The Causes and Triggers of Multiple Sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disease that primarily affects the central nervous system, which includes the brain and spinal cord. It’s characterized by the immune system mistakenly attacking the protective sheath (myelin) that covers nerve fibers, causing communication problems between the brain and the rest of the body. 

While MS is often recognized by its physical symptoms, its effects go beyond just the physical realm. It can affect cognitive function, leading to difficulties with memory, attention, and problem-solving. Emotional changes are also common, with individuals experiencing mood swings, depression, or anxiety. Knowing about the causes and triggers of MS is essential for several reasons. It empowers you with the knowledge to make informed decisions about care and management, and understanding what might exacerbate symptoms or lead to relapses can help in avoiding certain triggers and adopting lifestyle changes that promote well-being.

Whether you’ve been living with MS for a while or are just starting to learn about this condition, we will be unraveling the complexities of MS and breaking down the different genetic, environmental, and lifestyle factors that may trigger the condition.

Genetic Factors Influencing Multiple Sclerosis

Our genes carry the instructions for every biological process in our bodies, including the immune system’s functioning. In the context of MS, certain genetic variations can increase the likelihood of developing the condition. While no single gene causes MS, several genetic markers have been associated with an increased risk. 

• familial predisposition to MS: MS is not directly inherited like some genetic diseases, but having a family member with MS can increase your risk. This familial risk suggests a genetic component to MS, although the exact inheritance pattern is unclear. If you have parents or siblings (first degree relatives) with MS, your risk of developing the disease over your lifetime is estimated to be 3%, which is 10 to 30 times higher than the general population risk of 0.1%–0.3%. Sharing this information with your health care provider can help in understanding your personal risk and in making informed decisions about your health. (Source)

• identification of specific genes strongly correlated with MS: Researchers have identified over 200 genetic variants that are more common in people with MS compared to the general population. These genes are involved in various aspects of the immune system and other biological processes, showing there’s a complex interplay of factors that lead to the development of MS. (Source)

It’s not just about the genes you inherit; it also matters how they interact with your environment. Factors such as vitamin D levels, smoking, and viral infections can influence the expression of genetic predispositions, potentially triggering the onset of MS in susceptible individuals. 

Environmental Triggers of Multiple Sclerosis

The Role of Infections

Infections have long been suspected to play a role in triggering MS. Among them, the Epstein-Barr virus stands out as a significant suspect. 

• role of Epstein–Barr virus (EBV) in triggering MS: The Epstein–Barr virus has been linked to an increased risk of developing MS. Studies have found that risk of developing MS increases by 32 times in individuals who have been infected with EBV. The exact mechanism isn’t fully understood but it is believed that the virus may drive inflammatory reactions in the body that lead to MS. (Source, Source)
• how infections may initiate or exacerbate MS: Antigens (substances that trigger an immune response) within viruses may have a similar shape and size to molecules within the body, a phenomenon known as “molecular mimicry.” Antibodies formed to defend against the foreign antigen may then mistakenly attack cells in the nervous system, triggering or worsening MS symptoms. (Source, Source)

Vitamin D and Sunlight Exposure

Vitamin D deficiency has been associated with an increased risk of developing MS. People who live farther from the equator, where there is less sunlight and hence lower natural production of vitamin D, have a higher incidence of MS. Vitamin D is known to have several roles in the immune system, including the regulation of immune cells that are involved in the autoimmune response seen in MS. Although there is increasing evidence on the association between vitamin D and MS, more research is needed in order to establish the effect of vitamin D supplementation on MS. (Source)

Lifestyle Factors Influencing Multiple Sclerosis

Living with multiple sclerosis involves more than just medical treatments; it encompasses a holistic approach in which lifestyle factors play a crucial role. Let’s explore how diet and nutrition, as well as physical activity and stress, can influence MS risk and symptom management.

Diet and Nutrition

The food you eat can play a significant role in managing MS symptoms and influencing disease progression.

• influence of diet on MS development: A balanced diet rich in fruits, vegetables, gluten-free whole grains (such as quinoa, rice, and buckwheat), and lean protein can support overall health and may help manage MS symptoms. Some studies suggest that diets high in saturated fats may worsen MS symptoms, while those rich in omega-3 fatty acids may offer protective benefits. It’s important to consult with a health care provider or nutritionist to tailor dietary choices to your individual needs. (Source)
• role of gut health and dysbiosis in MS: Emerging research indicates that gut health plays a role in MS. Dysbiosis — imbalance in the population of microbes living in the gut, known as its microbiome — might influence the immune system and contribute to MS development. A healthy gut microbiome, nurtured by a diet rich in fiber and various nutrients, may help reduce MS-related inflammation. (Source, Source)

Physical Activity and Stress

Physical activity and stress management are also key components in the holistic management of MS.

• effect of physical activity on MS risk and progression: Regular gentle movement tailored to individual needs is beneficial for those with MS. It can improve strength, reduce fatigue, and enhance quality of life. Research has found that exercises focusing on building strength and flexibility can help manage symptoms, reduce the risk of relapse, and slow disease progression. That said, it’s important to strike a balance and listen to your body to ensure you’re not overexerting yourself. (Source) 
• role of stress and its physiological effects related to MS: Chronic stress can have a detrimental effect on MS and can worsen symptoms, so it’s important to keep an eye on emotional, mental, or physical signs of stress. Stress management techniques, such as mindfulness, yoga, and relaxation exercises, can be beneficial in reducing the effects of stress on MS symptoms. (Source, Source)

Smoking

Lifestyle choices, particularly smoking, have been identified as risk factors for MS.

• smoking increases risk of developing MS: Smoking can increase your risk of developing MS by 50% and is associated with more severe disease and faster progression. The harmful effects of smoking may be due to its negative effects on the immune system and the pro-inflammatory effects of cigarette smoke on the lungs. (Source)

Hormonal Factors That Influence Multiple Sclerosis

Women are up to 3 times more likely to develop MS compared to men. This gender disparity raises important questions about the role of hormonal factors in the development and progression of MS. 

• the role of sex hormones: Research indicates that sex hormones, particularly estrogen and progesterone, may influence immune system function and susceptibility to autoimmune diseases like MS. These hormones can modulate the immune response, potentially affecting the development and course of MS. Women experience significant fluctuations in these hormone levels throughout their lives, which might contribute to the higher incidence of MS observed in women. (Source)
• pregnancy and MS risk: Interestingly, pregnancy, a period of high hormonal changes, particularly high levels of estrogen and progesterone, has been observed to temporarily reduce the risk of MS relapses. However, after birth, the risk of relapse increases, possibly due to hormonal shifts back to pre-pregnancy levels. This further supports the role of sex hormones in modulating MS risk and activity. (Source, Source) 
• menopause and MS: The onset of menopause, which involves a significant drop in estrogen levels, may also affect MS. Some studies suggest the transition into menopause can be associated with changes in MS symptoms or disease progression, although more research is needed to fully understand this relationship. (Source)

The Bottom Line

Multiple sclerosis is an autoimmune condition with an array of causes and triggers. Understanding these influences is not just about identifying what causes MS; it empowers you with the knowledge to manage your condition effectively. Recognizing the interplay of genetic, environmental, lifestyle, and hormonal factors allows for a more personalized approach to treatment and care. It also allows for potential prevention strategies and lifestyle modifications that can positively affect the course of the disease. 

At WellTheory, we understand that every individual’s journey with MS is unique. Our approach is member-centric, empathetic, and inclusive, ensuring that our guidance and resources cater to the diverse needs of our community. We’re here to support you regardless of where you are on your autoimmune journey.