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Home » News & Future Directions » Does Diet Matter in Multiple Sclerosis?
News Synthesis | 25 Nov 2014
Diet is the ever-moving target in MS research. In this story, we'll look at the facts, fiction, and continued struggles of researching dietary contributions to multiple sclerosis.
Cynthia McKelvey
Every morning, "V" starts her day with "bulletproof coffee": coffee blended with butter and coconut oil. Then she turns on some music, and she dances. A couple of years ago, V couldn't do much of anything. Diagnosed with relapsing-remitting multiple sclerosis (RRMS) in 1987 at the age of 23, by 2001, her ability to move was severely impaired, she couldn't fully use her hands, she had trouble swallowing, and she needed full-time care.
Around 2012, V came across a video of a TEDx talk by physician Terry Wahls in which she discussed how diet and lifestyle changes appeared to free her of disability from her own multiple sclerosis. V made a change and is now living independently and pursuing gainful employment.
"I lost all of my money. My illness took everything from me. My marriage, family, friends, everything," V told MSDF. "Now I take care of myself 100%. I have full use of my hands and I take no medications at all."
Wahls's dietary regimen, which she calls the Wahls Protocol, is modeled after the so-called paleo diet, which aims to emulate the dietary patterns of our human ancestors during hunter-gatherer times, before the development of agriculture.
Charismatic and controversial physicians like Terry Wahls, M.D., a professor of clinical medicine at the University of Iowa, and George Jelinek, M.D., of the University of Melbourne in Australia have each developed diet and lifestyle protocols that they claim have helped free them from the shackles of multiple sclerosis.
But the idea that some physicians are promoting diet-based therapies—even if they're not calling them cures—rubs some experts the wrong way.
Is it nonsense?
"I think it's nonsense," Michael Rasminsky, M.D., Ph.D., of McGill University in Montreal said of the Wahls Protocol, which includes diet, exercise, and mindfulness training intended to ameliorate the symptoms of MS. "People have remissions. I think it would be very foolish to assume there is a causal relationship between evident improvement clinically and any medication or diet she was or was not taking."
But both Wahls and Jelinek are putting their theories to the test. Wahls is going the clinical route while Jelinek is going the epidemiological route. Their strategies demonstrate the difficulty in studying the relationships between diet and disease. Setting up controls, getting participants to adhere to protocols, controlling for bias in data collection are all common problems in researching diet.
The history of MS research is replete with attempts to study a host of nutrients, their contributions to the risk of MS, and whether they improve or worsen symptoms. But the data are complex and unwieldy. At first, with the work of the late Roy Swank, M.D., Ph.D., it seemed that saturated fat was a risk factor for MS. Now those data are looking shaky. With the exception of vitamin D and salt, no concrete evidence exists to suggest that certain nutrients have any effect on MS.
But it's not for lack of trying.
The vitamin D connection
The northernmost and southernmost latitudes of the globe are known to have higher rates of MS in the population. It's thought that reduced exposure to sunlight leads to lower levels of vitamin D, increasing the risk of MS (Schwarz and Leweling, 2005; Riccio, 2011; von Gendern and Mowry, 2012). There is evidence that low vitamin D levels also exacerbate MS disease activity: Relapses are most common in the early spring when vitamin D levels are low, and lesions frequently appear on MRIs about 2 months after vitamin D exposure dips in the winter (Schwarz and Leweling, 2005; von Gendern and Mowry, 2012). However, vitamin D's ability to stave off relapses is still in dispute. A 2013 meta-analysis reported no significant relationship between the vitamin and the risk of relapse (odds ratio 0.98, 95% CI 0.45-2.16, James et al., 2013).
But there's a difference between vitamin D3, the form of the vitamin synthesized in the skin in response to sun and diet exposure, and vitamin D2, the form obtained from the diet.
"Recently, with the push to supplement vitamin D, there's been a push towards using more vitamin D3. Vitamin D2 seems like it might be less biologically active," Kassandra Munger, Sc.D., of the Harvard School of Public Health said to MSDF.
Even if vitamin D may not be effective in preventing relapses, it may still have some use in MS patients. Evidence suggests that fatigue may be a product of inflammation rather than the result of a dysfunction in the arousal centers of the brain (Sumowski and Leavitt, 2014; Heesen et al., 2006). Vitamin D is thought to exert its effect on MS by modulating inflammation. Recently, a double-blind, placebo-controlled study found that a vitamin D3 analog called alfacalcidol successfully treated fatigue in MS patients (41.6% drop in Fatigue Impact Scale, Achiron et al., 2014).
Studies in vitamin D have typically taken a top-down approach, starting with epidemiological research and moving onto clinical and laboratory studies. However, some research teams are having success with a bottom-up approach, starting with laboratory work examining how certain nutrients affect the immune system. These studies have focused on salt intake and calorie restriction as good candidates for further study.
Salt and calorie restriction
Data in mice and humans demonstrate that salt modulates differentiation in Th17 cells. Additionally, high-sodium diets in mice lead to a more aggressive course of experimental autoimmune encephalomyelitis (EAE) (Klienewietfeld et al., 2013; Farez et al., 2014), suggesting that dietary sodium may be a risk factor for MS. A recent study suggests that dietary sodium also exacerbates disease activity. In a group of 70 patients with RRMS, Farez et al. (2014) found that high sodium intake was associated with a 2.75- to 3.95-fold increase in exacerbation rate.
Piccio et al. (2008) demonstrated that chronic calorie restriction ameliorated symptoms in EAE mice. Investigators restricted the mice to 60% of their normal calorie intake, starting when they reached 5 weeks old. The calorie-restricted mice had an average relapse rate per mouse of 0.5, compared to animals on a normal diet (1.1) and high-fat diets (1.4).
Anne Cross, M.D., of Washington University in St. Louis presented follow-up mechanistic data to Piccio et al. (2008) at the 2014 ACTRIMS-ECTRIMS meeting in Boston. Calorie restriction appears to reduce pro-inflammatory leptin and interleukin-6, while increasing adiponectin, an anti-inflammatory molecule (abstract).
In an interview with MSDF, Laura Piccio, M.D., Ph.D., of Washington University in St. Louis said that she and her team are conducting research in a few volunteers with MS to see if calorie restriction may improve clinical outcomes in MS. To keep the participants safe, Piccio and her team are adjusting their protocol to alternate-day fasting. The volunteers will fast every other day and are otherwise able to eat without any restrictions, with the recommendation that they stick to a healthy diet.
But what is a healthy diet?
During the same ACTRIMS-ECTRIMS session, Dalia Rotstein, M.D., MPH, of St. Michael's Hospital in Toronto, Canada, looked at various diets and the incidence of MS in the Nurses' Health Studies I and II—long-term prospective studies in which volunteers keep track of their daily eating habits. Rotstein and her colleagues, including Kassandra Munger, catalogued the diets of 480 people with MS and rated them according to three different dietary health scales: the Alternative Healthy Eating Index-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) index, and the Dietary Approaches to Stop Hypertension (DASH) index.
These indices rate healthy foods in different ways. For example, the aMED index emphasizes consuming olive oils and legumes. The DASH index, on the other hand, values low-fat, low-salt diets.
But none of these indices seemed to affect the risk for adults to develop MS, according to Rotstein's study (abstract). However, it remains possible that dietary patterns in childhood and adolescence may have more of an effect. In particular, obesity in adolescent girls seems to be linked with an earlier onset of MS (Hedström et al., 2014; Kavak et al., 2014).
"We can't say from our findings how dietary patterns might be linked to the course of MS once they have the disease," Rotstein emphasized in an interview with MSDF.
Another issue raised by Rotstein's study is that there is no current consensus on what makes a one-size-fits-all healthy diet, or if healthy diets vary from person to person. Experts generally suggest that consuming most of one's calories via fruits and vegetables is a good first step. Another common suggestion is to avoid processed foods with refined sweeteners and added flavors, dyes, and preservatives. These tips seem commonsensical, but other tips are subject to further scrutiny.
Demon fat and angel fat?
The latest debate in the world of diet is challenging a closely held belief: Maybe fat isn't so bad for you. In the 1960s, fat—particularly saturated fat—was demonized as the progenitor of heart disease. The thinking was that fat increased "bad" cholesterol, clogging the arteries and leading to heart disease. Lately, some have suggested that saturated fat may not deserve its status as the demon nutrient, though that idea is rife with controversy (Chowdhury et al., 2014. See article for accompanying comments and letters.).
Swank was investigating fatty acids as early as the 1940s. He observed that populations that did not consume as much fat as the typical Westerner had lower rates of MS. He suggested that fat consumption may be a risk factor for MS and that MS patients who ate lower amounts of fat may live longer.
What is now known as the Swank diet involves consuming no more than 10 to 15 grams of saturated fats and 20 to 40 grams of unsaturated fats daily. By comparison, the U.S. Office of Disease Prevention and Health Promotion recommends that a healthy person consuming an average of 2000 calories per day should take in 65 total grams of fat, with less than 20 grams coming from saturated fats.
Swank was known for his landmark study, starting in 1950 and ending in 2000, in which he followed 150 patients with MS who chose to follow the Swank diet. He tracked the association between diet and their mortality rate. On the official Swank MS Foundation website, the study summary reads:
"All patients did not follow the diet carefully and records of their diet revealed this. In 1991 a record of progress was published in Nutrition. 70 of the 150 patients consumed an average of 17 grams of fat daily, 21% died. Those eating an average of 30 grams of fat daily, 75% died. And those eating an average of 42 grams of fat daily, 81% died."
But Swank's results have never been replicated. Some investigators noticed that, rather than avoiding fat all together, populations that eat foods high in polyunsaturated fatty acids (PUFAs)—the so-called good fats—had lower rates of MS than populations that didn't eat as many PUFAs. PUFAs are typically found in fatty fish and other seafood. Some researchers decided to look into whether PUFAs have any effect on disease course.
In 2012, Stig Wergeland, M.D., Ph.D., of the University of Bergen in Norway and his colleagues ran a double-blind placebo-controlled study of PUFAs in people with MS. Wergeland and his colleagues measured MRI activity, relapse rate, disability progression, fatigue, and quality of life in people with MS taking a placebo, a high dose of PUFAs (2200 mg), and the high dose of PUFAs while also using interferon-β (Torkildsen et al., 2012).
In an interview, Wergeland told MSDF that the dietary equivalent of eating 2200 mg of PUFAs daily would involve eating fatty fish and "nothing but." But despite the high dose of PUFAs, the trial found no positive effect on disease activity.
"It was quite convincing negative results. It was consistent throughout all the measures," Wergeland said.
The concept that PUFAs may have an anti-inflammatory effect comes from the idea that the compounds—long chains of unsaturated hydrocarbons—are themselves precursors of anti-inflammatory molecules.
"Theoretically, from a biochemical standpoint, it sounds plausible," Wergeland said. "You eat the precursors of the inflammatory cytokines [saturated fatty acids] or the precursors of the anti-inflammatory cytokines [PUFAs]. And why shouldn't that be reflected downstream?"
Wergeland said that once the inflammatory cascade activates, it is "very powerful," and that people generally have an excess of all the precursors from their diet no matter what. Changing one's fat consumption would then merely be adding drops to a bucket.
Clinically difficult
While Wergeland was able to perform a double-blind, placebo-controlled study, good clinical data in diet are notoriously difficult to obtain.
Some investigators, such as Wahls, believe it's not just any one nutrient that contributes to promoting or hindering disease activity. Rather, it's a concert of multiple nutrients and vitamins that's needed to achieve the disease-modifying effect that she and her acolytes claim. Wahls is putting her protocol to the test in a clinical setting. She initially looked at safety in a small, nonrandomized and uncontrolled trial. Participants showed an average of 42% improvement in Fatigue Severity Scale scores (Bisht et al., 2014). She says she intends to do larger follow-up studies that are controlled and randomized.
However, there are great challenges to studying diet in a clinical setting.
The National MS Society recently hosted a meeting on lifestyle in MS. According to Kathleen Costello, M.S., ANP-BC, MSCN, of the National MS Society, the first hurdle in studying diet is getting patients to adhere to the protocols.
"Adherence is quite complex," Costello told MSDF. "How do you make sure that people are adhering to a diet that is understudied? Do you have them get specific meals, do you bring them in under controlled conditions?"
More problems arise when determining how comorbidities and medications factor in, how to properly perform a placebo-controlled trial, and how long to perform the study—just to name a few.
"That's not a reason not to do them, it is a reason to carefully consider how they're done," Costello said.
There are several different approaches one can take, aside from the clinical trial, to study diet. There is the observational epidemiological study, such as those described above that looked at fat consumption across populations and compared them with MS rates. Another method is to ask a cohort of people to recall their diet before developing MS to assess risk factors, or after developing MS to assess dietary contributions to disease progression.
However, Munger told MSDF that people are generally poor at recalling their diet, especially after being diagnosed with a chronic disease. She said that people are more likely to say that they ate more of foods they think contributed to their disease. Prospective studies such as the Nurses' Health Studies control for that bias since they follow the participants through their life before they get sick and monitor their diet in real time.
Everyone MSDF spoke to agreed that diet is a complex and understudied aspect of MS, but that people living with MS are very concerned about whether it is something they should be paying attention to.
Can't hurt, might help?
Despite the lack of evidence, people with MS do still attempt to make changes in their diet in the hopes that it will effect some sort of positive change, and there isn't any harm in that, is there?
Most of the physicians MSDF spoke with said that they don't make any specific recommendations to their patients about dietary changes, except to supplement their vitamin D intake.
"I don't discourage my patients when they tell me they've taken some dietary interventions or tried to change towards a PUFA-rich diet," Wergeland said. "I don't want to advocate against that. If they feel it helps them, well, who am I to tell them that they shouldn't do it?"
Another important note is that adopting a healthier eating strategy may help stave off comorbidities that could exacerbate MS. But, as mentioned earlier, sometimes it's hard to differentiate between a healthy and an unhealthy diet.
"I think what's important to consider is that diets that are very restrictive can be harmful," Munger said. "Ultimately the best thing an MS patient can do is [make] sure he or she can get a balanced diet."
But what about people with MS like V, Jelinek, and Wahls, who discontinue drug-based therapy in favor of lifestyle changes? While they do not appear to be harming themselves and are not claiming to be cured of MS, are they potentially harming others by promoting their own stories? It's unclear.
Both Wahls and Jelinek say that anyone choosing to participate in their respective protocols should do so under the advice of their primary care doctor. Neither of them recommends that anyone go off disease-modifying therapies in favor of diet or exercise.
When asked why she chose to promote her lifestyle protocol before finishing her clinical trials, Wahls said, "You can't wait forever."
"I made a different professional choice with what I feel is a more moral approach, trying to get the message out about diet and lifestyle," Wahls said. "I respect that there are others who disagree with that approach and that feel that it's immoral to talk about lifestyle until there's clinical data that shows a definitive effect for change. That's a valid perspective. It's just not my perspective."
Due to the National MS Society's new initiative to augment lifestyle research, it's likely that a host of new and better data will eventually arrive to answer long-standing questions of diet.
"[The NMSS believes] that additional research is needed, but we needed to address the study design and methodology issues," Costello said. "So that when we do look at results, we're comparing apples and apples and not apples and oranges."
Until then, the general advice is: Take in more vitamin D; avoid salty, fatty foods; eat more fruits and vegetables, and keep a balanced intake of nutrients.
What other understudied nutrients and aspects of diet may affect MS?
How can diet be properly studied in controlled settings?
Can there be a true placebo group in a clinical trial of a full dietary regimen?
What are the standard guidelines that should be set for studying diet?
Special thanks to Gloria von Geldern and George Jelinek, who provided valuable insight and background while reporting this story.
Piccio's work is supported by grants from the Consortium of MS Centers, National MS Society, McDonnell Center for Cellular & Molecular Neurobiology, Nutrition and Obesity Research Center, Fondazione Italiana Sclerosi Multipla, Barnes-Jewish Foundation, and National Institutes of Health. She is also a Harry Weaver Neuroscience Scholar of NMSS.
Wergeland has received honoraria for lecturing and travel grants from Sanofi-Aventis, Bayer Schering, Merck Serono, Biogen Idec, and Novartis. His clinical trial was supported by Western Norway Regional Health Authority, Norwegian Multiple Sclerosis Society, Pronova Biocare, Amersham Health, Norway, and Merck Serono, Norway.
Munger's work is supported by grants from the NIH.
Rasminsky declared no conflicts of interest.
Wahls's work is supported by the Institute for Clinical and Translational Science at the University of Iowa, which in turn is supported by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program. Her clinical trial also received in-kind support from DJO Inc., Pinnaclife Inc., TZ Press LLC, and the Department of Veterans Affairs, Iowa City, Iowa.
Wahls also receives royalties from Penguin Random House for The Wahls Protocol and has an equity interest in Dr. Terry Wahls LLC, Xcellerator LLC, and TZ Press LLC. She owns the trademarks Wahls™ Diet, Wahls Paleo™ and Wahls Paleo Plus™, and Wahls Protocol™.
Higher weight in adolescence and young adulthood is associated with an earlier age at multiple sclerosis onset.
Kavak KS, Teter BE, Hagemeier J, Zakalik K, Weinstock-Guttman B, on behalf of the New York State Multiple Sclerosis Consortium, on behalf of the New York State Multiple Sclerosis Consortium
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Leptin and other adipokines in EAE and MS
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Clinical Research, Laboratory Research, Methods, People
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Irina Mikhailichenko, National College of Natural Medicine
And how exactly is Dr. Wahls "potentially harming others by promoting her own story"?
What harm do you suppose she is doing in promoting organic vegetables, wild caught fish and supplements that she has researched?
If the harm is "Oh, I am not going to have my sweets that I am addicted to", then I agree.
S. Swiatlo, health interactions
"I respect that there are others who disagree with that approach and that feel that it's immoral to talk about lifestyle until there's clinical data that shows a definitive effect for change. That's a valid perspective. It's just not my perspective." Dr. Wahl's quote. I hope the NMSS is not wasting valuable resources on dietary recommendations that are purely anecdotal. CCSVI hopefully has shown that we should not be lead blindly down dark alleys.


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How would you gauge someone's reputation on TruStory?
Disclaimer: This isn't my question or answer. This is @danielkuh's. Gotta give credit where credit's due.
"I would gauge someone's reputation on TruStory by seeing this person's impact. The more times I see a person and receive value from their story or argument, the higher thir reputation is, in my opinion.
The number of creds and ranking they have within specific categories.
How consistently are they accurate with regards to their claims & arguments.
Do I find value in their stories — This is subjective but still an important criterion for me to determine if I think this person is reputable."
Amount of Cred they have. Cred factors in a bunch of things like the accuracy of their posts (claims, backings, challenges), so it's a convenient way to compare reputations of people.
Proximity to people I trust. If there's someone with relatively low amount of Cred, it doesn't mean they automatically have a low reputation to me. If someone who I trusted found this person helpful, they'd go up a notch in my book. I.e. if @bhaumik or @paulapivat found someone helpful, I know they'd be helpful for me too.
Subjectivity. Just reading their claims and analyses. It's slow and time-consuming but I think this is actually the best way to evaluate someone, in my opinion. Some things just can't be accounted by numbers.
Cred - this seems like a good aggregate number of passive activity, but I'd want to see a granular breakdown of the type of activities that led to cred. Was it mostly from backing claims? Or challenging? Or creating new claims?
Specialist - I'd want to see which categores someone is most active in. I value Zareef's reputation in Token Economics given his strong activity there but wouldn't necessarily consider him to be a strong source on Regulation-related claims unless I saw him analyzing evidence there.
Depth of evidence - from my understanding, there is no Cred gained from adding evidence so we need to showcase strong examples of this within the app. Maybe we add the ability for users to upvote to evidence they found helpful (or more aggressively "Did you learn something new?")? We can then showcase the most upvoted analysises on the user profiles? Reading evidence is where I gain the most knowledge from and lend credibility to people. At this stage, I care less about how many claims they accurately backed or challenged.
Reach & further debate - Was the content interesting to people outside of the community? Was it shared on Twitter/Facebook? How many impressions? Did the post encourage further discussion and encourage new evidence? Did new users sign up as a direct result of reading the post?
Referrals - On a similar vein, if a user recruits 5 friends to join the network who immediately start contributing, I'd want to recognize that behavior as it's adding value for all of us. Maybe we could display either the number of users referred or the aggregate amount of Cred the referred users have earned?
I think once TruStory is fully into the App version and game on then the amount of Cred they posses is the only factor required to gauge someone's reputation on TruStory. But during the discourse times the overall value of content created on TruStory (quantity & quality) , number of TruStory tweeted content (popularity), expertise they bring to a specific category (knowledge level), number of fellow TruStorians they have brought in (referrals) can be used. I think any entity can only begin as centralized and eventually decentralize by the robustness of token economics in play.
I definitely think it's important to take into consideration @bhaumik's first point in response.
What if person A has 1000 Cred but only gains Cred by backing claims that a majority of people back. Person B has 500 Cred but gains this from creating their own claims, backing other claims and refuting other people's claim.
Person A is technically consistently more correct than person B but I'd argue person B to have a better reputation overall. Person A gives no value to the community while person B is trying.
Would you still deem Person A more reputable than Person B?
I'd echo all the sentiments above.
I think there are many ways to gauge someone's reputation on TruStory. As I understand, Cred is an attempt to incentivize truth via staking in support/or challenge of a story. It represents a quantitative measurement and is one piece of the picture. Other quantitative measurements are the Leaderboard engagement metric. The good thing is, Cred can't be bought so we can avoid conflating reputation with wealth.
At the moment we have Cred for supporting/challenging the content of the claim. In addition, I'd also consider quality of analysis and importance of topic to wider crypto community beyond TruStory would also be important to capture.
I'd also like to consider qualitative measures that maybe more difficult to get at. How much the person is helping community members, sharing knowledge, answering questions, getting community members involved - - a lot of which is more challenging to quantify, but definitely work towards reputation building.
You currently don't Earn Cred for purely creating a claim. You earn my backing / challenging / voting. It's too easy to game earning Cred by creating a bunch of stories.
I very much disagree @danielkuh. You create more value by participating in the debate than by purely creating claims. Anyone can create claims by going to some news site and pulling claims. It takes 5 seconds. Analyzing claims is how you create the most value for end users.
I like Bhaumik's idea of rewarding people who post claims or responses with a depth of evidence. As he mentioned, you could have something like a "found this helpful" button that other users could click. The amount of "helpful" votes a user receives can figure into their reputation (not Cred).
I'm uneasy about the idea of incorporating any form of popularity metric (Facebook, Twitter, etc., engagement/impressions) in the reputation score. One of the many maladaptive incentives of social media is the conflation of popularity with truth. Having even the slightest inbuilt reward (via reputation score) for creating 'popular' claims or responses could gradually skew this project in a direction at odds with the original goals. That being said, creating claims that get attention on other platforms is fun in and of itself – that is its own reward. But popularity doesn't need to be incentivized via Cred or reputation.
I agree w/ not rewarding creation of claims. But my interpretation of active participation in the debate includes evidence-gathering. As Daniel mentions, I could easily spend a 2-3 minutes every day just backing claims that a majority of people have backed, without even reading the debate.
as nice as that sounds, that gets complex and subjective and easy to game very quickly. A user shouldn't need a manual to understand how incentives work in TruStory. The core of TruStory is that you are putting skin in the game for everything you do (back, challenge, vote). Votes are weighted by your reputation, which can only be earned through backing, challenging and voting. The more skin in the game, the more value you're adding to the network, hence the more reputation you earn.
That's cool. I would imagine likes are dangerous. You'd want to use them as weight, but I find heavily liked messages/pictures to be shareable or loud, not necessarily honest.
And, if they are willing to collaborate.


It's that time again! December is flying by, and day eight is already upon us!
How have you found the competition so far? Hopefully, there will be lots of you out there with correct answers and we will have lots of potential winners to choose from in time for Christmas Day.
Today's question is about a very popular member of the 'Goo….. Limahl.
Prize pack 2, should you be lucky enough to win it, contains a huge chunk of Limahl's back catalogue as well as his most recent single, 'London for Christmas', on CD.
A great prize that we can't wait to give to a worthy fan!
Cocktail destination for Limahl whilst spending Christmas in London?
We know that we say this every day, but please don't email your answers to us right now.
Keep them until the end of the competition and we will reveal all….
Need the solution to today's question?
Check out our 'Track of the Week' located on the right side of every KajaFax page.
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You can see her on TV and hear her on top radio stations throughout the U.S. Amy specializes in relieving your intense anxiousness, severe sadness, children behavior challenges, symptoms of autism and feeling stuck.
She is a Certified Practitioner, Speaker, and an accredited teacher, teaching courses on becoming a Practitioner for Emotional Health. Amy also studied homeopathy for three years with the NY School of Homeopathy affiliated with School of Homeopathy in England.
She has since formulated an all natural, award-winning body care line infused with a specific blend of flower remedies and essential oils to enhance positivity and move us to feeling peace, calm and joy, as well as other Emotional Health Care Products sold through Amazon.
She maintains a consulting practice in New Jersey, Chicago(IL) and does telephone/skype consultations worldwide.
She can be emailed at [email protected]; or skype "amy.c.50" or phone at 1-800-474-1667, whether for a free consultation or to come and speak at your group.
Her website is strongestminds.com. Amy maintains a consulting practice in Illinois and does telephone consultations worldwide. You can connect with her on Facebook, LinkedIn, Instagram, Twitter, Youtube, Google+ and Pinterest.
How to Break your Bad Habits Using Flower Remedies?


How Much Will Your Serviced Apartment Cost In London?
Home/ Blog/ How Much Will Your Serviced Apartment Cost?
We believe in being transparent about costs. There should be no nasty surprises when you choose to book your serviced apartment through London Serviced Apartments. In fact, we're so convinced there shouldn't be any hidden costs that, unlike many other providers, we are completely upfront on our website and match this with our Lowest Price Guarantee. We can tell you that choosing to stay in a London Serviced Apartment will save you around 30% compared to a hotel – but we want you to see the actual figures.
Cost is of paramount importance for the vast majority of people seeking an apartment to stay in. It may even be the primary reason that you are choosing an apartment over a hotel.
The primary cost is, of course, the per night rental charge. This is the amount that the apartment costs per night. If you browse our apartments you will see that we have a tab for each listing stating the rates for that apartment.
Let's look at that with an example for two bedroom apartments. A 7 night stay in the Gate House Apartments costs from £198 per night. A 2 night stay in the Park Lane Apartments also for a two bedroom option, will cost you £122 per night. That's quite a difference for the same sized apartment. However, the first is in London Bridge, on the doorstep of the City, whereas the second is in Croydon, a train ride away from central London. The price reflects this.
So to give you a clear indication of the apartment rental charges you need to look first at the rates.
What is Included in a Serviced Apartment Rate?
Next you need to consider exactly what is included in the rates. This is where you might run into difficulties with other companies that are less upfront. You should know exactly what you are committing to, and liable for, before making the booking.
The beauty of a serviced apartment is that you are getting hotel service. Therefore concierge, reception, and standard housekeeping are included, as are the basic costs of utility provision and local taxes. It will also include linen, towels, crockery, and cutlery. Unlike with many other providers, these costs don't get added quietly to your bill.
At London Serviced Apartments we partner with a range of different professional serviced apartment providers. Each has slightly different terms and conditions beyond the basics which are included. We only work with those who are prepared to be upfront about these. Therefore, just about 'Rates' on each of our property listings, you can view the specific Booking Terms and Conditions for that apartment. Here you will find any additional charges which may be levied. For example, there will be information about the Cancellation Policy and how refunds are processed, as well as liability for losses, claims and damages arising from your stay (including additional cleaning if needed). It may also include administration fees for booking changes, and details of costs such as telephone calls made in the apartment.
You can also see clearly what is included in your short-listed apartments by viewing the bullet-points under the image gallery. Here you will find information on how frequently maid service is included, whether free Wi-Fi is included, and details of the concierge, reception, and welcome packs. Here you will also see if any additional services are available, but chargeable. For example, and extra bed may be provided free of charge, or you may have to pay a surcharge, and the same with parking.
No More Costs – But Great Savings!
So, with a quick browse of our apartments you can easily see the cost of a London Serviced Apartment. There are no other surprise costs waiting for you. However, there are some other surprise savings. Not only do we have our Lowest Price Guarantee, we are also able to offer you a 10% discount on Minicab, Minibus, Courier, Executive Car and Chauffeur Travel throughout London with our partner, Parker Car Service. When you realise how much private transport in London costs, you'll soon realise the huge benefit that brings.
If that's not enough, don't forget to check out our Special Offers. Make your serviced apartment booking today, and be sure you know the exact costs.