Sulfur is a naturally occurring mineral that is found primarily near hot
springs and volcanic craters. Sulfur has a distinct "rotten egg" smell which is
caused by sulfur dioxide gas escaping into the air. It is available in two
supplement forms -- dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) --
and both forms have been touted widely as effective treatments for pain.
Sulfur is part of the chemical structure of three different amino acids (the
building blocks that make up protein) -- namely, cystine, cysteine, and
methionine. Sulfur works with vitamins B1 (thiamine), B5 (pantothenic acid), and
H (biotin) to promote metabolism and communication between nerve cells. Sulfur
is found abundantly in keratin, a protein that strengthens hair, nails, and
skin. Occasionally referred to as "nature's beauty mineral," sulfur plays a role
in the production of collagen, a protein that helps keep skin elastic and
Sulfur-containing mud baths (often called balneotherapy) help in the
treatment of skin disorders and arthritis. Balneotherapy is one of the oldest
forms of therapy for pain relief for people with arthritis. The term "balneo"
comes from the Latin word for bath (balneum) and refers to bathing in thermal or
mineral waters. Some people also claim that these baths are useful for allergies
and respiratory disorders. However, there is no scientific evidence for these
traditional uses. In fact, many (but not all) studies suggest that there may
actually be a connection between sulfur gases in the environment and the rise in
allergy and respiratory related illnesses, particularly asthma, throughout
industrialized countries. The sulfur gases responsible for pollution in the
environment come primarily from coal-fired power stations.
Sulfur baths, and other forms of sulfur applied
directly to the skin, seem to benefit psoriasis, eczema, dandruff, folliculitis
(infected hair follicles), warts, and pityriasis versicolor (a chronic skin
disorder characterized by patches of skin that differ in color from the usual
Well-designed studies, primarily conducted in
Israel, suggest that balneotherapy (including sulfur baths with or without mud
packs and/or soaks in the Dead Sea) can help treat several different kinds of
arthritis including osteoarthritis, rheumatoid arthritis, and psoriatic
Positive effects experienced by those receiving sulfur baths and other spa
therapies include improved strength, decreased morning stiffness, better walking
ability, and decreased inflammation, swelling, and pain in joints, particularly
the neck and back.
Mud packs and Dead Sea salts dissolved in a regular bath tub were also found
to improve symptoms of arthritis, but not as effectively as the Dead Sea itself.
Several studies have also suggested that DMSO applied topically to affected
areas may reduce pain and swelling in those who suffer from rheumatoid arthritis
and osteoarthritis, but not all studies on this topic agree and more research is
Pain and Injury
Use of topical DMSO for people who have
bursitis, tendonitis, or a joint sprain has led to improvement in symptoms,
including decreased pain and improved range of motion, in up to 72% of
participants in a series of studies. For the most part, however, none of these
studies has been considered scientifically rigorous. Plus, there are additional
studies on this subject that have not shown improvement in injury related
symptoms from DMSO compared to placebo. Therefore, most experts feel that more
research is needed before conclusions can be drawn about the value of DMSO for
pain or injuries.
Although research is somewhat limited,
DMSO is approved by the FDA to treat interstitial cystitis (bladder inflammation
causing frequent and nighttime urination as well as pain), as it may relieve
pain and other symptoms associated with this inflammatory condition. When used
to treat interstitial cystitis, a physician inserts a liquid solution of DMSO
directly into the bladder. General anesthesia may be required in some cases
because the process can be painful and may cause bladder spasms.
DMSO is also under investigation for the treatment of
scleroderma (a connective-tissue disease that causes a progressive build up of
tough scar-like tissue in the skin and internal organs), amyloidosis (a group of
diseases in which amyloid -- a protein-like substance -- builds up in the organs
and tissues), Sjogren's syndrome (a connective tissue disorder that generally
includes arthritis, dry eyes, and dry mouth), and spinal cord injuries. However,
the results thus far are not very promising and the tests being conducted are
often evaluating DMSO as a prescription drug, not as a dietary supplement.
The elemental mineral form of sulfur is found in rocks near hot springs and
volcanoes. The form the body ingests is found in protein-rich foods such as
eggs, meat, poultry, fish, and legumes. Other good sources include garlic,
onions, brussels sprouts, asparagus, kale, and wheat germ.
Sulfur supplements are available in two main forms -- dimethyl sulfoxide
(DMSO) and methylsulfonylmethane (MSM). Each of these substances, first DMSO in
the 1960s and 1970s and more recently MSM, has been touted to treat many
conditions, particularly those related to pain. The only use for which DMSO is
approved by the FDA is interstitial cystitis (inflammation of the bladder),
which is injected under medical supervision.
DMSO, first made in 1866, is prepared from byproducts of paper manufacturing
and used as an industrial solvent. MSM is derived from DMSO.
Although sulfur is available as a dietary supplement in tablets and capsules,
supplemental sulfur is generally not necessary because appropriate amounts are
obtained from a well-balanced diet that includes the recommended daily allowance
of protein. People who follow a vegan diet, however, are at risk for sulfur
Ointments, creams, lotions, and dusting powders containing sulfur are
available to provide relief from skin rashes. Natural sulfur baths (the kind
usually found at hot springs) may help ease pain associated with arthritis.
|How to Take It|
There are no known scientific reports on the pediatric use of sulfur.
Therefore, use as a supplement is not currently recommended for children.
There is no Recommended Dietary Allowance (RDA) for sulfur because
appropriate amounts of this mineral are obtained from a well-balanced diet that
includes the recommended daily allowance of protein.
- Arthritis: oral doses of 500 to 1,000 mg MSM per day may decrease
symptoms; or, topical doses of 60% to 90% DMSO applied 1 to 3 times per day
- Amyloidosis: oral doses of 7 to 15 g DMSO per day; or, topical doses
of 50% to100% DMSO applied 2 times per week.
Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
Sulfur, by itself, is not toxic to the body. However, some people are highly
allergic to relatives of sulfur such as sulfites and sulfa drugs. Sulfites are
used as food preservatives (such as in beer and wine) and can trigger asthma,
hives, and other allergic reactions. Sulfites may also cause stomach pain,
nausea, diarrhea, and even seizures in certain individuals. Sulfa drugs can
cause skin rashes, high fever, headache, fatigue, and gastric problems.
Side effects from DMSO and MSM also include nausea, headache, and rash.
Those with known allergies to sulfa-containing medications and/or sulfites
should avoid sulfur supplements as a precautionary measure.
Sulfur should not be used during pregnancy.
There are no reports in the scientific literature to suggest that sulfur
interacts with any conventional medications.
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|Review Date: April 2002|
|Reviewed By: Participants in the review process include: Ruth DeBusk, RD, PhD, Editor,
Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH. All interaction sections have also
been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The
Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000),
Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March
2000), Clinical Assistant Professor, University of Maryland School of Pharmacy;
President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH,
MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative
Medicine, Honolulu, HI.|
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