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Monday, March 25, 2019

What Is Multiple Sclerosis? from Dr. Mercola

What Is Multiple Sclerosis? from Dr. Mercola

Story at-a-glance

  • Multiple sclerosis is an autoimmune disorder that causes problems in your brain, spinal cord and central nervous system, and is classified into five types
  • There are no known causes of MS, although there are risk factors that make you more susceptible to this disease
  • Initial MS symptoms are seen in the eyes, face, feet, limbs, legs and trunk
  • Aromatherapy, exercise, physical therapy, acupuncture and homeopathy can help address MS. Some medications, while they’re recommended by most doctors, are ineffective in providing relief from the disease
Your central nervous system plays a big role in stimulating thoughts, feelings and movements, and helps control breathing, heart rate and body temperature.1 Maintaining optimal central nervous system health is important because it can be threatened by a disease like multiple sclerosis (MS), which can negatively affect daily routines and cause health problems.
MS is an autoimmune disorder that affects 2.3 million people worldwide,1 and targets your brain, spinal cord and central nervous system.3 It’s not known exactly how many have MS in the U.S., since some symptoms aren’t recognizable, and the Centers for Disease Control and Prevention (CDC) doesn’t require physicians to disclose new cases.4
However, the National MS Society in 2017 launched a study of Medicare, Medicaid, the Veteran’s Health Administration and private insurers and found that nearly 1 million people in the U.S. are living with MS — nearly twice what was thought. This information was reported in October 2017 at the world’s largest MS research meeting.5
In the U.K., in 2010 — the latest available statistics — estimates showed that 126,669 people were diagnosed with MS, while 6,003 new cases were reported in that same year.6
Providing yourself with adequate knowledge may assist you in managing MS better and preventing recurring problems. Read this guide to learn more about MS: what causes it in the first place, its common indicators and how to alleviate the condition without raising your risk for side effects.

What Is Multiple Sclerosis?

Multiple sclerosis occurs when the immune system attacks the myelin or protective fatty covering of nerve fibers in your brain and spinal cord. Myelin damage may cause nerve fiber exposure, communication problems between the brain and the rest of your body, or permanent nerve damage.7
MS is more prevalent in women compared to men, and while it’s not clear why this is the case, a 2014 study published in The Journal of Clinical Investigation provided some insights. Researchers determined that a blood vessel receptor protein called sphingosine-1-phosphate receptor 2 (S1PR2) was present in higher amounts in female mice susceptible for MS compared to male mice.8,9

What Are the Common Symptoms of Multiple Sclerosis?

Signs and symptoms of multiple sclerosis can differ, depending on the nerves affected and amount of damage dealt to them. The first signs of multiple sclerosis occur between 20 and 40 years old. Early symptoms of multiple sclerosis can appear in your:
• Eyes
◦ Diplopia or double vision
◦ Nystagmus or involuntary eye movements
◦ Partial or complete vision loss (one eye at a time)
◦ Optic neuritis, or injuries to the nerve connecting your eye to your brain that can affect one or both eyes, and result in blurry vision and eye pain during movement. Colors may appear to be dull as well
• Legs or trunk
◦ Numbness or weakness
◦ Tingling
◦ Muscle spasms on leg muscles that may be mildly stiff or strong and painful
• Limbs — Numbness or weakness in one or more limbs, on one side of the body at a time
• Face or feet — Numbness
Other multiple sclerosis symptoms to watch out for include:10,11
• Lhermitte's sign, which consists of electric shock-like sensations that move down to the spine or toward your arms or legs and occur when you move your head or neck
• Tremors or uncontrollable shaking12 that are minor or very intense
• Pins and needles feelings
• MS "hug" or tightness around the ribs or upper belly
• Severe itching, burning, stabbing or tearing pains
• Walking problems
• Constipation, difficulty emptying bladder, or increased need to pee or relieve yourself at night
• Speech impediments like slurred or nasal speech
• Swallowing problems
• Dizziness
• Fatigue that triggers sleepiness, slower thinking and weak muscles, usually in the afternoon
• Reduced sex drive and response to touch, difficulties reaching orgasm, vaginal dryness or erection problems
• Increased risk for anxiety, depression and emotion-related problems
• Difficulties focusing on daily tasks, lessened attention or fuzzy memory
• Heat problems while warming up for exercise that may cause feelings of tiredness or challenges in controlling body parts like the foot or leg
Patients may experience remissions and not develop symptoms for months or years,13 but will notice that they come back sooner or later. In other instances, symptoms constantly come and go, lingering in the body or healing permanently.14 The worst-case scenario would be indicators gradually worsening a few weeks or months after diagnosis, or a relapse.15
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What Causes Multiple Sclerosis?

It’s not clear what exactly causes MS, given it’s an autoimmune disorder, although factors that may place you at a higher risk for this disease have been determined, and include:16,17
• Age — This disease targets people 15 to 60 years old, although it can develop at any age.
• Sex — Multiple sclerosis symptoms appear in more females than males. Women are twice as likely to be diagnosed with the disease.
• Race — The highest MS risk was recorded among Caucasians, especially those with Northern European descent. Asians, Africans or Native Americans have the lowest MS risk.
• Climate — People living in areas with temperate climates like Canada, northern U.S., New Zealand, southeastern Australia and Europe are more prone to develop MS.
• Smoking — Smoking is linked to the onset of the disease, and a higher risk of progression to more debilitating stages of MS.18
• Presence of other autoimmune diseases — Those diagnosed with thyroid disease, Type 1 diabetes or inflammatory bowel disease have an increased MS risk.
• Genetics — There’s a 3 to 5 percent chance you may be diagnosed with MS if you have a sibling with the disease, while you’re 20 to 40 percent more likely to develop it if your identical twin is affected.
• Exposure to the Epstein-Barr virus — Antibodies to this virus are found in MS patients, meaning that they’ve been exposed to this pathogen. MS risk is also said to be higher in people who developed an Epstein-Barr virus-caused sickness.

Types of Multiple Sclerosis

Multiple sclerosis can be divided into the following stages:
1. Clinically isolated syndrome (CIS) — Also called demyelination, CIS is the first MS “stage.” It’s characterized by appearance of inflammation- or myelin loss-caused neurologic symptoms lasting for 24 hours. CIS occurs because of an immune system error that prompts your body to attack myelin or the protective cover of nerve cells in the brain or spine.
This causes appearance of scars or lesions and makes it challenging for signals to move between your brain and body. CIS is further classified into monofocal (appearance of one symptom) or multifocal (appearance of two or more symptoms). While CIS may progress into further MS stages, some people remain or never move past it.19,20
2. Relapsing-Remitting Multiple Sclerosis — Initial indicators appear in 85 percent of patients, especially those in their early 20s. They experience relapses or constant attacks of symptoms, and possibly have remissions or undergo a recovery period that can take weeks, months or years.
Most people at this stage may have a secondary progressive disease. Cases vary from one another because MS can affect different nerves, and influence the severity of the attack, degree of recovery and time between relapses.
3. Primary Progressive Multiple Sclerosis — Affecting about 10 percent of MS sufferers, primary progressive MS targets middle-aged people, with the average age being 40 years old.
Being diagnosed with this type of MS is challenging because it gradually worsens, doesn’t trigger symptoms that can be distinguished immediately, yields little to no chance of recovery and fails to respond to common MS treatments. Patients may experience disability earlier compared to those with relapsing-remitting MS.21
4. Secondary Progressive Multiple Sclerosis — This can arise roughly 10 to 20 years after initial diagnosis of or living with relapsing-remitting MS. At this stage, there’s a lack of relapses or remissions but numerous changes in nerve damage. Although it’s unclear why this progression happens, people can exhibit less inflammation and a slow decline in nerve function.
As one of the final stages of multiple sclerosis, secondary progressive MS is prevalent in those who haven’t fully recovered from relapses, and they usually progress to this stage faster. In older patients, there’s a short amount of time between an initial MS diagnosis and secondary progressive MS. Secondary progressive MS is difficult to treat, and some symptoms can worsen. While some treatments may work, problems related to body usage and function may arise.
5. Progressive Relapsing Multiple Sclerosis — Considered the least common form of MS, it affects only 5 percent of patients. They experience relapses frequently, with some symptoms continuing or even worsening between relapses. However, as WebMD reiterates, information regarding this type of MS is scarce.

What’s the Life Expectancy for Multiple Sclerosis?

If MS is left untreated, you may develop the following complications:22,23
• Muscle stiffness or spasms
• Paralysis in the legs
• Bladder, bowel or sexual function problems
• Chest infections
• Forgetfulness or mood swings
• Epilepsy
• Higher depression risk
• Swallowing difficulties
Additional medical care is needed in 20 percent of patients, as some must be bedridden or institutionalized. Another 20 percent require use of a wheelchair, cane or crutches to move properly. The remaining 60 percent can walk without assistance. Generally, prognosis is good for one-third of people with multiple sclerosis, and they can live without disabilities and only experience intermittent periods wherein symptoms manifest.24
Studies conducted regarding the lifespan of multiple sclerosis patients yielded different results, but the principle is the same. Results of a 2013 Neurology article showed that those with MS have a higher mortality risk compared to the general population, with their lifespans decreased by seven to 14 years.25 Another study, published in Multiple Sclerosis and Related Disorders in 2014, highlighted that the median survival from birth was six years lower.26

How to Diagnose Multiple Sclerosis

There are no tests that mainly aim to diagnose MS, so a differential diagnosis is usually carried out. This is done by eliminating potential diseases that cause indicators similar to MS. Challenges of a differential diagnosis include some symptoms’ tendency to be vague or identical to those of other conditions.27 A final multiple sclerosis diagnosis will likely depend on two factors:28
• Symptom patterns — A doctor can check if you have relapses, remissions or progressions of symptoms.
• Magnetic resonance imaging (MRI) scan results — This can check if lesions appeared in your nervous system at different periods and in various areas of your body.

Tests for Multiple Sclerosis

Examining your medical history and doing a thorough examination are the first steps your doctor will perform to diagnose MS. Any of the following tests can also be recommended so your doctor can know more about your condition:29
• Blood tests — Blood tests can help diagnose multiple sclerosis and rule out other conditions.
• Lumbar puncture (spinal tap) — A small sample of cerebrospinal fluid30 is taken from your spinal cord and sent to a laboratory for analysis. Results can determine if there are abnormalities in MS-linked antibodies in your system. A lumbar puncture also assists in eliminating the possibility of your being affected with infections and conditions similar to MS.
• MRI scans — You will receive an intravenous injection with a contrast material that seeks to determine areas on your brain and spinal cord with lesions, to check whether the disease is in an active state or not.
• Evoked potential tests — They use visual (moving visual patterns) or electrical (short electric impulses applied to arm or leg nerves) stimuli directed toward your nerves to elicit a response from them. Electrical signals produced by the nervous system as a response are recorded, with electrodes measuring the speed in which information moves through nerve pathways.
• Neurologic examinations — To look for nerve damage that may indicate MS, a neurologist will check for abnormalities or changes or weakness to vision, eye movements, hand or leg strength, balance and coordination, speech and reflexes.31

Ideal Multiple Sclerosis Treatments

There’s still no cure for multiple sclerosis. Medications like corticosteroids, beta interferons, ocrelizumab (Ocrevus), glatiramer acetate (Copaxone), dimethyl fumarate (Tecfidera), muscle relaxants, prednisone, interferon and fatigue-reducing drugs are recommended by conventional doctors to ease symptoms.
I strongly advise that you avoid multiple sclerosis medications if you can for a couple of reasons. For one, while they might help prevent development of new brain lesions and lessen symptom frequency and severity, they can also increase your risk for adverse effects. For example, prednisone is a steroid hormone that can significantly impair your immune system.32 Other drugs, such as the beta interferon Avonex, may exacerbate existing seizure disorders or impair liver function.33
Since each drug will come with its own set of side effects, it’s important, as much as possible, to opt for a more holistic approach and address MS with the following methods:34
• Increasing exercise — Working out may assist in boosting strength, balance, muscle tone and coordination. Exercises that are ideal for multiple sclerosis include walking, stretching, low-impact aerobics, yoga, tai chi, stationary bicycling or swimming and other water exercises (if dealing with heat problems).
• Physical therapy — A physical or occupational therapist may help you learn stretching and strengthening exercises and teach you how to use devices for your daily activities. Using a mobility aid, if needed, alongside physical therapy may assist in alleviating leg weakness and related issues.
• Acupuncture — This ancient practice is known to release neurohormones and opioids in the body that can help slow down or inhibit MS progression.35 A 2003 Physiotherapy article discussed the case of a woman who underwent acupuncture for 20 minutes weekly for seven weeks and felt more alert and energetic after the treatment period.36
• Homeopathy — Various homeopathic treatments may work for different MS symptoms, such as:37,38
◦ Causticum for bladder problems or urinary retention
◦ Nux Vomica for bowel dysfunction or constipation
◦ Phosphorus for optic neuritis
◦ Ignatia for cramps and spasms
◦ Secale for sensory issues
• Cooling devices like scarves or vests — MS symptoms may exacerbate once body temperature rises. You can prevent this by using cooling scarves or vests, or decreasing your exposure to heat.39

5 Essential Oils for Multiple Sclerosis

Essential oils can act as a natural treatment for multiple sclerosis, especially when incorporated into aromatherapy. A 2014 article in the Journal of Traditional and Complementary Medicine emphasized that aromatherapy can assist with symptomatic relief, aid in promoting better sleep quality, relaxation and joint and muscle mobility, and promote a better sense of well-being.40 Some essential oils that may be helpful include:41
• Roman chamomile — It can promote sedative effects, induce calmness and boost alertness.42
• Rosemary — This was proven to raise feelings of alertness and cheerfulness, and aid in increasing attentiveness and vigor.43 According to authors of a 2007 Psychiatry Research study, a combination of lavender and rosemary oils aided in lowering cortisol or stress hormone levels.44
• Black pepper — If you’re dealing with constipation-related problems, black pepper oil may help address them.45
• Juniper — Aside from helping stimulate your urinary system, juniper oil may aid in reducing urinary tract infection risk.46
• Neroli — Neroli oil is known to combat acute and chronic inflammation because of its central and peripheral antinociceptive abilities, a capability further boosted by the presence of some biologically active constituents.47
Before using essential oils, talk to a physician and take an allergen patch test to see if your skin will react negatively. When applying an essential oil topically, dilute it in a carrier oil like coconut, sweet almond, olive or jojoba to reduce your risk for side effects.

How to Prevent Multiple Sclerosis

There’s no specific technique that can ultimately stop this disease from affecting you, but gradually practicing these activities may aid in multiple sclerosis prevention:48
• Optimize your vitamin D levels — Multiple studies concluded that vitamin D helps lower MS risk and delivers therapeutic abilities.49,50 Sensible sun exposure is arguably the best way to maintain optimal vitamin D levels. Have your vitamin D levels tested twice a year, making sure that levels fall between 60 and 80 ng/mL (150 to 200 nm/L),51 and not below 40 ng/mL.
If your current location doesn’t get much sunlight or has limited sun exposure, take high-quality vitamin D3 supplements, and raise your intake of calcium, magnesium and vitamin K2 to ensure your vitamin D levels remain stable. Learn more about the health benefits of maintaining adequate vitamin D levels by checking out “For Optimal Health, Make Sure You Have a Vitamin D Level of 60 ng/mL.”
• Get enough high-quality sleep — Sleep problems often arise because of stress, arm or leg problems, inactivity, mental health issues like depression or brain lesions.52
• Reduce your stress levels — High stress levels can exacerbate symptoms. Examples of stress-relieving activities include, yoga, tai chi, massage, meditation, deep breathing exercises,53 quick high-intensity exercises, aromatherapy and the Emotional Freedom Techniques (EFT).
• Quit smoking — Authors of a 2012 Therapeutic Advances in Neurological Disorders article revealed that smoking was associated with a higher risk of disease progression and disability.54

What’s the Best Multiple Sclerosis Diet?

Paying attention to what you eat and making better dietary choices may help alleviate MS symptoms. You may achieve this goal by implementing a ketogenic diet that can prompt your body to burn fat as its main fuel source and cause your liver to create more brain-boosting ketones.
A ketogenic diet involves significantly reducing intake of net carbohydrates (total carbs minus fiber), and consuming low to moderate quantities of high-quality proteins and increased amounts of organic vegetables and beneficial healthy fats such as:
  • Butter made from raw, grass fed milk
  • Organic pastured eggs
  • Black sesame, cumin, pumpkin or hemp seeds
  • Raw nuts like macadamias or pecans
  • Raw cacao butter
  • Ghee (clarified butter), lard and tallow (excellent for cooking)
Avoid the following foods if you want to combat MS symptoms, as they may worsen your condition:
• Processed fats and vegetable oils — Processed fats and vegetable oils can trigger health problems and increase your risk for other debilitating conditions like coronary heart disease.55
• Grains — Results of a 2011 BMC Neurology study revealed that MS patients have a higher celiac disease (CD) risk. The authors recommend people with antibodies for CD be tested early and make needed dietary changes.56
• Sugar and sweeteners especially processed fructose — Excessive sugar consumption can cause obesity and become a precursor of autoimmune disease,57,58 and raise uric acid levels59 that result in chronic, low-level inflammation.60
Artificial sweeteners aren’t a good choice either. For example, aspartame contains some methanol, which the body can’t safely break down into formic acid because it doesn’t have enough enzymes for this process. Instead, methanol is transformed into a dangerous neurotoxin called formaldehyde.
Ideally, total daily fructose consumption must be within 25 grams. You can also reduce your limit to 15 grams a day if you have a chronic disease, at least until your condition is under control.

Living With Multiple Sclerosis

Dealing with MS is difficult, but there are measures you can take to help you get through the challenges caused by this condition:61,62
• Join a support group — This can allow you to interact with other patients, discover how others approach the situation you’re in and discuss your current feelings.
• Consult a counselor or therapist — This is ideal if you’re not comfortable sharing your feelings, especially regarding sensitive issues, with a group and want a one-on-one approach.
• Talk to a mental health professional if needed — An article published in Psychiatric Clinics of North America in 2007 revealed that MS patients may develop psychiatric problems like anxiety and depression.63 Talking to a mental health professional may help you understand issues that may surface and learn about other methods that’ll help you address problems on your own.
• Connect with friends and family — They can help you deal with health issues.
• Write in a diary or journal — If possible, show entries to your counselor so they can learn about the issues you’re struggling with and suggest ways to overcome them.
• Sustain current routines and exercise control over them — Because of the level of uncertainty connected to MS, being on top of your daily schedule can help you gain some control over your life.
• Improve sleep quality — Doing yoga, deep breathing exercises or meditation can help promote better sleep. You can also try listening to relaxing music or stop using electronic gadgets altogether before bedtime.

Assess Your Multiple Sclerosis Risk and Try to Prevent It Before It’s Too Late

You may feel like there’s a very low chance people diagnosed with multiple sclerosis can feel better because of the excruciating pain it normally triggers, but that’s not the case. There are effective ways for you to combat the symptoms without resorting to conventional treatments that cause further harm.
Before addressing MS symptoms, seek the guidance of your doctor to determine if your condition will allow you to perform certain activities, and check for ideal treatments for your current state. If you feel like you may be at risk for developing MS, talk to your doctor about it and see what you can do to prevent it from appearing in the future.

Frequently Asked Questions (FAQ) About Multiple Sclerosis

Q: How do you get multiple sclerosis?
A: No cause has been determined for MS, but the following factors may make it possible for you to have a higher risk for it:64
  • Age
  • Sex
  • Race
  • Climate
  • Smoking
  • Genetics
  • Epstein-Barr virus exposure
  • Diagnosis of other autoimmune disorders
Q: Is multiple sclerosis an autoimmune disease?
A: Yes. MS is an autoimmune disorder that attacks areas of your brain, spinal cord and central nervous system.65
Q: Is multiple sclerosis hereditary?
A: Genetics can play a role in increasing your multiple sclerosis risk. According to WebMD, people with siblings or identical twins diagnosed with MS are more likely to be affected.66,67
Q: Is multiple sclerosis contagious?
A: No. MS isn’t a communicable disease that’s transferred from one person to another68,69
Q: Can you die from multiple sclerosis?
A: Multiple sclerosis can be fatal for some patients because the disease itself or its complications can cause death.70
Q: How does it feel to have multiple sclerosis?
A: MS can be painful and can cause numbness or weakness in your legs or trunk, limbs, face or feet. This disease can trigger other agonizing indicators like muscle spasms on your legs, eye problems, Lhermitte’s sign or electric shock-like sensations, tremors or uncontrollable shaking, MS hug, dizziness and fatigue.71,72
Q: How do you test for multiple sclerosis?
A: Your doctor will first check your medical history and perform a medical exam. If additional information is required, you can undergo blood tests, lumbar puncture or spinal tap, magnetic resonance imaging (MRI) scans, evoked potential tests or neurologic exams.73,74
Q: How long can you live with multiple sclerosis?
A: It’s not known how long someone with MS can live after diagnosis, but results from different studies suggest that the disease can decrease lifespans by six75 to 14 years.76
Q: Can multiple sclerosis go away on its own?
A: There are periods called remissions wherein you won't experience symptoms for months or years, although it's possible that some indicators will reappear.77 Some can experience phases when indicators instantly come and go, affect the body for a longer period of time or go away permanently without causing appearance of new symptoms.78
Q: Can multiple sclerosis be treated naturally?
A: There's no guarantee that the following methods can help you completely heal from MS, but they can aid in addressing symptoms:79
• Safe exercises
• Physical therapy
• Acupuncture
• Homeopathy
• Cooling devices
Aromatherapy can help promote symptomatic relief, better sleep, increased relaxation, improved joint and muscle mobility, and feelings of well-being.80 Roman chamomile, rosemary, black pepper, juniper and neroli essential oils (diluted in a safe carrier oil) can be useful.81
Q: What foods are good for multiple sclerosis?
A: If you have MS, try following a ketogenic diet and increasing your intake of fresh and organically grown vegetables and high-quality healthy fats like animal-based omega-3s from wild-caught Alaskan salmon, anchovies, sardines and krill oil, coconut oil, MCT oil and avocados. At the same time, consume low-to-moderate portions of good-quality proteins and cut back your intake of net carbohydrates.
Q: Is green tea good for multiple sclerosis?
A: According to a 2015 article in The American Journal of Clinical Nutrition, a type of catechin found in green tea called epigallocatechin-3-gallate (EGCG) promoted enhanced metabolism among subjects with relapsing-remitting MS.82
Q: What vitamins should I take for multiple sclerosis?
A: Vitamin D is one example, with studies pointing out a link between enhanced levels of this all-important vitamin to improved conditions.83,84,85 The best way to optimize vitamin D levels would be via sensible sun exposure, but you can take high-quality vitamin D3 supplements alongside increased intake of calcium, magnesium and vitamin K2 if you live in a place that fails to receive enough sunlight or has limited sun exposure.
The National Multiple Sclerosis Society also recommends increasing your intake of foods rich in vitamins A, B6, B12, C and E because they possess antioxidant capabilities that can combat free radicals and help improve your condition.86
Q: What should I avoid if I have multiple sclerosis?
A: If possible, refrain from a purely pharmaceutical approach to treating your condition with corticosteroids, beta interferons, ocrelizumab (Ocrevus), glatiramer acetate (Copaxone), dimethyl fumarate (Tecfidera), muscle relaxants, prednisone, interferon and fatigue-reducing drugs,87 as each comes with its own set of side effects. Also, in many cases it’s been shown that drugs alone are often not successful.
You should also avoid smoking, increasing stress levels, and consuming high amounts of processed fats, vegetable oils, grains, sugars and artificial sweeteners, because they can cause health problems and possibly worsen your symptoms.88,89
Q: What type of exercise is good for multiple sclerosis?
A: If you have MS, exercising can help with strength, balance, muscle tone and coordination. Some of the best exercises to perform include walking, stretching, low-impact aerobics, yoga, tai chi, stationary bicycling, and swimming or other water exercises.90
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