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As my readers know, my ankle arthritis has responded dramatically to DMSO, but recently I’ve had these pesky domestic issues. So I decided to read Stanley Jacob’s 1999 book, The Miracle of MSM, about a related compound without the stench. Dr. Jacob was the father of MSM and DMSO, the first to recognize their clinical utility and to conduct significant research.
MSM (methylsulfonylmethane) and DMSO (dimethylsulfoxide) are nearly the same
In the late 1950s, Dr. Stanley Jacob was freezing kidneys at Harvard and MIT, trying to preserve organs for transplantation. A British scientist named Lovelock had published research on chemical compounds that could freeze red blood cells while keeping them alive. One compound caught Jacob’s attention: dimethyl sulfoxide, or DMSO.
Crown-Zellerbach Corporation in Washington State extracted DMSO from lignin, the organic cement that binds wood fibers together. The company was exploring industrial uses for this solvent when Jacob contacted them for medical research supplies.
By 1963, DMSO was making headlines. It didn’t just preserve tissue—it moved through tissue and carried other materials with it. When applied to skin, it penetrated immediately. It reduced pain within an hour when rubbed over a sprained ankle or burn. The swelling visibly resolved.
The New York Times called it “the most exciting thing in medicine” and compared it to penicillin. Major pharmaceutical companies competed for patents. Over 1,500 studies involving 100,000 patients showed potential for arthritis, bursitis, tendinitis, and musculoskeletal inflammation.
In 1965, the FDA burned it all down. Supposedly spooked by the thalidomide disaster in Europe, where a sedative caused severe birth defects, the agency rejected all new drug applications, including DMSO. Without the pharmaceutical industry's backing, DMSO’s path to approval stalled.
The truth was darker. DMSO was on the verge of destroying the market for a vast swath of prescription painkillers, curing many chronic diseases, and preventing many mortal diseases such as strokes and heart attacks. It would have been a financial apocalypse for healthcare and big Pharma. This passage from Butchered by “Healthcare” explains FDA corruption:
In recent years, however, direct payments from drugmakers to the FDA took the oversight process hostage. Since 2002, pharmaceutical companies have paid about two-thirds of the FDA’s $4.7 billion budget through “user fees.” This money from the industry goes straight to the FDA, mostly during the patent process. Critics have said the companies should pay taxes instead. In 2007, four retired FDA commissioners agreed: the system creates the wrong incentives (Deadly Medicines and Organized Crime, Peter Gøtzsche). Jessica Wapner, in a PLOS blog, wrote that the structure puts the FDA in the pockets of the drug industry.
Any student of influence understands how and why this works. The payments, totaling over $3 billion in 2016 alone, create enormous leverage. Michael A. Carome, Director, Public Citizen’s Health Research Group, concluded, “User fees fundamentally changed the relationship between the FDA and the pharmaceutical industry such that the agency now views the industry as a partner and a client, rather than a regulated entity.” Megan McArdle coined a name for this in a Bloomberg article: regulatory capture. She says that the regulators who are in place “to tame the wild beasts of business instead become tools of the corporations they regulate.”
The research continued, and in 1970, DMSO was approved for veterinary use. By 1978, it was being prescribed in the Soviet Union for 30 million patients annually. In 1980, Dr. Jacob appeared on 60 Minutes and demonstrated dramatic pain relief in a car accident victim. By then, 20 million Americans were already using DMSO purchased without a prescription from health food stores, gas stations, and veterinary suppliers.
Today, DMSO is used in approximately 125 countries. More than 55,000 studies document its properties for tissue healing and remodeling in diseases, including even amyloidosis. In the U.S., its sole FDA approval is for bladder instillation to treat interstitial cystitis, an inflammatory bladder disease. However, DMSO remains available without a prescription from industrial suppliers, veterinary sources, and some health retailers. A special Oregon law allowed Jacob to prescribe it for other conditions at his Portland clinic.
Enter MSM: DMSO’s Odorless Offspring
In the late 1970s, Robert Herschler - the Crown-Zellerbach chemist who had worked with Jacob on early DMSO research - suggested studying DMSO’s metabolites. When DMSO enters the body, approximately 15% converts to dimethyl sulfone (MSM) by attaching an oxygen atom. A smaller percentage converts to dimethyl sulfide (DMS), which causes DMSO’s notorious fishy odor.
MSM is dimethyl sulfone, also written as DMSO₂. This metabolite stays in the body much longer than DMSO. A 1967 Merck study found DMSO cleared from urine after 120 hours, while MSM excretion continued beyond 480 hours. The researchers suggested “more extensive tissue binding” explained MSM’s persistence.
Jacob began using MSM with patients in the early 1980s. He discovered it produced many—but not all—of DMSO’s effects without the odor problem. The first scientific paper describing MSM appeared in 1982 in the New York Academy of Sciences proceedings. Veterinarians adopted it after seeing results in animals. Word spread among patients who experienced relief.
Unlike DMSO, MSM cannot transport medications through the skin. Unlike DMSO, its antioxidant effects remain unclear. But MSM shares DMSO’s most valuable therapeutic properties while eliminating the single most significant barrier to long-term use: the smell that makes people quit treatment even when it’s working.
Shared Mechanisms
DMSO, MSM, and water are small molecules, which allows them to pass through cell membranes and tissue.
Pain-signal blocking: DMSO blocks peripheral nerve conduction, providing analgesia. (Examine) Research at Southern Illinois University (1993) showed DMSO slows pain impulses along C-fiber nerves even at low concentrations. These fibers conduct deep, aching pain from arthritis and injuries. Based on clinical observation, MSM appears to work similarly, though no formal studies have tested this.
Anti-inflammatory action: Both compounds reduce inflammation, which can increase pressure on nerves and cause pain. For example, when applied topically to a sprained ankle, visible swelling decreases within an hour.
Enhanced blood flow: Both dilate blood vessels and increase circulation, speeding nutrient delivery to damaged tissue and supporting repair.
Muscle relaxation: Injury and inflammation trigger muscle spasms—sudden contractions that cause additional pain. Both DMSO and MSM reduce this spasm. You can feel the difference by touching the affected muscle before and after treatment, or measure it with electromyography.
Scar tissue modification: Both compounds alter the crosslinking process in collagen formation. Crosslinking occurs when new structural proteins knit to existing tissue at surgical or trauma sites. By modifying this process, they reduce the formation of excessive scar tissue.
Brain-level effects: Studies show DMSO can temporarily block central pain response, where pain is perceived in the brain. One researcher compared this to morphine’s effect, noting DMSO works both locally (at nerve fibers) and systemically (in the brain).
Critical Differences Between DMSO and MSM
The odor factor: This single difference explains why MSM is becoming popular. DMSO produces a distinctive fish or oyster smell and taste regardless of application method - IV, oral, topical, nasal, bladder instillation, or injection. The smell comes from DMS conversion. MSM produces no odor because it doesn’t convert to DMS.
Drug delivery capability: DMSO’s ability to carry medications through skin made it initially attractive to pharmaceutical companies. It can transport their patented drugs into the bloodstream, bypassing the digestive tract where many side effects occur. MSM cannot do this.
Regulatory status: DMSO has FDA approval only for interstitial cystitis bladder instillation, though it remains available without prescription from various suppliers. Quality and purity vary by source - pharmaceutical-grade DMSO differs significantly from industrial-grade. MSM is a nutritional supplement available without prescription in standardized formulations.
Administration routes: DMSO is used topically, intravenously, orally, and via bladder instillation. Oral DMSO protocols range from 3-20 grams daily for serious conditions like amyloid A amyloidosis, with typical dosing of 5-10 ml (1-2 teaspoons) per day. For peptic ulcers, 2,000 mg daily has been used (PubMed). MSM is primarily taken orally as capsules or crystals (2-8 grams daily is typical, up to 40+ grams for severe cases), and applied topically as a gel, cream, or lotion.
Potency and speed: DMSO appears somewhat stronger for acute conditions and severe trauma. It often produces rapid relief—sometimes within hours. MSM typically takes longer—days to weeks—though some patients report immediate effects. For chronic pain, this difference matters less than sustained relief without side effects, which they both provide.
Skin reactions: If not diluted in water, DMSO occasionally causes redness, warmth, and skin irritation at application sites. Repeated use of industrial-quality DMSO can cause minor skin damage. MSM produces no skin reactions beyond rare individual sensitivities.
Both Are Remarkably Safe and Non-Toxic
The LD-50 test determines the amount of a substance that kills half the laboratory animals tested. For MSM, this exceeded 17.5 grams per kilogram of body weight. Table salt’s LD-50 is 2.5 to 3 grams per kilogram. DMSO is similar to MSM: 14.5 grams per kilogram. All these are exceedingly nontoxic.
Human volunteers showed no toxic effects taking up to 1 gram per kilogram daily for 30 days - about 68 grams for a 150-pound person. Some patients have taken over 100 grams daily under medical supervision without serious side effects.
DMSO shares this extraordinarily low toxicity profile. Over 55,000 studies and an estimated half-billion patients worldwide have used it, with only one documented death attributed to drinking a liter of it at once. Occasional allergic reactions occur, but serious adverse events are virtually nonexistent.
The most common MSM “side effect” is gastrointestinal discomfort if too much is taken at once - similar to vitamin C’s bowel tolerance limit. Reducing dosage or dividing doses throughout the day eliminates this problem.
Both compounds are safer than aspirin, acetaminophen, and NSAIDs, which cause over 16,000 deaths and 100,000 hospitalizations in the U.S annually. Most of this is due to gastrointestinal bleeding.
Sulfur: The Forgotten Essential Element
Both DMSO and MSM derive their therapeutic properties, in part, from their sulfur content. MSM is one-third sulfur by weight. Understanding sulfur’s role in the body explains another way these compounds work.
Sulfur is the eighth most abundant element in living organisms. In humans, approximately 1% of body weight is sulfur - more than many better-known minerals.
Hair, nails, and skin contain high levels of sulfur. When hair is burned, it smells like sulfur.
Sulfur amino acids: Methionine and cysteine are the body’s primary sulfur-containing amino acids. Methionine is essential - you must get it from food because your body can’t make it. Methionine converts to cysteine, which forms glutathione, the body’s master antioxidant and detoxifier.
These amino acids build proteins that form muscles, bones, hair, teeth, blood, organs, enzymes, hormones, and antibodies. Without adequate protein - and thus sulfur amino acids - children don’t grow properly. Adults experience chronic fatigue, mental depression, weakness, poor infection resistance, and slow healing.
Sulfur’s healing tradition: For thousands of years, sulfur hot springs attracted people seeking relief. The ancient Egyptians burned sulfur to ward off evil spirits. Throughout history, physicians prescribed mineral baths rich in sulfur for arthritis and other inflammatory conditions.
Garlic, perhaps the most famous sulfur medicinal, was used 4,300 years ago by the Sumerian civilization for fevers, inflammation, parasites, and as a general tonic. Louis Pasteur discovered that garlic destroyed harmful bacteria. Albert Schweitzer used garlic compounds for amoebic dysentery. Modern research identifies at least 100 sulfur compounds in garlic that validate its folk medicine applications.
Foods with distinctive cooking smells—such as cabbage, onions, and horseradish—or those that make eyes water when cut have high sulfur content. These sulfur-bearing vegetables contain compounds that inhibit experimentally induced cancers in laboratory studies.
The deficiency question: Despite sulfur’s unquestionable importance, medical “science” doesn’t track it like other minerals. The USDA doesn’t compile sulfur content data for foods. No recommended daily allowance exists. The assumption is simple: if you eat adequate protein, you get sufficient sulfur from methionine and cysteine.
But this hasn’t been rigorously tested. Evidence suggests problems may exist with methionine metabolism. Deficiencies in B vitamins (especially B₆ and folic acid), magnesium, and zinc prevent proper methionine processing. These are all common in Western diets and cause homocysteine buildup. This is a toxic amino acid that triggers cardiovascular disease, affecting 57 million Americans.
Nutritional biochemist Jon Pangborn analyzed 1,500 individuals with food intolerances, degenerative diseases, and neuromuscular dysfunction. He found methionine metabolism was “the most frequently impaired or disordered amino acid” in these patients.
MSM may act as a sulfur donor in amino acid metabolism, with studies showing incorporation of radiolabeled sulfur into methionine and cysteine in guinea pigs after oral MSM administration (Clinician). This supplementation could address sulfur amino acid abnormalities when the body faces physical stress or metabolic challenges.
Clinical Applications: What Conditions Respond
Both DMSO and MSM have demonstrated effectiveness for overlapping conditions:
Conditions responding to both:
Degenerative arthritis (osteoarthritis)
Rheumatoid arthritis
Chronic back pain
Muscle pain and soreness
Fibromyalgia
Tendinitis and bursitis
Carpal tunnel syndrome
Athletic strains and sprains
Post-traumatic pain and inflammation
Interstitial cystitis
Scleroderma
TMJ (temporomandibular joint syndrome)
DMSO’s additional proven uses:
Acute head and spinal cord trauma
Stroke
Heart attacks
Burns
Life-threatening emergency situations requiring rapid anti-inflammatory response
MSM’s strengths:
Allergies (pollen, food sensitivities)
Asthma
Sinusitis
Long-term chronic pain management
Conditions requiring indefinite supplementation
A 2008 systematic review found that both DMSO and MSM trials reported significant improvement in pain outcomes for osteoarthritis, though optimal dosage and treatment duration remain unclear (ScienceDirectPubMed). Clinical experience shows that approximately 70% of pain patients experience significant relief with MSM. Response varies from immediate (rare but documented) to gradual improvement over weeks or months.
Dosing
DMSO
Topical: 25-90% DMSO concentration applied 3-4 times daily. 100% causes skin irritation. A concentration of 60-90% may be optimal. (MSK Medicine) Lower concentrations (25-45.5%) have been used in studies, but may not work as well.
Oral:
Yoho note: The following recommendations from the 1999 book are too conservative for such a safe medicine; other sources are more liberal. The most credible sources I have seen suggest experimenting with your response to DMSO by taking between one and eight teaspoons daily, divided into two doses.
A gram is one cc fluid volume, a teaspoon is five cc, and there are three teaspoons in a tablespoon. I take a tablespoon twice a day, each time in a glass of water.
General use: 5-10 ml (1-2 teaspoons) daily
Serious conditions: 3-20 grams daily (20 grams is four teaspoons)
Peptic ulcers: 2 grams daily (This is 2/5 of a teaspoon if it were water.)
It can be mixed with tomato or grape juice to mask the taste. (PubMed). Yoho: it doesn’t bother me, but maybe my taste buds are shot.
Small doses of 5-7 drops twice daily (mixed in water) are a conservative dosing that is advocated by a few.
Intravenous: 50-100 cc DMSO added to 500 cc glucose or saline solution, administered over 2-3 hours (PubMed). This is also used at 1 gram per kg of body weight in a 40% solution for spinal cord trauma. Yoho: IV DMSO has become prohibitively expensive due to Pharma.
Veterinary: 0.5 to 1 g/kg body weight orally and intravenously for large animals.
MSM Dosing Protocols
Oral:
Maintenance/general health: 2 grams daily
Therapeutic relief: 2-8 grams daily
Severe conditions: 15-40+ grams daily (40 grams is eight teaspoons)
Maximum tested safely: 68 grams daily for 30 days (human volunteers)
Clinical trials have used 2,250 mg (2.25g), 3g twice daily (6g total), with a suggested optimal dose of 4-6 g/day (MSK MedicineClinician).
Topical: Applied as gel, cream, or lotion 2-4 times daily to affected areas. Can be fortified by mixing additional MSM crystals (ground to powder) into commercial preparations.
Dissolution: Maximum solubility in room-temperature water is approximately 15% by volume (one teaspoon of crystals per ounce of liquid). Higher concentrations dissolve in warm/hot water.
Using both
For maximum benefit with either compound, use both orally and topically. The supplement works systemically from inside, while topical application delivers concentrated relief directly to affected areas.
No established therapeutic equivalency exists between DMSO and MSM.
1. The 15% metabolic conversion is not therapeutic equivalence
About 15% of DMSO metabolizes to MSM, but it’s unclear how many of DMSO’s properties can be attributed to MSM (Clinician). This metabolic fact doesn’t translate to “100mg DMSO = 15mg MSM therapeutically.” When you take DMSO, your body converts some to MSM. That’s a metabolic pathway, not a dosing formula.
2. Different administration routes prevent direct comparison
DMSO is used topically, orally, and intravenously, with a half-life of 12-15 hours, whereas MSM, one of its metabolites, has a longer half-life, perhaps days.
MSM is primarily oral with topical applications. Bioavailability, absorption rates, and tissue distribution differ dramatically between these routes. MSM reaches peak serum concentration at 2.1 hours with a half-life of 12-15 hours and remains detectable for 48 hours after a single dose. (Other sources say it may last several days.)
3. Potency differences remain unquantified
Jacob states MSM may not be “quite on a par with DMSO” for acute situations, but provides no numerical comparison. Systematic reviews note that the optimal dosage and treatment duration for both compounds remain unclear due to methodological issues in existing studies.
4. They’re used for different clinical scenarios
DMSO excels at acute trauma and emergencies. MSM excels at chronic management and long-term supplementation. They’re complementary tools, not interchangeable alternatives.
Key insight: Patients switching from DMSO to MSM in Jacob’s clinic experimented to find individual effective doses, confirming that no simple conversion formula exists.
Both Compounds Are Blood Thinners
DMSO counteracts platelet aggregation in studies. MSM may result in mild blood thinning or anti-coagulant actions and should not be taken with anticoagulant drugs like high-dose aspirin, vitamin E, ginkgo biloba, Coumadin, or other blood thinners. (Herbs2000)
This matters for anyone taking anticoagulants (heparin, dicumarol) or regular aspirin. While blood-thinning effects could provide cardiovascular protection, combining either compound with prescribed blood thinners requires medical supervision.
Warning signs of excessive blood thinning: unexplained bruising or increased bleeding from hemorrhoids. Anyone on blood-thinning medication should consult their physician, start with very low doses, increase slowly, and monitor coagulation studies.
Yoho comment: DMSO is anti-thrombotic (anti-clot). It should replace many blood thinners used for various applications. Although it likely would need to be taken twice a day, it is far safer and less expensive than anything we have.
As far as I know, the efficacy of chronic use for things like atrial fibrillation is unstudied. Imagine what kind of medical world we would live in if we had honest regulators and spent our money and time on the best therapies instead of only looking under the money tree.
Accelerated Healing
Both DMSO and MSM appear to speed tissue repair beyond simple pain relief. Physicians using MSM report accelerated improvement in resistant cases—reduced pain, increased range of motion, improved neurological coordination, and joints returning to more normal shapes. (Yoho emphasis; I am slowly experiencing ankle arthritis improvement.)
Post-surgical recovery improves with MSM or DMSO. Patients report faster healing, less need for pain medication, and an earlier return to normal function after knee replacements and other surgeries. Surgeons note three-week recovery status resembling typical three-month progress.
This acceleration likely results from multiple mechanisms: reduced inflammation allows unimpeded healing, enhanced blood flow delivers more nutrients, reduced muscle spasm prevents additional damage, and sulfur availability supports protein synthesis for new tissue.
MSM Is Reaching the Mainstream
DMSO’s odor problem and the regulatory fraud by the Pharma-captured FDA kept it out of the mainstream despite international use and documentation of studies surpassing those of most patent drugs. MSM eliminates both barriers.
As a nutritional supplement, MSM bypasses pharmaceutical approval. No prescription means easy access. No patent protection means multiple manufacturers compete, driving costs down.
The explosion of interest in alternative medicine since 1990 created receptive conditions. A 1993 New England Journal of Medicine study found that one-third of Americans visited alternative practitioners. By 1998, this rose to 40%, with chronic pain as the most frequently cited condition (37%).
MSM fits perfectly: natural, safe, effective for pain without serious side effects, and affordable. Patient word-of-mouth drives adoption.
Many doctors first hear about MSM when patients report improvements. As one Florida physician noted, “This is patient-driven. They say their pain is 50% better or more. No one has mentioned any negative effect.”
Choosing Between DMSO and MSM
Choose DMSO if:
You have acute, severe conditions requiring rapid intervention
A physician prescribes it for interstitial cystitis
You can tolerate the odor
Your condition might benefit from DMSO’s drug-delivery capability
Consider MSM if:
You need long-term pain and inflammation management
DMSO’s odor is unacceptable
You have chronic arthritis, fibromyalgia, or musculoskeletal pain
You suffer from allergies alongside pain conditions
Consider both if:
You prefer nutritional approaches to pain management
You want to avoid prescription drugs such as NSAIDs and their side effects
You have severe chronic pain requiring maximum intervention
Short-term DMSO could jumpstart improvement before MSM maintenance
The relationship between DMSO and MSM resembles parent and offspring. DMSO pioneered sulfur-based therapeutic intervention. It was so effective that it would have destroyed the sales of many patented medications, so it faced a hostile FDA that was entirely corrupted by industry money. MSM inherited DMSO’s most valuable properties while eliminating its biggest liability.
For millions suffering chronic pain, MSM offers what DMSO promised but couldn’t fully deliver: safe, effective, long-term relief without social stigma. The supplement doesn’t cure underlying diseases. It relieves symptoms, reduces inflammation, and supports healing for as long as you take it.
After nearly 20 years of clinical use involving thousands of patients, MSM has established itself as a legitimate pain management tool deserving serious medical attention and further research. The fact that it works for roughly 70% of chronic pain sufferers - without the death toll, hospitalization rate, and side effect profile of conventional pain medications - makes it a valuable addition to any pain management strategy.
A few references
Because of the FDA’s suppression, research has stalled, and The Miracle of MSM by Stanley Jacob and his other book about DMSO HERE are better than more recent references.
A summary from Examine is HERE.
Osteoarthritis review.
An MSM YouTube lecture is HERE.
Sources
I buy DMSO by the gallon HERE for $120. I like MSM in powder form, so I bought a kilogram (2.2 lb) of MSM powder HERE for $28. Other forms of MSM are HERE.
I have one of THESE $20 digital scales to learn how big a scoop I need for powder supplements. Just zero the empty scoop on the scale, fill it, and weigh.
Editing credits: Jim Arnold of Liar’s World Substack, Ann Waldeck, and Elizabeth Cronin.
To learn how to help me without spending money, read THIS.
Disclaimer: This is not medical advice; I am retired from that.
