Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS). The CNS is comprised of the brain and spinal cord and controls most functions of the body and mind.  It is estimated that 2.3 million people worldwide are living with the disease. MS can begin at any age but is most often diagnosed between 20 and 40 years of age, and affects woman more than men.

What are the Symptoms of MS?

Symptoms vary in type and severity among individuals and can come and go, as well as worsen over time. No two individuals are the same but the most common symptoms include fatigue, numbness, weakness, cognitive changes, poor coordination, pain, depression, imbalance, blurred vision, and problems with concentration and memory. 

How is MS Detected?

Often times, early symptoms of MS can be ignored or hard to detect. Currently, there is no single laboratory test available to rule in or out the diagnosis of MS. MS refers to many (multiple) areas of the CNS becoming damaged or scared (sclerosis). Myelin, the tissue that wraps around our nerves and is responsible for conducting chemical signals throughout our bodies, is typically damaged the most (also known as demyelination). It might be helpful to think of myelin as a hose, and the water that flows through it as the chemical signals that are responsible for our movements, sight, sensory perceptions (such as hot, cold, pain), and more. When the hose becomes porous or damaged, an array of problems can arise. Magnetic resonance imaging (MRI) is very helpful in diagnosing MS as it can detect demyelination and other changes within our nervous systems. In conjunction, spinal fluid analysis has become useful in diagnosing MS in a more accurate and in a timely manner. 

Due to demyelination, the early signs of MS often include changes in sensations (touch, burning, itching) and loss of strength of an arm or leg. As damage to the myelin sheath occurs, nerve signals to the eyes, brain, and spinal cord slow down or stop. As this worsens, the brain can shrink and nerve fibers are destroyed leading to worsening symptoms and decreased cognitive functioning. 

What causes MS?

While the underlying cause behind MS is not known, there are a few possible causes. 

• Viruses and infections such as retrovirus and herpesvirus. 
• Vitamin D deficiency: Those living near the equator or in tropical environments are at a lower risk for MS, especially within the first 15 years of their lives. 
• Food allergies and poor diet: MS is thought to be an autoimmune response, where the bodies own immune cells attack the nervous system. Increased inflammation and a gastrointestinal microbial imbalance, also known as dysbiosis, could play a role in the disease process. A poor diet can cause poor gut health, inflammation, and nutrient deficiencies. 
• Mold toxicity
• Immunizations 
• Emotional stress: While emotional stress may not be the underlying cause it can trigger flare ups in those suffering. It is common for MS symptoms to come and go, alerting between periods of remission and relapse (or flare ups). The reason the cycle of remission and relapse occurs, is because the myelin surrounding the nerves may be repeatedly repaired and destroyed. Remission can last for months or years with the majority (80 to 85 percent) of those with MS having relapsing-remitting MS. Other possible stressors may included but are not limited to dehydration, overexertion, lack of sleep, heat exhaustion, hormonal fluctuations, and having an illness such as a fever, flu, or other virus. 
• Family history: For those with MS, it is estimated that about 15 percent of them have a close family relative with MS and 5 percent a sibling that is also affected. 

Other risk factors include being a woman, smoking, childhood obesity, and being between the ages of 20 and 40. 

What are the types of MS?

There is no way to predict how MS will progress but there are four different disease courses it can take.

• Relapse-remitting MS: This is the most common disease course. It is defined by periods of increasing or new neurological symptoms (also known as a relapse) and is followed by periods of partial or complete recovery (also known as remission.) There is no apparent progression of the disease during these remissions. 
• Secondary progressive MS: Those diagnosed with relapsing remitting MS often progress to secondary progressive MS. This follows an initial relapse-remitting pattern but is characterized by a more progressive course, with or without relapses or new MRI activity. It is also known as a progressive relapsing pattern, in which there is a progressive worsening of neurological function. 
• Primary progressive MS: This form has a gradual but steady progression of debilitating symptoms and often has few or no relapses or remissions. Approximately 15 percent of those with MS will have this form. 
• Clinically isolated syndrome: This refers to the first episode of a neurological symptom lasting at least 24 hours. Some might only have a single ongoing symptom for months or years, with no other signs of the disease. 

Is There a Cure For MS?

At this time there is no known cure for MS. Corticosteroid drugs are often used to help stop the immune system from attacking its own tissues and cells. Other drugs are often utilized to treat specific symptoms such as blurred vision, weakness, or tingling. Also, there is an array of “disease modifying drugs” that have been developed to lengthen the periods of remission and decrease the severity of flare ups. Not everyone is relieved by these drugs but they can be very supportive for others. 

In addition to conventional therapies, there are some natural treatments that may aid in the management and quality of life for those suffering. Here are a few to consider. 

Exercise and stress reduction 

Exercise influences the quality of life. It can down regulate biosynthesis pathways and inflammation, stimulate the production of anti-inflammatory cytokines, as well as up-regulate oxidative metabolism. (1) In addition, exercise has been shown to be beneficial when it comes to stress management. Controlling emotional and physical stress plays a vital role in reducing the number of relapses and prolonging periods of remission. Exercise improves coordination, chronic fatigue, and may help prevent or slow the progression of disabilities. Mild physical exercise is recommended. A few options are yoga, tai chi, brisk walking, or swimming.

Vitamin D

The exact role vitamin D plays in development of MS is unknown. However, vitamin D deficiency does have an impact on neurological development, immunity, and neuroinflammation. If you can, be outside in the sunlight for at least 15 minutes a day. For those living in darker, cooler places, you can supplement with vitamin D3. Ideally, get your vitamin D levels checked by your physician so you can dose according to your needs. You may be surprised to discover how low your vitamin D levels really are.

Supplements

Beyond vitamin D there are several supplements that can help support your immune system and mitigate symptoms. (2)

• Probiotics: Probiotics help to maintain a healthy gut flora and decrease inflammation in the gastrointestinal tract.
• Fish oil (2,000mg daily): Fish oil is great at reducing inflammation, as well as being good for your nervous system. Also, consider eating fish such as salmon.
• Digestive enzymes: Digestive enzymes can reduces the bodies reaction to foods as well as aid in digestion. Remember, the less reactive our bodies are, the less likely it is to attack itself.
• Vitamin B12: Vitamin B12 plays a role in the formation of nerves.
• Turmeric: This herb has anti-inflammatory benefits.
• Mustard oil: Contains glycosides, which fight free radicals.
• Green tea: Contains powerful antioxidants and supports metabolic health.

Diet

No specific diet has been found to cure or prevent MS. However, there is evidence to suggest diets high in healthy fats and antioxidants can be beneficial. Our highly processed western diets filled with sugar, high salt content, fried foods, and low fiber could be a trigger. A 2018 study concluded that, “participants with diet quality scores in the highest quintile had lower levels of disability.” A dietary questionnaire estimated the intake of foods such as added sugar, red/processed meats, whole grains, fruits, vegetables, and legumes. A higher score denoted a healthier diet. (3)

It’s best to aim for a diet as close to the Mediterranean Diet as possible. Research shows the Mediterranean Diet can reduce inflammation, cardiovascular disease, improve endothelial function, and protect cognitive health. (4) Believe it or not but fats are essential in forming and protecting our myelin sheaths and nerves. So don’t be afraid to consume the right type of fats. 

So let’s break down some foods to eat:

• Aim for unprocessed foods whenever possible. Try to always buy organic, whole foods. These are foods found in their natural state (e.g. a carrot or broccoli), and not processed into a food product by a company.
• “Eat the rainbow” in regard to fresh fruits and vegetables. The variety of colors helps to provide your body with an array of antioxidants that can prevent inflammation and free radical damage. Plant foods containing sulforaphane (SFN) have been found to be some of the best for managing MS. This is because they reduce oxidative stress and inflammation, demyelination and autoimmune responses. (5) Great sources of SFN are bok choy, kale, collard greens, broccoli, Brussels sprouts, and other cruciferous vegetables.
• Complex Carbohydrates may help maintain good gut flora and reduce inflammation. 
• Lecithin rich foods: Beans, broccoli, and cabbage are just a few examples of foods high in lecithin. Lecithin helps make up the protective sheaths surrounding our brain and nervous system.
• Foods high in omega 3 fatty acids. These include salmon, mackerel, trout, herring, and sardines.
• Pre and probiotic foods help maintain a healthy gut flora. Think of foods such as kefir, raw garlic, cultured vegetables, and kimchi. 

Here are some foods to avoid:

• Sugar! Too much sugar leads to systemic inflammation, premature aging, and disrupted immune responses. 
• Alcohol: Alcohol is toxic to our bodies and causes inflammation.
• Food allergens. Food allergens can cause your immune system to over react and make MS symptoms worse. For some, this may include gluten and dairy.
• Processed foods. Aim to eat foods with only one ingredient and make sure to read labels for additives, fillers, binders, and other chemicals. You don’t want all that extra junk going into your body if you can avoid it.

Good Hygiene

Limit exposure to viruses and infections. Take precautions such as washing your hands frequently, clean the equipment used at an exercise facility, clean and disinfect working surfaces regularly, wash dirty bedding, linens, and surfaces that come in contact with someone who has an infection or is sick.  

Does MS Get Worse Over Time?

Unfortunately, even with treatment, it is common for those suffering from MS to worsen over time. This can sometimes lead to individuals becoming disabled and unable to care for themselves. While life expectancy has increased with time, often those with MS live around 7 years less than the general population. This is due to disease complications and other medical conditions.  Many of the complications such has heart disease can be managed. However in a few rare circumstances, the disease can rapidly progress and be fatal. 

If you believe that you are experiencing symptoms of MS or have MS, it is important to get diagnosed and treated by a medical professional. Visit your doctor right away if you have any pain, weakness, vision changes, tingling, or burning sensations.

If you or a loved one are living with MS, consider joining a local support group. Don’t be afraid to get the help you need.You are worth it!