Sulfur

Introduction

Overview

Sulfur is a naturally occurring mineral that is found primarily near hot springs and volcanic craters. It has a distinct "rotten egg" smell, caused by sulfur dioxide gas escaping into the air. As a supplement, sulfur is available in two forms -- dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM). About 15% of DMSO breaks down into MSM in the body. Both have been touted as treatments for pain.

MSM occurs naturally in some plants (such as horsetail), fruits and vegetables, some grains, and milk. The supplement combines DMSO with hydrogen peroxide. MSM is important in joint health and helps form connective tissue (cartilage, tendons, and ligaments). It may also slow the nerve impulses that transmit pain signals, reducing pain.

DMSO is a chemical byproduct of papermaking and is used as an industrial solvent, as well as for medicinal purposes. The Food and Drugs Administration has approved DMSO for intravesical use (meaning it is instilled in the bladder by a doctor) to treat interstitial cystitis. It is also used in creams and taken by mouth for pain and other conditions. Unlike MSM, DMSO is absorbed through the skin. Never use industrial-grade DMSO as a supplement, because it may contain dangerous impurities. You should talk to your doctor before either taking DMSO internally or applying it to your skin.

Sulfur-containing mud baths (often called balneotherapy) can help treat skin disorders and arthritis. Balneotherapy is one of the oldest forms of pain relief for people with arthritis. The term "balneo" comes from the Latin word for bath (balneum) and refers to soaking in thermal or mineral waters. Some people claim these baths are useful for allergies and respiratory disorders, but there is no scientific evidence for these uses. People also apply sulfur products topically to treat acne and other skin conditions. Many (but not all) studies suggest there may be a connection between sulfur gases in the environment and the rise in allergy and respiratory illnesses, particularly asthma.

Skin Disorders

Sulfur baths, and other forms of sulfur applied 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 skin tone).

Arthritis

• Balneotherapy -- Well-designed studies, primarily conducted in Israel, suggest that balneotherapy (including sulfur baths with or without mud packs or soaks in the Dead Sea) can help treat several different kinds of arthritis, including osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis. People who took sulfur baths and other spa therapies improved strength, decreased morning stiffness, had better walking ability, and decreased inflammation, swelling, and pain in joints, particularly in the neck and back. Mud packs and Dead Sea salts dissolved in a regular bath tub also improved symptoms of arthritis, but not as effectively as the Dead Sea itself.
• MSM -- MSM is a popular supplement for treating the pain of arthritis, including both OA and RA, despite a lack of scientific evidence. One preliminary study suggested that 6,000 mg of MSM did improve pain and function without side effects in people with OA of the knee. Some preparations of MSM combine the mineral with glucosamine to treat OA. One study suggests that approach might be effective, but more research is needed.
• DMSO -- Several studies suggest that DMSO, applied in creams, may reduce pain and swelling in people with RA and OA, but not all studies agree. More research is needed.

Allergic Rhinitis (Hay Fever)

One preliminary study showed found that supplementation with 2,600 mg per day of MSM for 30 days reduced symptoms of seasonal allergies, but more and larger studies are needed to determine whether there is any real beneficial effect.

Shingles

Topical DMSO has been proposed as a treatment to relieve pain and inflammation of shingles (herpes zoster). Some evidence suggests it may lessen the number of lesions and decrease inflammation, but more studies are needed.

Interstitial Cystitis

Although research is limited, the FDA has approved DMSO to treat interstitial cystitis (chronic bladder inflammation that causes frequent and nighttime urination, as well as pain). When DMSO is used to treat interstitial cystitis, a physician inserts a liquid solution of DMSO directly into the bladder. General anesthesia may be required because the procedure can be painful and may cause bladder spasms.

Amyloidosis

Several case reports suggest that DMSO, applied in creams or taken by mouth, may help treat amyloidosis (a condition where excess protein builds up in the body's organs, damaging them). However, because the condition is rare, no scientific studies have examined whether or not DMSO has any benefit. Take DMSO (or apply it in creams) only with your doctor's supervision.

Dietary Sources

MSM 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.

Available Forms

Sulfur supplements are available in two main forms -- dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM).

For healthy people who eat a well-balanced diet, supplemental sulfur is generally not necessary. People who follow a vegan diet, however, may be at risk for sulfur deficiency.

Ointments, creams, lotions, and dusting powders containing sulfur are available to treat skin rashes. Natural sulfur baths (the kind usually found at hot springs) may help ease pain associated with arthritis.

How to Take It

Pediatric

There are no known scientific reports on the pediatric use of sulfur, and it should not be given to a child.

Adult

There is no recommended dietary allowance for sulfur. Most people get all they need from their diet.

• Arthritis: dose by mouth of 1,000 - 3,000 mg MSM per day; or topical doses of a cream or gel with 25% DMSO applied 1 - 3 times per day
• Amyloidosis: dose by mouth of 7 - 15 g DMSO per day; or, topical doses of 50 - 100% DMSO applied 2 times per week.

Precautions

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

Scientists believe MSM is safe, even at high doses. However, you should talk to your doctor before taking large doses of this or any supplement.

Side effects of taking DMSO internally include headache, dizziness, drowsiness, nausea and vomiting, diarrhea, or constipation. Used topically, DMSO can cause skin irritation. If you have diabetes, asthma or liver, kidney or heart conditions, avoid DMSO. Never take industrial-grade DMSO. Do not take DMSO internally except under your doctor's supervision.

DMSO should not be used by pregnant or breastfeeding women.

Possible Interactions

There are no reports in the scientific literature to suggest that MSM interacts with any conventional medications.

However, DMSO may interact with other medications. Talk to your doctor before using DMSO.

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Alternative Names