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Methylsulfonylmethane (MSM) -- also known as methyl sulfone or dimethylsulfone (DMSO2) -- is an odorless breakdown product of dimethyl sulfoxide (DMSO) . Its principal advocates have been Robert M. Herschler, Ph.D., and Stanley W. Jacob, M.D., of Oregon Health Sciences University. Herschler, who is a research biochemist, holds eleven patents for MSM awarded between 1981 and 1996. Jacob, a longtime advocate of using DMSO for treating arthritis, holds one patent (awarded in 1996) and has co-authored a book called The Miracle of MSM .
Herschler's claims for MSM are not modest. The background information section of a 1985 patent, for example, states:
MSM is an ameliorating agent for a variety of pathological conditions when administered systemically and preferably orally to persons displaying symptoms of physiological response to stress, e.g., gastrointestinal distress, inflammation of the mucous membranes and allergic reactions.
In particular, I have found that when those stress response symptoms include gastrointestinal upset, e.g., diarrhea, constipation, nausea, hyperacidity and/or epigastric pain, or inflammation of the mucous membrane, especially of the gastrointestinal and/or respiratory tract, dramatic relief from those symptoms can be achieved by the oral ingestion of MSM.
I have also found that the oral ingestion of MSM can be beneficial in treating a variety of other conditions that one would not expect to be responsive to MSM.
Accordingly, it is an object of this invention to provide a method for the amelioration of physiological symptoms of stress employing MSM.
Another object is the provision of pharmaceutical compositions comprising a stress-inducing physiologically acceptable pharmaceutically active agent and a stress-relieving amount of MSM.
Other objects will be apparent to those skilled in the art to which this invention pertains .
The "detailed discussion" section of the patent describes how more than a hundred patients were helped with a wide variety of health problems. But it provides no details about who administered the treatment, where and when it was done, whether an appropriate experimental protocol (randomization, blinding, controls, etc.) was used, and whether any report has been published. Herschler also states that MSM is "a preferred dietary source of sulfur" and that an intake of 0.5 to 1 mg/kg body weight per day is "desirable." 
Jacob's patent document claims that MSM is effective against snoring . The Miracle of MSM states that MSM has been used at Jacob's DMSO clinic at Oregon Health Sciences University and has helped many patients with a variety of painful conditions .
MSM marketers are making similar claims. One, for example, states that MSM can relieve stress and constipation; help heal Candida, asthma, emphysema, arthritis and tendinitis; reduce muscle cramps and back pain; increase stamina and relieve lactic acid buildup during workouts; detoxify and energize the body; increase blood circulation; strengthen capillary walls, healing varicose veins; help keep hormones in balance; relieve allergies to foods, drugs and environmental irritants; aid the liver in bile secretion and choline production; control stomach acidity while maintaining body's normal pH balance; coat and help heal intestinal walls; increase body's ability to produce insulin; aid carbohydrate metabolism; boost vitamin, mineral, amino acid, and antioxidant utilization; speed wound healing; help keep hair; and keep skin and nails healthy and beautiful . Another marketer states that the conditions that have responded to MSM include: acne; allergies; arthritis; asthma; Candida yeast infections; carpal tunnel syndrome; chronic fatigue; constipation; diabetes; digestive disorders; fragile hair and nails; migraine headaches; muscle pain and cramps; parasites; skin damage and aging; toxic build-up; and ulcers .
MSM is marketed as single-ingredient products and combined with various other ingredients. It is available for oral use in capsules and tablets, and for application to the skin in a lotion, cream, or gel. According to Herschler:
A single oral dose of MSM is usually not effective. . . . Therefore, the MSM is usually administered in successive spaced dosages, either periodically throughout the day or on successive days, or both, until such amelioration occurs, e.g., for 2 to 21 days or even longer. The amount of MSM in each dose usually is not critical, particularly when several successive doses are administered, because the ingested MSM accumulates in the body tissues and fluids, i.e., reaches an effective titre. Individual doses of as low as 50 mg. are sometimes effective and doses as high as 1,500 mg or more are well tolerated. The usual individual dose is about 100-1,000 mg., preferably 250-500 mg. Total daily dosages of 100-5,000 mg, preferably 250-2,000 mg, more preferably 500-1,500 mg, are usually employed. The effective dosage depends to some extent on the nature and severity of symptoms manifested; the cause of those symptoms; and the MSM blood level of the patient prior to the administration of the MSM thereto .
The Miracle of MSM states that "for severe, deep-seated conditions, you will probably need higher doses, and sometimes much higher, to experience relief." 
In living organisms, sulfur is found mainly in organic molecules. Humans obtain it by absorbing the sulfur-containing amino acids methionine, cysteine, and cystine . Thus it is automatically obtained by consuming adequate amounts of protein foods (meat, fish, poultry, eggs, milk, cheese, nuts, and legumes) and requires no separate consideration. Limited amounts are present in inorganic sulfates, sulfides, and thiamin; and sulfur is also a part of biotin and pantothenic acid. Although sulfur is considered to be an essential mineral, no dietary requirement for inorganic sulfur has been found and no Recommended Dietary Allowance or Estimated Safe and Adequate Daily Dietary Intake has been established for it. In fact, the 10th edition of Recommended Dietary Allowances does not discuss it.
Herschler's patent documents claim that "the average diet is deficient in methylsulfonylmethane because it is readily lost during conventional food processing, such as frying, dehydrating, dilution with synthetic fillers and other poorly nutritional additives, cooking, radiation or pasteurizing, and long-term storage" . This statement is absurd, because the amount of sulfur in protein foods is not affected by processing. Since Americans tend to consume more protein than they need, "sulfur deficiency" is very unlikely and would not occur without obvious evidence of severe malnutrition. If it could occur, the remedy would be to eat adequate protein, not to supplement with MSM.
Medline searches for "methylsulfonylmethane, "MSM," and "dimethylsulfone" found few reports on MSM published in mainstream scientific journals between 1966 and 2000 and none in which MSM was tested for effectiveness against any human ailment. Two studies in rats found that MSM delayed the onset of chemically induced cancers [9,10]. However, since no further studies have been reported in more than 10 years, this appears not to have been a fruitful line of research. Another study found no effect on the onset of diabetes in rats .
The claim that MSM is an important source of dietary sulfur is unsupported by published research. One study that involved feeding MSM to guinea pigs found that the sulfur from MSM was absorbed rapidly into the blood stream and was incorporated into methionine and cysteine of serum proteins. However, most of the sulfur appeared in the urine; less than 1% was incorporated into serum proteins. Increasing the dosage of MSM 100-fold increased the incorporation into serum proteins only 3-fold, indicating that the capacity to use MSM in this pathway is limited . Thus, while MSM is naturally present in small amounts in a variety of foods, its contribution to sulfur metabolism in humans is likely to be negligible.
Karl Loren (whose birth name was Loren Karl Troescher) operates what he calls "The Largest Web Presence For MSM On The Planet," a site that markets MSM products with many health claims and testimonials for them. In October 2000, the FDA warned him that the long list of therapeutic claims he was making for these products made them drugs would be illegal to market without FDA approval. The letter stated that the FDA had seen no evidence that the products were safe and effective for their intended uses .
No published research studies link MSM to any of the health claims made by its marketers. Sulfur needed in human metabolism comes from dietary protein. MSM supplements probably make little or no contribution to the body's sulfur requirements. Thus there is no good reason to use MSM supplements.
Ms. Lang is a clinical dietitian who works in a home-care setting in Baltimore. Thomas J. Wheeler, PhD, and Manfred Kroger, PhD, reviewed and helped to edit this article.