Are there symptoms associated with MGUS or SMM?
This is a frequently asked question. Some patients with MGUS or SMM experience symptoms which may be associated with their condition. A recent (2020) review shows that even though the annual risk of progression from MGUS to a more serious disease is only approx. 1% (ie most patients do not progress!) MGUS patients appear to suffer from a greater prevalence of certain conditions.
Below is a list of these conditions based on this review article. I have tried to summarise the information and add a bit of diet/natural medicine information for patients who display some of these symptoms.
Osteoporosis & Bone Fractures
A number of studies have demonstrated an association between MGUS/SMM and low bone mineral density/osteoporosis, which, in turn increases the risk of fractures – particularly the vertebrae and hip.
What can you do? Healthy, strong bones require multiple minerals including magnesium, zinc, vitamin C, calcium, vitamin D, vitamin K – among others. Eating healthy foods (vegetables – particularly green ones – legumes, nuts and seeds, and 2 fruits – per day) does supply many of these.
Vitamin D requires a special mention. Researchers examined the correlation between serum Vitamin D levels of 50 MGUS and SMM patients and markers of bone metabolism. They showed that oral vitamin D (calciferol) supplementation (6000 I.U. daily for 8 weeks followed by 2000 I.U. daily) is correlated with a reduction in bone disease progression.
Studies with MGUS/SMM patients show a two to three-fold increase in the relative risk of bacterial and viral infections – particularly of the respiratory system.
What can you do? Vitamin D also plays an important role in the functioning of the immune system. Other nutrients involved in boosting immunity include vitamin C (capsicum, citrus, kiwi fruit, tomatoes etc) and zinc (legumes, nuts, seeds etc). Don’t forget garlic, ginger and mushrooms too!
A large Scandinavian study has found an approximately three-fold increase in the relative risk for peripheral neuropathy in cases of MGUS [prevalence is low -in about 5% of MGUS patients].
What can you do? Neuropathy can be a challenge however there is some clinical evidence that a good vitamin B complex may help – particularly vitamin B12. Another compound that may help is Palmitoylethanolamide (PEA) which is a natural anti-neuroinflammatory supplement. Vitamin E has also been suggested.
Cardiovascular (CVD) disease
Some patients with MGUS experience an increased risk of arterial diseases compared to controls without MGUS and the mortality rate from CVD in MGUS patients has been repeatedly reported to be increased compared to matched controls without MGUS. The reasons for this are poorly understood!
What can you do? If it is determined that you are at increased risk from CVD, then following a ‘heart healthy’ diet and lifestyle is recommended.
These conditions only afflict a minority of patients with MGUS/SMM, but nevertheless they need to be considered on an individual patient basis.
Patients with MGUS/SMM are routinely monitored (1-12 month monitoring visits) by their treating doctors. Despite the potential anxiety caused by these visits, such monitoring is important as it has been associated with improved outcomes. It provides the opportunity to reinforce bone protection strategies, routine vaccination as well as for early identification of progression to symptomatic myeloma or lymphoproliferative disease.
So please keep up with your monitoring visits, keep exercising as this is beneficial too for all the above possible symptoms and maintain a healthy diet!
A helpful website – Sparkcures – keeps MGUS/SMM patients up to date with clinical trials that are currently being carried out.