circulatory system of an adult human male is about 0.2 parts per million (3). Normal human adults excrete from four to eleven milligrams of MSM per day in their urine. Experiments using radiolabeled sulfur (S35) in MSM have shown that after ingestion the sulfur in MSM helps form the essential amino acids methionine and cysteine (4).

MSM is rated as one of the least toxic substances in biology, similar in toxicity to water (5). The lethal dose (LD5O) of MSM for mice is over 20 grams per kilogram of body weight. Hundreds of patients have been treated at the Oregon Health Sciences University (6) with oral MSM at levels above two grams daily for many years without serious toxicity.

Since sulfur is found to be needed for the formation of connective tissue, MSM has been studied for its use in treating arthritis of various types (7). Sulfur concentration in arthritic cartilage has been shown to be about one-third the level compared to normal cartilage (8). In addition, the amino acid cystine has been noted to be diminished in arthritic patients.

Personal communication with Stanley Jacob, M.D., Gerlinger Professor, Department of Surgery, Oregon Health Sciences University, Portland, Oregon, substantiated his personal experiences using MSM in the treatment of patients with degenerative (osteoarthritis) arthritis.

Study Design
MSM was provided in a crystalline form, which we encapsulated in a clear gelatin capsule providing 750 mgs of MSM per capsule. The placebo substance, which was also placed in clear gelatin capsules, consisted of sugar (sucrose) to which a small amount of quinine sulfate was added to create a slightly bitter taste. This was done in case the capsule was opened and tasted, since MSM also has a slightly bitter taste.

A total of sixteen patients were studied over a period of four months. Initially twelve patients were admitted to the study and subsequently (two months later) an additional four patients were added to the study group. The initial twelve patients were divided as follows. Eight were given the MSM, while four received the placebo. Later, the additional four patients were divided into two on MSM and two on placebo. Totally, therefore, we had ten patients on MSM and six patients on placebo.

Criteria for Selection
Patients ranged from age 55 to age 78. All patients had x-ray evidence of degenerative joint disease (degenerative arthritis). All patients had pain in the involved area ranging from four weeks to six months. Most of the patients had tried non-steroidal anti-inflammatory drugs or aspirin type compounds. None had taken steroids either orally or by injection. All non-steroidal anti-inflammatory drugs or other anti-arthritic medications or alternative health remedies were stopped at least three days prior to their entering the study.
Patients were randomly chosen by lot and assigned to either the active (MSM) group or the placebo group. The treating physician did not have knowledge as to which patient received which agent until after the completion of the study. An independent evaluator kept records until the study was terminated. Both the patients and the physicians were blinded.

Of the eight patients of MSM, two had osteoarthritis in their hands, three had lumbar degenerative joint disease, two had degenerative arthritis in their knees, and one had arthritis in the shoulder.
Of the six patients who received the placebo, two had degenerative arthritis in the knees, two had lumbar degenerative joint disease, one had degenerative arthritis in the hip, and one has osteoarthritis in the neck.

Patients were instructed to take two capsules on an empty stomach in the A.M. after arising and one capsule before lunch. This constituted a 2250-milligram dose of MSM daily and zero dose of MSM on the placebo.

Each patient was administered a visual analog scale (V.A.S.) which consisted of a 10-cm line anchored at one end by a label of "no pain" and at the other end a label of "pain as bad as could possibly be." The scoring is accomplished by having the patient mark the line indicating pain intensity, and the line is then measured to the mark on a 1-100 scale (9).


The V.A.S. was completed by each patient at the four-week and at the six-week visit. Records were measured by an independent evaluator. At the four-week visit, the patients on the MSM showed a 60 percent improvement on average, while at the six-week V.A.S. evaluation the patients showed an 82 percent improvement in pain on average. Those on the placebo showed an improvement of 20 percent on average at four weeks and an 18 percent improvement on average at six weeks.

This preliminary simple study was performed to initially evaluate 16 patients suffering from degenerative arthritis as to the effect of using MSM to control their pain. Eight patients, randomly chosen, were treated with 2250 mgs of MSM per day. Six patients received placebo capsules. Results indicate a better than 80 percent control of pain within six weeks of beginning the study, while only two patients showed a minimal improvement (less than 20 percent) on the placebo. Although this was only a simple preliminary study, it appears that a more intensive investigation of MSM is warranted. A larger group of arthritic patients and an additional measurement evaluation (such as range of motion, etc.) should be utilized in such a future study. MSM may offer a significant new nutritional substance for the control of arthritic pain as a safe, non-toxic method.

1. Lovelock, J.E. et al. Nature, Vol.237, p452, 1972
2. Williams, K.l.H. etal. Arch Biochem Biophys, Vol.113, p251, 1966
3. Jacob, SW. and Herschler, R., Ann NYAcad Sci, Vol.411, pxii 1983
4. Richmond, V.L., J Nutrition, Vol.116 NO.6, June, 1986
5. Deichman, W.B. & Gerarde, H.W. "Toxicology of Drugs & Chemicals, 4th Edition, Arcadia Press, 1969
6. Jacob, S.W., Oregon Health Sciences University, Portland, Oregon, Personal communication
7. Jacob, S.W., Oregon Health Sciences University, Portland, Oregon, Personal communication
8. Rizzo, R. et al. Jour Exp Zool, 1995 September, 1,273(1):82-6
9. Carlson, A.M. Pain, 16:86, 1983

Quotes from "The MSM miracle" By Dr. Earl L. Mindell

Collagen is the most abundant protein in the body and the dominant component of tissue and bones. Collagen works with fibers of another protein called elastin, which gives skin its elasticity. The two types of fibers together account for the degree of resilience and skin tone found in skin.

MSM is responsible for the flexible bond between cells, including those that make up the skin. It acts to block undesirable chemical and physical cross-linking or bonding of collagen which is associated with tough, aging skin. Consequently, MSM enhances tissue pliability and encourages the repair of damaged skin. Tests conducted among laboratory animals indicated that wound healing occurred faster with a group receiving MSM, but the fastest healing was among a group receiving MSM plus vitamin C. If there is insufficient MSM in our body when new cells are being manufactured, the new cells become rigid. This rigidity can con-tribute to cracking, wrinkles, and scar tissue. When sufficient MSM is present it serves to make the skin softer, smoother and more flexible, allowing it to stretch easily with movement.

Scars are overgrowths of collagenous tissue that appear on skin as the cut or wound heals. Normally, the wound heals flat and firm leaving little sign of the injury. However, when the body is deficient in MSM and vitamin C, the new tissue will be elevated leaving an unattractive, raised scar. With adequate MSM along with vitamin C, these unsightly scars have been observed to disappear over time.

Some plastic surgeons and dermatologists will recommend collagen injections for minimizing wrinkles and scars. Enzymes, however, will break down injected collagen, in about two years. Money that people spend on cosmetic products with collagen as an ingredient is equally wasted, since skin cannot absorb the protein. Nutritional support of our body's own collagen, including MSM supplementation, is a much better idea, as the following case history clearly illustrates.

Hank was trapped in a burning car for twenty minutes, leaving parts of his body badly burned. For years afterward he would lie awake nights from the pain caused by the scarred tissue and adhesions. Finally he heard about nutritional sulfur (MSM) and after only a few days of applying it on his flat and purple burned areas, Hank's pain dramatically subsided, the scar tissue virtually disappeared and the purple areas returned to a healthy pink. This is the result of the effect of MSM stimulating the production of healthy collagen while bringing elasticity back to his skin.

The minerals that nourish healthy skin, including nutritional sulfur or MSM, and copper can be obtained from eating raw, dark, leafy vegetables, shellfish and whole grains, or via convenient supplements. Iron is another nutritional mineral important to skin and found in black strap molasses, poultry, fish and parsley. Vitamin C, required for the production of collagen, is abundant in a variety of fruits and vegetables.

Information was taken from The MSM miracle By Dr. Earl L. Mindell
MSM (Methyl-sulfonyl-methane) FOR SKIN, HAIR AND NAILS
Quotes from "The miracle of MSM" By Dr. Stanley W. Jacob,M.D. .

One day in the summer of 1998, as we were writing the book, two women independently called the Portland clinic and excitedly remarked how their wrinkles had "vanished" after they started taking MSM. Does MSM really get rid of wrinkles? They wanted to know.

The answer is that MSM does a lot of good things for the body but there is no evidence that it erases wrinkles. Many women observe that it makes their skin softer. This effect probably also softens the wrinkle lines.

"Well, that's good enough for me," one of the callers said. "I'm happy with what I'm seeing. You should probably call MSM an internal cosmetic."

MSM is one-third sulfur, and sulfur has a reputation for being nature's "beauty mineral," for keeping the hair healthy and the complexion youthful. Skin, hair, and fingernails are normally quite high in cystine, one of the sulfur amino acids that gives keratin, a particular kind of protein found in these tissues, its property of toughness.

As physicians who treat patients for pain disorders, we are not experts in the field of cosmetics. But we do receive frequent feedback from our patients about how surprised they are to experience the cosmetic bonuses of MSM: softer skin, harder nails, and thicker hair. This gives us additional clinical evidence that MSM is a biologically active source of sulfur that is utilized by the body. We have it from long-time users that even in hot, skin-harsh places like Las Vegas, MSM keeps the skin soft and pliable. One such person is Sally Christy, 58, a contract administrator for a public utility in Nevada. She has been using an MSM lotion as a makeup base for more than twenty years.

"People tell me how soft my skin is, and for somebody my age living in a dry climate, where skin can easily become brittle, a natural product like this is a blessing for my skin," she says. "If you live out here in the desert for a long time, the climate starts to show on your face. My experience is that it definitely helps ward off wrinkling and keeps my skin youthful. I could buy any moisturizer on the market, but I don't need it. I choose to stick with MSM because it has worked so well for me."

Far from the sun and sand of Las Vegas, in Burlington Ontario, Liz Miners of Lizanne's Hairdressing Salon has turned many of her clients on to MSM. Just as Christy does, Miners suggests the lotion as a makeup base. "Cleanse your face as normal, then rub in some of the lotion. Ii helps the makeup go on smoother. You see softer, more pliable skin," she says. "Dry, scaly skin becomes more supple. Some people notice the change right away. For others, with bad skin conditions, it takes a while."

Miners recommends both the external lotion and the sulfur rich MSM crystals to feed the skin from the inside. She uses the lotion twice a day and takes a teaspoon (about five grams) of crystals in an ounce of water once a day. "You can use the lotion on your face, arms, feet, and hands,' she states. "It has healing benefits wherever you put it. One of my customers is a woman with dermatitis. The face and neck would always look slightly scalded. She has been using cortisone cream for many years and they don't seem to be doing much for her any more. She takes about five grams of the crystals every day with the lotion. After five weeks her skin has almost cleared up totally. She is pretty amazed. A friend used the lotion on her heels, which wet always leathery and cracking. It was very uncomfortable for her. After three or four weeks her heels became much softer. She stopped using the MSM and the condition returned. Now she use it continually and her heels are better again.

MSM speeds hair growth as well, says Miners. "That's good for my industry," she quips. "And the hair seems thicker. I do a lot of hair coloring and quite often when you color the hair you can take a hair strand and break it. The process may in some ways weaken the hair. I've noticed that after people start taking MSM on a regular basis that their hair is stronger.

It's the same for nails. "They grow faster and stronger," she says. "Nails aren't as brittle. You don't seem to have as many hangnails."

"Stronger fingernails is a common "side effect" mentioned by female patients" says Dr Ronald M Lawrence M.D. These are often individuals with a lifelong history of fragile, brittle nails. After taking MSM regularly for a month or longer, they happily tell me their nails have become tough and no longer splitting or breaking off. Recently I met a young woman in a neighborhood health food store whom I recognized as a check-out cashier in the supermarket where I often shop. We started chatting and she mentioned a problem with splitting nails. She was frustrated at her inability to grow long nails. I mentioned MSM to her and she said she would try it. I saw her again a couple of months later in the supermarket. She excitedly held her hands up. "Look," she said, "that stuff you told me to take really works!"