Multiple Sclerosis

Multiple Sclerosis Care and Management

Navigating multiple sclerosis can often be confusing, especially if you’re doing it on your own. Whether you’re newly diagnosed, have been living with the condition for some time, or know someone else with MS, understanding the symptoms and what triggers them can help you improve your quality of life with MS. There are a variety of conventional treatments, such as medication, and holistic approaches, such as nutrition and lifestyle adjustments, that can support your symptoms and help you lead a fulfilling life. 

Conventional Treatment

Understanding the available conventional treatment options is a crucial step in managing MS. It’s important to remember that while each treatment has its benefits, they also come with potential side effects.  With this in mind, let’s explore what treatment options are available. 

  • corticosteroids: Corticosteroids, especially methylprednisolone, are often the first line of defense during an MS flare-up. They work by reducing inflammation and can help speed up recovery from a relapse. However, it’s important to be aware that corticosteroids are not a long-term solution. They’re usually prescribed for short periods due to potential side effects such as mood swings, increased blood sugar levels, and bone thinning. (Source, Source)
  • disease-modifying therapies (DMTs): DMTs are designed to reduce the frequency and severity of relapses and slow the progression of the disease. There are various types of DMTs, including injectables, oral medications, and infusions. Each DMT works differently and has its own set of potential side effects, ranging from liver damage to increased risk of infections. (Source, Source)
  • immunosuppressants: Immunosuppressants such as methotrexate are used in some cases to suppress the immune response that causes MS symptoms. They can be effective, especially in more aggressive forms of the condition, but their use requires careful monitoring due to the risk of increased susceptibility to infections and liver damage. (Source)
  • biologics: Biologics, like ocrelizumab, are drugs made from living organisms and are designed to target specific components of the immune system. Biologics have shown promise in reducing relapse rates and slowing disease progression, particularly in primary progressive MS. However, they do have side effects, including injection site reactions, shortness of breath, and increased risk of infections. (Source, Source)

Plasma Exchange

Plasma exchange is a process in which plasma, the fluid remaining after red and white blood cells and platelets have been removed from the blood, is taken from the body and replaced with a plasma replacement fluid. This procedure is aimed at removing harmful substances present in the plasma that are believed to contribute to the MS disease process. This treatment is typically considered during acute flare-ups when there is a lack of response to high-dose corticosteroids. Some side effects of plasma exchange include allergic reactions, low blood pressure, hypothermia (low body temperature), and hypocalcemia (low blood calcium levels). (Source, Source, Source)

Nutrition

Inflammation is a known contributor to MS. Incorporating nutrient-dense, anti-inflammatory foods into your diet can help manage your symptoms and improve your overall health. Regularly consuming foods that are rich in nutrients such as vitamins, minerals, fiber, probiotics, and antioxidants is also beneficial for your gut health. This is important in managing MS symptoms as research has found that those with MS have an altered gut microbiome (dysbiosis). The gut contains about 70%–80% of the body’s immune cells, so any changes to the gut microbiome can lead to immune dysregulation. (Source, Source)

Anti-Inflammatory Foods

These nutrient-dense foods may help lower inflammation and manage MS symptoms:

  • leafy greens (spinach, kale, swiss chard)
  • cruciferous vegetables (broccoli, Brussels sprouts)
  • colorful fruits
  • foods rich in healthy fats (salmon, trout, mackerel, avocado, extra virgin olive oil)
  • probiotic-rich foods (sauerkraut, kimchi, miso)
  • bone broth

(Source, Source, Source)

Foods To Avoid

Understanding which foods may potentially worsen your symptoms is just as important as knowing which foods can help improve your health. Here are a some foods that are pro-inflammatory or are known to impair the balance of gut bacteria:

  • refined sugars
  • alcohol
  • caffeine
  • processed foods
  • dairy 

(Source, Source)

Supplementation

In addition to regularly consuming nutrient-dense foods, supplements can be a helpful tool in managing your symptoms. Before incorporating any supplements into your daily routine, make sure to check in with your health care provider.

Vitamin D

Vitamin D, often referred to as the “sunshine vitamin,” has been a focal point of MS research. Low levels of vitamin D have been linked to an increased risk of developing MS and may influence disease activity and progression, though more studies are needed to understand the exact association between vitamin D and MS. (Source

Vitamins B1, B6, B12

The B vitamins, particularly B1 (thiamine), and B12 (cobalamin), play crucial roles in nerve function and energy production. For individuals with MS, these may help in managing fatigue. One study found that vitamin B12 and vitamin B9 (folate) improved both physical and mental quality of life. Vitamin B12 in particular is essential for maintaining the myelin sheath, the protective covering of nerves that is often damaged in MS. (Source, Source, Source)

Vitamin A

Vitamin A is crucial for maintaining vision health, immune function, and cell growth. More research is needed on the exact relationship between vitamin A and MS, however supplementing vitamin A may potentially aid in the maintenance of a healthy immune response.  (Source, Source)

Omega-3 Fatty Acids

Omega-3 fatty acids are known to have anti-inflammatory properties. A study using mice published in the journal BMC Neuroscience found that omega-3 fatty acids may lower inflammation linked to MS and so may also reduce MS severity. It’s important to note, though, that the study was conducted with mice, so more research will be needed to confirm its benefits for humans. (Source, Source

Probiotics

There is increasing evidence showing the connection between gut health and autoimmune diseases, including MS. The gut microbiome aids in the development of the immune system, while the immune system regulates the interactions between the gut and the rest of the body. Probiotics can keep your gut microbiome balanced and may help reduce inflammation.  (Source, Source)

Lifestyle

Living with a chronic condition like MS has its unique challenges, but adopting certain lifestyle practices can help manage your flare-ups and enhance your quality of life. 

Mindful Movement Practices

Adding gentle, mindful movement to your daily routine can reduce fatigue, boost your mood, and be incredibly beneficial to your overall health. Exercise looks different for everyone — maybe you enjoy yoga, swimming, or stretching. Even incorporating simple acts of walking up the stairs instead of taking the elevator, or going for short walk breaks throughout the day, add up to a lot of extra movement. Before starting a new workout plan, be sure to consult with your health care provider to ensure that your new routine fits your current needs. (Source)

Practicing Good Sleep Hygiene

A good night’s sleep is an integral part of a healthy lifestyle, but autoimmunity can make it hard at times to achieve this. About 38% of those with MS experience poor sleep. Research indicates that a chronic lack of sleep may be a factor in the risk of developing autoimmune diseases. Incorporating good sleep hygiene practices into your evening routine such as maintaining a regular sleep schedule, creating a comfortable sleep environment, eliminating electronic devices from the bedroom, and avoiding stimulants like caffeine in the evening can help you get quality sleep. (Source, Source, Source)

Stress Management Techniques

Stress management plays a crucial role in managing MS. Chronic stress can trigger the immune system, causing an inflammatory response that can worsen your symptoms. Techniques such as journaling, meditation, and spending time in nature can be powerful tools in your stress management arsenal. (Source, Source, Source)

Source)

Physical Therapist or Occupational Therapist

Physical and occupational therapists are invaluable for maintaining and improving mobility, strength, and daily functioning. They can teach you exercises to manage symptoms like muscle stiffness and recommend strategies to protect your joints during daily activities. 

Mental Health Practitioner

MS can take a toll not just physically, but mentally and emotionally. A mental health practitioner, such as a psychologist or counselor, can support you in coping with the challenges of living with MS. 

WellTheory’s Perspective and Approach

At WellTheory, our approach to managing MS and other autoimmune conditions is rooted in a deep understanding of the journey each individual faces. We believe in a holistic, member-centered approach that bridges the gap between conventional treatments and your day-to-day lives. 

  • holistic and integrated care: Autoimmune conditions are multifaceted, affecting not just your physical health but also emotional and mental well-being. Our approach is to look at the whole person and not just the disease — this means our care team at WellTheory works alongside conventional medical treatments, complementing them with evidence-based lifestyle adjustments. 
  • personalized care plans: Each individual’s experience with autoimmunity is unique. We ensure that we understand your specific situation, symptoms, and lifestyle to create a care plan that is tailored to you. 
  • collaborative and continuous care: We believe in continuous care and support throughout your health journey. This includes regular follow-ups, ongoing support from our team, and adjustments to your care plan depending on your health goals.

The Bottom Line

There are a variety of treatment options available for MS. Utilizing both conventional treatments as well as nutrition and lifestyle adjustments can help manage your symptoms. Your care plan for MS is unique to you and will depend on your symptoms and what works for your body — with the right support and care, you can lead a fulfilling life with MS.

References

Altieri, C., Speranza, B., Corbo, M. R., Sinigaglia, M., & Bevilacqua, A. (2023). Gut-microbiota, and multiple sclerosis: background, evidence, and perspectives. Nutrients, 15(4), 942. https://doi.org/10.3390/nu15040942

Bunganic, R., Blahutova, S., Revendova, K., Zapletalova, O., Hradilek, P., Hrdlickova, R., Ganesh, A., Cermakova, Z., Bar, M., & Volny, O. (2022). Therapeutic plasma exchange in multiple sclerosis patients with an aggressive relapse: An observational analysis in a high-volume center. Scientific Reports, 12(1), 18374. https://doi.org/10.1038/s41598-022-23356-w

Calder, P. C. (2010). Omega-3 fatty acids and inflammatory processes. Nutrients, 2(3), 355–374. https://doi.org/10.3390/nu2030355

Čarnická, Z., Kollár, B., Šiarnik, P., Krížová, L., Klobučníková, K., & Turčáni, P. (2015). Sleep disorders in patients with multiple sclerosis. Journal of Clinical Sleep Medicine, 11(5), 553–557. https://doi.org/10.5664/jcsm.4702

Centers for Disease Control and Prevention. (2022, September 13). Good sleep habits. U.S. Department of Health and Human Services. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

Christ, A., Lauterbach, M., & Latz, E. (2019). Western diet and the immune system: An inflammatory connection. Immunity, 51(5), 794–811. https://doi.org/10.1016/j.immuni.2019.09.020

Cleveland Clinic. (2022, September 20). Plasmapheresis (plasma exchange): Therapy, procedure & what it is. https://my.clevelandclinic.org/health/treatments/24197-plasmapheresis-plasma-exchange

Cleveland Clinic. (2024). Methylprednisolone injection: Uses & side effects. https://my.clevelandclinic.org/health/drugs/20651-methylprednisolone-solution-injection

Costantini, A., Nappo, A., Pala, M. I., & Zappone, A. (2013). High dose thiamine improves fatigue in multiple sclerosis. BMJ Case Reports, 2013, bcr2013009144. https://doi.org/10.1136/bcr-2013-009144

Finkelsztejn, A. (2014). Multiple sclerosis: Overview of disease-modifying agents. Perspectives in Medicinal Chemistry, 6, 65–72. https://doi.org/10.4137/PMC.S13213

Halabchi, F., Alizadeh, Z., Sahraian, M. A., & Abolhasani, M. (2017). Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurology, 17, 185. https://doi.org/10.1186/s12883-017-0960-9

Huang, Z., Liu, Y., Qi, G., Brand, D., & Zheng, S. G. (2018). Role of vitamin A in the immune system. Journal of Clinical Medicine, 7(9), 258. https://doi.org/10.3390/jcm7090258

Hussain, T., Tan, B., Yin, Y., Blachier, F., Tossou, M. C. B., & Rahu, N. (2016). Oxidative stress and inflammation: What polyphenols can do for us? Oxidative Medicine and Cellular Longevity, 2016, 7432797. https://doi.org/10.1155/2016/7432797

Lamb, Y. N. (2022). Ocrelizumab: A review in multiple sclerosis. Drugs, 82(3), 323–334. https://doi.org/10.1007/s40265-022-01672-9

Malinowski, L., Yu, M., & Hull, S. (2022). Lifestyle medicine as treatment for autoimmune disease. Journal of Family Practice, 71(1 Suppl Lifestyle), eS90–eS92. https://lifestylemedicine.org/wp-content/uploads/2022/08/ACLM-Article-LM-and-Autoimmune-Disease.pdf

Mayo Clinic. (2023, February 1). Ocrelizumab (intravenous route). https://www.mayoclinic.org/drugs-supplements/ocrelizumab-intravenous-route/side-effects/drg-20406139

Mohr, D. C., Hart, S. L., Julian, L., Cox, D., & Pelletier, D. (2004). Association between stressful life events and exacerbation in multiple sclerosis: A meta-analysis. BMJ, 328(7442), 731. https://doi.org/10.1136/bmj.38041.724421.55

Moser, T., Harutyunyan, G., Karamyan, A., Otto, F., Bacher, C., Chroust, V., Leitinger, M., Novak, H. F., Trinka, E., & Sellner, J. (2019). Therapeutic plasma exchange in multiple sclerosis and autoimmune encephalitis: A comparative study of indication, efficacy, and safety. Brain Sciences, 9(10), 267. https://doi.org/10.3390/brainsci9100267

National Institute of Neurological Disorders and Stroke. (2023, November 28). Multiple sclerosis. U.S. Department of Health and Human Services, National Institutes of Health. https://www.ninds.nih.gov/health-information/disorders/multiple-sclerosis

Nozari, E., Ghavamzadeh, S., & Razazian, N. (2019). The effect of vitamin B12 and folic acid supplementation on serum homocysteine, anemia status and quality of life of patients with multiple sclerosis. Clinical Nutrition Research, 8(1), 36–45. https://doi.org/10.7762/cnr.2019.8.1.36

Nunes, A. C. de F., & Piuvezam, G. (2019). Nutritional supplementation of vitamin A and health-related outcomes in patients with multiple sclerosis. Medicine, 98(25), e16043. https://doi.org/10.1097/MD.0000000000016043

Robertson, D., & Moreo, N. (2016). Disease-modifying therapies in multiple sclerosis: Overview and treatment considerations. Federal Practitioner, 33(6), 28–34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366576/

Shahbazi, R., Sharifzad, F., Bagheri, R., Alsadi, N., Yasavoli-Sharahi, H., & Matar, C. (2021). Anti-inflammatory and immunomodulatory properties of fermented plant foods. Nutrients, 13(5), 1516. https://doi.org/10.3390/nu13051516

Siegert, E., Paul, F., Rothe, M., & Weylandt, K. H. (2017). The effect of omega-3 fatty acids on central nervous system remyelination in fat-1 mice. BMC Neuroscience, 18(1), 19. https://doi.org/10.1186/s12868-016-0312-5

Sintzel, M. B., Rametta, M., & Reder, A. T. (2018). Vitamin D and multiple sclerosis: A comprehensive review. Neurology and Therapy, 7(1), 59–85. https://doi.org/10.1007/s40120-017-0086-4

Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., Fernández de la Cruz, L., Almqvist, C., Fall, K., & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. JAMA, 319(23), 2388–2400. https://doi.org/10.1001/jama.2018.7028

Stankiewicz, J. M., Kolb, H., Karni, A., & Weiner, H. L. (2013). Role of immunosuppressive therapy for the treatment of multiple sclerosis. Neurotherapeutics, 10(1), 77–88. https://doi.org/10.1007/s13311-012-0172-3

Stoiloudis, P., Kesidou, E., Bakirtzis, C., Sintila, S.-A., Konstantinidou, N., Boziki, M., & Grigoriadis, N. (2022). The role of diet and interventions on multiple sclerosis: A review. Nutrients, 14(6), 1150. https://doi.org/10.3390/nu14061150

Institute for Functional Medicine. (n.d.). The functional medicine approach. https://www.ifm.org/functional-medicine/what-is-functional-medicine/

Wiertsema, S. P., van Bergenhenegouwen, J., Garssen, J., & Knippels, L. M. J. (2021). The interplay between the gut microbiome and the immune system in the context of infectious diseases throughout life and the role of nutrition in optimizing treatment strategies. Nutrients, 13(3), 886. https://doi.org/10.3390/nu13030886

Wu, F., Xu, K., Liu, L., Zhang, K., Xia, L., Zhang, M., Teng, C., Tong, H., He, Y., Xue, Y., Zhang, H., Chen, D., & Hu, A. (2019). Vitamin B12 enhances nerve repair and improves functional recovery after traumatic brain injury by inhibiting ER stress-induced neuron injury. Frontiers in Pharmacology, 10, 406. https://doi.org/10.3389/fphar.2019.00406

Zheng, D., Liwinski, T., & Elinav, E. (2020). Interaction between microbiota and immunity in health and disease. Cell Research, 30(6), Article 6. https://doi.org/10.1038/s41422-020-0332-7

Zielinski, M. R., Systrom, D. M., & Rose, N. R. (2019). Fatigue, sleep, and autoimmune and related disorders. Frontiers in Immunology, 10, 1827. https://doi.org/10.3389/fimmu.2019.01827

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