Ask Surly Amy: MSM

Surly Amy,

Several months ago a friend of mine was involved in a serious car accident. She has been undergoing PT for months, and recently lamented all the medical expenses she is incurring because someone else ran a red light.

A friend of her’s recommended something called MSM to help with the pain. She said it’s the long name for sulfur and that it doesn’t interfere with other meds.

I guess it’s good that the friend isn’t telling her to stop taking her prescriptions but I was wondering if this is sound advice?


Dear 9bar,

As usual I have to say that I am not a doctor and that you should always seek professional medical advice before taking any kind of supplement or any type of medicine. You should not never take pills or supplements of any kind just because your friend or other non-MD says so. So to quickly answer the question, no, it is NOT sound advice.

Also, supplements can often counteract with regular medications, so for someone to claim that a supplement will not interfere with other medications, without knowing the patient’s pain control regimen is flagrantly incorrect. It is also part of what is known as the natural fallacy. People often assume that a product advertised as natural or something you can purchase without a prescription is safe. This is often not the case. Cyanide is natural, nightshade is natural and bears are natural. All of these things will murder your face in the correct dose.

MSM is Methylsulfonylmethane. It is known by several other names including DMSO2, methyl sulfone, and dimethyl sulfone. It is also known by the FDA because in 2000 the FDA warned one MSM promoter, Karl Loren, to cease and desist from making therapeutic claims for MSM. This warning was issued because there is currently no credible evidence to support the claim that adding sulfur in the form of a supplement can reduce pain or inflammation or cure cancer or any of the other health claims associated with it.

A more detailed analysis of MSM or DMSO can be found here on Quackwatch.

Please tell your friend to see a Medical Doctor for pain problems and at the very least to inform her primary care physician if she is taking any over-the-counter or over-the-internet supplements.

Got a question you would like some Surly-Skepchick advice on? Send it in! We won’t publish your real name, unless you want us to and creative pseudonyms get bonus points! Just use the contact link on the top left of the page.

Amy Roth

Amy Davis Roth (aka Surly Amy) is a multimedia, science-loving artist who resides in Los Angeles, California. She makes Surly-Ramics and is currently in love with pottery. Daily maker of art and leader of Mad Art Lab. Support her on Patreon. Tip Jar is here.

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  1. It’s woo. But, probably harmless woo, as long as she doesn’t stop taking her real treatments.

    It’s like vitamins. Eat a healthy diet, and taking extra doesn’t really help anything. Sulfone is available through eating onions, nuts, and a variety of other things. And, the folks peddling this stuff use the classic “snake oil” cure-all lines that we’ve seen time and time again.

    In short, it doesn’t do shit.

      1. It’s not really a medication. It’s very inert and non-reactive. I liken it to the effect that vitamins have – largely no effect, and probably harmless. If you take like 10 iron tablets and too much zinc, I think it can do some harm, but basically taking vitamins is “mostly harmless.” This sulfon stuff is about the same.

    1. There has been a lot of recent studies that show that taking vitamins especially in large doses can be dangerous and can shorten your lifespan. There is also evidence than unless directed by your doctor supplements are not a good idea. For a very reasonable look at the evidence see this article on Science Based Medicine by Dr Steve Novella:

      Also, sulfer absorbed by the skin is not just like eating an onion or taking a vitamin.
      And many over the counter and “natural” remedies can counteract with medicines the person may already be taking.

      1. Clearly, all good points.

        A person should always discuss the kind and quantities of substances one is taking with one’s doctor. I’m not a fan of vitamins. They are largely woo, and generally have little effect and do the average person little to no good. And, clearly, taking large doses runs some risks.

        I didn’t say that eating sulfon was just like eating an onion. I only meant that onions and nuts have that substance in it. So, if you eat enough of a balanced diet, you probably get all the sulfon you need. Unless a medical doctor says “your body seems deficient in MSM” I wouldn’t bother taking it.

      2. It kind of bugs me that you keep saying vitamins as in “vitamins in general” and not ” vitamin pills”. I mean, suggesting that natural vitamins in their natural state are harmful is pretty much insane.

  2. “Cyanide is natural, nightshade is natural and bears are natural. All of these things will murder your face in the correct dose.” Best. Quote. Ever!

      1. Forget MSM…what about this bear stuff? Is it available over the counter or do I need a prescription? Is it FDA approved? Any research on PubMed?

        Are there recreational uses?

        WARNING: Side effects of bear include intense pain, bleeding, death and loss of picnic baskets. If you experience any of these symptoms, discontinue use immediately and consult a physician.

  3. From what I understand about looking into what MSM was about quite a while ago, it’s actually a biproduct of the pulp and paper industry. I can’t find a good reference but even these quack sites are up front about it. It’s far from a “natural” product so perhaps some more real information about MSM and how it’s made from a pulp and paper biproduct may go some way to making the letter writer’s friend more skeptical.

    “MSM is commercially made by combining sulfur with paper mill pulp liquids to form DMS and is then purified and processed under pressure and heat, and further filtered and distilled to manufacture pure MSM.”

  4. Sorry Amy, I realized that after the fact. I get a bit overly excited because I find the fact that it’s a biproduct of the pulp and paper industry kind of alarming.

  5. Most doctors know very little about chemistry, or science in general. I say this as someone who has been doing chemistry for 33 years. You are better off checking with the manufacturer (easy to do now with the internet and all) of the pharmaceutical in question if you are concerned about interaction.

    MSM is not sulfur. Calling it sulfur is what one idiot who doesn’t know what they are talking about tells another. It is a naturally occurring compound that is basically an inert solvent. Not likely to help her, but also not likely to do any harm. But just because one guy tried to sell it as a panacea, it doesn’t mean that is has no benefit.

    That said, sulfur is extremely important biologically. Eat foods with sulfur containing amino acids, that’s what your body wants.

    Also, I don’t agree with dumping on supplements in general. While there are many outright lies out there about what this years miracle supplement can do, there are supplements that are unquestionably effective and completely safe. I use dietary enzymes quite often. They work, no doubt about it. If you doubt this, try using some Beano or lactase, they work. Also, ginger is a very effective anti-inflammatory and anti-nausea supplement. The related plant turmeric has numerous benefits that are still being investigated.

    Did you know that those wonderful statins that large numbers of people use to control their cholesterol level are natural materials that were sold as dietary supplements (as the plant derivative) for many years before the pharmaceutical was developed? So in this case, the supplement manufacturers were onto it before pharma. Since developing and marketing pharma versions of statins, they have now banned the sale of the natural plant supplement as a violation of their patent. Neat trick that. Assholes.

    1. Yes, yes. And if I want an uncontrolled amount of active ingredient and possible unexpected environmental toxins I can make a tea out of willow bark from my back yard for my headache.
      Or I can get a controlled amount of the active ingredient with two tablets. The biggest problem with supplements is that, thanks to heavy lobbying by its proponents, they are largely unregulated and can contain any amount of off-label crap, including actual medicine, that the manufacturer cares to toss in.
      And before someone decides that I am saying that prescription medicines have no problems, I am not, I am simply saying that prescription a OTC drugs are regulated and can’t make claims they can’t back up unlike the and unchecked bullshit claims and carefully worded pseudo-claims that are allowed in the name of “holistic” and “natural” medicine. All medicines and supplements, including natural, herbal, homeopathic, and vitamins should be regulated; period.

    2. Sooo… The basics of your reply are:
      Doctors are not chemists: you can’t trust them to tell you chemistry stuff. I am a chemist; trust me to tell you doctor stuff.
      DMSO2 is not sulfur. But sulfur is good for you.

      That and cursing at big Pharma, which they probably deserve a bit of.

  6. It’s like people telling you to take St John’s Wort or valerian because they’re ‘natural’ and “won’t do any harm”.

    some herbal supplements act adversely in a percentage of the population

    the desire for a good night’s sleep lead me to feelings of suicide. Thanks “natural supplements”.

    This infographic is based on the evidence for scientifically tested supplements:

  7. One of the side ads I got on this page is for “Puritan’s Pride Glucosamine Chondroitin MSM”. (Buy one, get one free.) Hey, if it’s good enough for genocidal religious fanatics who practiced pre-scientific folk medicine, it ought to be good enough for anyone!

  8. I would say it’s not valid advice, for all the reasons you list (natural fallacy, unevaluated nonexpert advice, etc.), though in this case it may be sound advice (empirically correct).

    MSM is well enough studied to argue with some justification that it is not toxic and is well tolerated for short term (months) oral use in the single-digit grams dosage range.

    Further, it does appear to work as an analgesic in humans (and horses, arguably less susceptible to placebo effects) through decently well-constructed (double-blind. placebo-controlled, randomized, etc.) studies.

    As for the ridiculous claims, sellers gonna sell. A skeptical consumer should take pre-sales health claims with a sufficiently large grain of salt.

    I do agree with the conclusion: it’s extremely important to keep one’s doctors informed of all medications and supplements.

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