Hair loss multiple sclerosis

Contents

MS treatment and hair loss: what you need to know

MS & Hair Loss

It’s normal to lose hair. We lose on average between 50 and 100 hairs a day, often without noticing. Most hair loss doesn’t need treatment and is either temporary and it’ll grow back or a normal part of getting older, but if you see an increase in hair loss and find your hair is thinning, this may be troubling.

Hair loss is not a symptom of multiple sclerosis, however hair loss is a side effect of some MS medications or other commonly prescribed medications. A diagnosis of MS could also be a contributing factor to stress-related hair loss. There is no direct evidence that alopecia is more common in patients with MS than in the general population.

You should consider seeing a physician if:

  • you have sudden hair loss

  • you develop bald patches

  • you’re losing hair in clumps

  • your head also itches and burns

  • you’re worried about your hair loss

Why is my hair thinning?

It can be difficult to establish the exact cause of hair loss and there are different types – hair falls out in patches, some in particular areas, or you can notice a general thinning of hair all over the head.

1. Genetic hair loss – female or male pattern baldness.

  • This is the most common form of hair loss and is permanent.

  • This is due to a family history of hair loss and is unrealted to MS.

  • This usually temples or the crown of the head in men

  • Often occurs as early as teenage years in men, increasing in likelihood with age

  • This usually happens in 50s or 60s for women or occasionally 30s or 40s.

  • Hair is lost at the front, top and the crown of the scalp for women.

2. Hair thinning (telogen effluvium)

The second most common type of hair loss, telogen effluvium occurs when there is a marked increase in hairs shed each day (300). It is characterized by an abrupt onset of diffuse hair loss usually seen 2-3 months after a triggering event. It is usually self-limiting lasting for 6 months, whereas in chronic telogen effluvium it persists beyond 6 months.

Common triggers of telogen effluvium include:

Hormonal

  • Pregnancy

  • Postpartum hair loss can be experienced 2 to 4 months after childbirth (40 – 50% of women)

  • Menopause

  • Discontinuing the use of birth control pills

Physiologic or emotional stress

  • Surgery or general anesthesia

  • Injury

  • Serious illness

  • Severe trauma, a stressful or major life event

Dietary triggers

  • Severe calorie restriction

  • Low protein diet

  • Lack of Omega 3 and 6

  • Vitamin D deficiency

  • Iron deficiency

  • Vitamin B deficiency

Medication

  • MS medication

You can find more information about each medication including side effects, risks and benefits in the medication area of the OMS website.

Immunosuppressive agents

Hair loss is relatively commonly observed in patients with multiple sclerosis who receive immunosuppressive agents, and is thought to be a consequence of toxicity to the hair follicle.2

These include:

  • Azathioprine – hair loss is a common side effect

  • Methotrexate – hair loss is a common side effect (occurs in 29.4% of people)3

  • Cyclophosphamide (the generic name for Endoxan, Cytoxan, Neosar, Procytox, and Revimmune)

Another potent anti-cancer drug, this is used to reduce the numbers of T and B cells that can trigger an immune attack. Hair loss is a common side effect.

  • Mitoxantrone (also called Novantrone)

Mitoxantrone is a chemotherapy drug also used for some types of cancer and hair loss is a known side effect. This drug can cause you to lose all your hair, however this will usually grow back once your chemotherapy treatment has finished.

  • Cladribine (Mavenclad)

Hair loss is a common side effect of Cladribine (Mavenclad), meaning it affects more than 1 in 100 people.

Other MS medications which can cause hair loss / thinning.

Common:

  • Beta-Interferons (Avonex, Rebif and Betaferon or Betaseron)

More than a third of patients had hair loss in the studies in which this was reported. In one study, more than half the patients experienced hair loss in the first six months of treatment.

  • Teriflunomide (Aubagio)

Hair loss is a common side effect of Teriflunomide (Aubagio). It is usually mild and temporary and does not require stopping treatment. One study found hair thinning occurred in 10–14% of teriflunomide-treated patients compared to 5% of placebo-treated patients.4

  • HSCT (Haemotopoeitic stem cell transplant)

An aggressive MS treatment that involves wiping out a patient’s immune system with chemotherapy – and then rebuilding it using stem cell transplants. Hair loss is often one of the side effects of the chemotherapy used during this treatment.

Infrequent – very rare:

  • Fingolimod (Gilenya)

Hair loss is an infrequent side effect of fingolimod (Gilenya). This means it occurs in between 1 in 100 and 1 in 1000 people.

  • Alemtuzumab (Lemtrada)

Hair loss appears to be a very rare side effect of Alemtuzumab (Lemtrada). One known case of alopecia universalis has been reported.5

  • Dimethyl-fumarate (Tecfidera, BG-12)

Hair loss is not a reported side effect of Dimethyl-fumarate (Tecfidera, BG-12) however there appears to be some anecdotal occurrences. One case was identified where hair loss occurred three months after starting Tecfidera. Hair re-grew over several months while the treatment was continued.6

Incidence not known:

  • Glatiramer Acetate (Capoxone)7

  • LDN

  • Natalizumab (Tysabri)

  • Steroids

  • Ocrelizumab (Ocrevus)

It is worth speaking to your neurologist about any medication if it is causing unwanted side effects, particularly if they are serious, but you must weigh up the benefits of a drug and whether it is improving MS symptoms.

It also might be that hair loss is a side effect of another drug you are taking:

  • Antidepressants and mood stabilizers

Depression is a common symptom or comorbidity of MS therefore antidepressants or mood stabilisers may be prescribed. Antidepressants are also often used to treat neuropathic pain syndromes. If you are taking one of these medications, it could be that they are causing the hair loss, this often happens 4-8 weeks after starting the medication. This is not permanent and hair usually recovers up to six months after the medication is discontinued.

  • Epilepsy medications

  • Migraine medications

  • Blood pressure medicines

  • HRT

  • Blood thinners

  • Acne medications

Other types of hair loss (unrelated to MS)

3. Symptom of another medical condition:

  • Thyroid disease

  • Scalp infections

  • Other autoimmune disease – e.g. lupus, Hashimoto’s disease, Graves’ disease, rheumatoid arthritis, alopecia areata (see below).

4. Alopecia Areata

Alopecia areata (AA) is a common autoimmune disorder that often results in unpredictable hair loss. Hair is lost in patches and occurs because the follicle is affected by inflammation. It is not possible to predict how much hair will be lost. 4 out of 5 affected people will experience complete regrowth within 1 year without treatment. Alopecia universalis is an advanced form of AA when there is a complete loss of hair on the body and alopecia totalis is when there is a complete loss of hair on the scalp – this happens in about 5% of people with AA.8

Someone with alopecia areata is slightly more likely than a person without it to develop other autoimmune conditions such as thyroid disease, diabetes, lupus and vitiligo. However there doesn’t appear to be a link between AA and MS. 9

5. Trichotillomania

Trichotillomania, also known as trich, is a hair pulling disorder when someone can’t resist the urge to pull out their hair. They may pull out the hair on their head or in other places, such as their eyebrows or eyelashes. This can cause bald patches.

Ways you can improve hair growth

There aren’t many proven treatments for hair loss but there are some things you can do to improve the health of your hair:

  • Make sure you are gentle with your hair. Avoid harsh treatments or colouring or tight hairstyles.

  • Take care of your scalp. Gently massage to increase blood flow and stimulate the scalp.

  • Keep your hair and scalp moistured – condition your hair regularly.

  • If you believe your hair loss could be caused by stress, try mindfulness based stress reduction and meditation. This is a key part of the OMS Recovery Program.

  • If you are being treated with chemotherapy, ask your doctor about a cooling cap. This cap can reduce your risk of losing hair during chemotherapy.

  • Make sure you are eating a balanced diet:

    • Essential fatty acids, especially omega-3s, play a key role in the health of your skin, hair, and nails. This is a key part of the OMS Recovery Program and can be found in: fatty fish such as salmon, tuna and mackerel, flaxseed oil and some nuts such as walnuts and almonds.

    • Vitamins B6, B12, and folic acid are important for healthy hair, although they don’t promote hair growth. If you follow a completely vegetarian or vegan diet, you may want to consider taking a B12 Supplement. Foods with B6 include bananas, potatoes, and spinach. You can get folic acid with plenty of fresh fruits and vegetables, especially citrus fruits and tomatoes. Whole-grain products, beans, and lentils also have it.

    • Protein is also critical for keeping your hair healthy. The World Health Organisation (WHO) suggests that 0.83 g/kg per day protein is adequate. Fish, cooked green vegetables, avocados, soy products, legumes, whole grains, nuts and seeds are all good sources and are recommended on the OMS Recovery Program.

    • Trace minerals like iron, magnesium, zinc, and biotin can also affect hair.

  • Get your iron levels tested to check that you are not anaemic.

  • Wait and see – most hair loss will stop in time and you will see regrowth.

Hair loss is not a symptom of MS, but could be related as a side effect of a medication, or due to the stress of an MS diagnosis. The majority of hair loss or thinning is temporary, and does not require treatment.

  • Selma Blair revealed she’s losing her eyelashes due to multiple sclerosis in a new Instagram post.
  • Along with thanking friends for their support, Selma said she’s lost all but three eyelashes on her right eyelid.
  • While MS doesn’t directly contribute to hair or eyelash loss, medication used for MS treatment may be to blame.

Since revealing her multiple sclerosis diagnosis in October, Selma Blair has been incredibly open with fans about what it’s like to live with the disease (she’s been extremely candid about her vocal, balance, and insomnia issues).

But now, Selma reveals she has a new symptom: hair loss.

Selma shared the news in a lengthy Instagram post, which started out with her thanking a few of her closest friends for making her life easier lately. Selma thanked Jaime King for having fresh flowers delivered to her home each week, Busy Philipps for sending food, and her best friend Sarah Michelle Gellar orchestrating all of it.

But then, Selma addressed her hair loss—specifically the loss of her eyelashes. “My right eyelashes all fell out except 3 corner ones,” Selma wrote, adding that it happened in August.

But now, she’s losing the lashes on her left eye, too. “Just started falling out in left eye so there goes my profile posing,” she wrote. “I guess immune system figured it has bigger kid to spank. I’m going to bed. With a lack of lashes but an abundance of love and beautiful flowers.”

Hold on, is hair loss a side effect of MS?

So, kind of. Hair loss actually has less to do with the MS itself and more to do with treatment someone might be on, explains Santosh Kesari, MD, PhD, a neurologist and neuroscientist at Providence Saint John’s Health Center in Santa Monica, Calif.

Related Story

“A number of medications can help slow the progression of disease but some are quite potent,” he says. “Some are even chemotherapy drugs and can cause things like hair loss,” though it’s unclear exactly what medication Selma is on for her MS.

While there it’s possible to switch medications if they’re causing unwanted side effects (like hair loss), Dr. Kesari says not to make that decision too hastily. “If hair loss is related to a drug and the drug is actually helping the MS, you want to consider that,” he says.

Props again to Selma for being so honest about her MS symptoms—sharing her struggles is hopefully helping a lot of other people with the disease realize they’re not alone.

Korin Miller Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.

Making Tysabri Decisions and Considerations

Tysabri (Natalizumab); the one disease modifying treatment (DMT) that most new (even experienced) Multiple Sclerosis patients try to avoid. Short needles, long needles and pills; injection site reactions, muscle aches, flu like symptoms, hair loss, stomach pain, head aches, diarrhea, scarring from injections, and even your heart rate slowing down! These are a random variety of the somewhat commonly reported side effects of other DMTs (also called DMDs for disease modifying drugs). None of these side effects sound too pleasant (and if you have been on a variety of DMDs you know they really aren’t much fun at all) so why would someone choose a treatment from the “smorgasbord of misery” when you could go into an infusion center once a month, sit back in a chair, and just chill for a 1 hour infusion? One word; PML (Progressive Multifocal Leukoencephalopathy). A rare and possibly fatal brain disease that attacks the myelin in the brain often causing symptoms very similar to MS such as motor deficits/weakness of the limbs, coordination issues (ataxia), cognitive issues such as memory loss or understanding/expressing language (aphasia), and various visual symptoms (to name a few).

People remember the bad, the scary, and not the good. I am pretty sure this is a natural phenomena (that has a name I am unsure of) designed to insure our brains remember what it thinks is more import to satisfy our natural desire to survive. The thing is, this is the 21st century; rarely do we need to make snap decisions in order to survive so let’s put that initial fear aside to try to look at this rationally so that we can try to understand why an MS patient might choose to take such a risk. First of all, it’s usually not a case of “once a month? That is way more convenient than taking a pill everyday or giving myself a shot X amount of times a week!” but more often it’s for people who have tried everything else with zero positive results. Their disease is so aggressive that no matter what DMD they try, the relapses just keep coming. Month after month they are going to the hospital for a three to five day infusion of steroids and sometimes going home with a bottle of the oral stuff. Steroids don’t always feel so great or have the loveliest side effects. They may take care of your relapse but you might gain weight, have mood swings, sprout some crazy acne, or loose bone density. After a while they may even stop working all together at which point you may think to yourself “OK that’s it! Nothing is working! I am sick of this hospital and their crappy food, I’m sick of not having a life because I am always relapsing, and now these stupid steroids are not even helping!” so what’s next?

The “big guns”, that’s what! At this point you’re more than likely willing to try anything to escape the revolving door of misery! Except for bees… seriously, Google it. Anyways, TYSABRI! This is how I came to the conclusion that it was worth the risk. I had to make a simple choice; did I want to become bedridden and get comfortable with being spoon fed my meals, having someone help me shower, and loosing every other ounce of independence I had grown to know or did I want to take a small risk for the possibility of maintaining my independence, not relapsing every month and doing the things I enjoy? I wanted to live an independent life! Though the risk of death by PML is not so common anymore (with all the protocols doctors now have to take when prescribing it) I remember laying in that hospital bed (all hooked up an uncomfortable, the metallic taste of steroids making their way through my blood stream and into my tongue) and thinking to myself “I would rather live 10 more years healthy and happy than 60 more years like this”. Again, is that even a likely scenario? Probably not anymore but I was definitely thinking about the worst-case scenario as an uneducated patient. Like I said, people remember the negative; “Oh my gosh, PML, that sounds so scary, it can kill you???” but they forget the bit about it not being all that common; I think a lot of people hear PML and look at it as if you were flipping a coin and had a 50/50 chance of getting PML. I will talk about the actual odds in just a moment.

OK, so that bit about lying in a hospital bed and getting frustrated over the fact that nothing was helping anymore? That was me. So I eventually started Tysabri and Acthar (an alternative to steroids) and it turned out to be the right medication for me. With the help of some physical therapy (and much perseverance) I went from a wheelchair, to a walker, to a cane, to walking around the house, to walking across the street to get the mail, to walking around the block, to walking a mile to the store and back, to driving, and finally to flying around the world; all while NOT laying down in a hospital bed feeling miserable. Tysabri gave me a life back and I say a life instead of my life because after all I have been through I will never be the same person as I was before and as well, Tysabri did not cure my MS, it just steadied it. I still have many symptoms and MS-related issues but that’s OK with me because this is MY life and I have come to terms with it. My “new normal” as many say, has not been so bad; I have traveled around and seen things that most people never will see in their life and none of that would have happened if I didn’t take a small risk and start Tysabri. This (in addition to my horrible MS experience right before I started Tysabri) changed the way I view people, life and the world; which is why I will never be the same person again. I am lucky to be able to say that and I am lucky that I have not had a relapse in almost 2 years and counting (knock on wood) and I really have no desire to go back to life in a hospital bed which is why this next bit put me in a bit of a panic.

I recently moved from Southern California to Colorado; I needed to start a new life, leave all the bad behind, find cooler climate and go where there was opportunity. I loved my Neurologist and my health care routine; it was working so great but I felt I was growing stagnant in life. My only fear about picking up and starting from scratch was finding a new neurologist. My SoCal Neurologist was nothing short of an MS genius and I really did not want to go from that to someone who I felt (not to toot my own horn) I knew more about MS than. My SoCal Neurologist was so involved in research, new the disease inside and out, cared only about his patients and not pleasing some drug reps; he was just awesome! Well I saw my new neurologist out here… and… let’s just say my one fear came true. On top of that they did a blood test to see if I had been exposed to the JC (John Cunningham) virus or not. The JC virus is a virus that most the population carries but it does not present in any way shape or form however, if you’re on an immunosuppressant (or immunomodulator like Tysabri) it can increase your chances of developing PML. You actually can’t get PML without the JC virus but the point is, I was now JC positive. My neurologist’s office called me the day the results came in and told me I needed to come in to choose a new therapy…

The following 7 days were long and torturous as I stressed over what this test meant, how stopping Tysabri would affect me, how I just knew I should not have left the safety of my SoCal Neurologist… I emailed and called his office many times looking for answers but I knew he was busy and so at first I only got replies from his nurses who all told me to stay on Tysabri. I grew so fatigued (stress and heat are my triggers) that I could hardly function! I was going crazy! Why was this happening NOW? I started taking Nuvigil again (for energy) since coffee was no longer helping and surprisingly (as my past results with this medication were not so great) it helped with my energy levels and my ability to think! I started doing more research and in about 10 minutes I found what I couldn’t find all week! This bit of info was so relieving and confirmed everything that everyone I called had told me.

According to the Tysabri website there are three main risk factors for developing PML; whether you are JC positive or negative, the length of time you have been on Tysabri and whether or not you have had past exposure to immunosuppressants (the powerful stuff like chemo not steroids). According to the chart on their website, my chances of getting PML when I was JC negative was less than 1/1000 and with the amount of time and my lack of an immunosuppressive history my odds after becoming JC positive were now a whopping… less than 1/1000… the same. So this new clinic was freaking me out for nothing! After 24 treatments my odds will rise a little but I am barely about to go in for number 18!

Now, why did I make you read that long life story about my experience with Tysabri if only to end at a simple conclusion? Well, let me tell you. In that week between receiving the test results and seeing my neurologist, I did a lot of thinking. I was not sure what this test meant and how it would affect my life and the direction I wanted to go. For all I knew my odds were now that 50/50 so that’s all I could think about; what to do. I thought about when I was in physical rehab for 6 weeks being spoon fed, trying to get around on my own in a wheel chair, type, speak, put my socks on, and so much more. I thought about that brief period of my life that felt like a year and found myself thinking the same thing I did while I was lying in that hospital bed sucking up steroids with my arm; “I would rather live 10 more years healthy and happy than 60 more years like that”. I now knew the risk; the odds. It was up to me to decide if it was a risk worth taking. “Yes, I believe it is”. I told my new neurologist that I am not changing therapies and that I would stay on Tysabri until a new medication comes out that I can safely switch to without rebounding. The rebound effect is basically a sort of withdrawal from Tysabri that occurs about 4 months after stopping treatment and then you just tank as the disease activity skyrockets. There are different risk factors for this as well such as how well the medication did for you and the length of time you were on it but I don’t know enough about it yet so don’t quote me!

I decided against this neurologist’s wishes (but with the full support of my SoCal Neurologist) to stay on Tysabri. I weighed the pros and cons and my scale was tipping (understatement) towards Tysabri. I know this positive JC result has put an “hour glass” on my current treatment but I am going to keep moving forward with life while trying to be as healthy and happy as I can instead of stressing. I will prepare for the day I have no choice but to switch therapies at which point I can only hope something new will have been approved (I got my eye on something). Making a decision like this is so personal and relevant to each individual’s risk factors for both PML and rebounding. All I can recommend is looking into the risk factor information on the Tysabri website (for PML) to see where you are and then try to determine if your at a high risk of rebounding. After all that technical, number stuff, it’s really up to you to decide what would be the best move to make. If you are at a high risk of developing PML or rebounding are you in the best position in life to take that risk? As of now there is really no easy way off Tysabri if it has worked really well for you so it’s a bit of a catch 22. Stay on it and risk PML or get off it and risk rebounding. Again, it’s a tough decision but a decision that is too personal for anyone to make but you. Here are some factors to consider;

  • Are you JC positive or negative?
  • Have you used powerful immunosuppressants in the past?
  • If you are already on Tysabri and trying to decide whether or not to stay on it, how long have you been on it?

(All that helps determine your “risk” of developing PML)

  • If you have done really well on Tysabri your’e more likely to rebound but if you have not seen much help from the medication you probably won’t. So how well has it worked for you?
  • Finally, do you truly trust your neurologist to have your well being in his/her best interest or are you kind of on your own here?
  • If you need to, get a second or third opinion from different neurologist (at different clinics)

As for me, I still have a lot of learning to do about all the details on Tysabri, PML, and the rebound effect but I can tell you one thing for sure; NO ONE cares about your health more than YOU so do what YOU think is best (unless you really trust your neurologist). Just remember this; every MS patient is different. What works for one may not work for another but you won’t know if something works until you try it right? So with that in mind, remember, it’s your health; it’s your life! I urge you to become your own advocate!”

Tysabri and Hair loss – from FDA reports

Summary:

Hair loss is found among people who take Tysabri, especially for people who are female, 40-49 old , have been taking the drug for 2 – 5 years, also take medication Avonex, and have Gait disturbance. This study is created by eHealthMe based on reports of 186,322 people who have side effects when taking Tysabri from Food and Drug Administration (FDA), and is updated regularly.

eHealthMe has been monitoring drugs since 2008. Our original studies have been referenced on 600+ peer-reviewed medical publications. On eHealthMe, patients can manage drugs and prevent side effects with real-world data, qualified professionals and financial protection. Join now, it’s free.

On Jan, 05, 2020

186,322 people reported to have side effects when taking Tysabri.
Among them, 1,274 people (0.68%) have Hair loss

Number of reports submitted per year:

Time on Tysabri when people have Hair loss *:

  • < 1 month: 12.62 %
  • 1 – 6 months: 23.34 %
  • 6 – 12 months: 18.3 %
  • 1 – 2 years: 17.67 %
  • 2 – 5 years: 24.29 %
  • 5 – 10 years: 3.79 %
  • 10+ years: 0.0 %

Gender of people who have Hair loss when taking Tysabri *:

  • female: 92.89 %
  • male: 7.11 %

Age of people who have Hair loss when taking Tysabri *:

  • 0-1: 0.0 %
  • 2-9: 0.1 %
  • 10-19: 0.52 %
  • 20-29: 7.09 %
  • 30-39: 20.86 %
  • 40-49: 32.33 %
  • 50-59: 26.07 %
  • 60+: 13.03 %

Conditions people have *:

  1. Gait Disturbance: 27 people, 2.12%
  2. Gastroesophageal Reflux Disease (a condition in which stomach contents leak backward from the stomach into the oesophagus): 18 people, 1.41%
  3. High Blood Pressure: 16 people, 1.26%
  4. Depression: 14 people, 1.10%
  5. High Blood Cholesterol: 14 people, 1.10%

Other drugs people take besides Tysabri *:

  1. Avonex: 182 people, 14.29%
  2. Tecfidera: 56 people, 4.40%
  3. Ampyra: 45 people, 3.53%
  4. Aubagio: 34 people, 2.67%
  5. Gilenya: 20 people, 1.57%

Other side effects people have besides Hair loss *:

* Approximation only. Some reports may have incomplete information.

A drug side effect can cost you financially

Out-of-pocket costs increase constantly and can be big. For example, Medicare beneficiaries paid average $5,500 in 2016. On eHealthMe, for only $10/month you can have up to $10,000 to pay for medical expenses or funeral services for serious adverse events caused by your drugs. Learn more.

Related publications that referenced our studies:

How the study uses the data?

The study is based on natalizumab (the active ingredients of Tysabri) and Tysabri (the brand name). Other drugs that have the same active ingredients (e.g. generic drugs) are not considered. Dosage of drugs is not considered in the study.

To check all the drugs that have ingredients of natalizumab and Hair loss:

  • Hair loss and drugs with ingredients of natalizumab (1,277 reports)

How severe was Hair loss and when was it recovered:

  • Hair loss in Tysabri

What’s eHealthMe?

eHealthMe is a health data analysis company based in Mountain View, California. We monitor and analyze the outcomes of drugs and supplements that are currently on the market since 2008. Original studies of eHealthMe have been referenced on 600+ peer-reviewed medical publications. On eHealthMe, health care professionals and consumers can study drugs with our free tools. Reports generated by our tools are personalized to gender and age. Choose a tool now.

What is Tysabri?

Tysabri has active ingredients of natalizumab. It is often used in multiple sclerosis. Check the latest outcomes from 186,758 Tysabri users, or browse all drugs.

What is Hair loss?

Hair loss has been reported by people with multiple sclerosis, rheumatoid arthritis, breast cancer, breast cancer female, chemotherapy. Check the latest reports from 156,375 Hair loss patients, or browse all conditions.

Browse side effects by gender and age:

Female: 0-1 2-9 10-19 20-29 30-39 40-49 50-59 60+

Male: 0-1 2-9 10-19 20-29 30-39 40-49 50-59 60+

How to use the study?

Patients can bring a copy of the report to their healthcare provider to ensure that all drug risks and benefits are fully discussed and understood. It is recommended that patients use the information presented as a part of a broader decision-making process.

Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

Fight with knowledge

Herpes Encephalitis and Meningitis. TYSABRI may increase your risk of getting an infection of the brain or the covering of your brain and spinal cord (encephalitis or meningitis) caused by herpes viruses that may lead to death. Infection of the eye caused by herpes viruses leading to blindness in some patients has occurred. Call your doctor right away if you have sudden fever, severe headache, or if you feel confused after receiving TYSABRI.

Liver damage. Symptoms may include:

  • Yellowing of the eyes and skin (jaundice)
  • Nausea
  • Vomiting
  • Unusual darkening of the urine
  • Feeling weak or tired

Call your doctor right away if you have symptoms of liver damage. Your doctor can do blood tests to check for liver damage.

Allergic reactions. TYSABRI may cause allergic reactions, including serious allergic reactions (e.g.,anaphylaxis). Symptoms can include:

  • Hives
  • Itching
  • Trouble breathing
  • Chest pain
  • Dizziness
  • Wheezing
  • Chills
  • Rash
  • Nausea
  • Flushing of skin
  • Low blood pressure

Serious allergic reactions usually happen within 2 hours of the start of the infusion, but they can happen at any time after receiving TYSABRI. Tell your doctor or nurse right away if you have any symptoms of an allergic reaction, even if it happens after you leave the infusion center. You may need treatment if you are having an allergic reaction.

Infections. TYSABRI may increase your chance of getting an unusual or serious infection because TYSABRI can weaken your immune system.

Multiple Sclerosis

Share on:

Overview

What Is It?
Multiple sclerosis (MS) is a chronic, sometimes disabling, disease of the central nervous system. In MS, the immune system—for reasons still not understood—attacks and destroys myelin and the oligodendrocytes that produce it.

Multiple sclerosis (MS) is a chronic, sometimes disabling, disease of the central nervous system affecting approximately one in 750 people in the United States, according to the National Multiple Sclerosis Society. It affects three to four times as many women as men. MS develops more often in Caucasians than in other races but recent data from the Kaiser Foundation indicates there is more MS among African Americans than previously thought.

The cause of MS is still unknown, but most researchers think it results from an abnormal response by the body’s immune system. Some researchers believe this abnormal immune response could be caused by a virus, although it is unlikely that there is just one virus responsible for triggering the condition. Researchers do know that MS is not contagious. And while it is not an inherited disease, genetic susceptibility plays a role. There is a higher risk for MS in families where it has already occurred. Other possible triggers include environmental exposures to toxins and heavy metals, as well as low levels of vitamin D. Smoking and obesity may worsen the condition.

It is believed that MS is an autoimmune disease. In MS, the immune system—for reasons still not understood—attacks and destroys myelin and the oligodendrocytes (oligo, few; dendro, branches; cytes, cells) that produce it. Though the body usually sends in immune cells to fight off bacteria and viruses, in MS they misguidedly attack the body’s own healthy nervous system, thus the term autoimmune disease. Rheumatoid arthritis and lupus are other types of autoimmune diseases.

In multiple sclerosis, these misdirected immune cells (certain types of lymphocytes, T-cells, B-cells and natural killer cells) attack and consume myelin, damaging the myelin sheath—the fatty insulation surrounding nerve cells in the brain and spinal cord. Myelin acts like the rubber insulation found in an electric cable and facilitates the smooth transmission of high-speed messages between the brain and the spinal cord and the rest of the body. As areas of myelin are affected, messages are not sent efficiently or they never reach their destination.

Eventually, there is a buildup of scar tissue (sclerosis) in multiple places where myelin has been lost; hence the disease’s name: multiple sclerosis. These plaques or scarred areas, which only are a fraction of an inch in diameter, can interfere with signal transmission. The underlying nerve also may be damaged, further worsening symptoms and reducing the degree of recovery. The disease can manifest itself in many ways. Sometimes the diseased areas cause no apparent symptoms, and sometimes they cause many; this is why the severity of problems varies greatly among people affected with MS.

Multiple sclerosis usually strikes in the form of attacks or exacerbations. This is when at least one symptom occurs, or worsens, for more than 24 hours. The symptom(s) can last for days, weeks, months or indefinitely.

The most common pattern of multiple sclerosis is relapsing-remitting MS. It is characterized by periods of exacerbation followed by periods of remission. The remissions occur because nervous system cells have ways of partially compensating for their loss of ability. There’s no way to know how long a remission will last after an attack—it could be a month or it could be several years. But disease activity usually continues at a low, often almost indiscernible level, and MS often worsens over time as the signal-transmitting portion of the cells—the axons—are damaged.

Most commonly, multiple sclerosis starts with a vague symptom that disappears completely within a few days or weeks. Temporary weakness, tingling or pain in a limb can be a first sign. Ataxia (general physical unsteadiness and problems with coordination), temporary blurring or double vision, memory disturbances and fatigue are also symptoms that can appear suddenly and then vanish for years after the first episode, or in some cases never reappear.

The symptoms of MS vary greatly, as does their severity, depending on the areas of the central nervous system that are affected. Most people suffer minor effects. The disease can, however, completely disable a person, preventing him or her from speaking and walking in the most extreme cases. The bodily functions that are commonly affected by MS are:

  • vision
  • coordination
  • strength
  • sensation
  • speech and swallowing
  • bladder and bowel control
  • sexuality
  • cognitive function (thinking, concentration and short-term memory)

A varying degree of dysfunction may occur within these general areas. For instance, one person may suffer blurred vision while another may suffer double vision. Or one person may suffer from tremors while another will experience clumsiness of a particular limb.

Specific symptoms associated with MS can include:

  • fatigue: a debilitating kind of general fatigue that is unpredictable and out of proportion to the activity; fatigue is one of the most common (and one of the most troubling) symptoms of MS.
  • cognitive function: short-term memory problems and difficulty concentrating and thinking, typically not severe enough to seriously interfere with daily functioning, although sometimes it does. Judgment and reasoning may also be affected.
  • visual disturbances: blurring of vision, double vision (diplopia), optic neuritis, involuntary rapid eye movement and (rarely) total loss of sight.
  • balance and coordination problems: loss of balance, tremor, unstable walking (ataxia), dizziness (vertigo), clumsiness of a limb and lack of coordination.
  • weakness: usually in the legs.
  • spasticity: altered muscle tone can produce spasms or muscle stiffness, which can affect mobility and walking.
  • altered sensation: tingling, numbness (paresthesia), a burning feeling in an area of the body or other indefinable sensations.
  • abnormal speech: slowing of speech, slurring of words and changes in rhythm of speech.
  • difficulty in swallowing (dysphagia).
  • bladder and bowel problems: the need to urinate frequently and/or urgently, incomplete emptying or emptying at inappropriate times, constipation and loss of bowel control.
  • sexuality and intimacy: impotence, diminished arousal and loss of sensation.
  • pain: facial pain and muscle pains.
  • sensitivity to heat: this often causes symptoms to get worse temporarily.

Though these are some of the symptoms commonly associated with MS, not all people with MS will experience all of them. Most will experience more than one symptom, however. There is no typical case of MS. Each is unique.

Today, life expectancy for those with MS is slightly less than normal.

Most people with MS begin experiencing symptoms between the ages of 20 and 50. But initial symptoms may be vague, may come and go with no pattern or may be attributed to other factors or conditions. For instance, a woman who experiences sudden bouts of vertigo once every few months may explain away the symptom by linking it to her menstrual cycle. Or, perhaps, someone who suddenly has a bit of blurry vision may blame too many hours at the office.

Diagnosis

Diagnosing MS involves several tests and a lot of discussions with several types of health care professionals. You can expect a complete physical examination, a discussion of your medical history and a review of your past and/or current symptoms.

You should pay attention to any symptom suggestive of MS. Early diagnosis of MS is important because a new generation of treatments introduced in the 1990s can reduce the frequency and severity of MS attacks. In fact, research has prompted health care professionals to change the diagnostic criteria to treat more cases of MS as early as possible.

At this point, there are no symptoms, physical findings or tests that alone can definitively show that a person has MS. Instead, physicians use several strategies, including a medical history, neurologic exam, tests such as visual evoked potentials (VEPs) and spinal taps and imaging tests such as magnetic resonance imaging (MRI), to make a diagnosis.

For a diagnosis of MS, a health care professional must:

  • Discover evidence of damage in at least two separate areas of the central nervous system (CNS), including the brain, spinal cord and optic nerves AND
  • Find evidence that the damages occurred at least one month apart AND
  • Be able to rule out all other possible diagnoses

In 2001, an international panel of experts convened to update the diagnostic criteria to include guidelines for using MRI, VEP and cerebrospinal fluid analysis to confirm an MS diagnosis faster. Health care professionals can use these tests to look for a second area of damage in a person who has experienced only one MS-like attack. These criteria were further revised in 2005 and again in 2010, termed the Revised McDonald Criteria, to speed up the diagnostic process even more.

The specific tests that help make an MS diagnosis include the following:

  • MRI: Health care professionals may use MRI to scan the brain for lesions indicating early evidence of damage, in addition to other tests. An MRI is painless and noninvasive. If you need one, a health care professional will have you lie on your back on a table. The table will be pushed into a tube-like structure and detailed pictures of your brain and, sometimes, spinal cord, will be taken. These images are able to show scarred areas of the brain.
    Bear in mind that a normal MRI does not ensure that a person does not have MS. About 5 percent of MS patients have normal MRIs, according to the National Multiple Sclerosis Society. However, it is important to note that the longer a person has a normal MRI, the more important it becomes to look for a diagnosis other than MS.
  • Visual evoked potential tests (VEPs): VEPs measure how quickly a person’s nervous system responds to certain stimulation. These tests offer evidence of neurological scarring along nerve pathways that may not show up during neurologic exams. Evoked potential tests are painless and noninvasive. A health care professional or technician will place small electrodes on your head to monitor your brain waves and your response to auditory, visual and/or sensory stimuli. The time it takes for your brain to receive and interpret messages is a clue to your condition.

  • Spinal tap: A spinal tap tests cerebrospinal fluid (fluid surrounding the brain and spinal cord) for substances that indicate strong immune activity in the central nervous system and helps rule out viral infections and other conditions that can cause neurological symptoms similar to those of MS. If you have this test, you will likely be given an injection of local anesthesia. Some people experience a transient headache and nausea after the test.

  • Blood tests: These may help rule out other potential causes of symptoms, such as Lyme disease, lupus and AIDS.

  • Optical coherence tomography (OCT): A relatively new test, OCT is a painless, noninvasive procedure that looks at the retinal structures at the back of the eye. Following an episode of optic neuritis, doctors use OCT to assess the condition of the retinal nerve. People with MS have a different retinal nerve fiber layer than people without MS. Doctors use OCT to learn more about optic neuritis and MS, as well as to get information about disease activity in a person with a suspected MS diagnosis.

If you are diagnosed with MS, it will almost certainly be one of four patterns:

  • Relapsing-remitting MS: This is the most common pattern of the disease at the time of diagnosis, affecting 85 percent of patients at this stage. People with this pattern of MS experience clearly defined exacerbations or relapses, followed by partial or complete remissions (or recovery periods) where the disease stops progressing.

  • Secondary progressive MS: Secondary progressive MS (SPMS) follows a course of relapsing-remitting MS; according to the National Multiple Sclerosis Society, most people with RRMS eventually transition to the SPMS form, where neurologic function progressively worsens over time. SPMS can be characterized as active or not active, as well as with progression or without progression. Active SPMS consists of relapses and/or new MRI activity. When SPMS is not active, there is no activity. SPMS with progression indicates there is evidence of disease or worsening of symptoms. When it is classified as without progression, the disease is not changing over time.

  • Primary progressive MS: This pattern of MS is characterized from the onset by a nearly continuous worsening of the disease, with no distinct relapses or remissions. There may be temporary plateaus with minor relief from symptoms but no long-lasting relief. About 15 percent of people with MS have primary progressive MS.

MS varies so greatly in each individual that it is hard to predict the course the disease might take. However, some studies show that people who have few attacks in the first five years following a positive diagnosis of MS, long intervals between attacks, complete recoveries and attacks that are sensory only in nature generally have a less debilitating form of the disease.

On the other hand, people who have early symptoms that include tremors, lack of coordination or frequent attacks with incomplete recoveries generally have a more progressive form of MS. These early symptoms indicate that more myelin (the fatty insulation surrounding nerve cells in the brain and spinal cord) has been damaged.

Since MS generally strikes a woman during childbearing years, many women with the disease wonder if they should have a baby. Studies show that MS has no adverse effects on the course of pregnancy, labor or delivery; in fact, symptoms often stabilize during pregnancy. Although MS poses no significant risks to a fetus, physical limitations of the mother may make caring for a child more difficult. Also, women with MS who are considering having a child should discuss with their health care professionals which drugs to avoid during pregnancy and while breastfeeding. The disease-modifying drugs are not recommended during breastfeeding because it isn’t known if they are excreted in breast milk.

Earlier this summer, Selma Blair, who was diagnosed with multiple sclerosis last year, shaved some of her head with the help of her adorable seven-year-old son, Arthur. Now, after an intense round of treatment for the rare condition, Blair has gone totally bald — and she’s embracing every minute of it.

The 47-year-old actor took to Instagram earlier this week to share the news in an emotional post about her journey. The post showcases a newly hairless Blair in the hospital, looking happy because she can finally go home. “I will sleep near my son and thank the stars every waking minute that he IS. I am. You are. This is what we have,” reads a section of the caption.

Then, in a follow-up post from yesterday, Blair revealed that she’s had a scab on her head for two months but really didn’t notice it until now. “It stands out to me as much as my newly bald head. I don’t mind it. I don’t mind the hair loss either. But if my eyebrows totally fall out, I am gonna be singing a different tune,” reads her candid caption.

Needless to say, it’s extremely heartwarming to see Blair be so accepting of her situation. Fans flooded the comment section with supportive messages like “You are beautiful in every way,” “You are an effortless beauty! Nothing can change that! ❤️” and “Still more beautiful than any of us. And the scab? Just another badge of honor 🧡.”

Cheers to Blair for showing so much strength and clearly making the best of the cards she was dealt. Hair or no hair, she’s beautiful inside and out.

Now read more about Selma Blair:

  • Kris Jenner Sent Selma Blair Flowers in Support After She Received Her Multiple Sclerosis Diagnosis
  • Selma Blair Shares Inspirational Video With Tips for Applying Makeup With Multiple Sclerosis
  • Selma Blair Let Her 7-Year-Old Son Shave Her Head, and the Result Is Actually Cute

Done reading? Now watch an Olympic figure skater’s full beauty routine:

You can follow Allure on Instagram and Twitter, or subscribe to our newsletter to stay up to date on all things beauty.

MS in Women: Common Symptoms

In general, MS symptoms are the same for both women and men. But the symptoms vary for everyone depending on the location and severity of nerve damage caused by inflammation.

Some of the most common MS symptoms are listed below.

Muscle symptoms

In MS, the body’s immune cells attack the nervous system. This can occur in the brain, spinal cord, or optic nerves. As a result, MS patients can experience muscle-related symptoms that include:

  • muscle spasms
  • numbness
  • balance problems and lack of coordination
  • difficulty moving arms and legs
  • unsteady gait and trouble walking
  • weakness or tremor in one or both arms or legs

Eye symptoms

Vision problems can occur in both men and women with MS. These can include:

  • vision loss, either partial or complete, which often occurs in one eye
  • pain when moving your eyes
  • double vision
  • blurred vision
  • involuntary eye movements
  • more generalized eye discomfort and visual difficulties

All of these eye symptoms are due to MS lesions in the part of the brain that’s responsible for controlling and coordinating vision.

Bowel and bladder changes

Both bladder dysfunction and bowel symptoms occur frequently in MS. Dysfunction in the pathways of the nervous system that control your bladder and bowel muscles cause these problems.

Possible bladder and bowel symptoms include:

  • trouble starting to urinate
  • frequent urge or need to urinate
  • bladder infections
  • urine or stool leakage
  • constipation
  • diarrhea

Numbness or pain

Feelings of numbness, tingling, and pain are common for many people with MS. People often experience these symptoms across the body or in specific limbs.

You might notice numbness that feels like “pins and needles” or a burning sensation. According to research, more than half of all people with MS will have some form of pain during their illness.

While some types of pain are related directly to MS, other forms of pain may be byproducts of how MS affects the body. For example, imbalances caused by walking problems may lead to pain from stress on your joints.

Trouble with speech and swallowing

People with MS may experience trouble speaking. Common speech problems include:

  • slurred or poorly articulated speech
  • a loss of volume control
  • a slowed-down rate of speaking
  • changes in speech quality, such as a harsh-sounding or breathless voice

MS lesions can also influence swallowing, causing problems with chewing and moving food to the back of your mouth. Lesions can also affect your body’s ability to move food through your esophagus and into your stomach.

Effects on the brain and nerves

A range of other brain and nerve symptoms may result from MS. These can include:

  • decreased attention span
  • memory loss
  • poor judgment
  • trouble reasoning or problem solving
  • depression, either from damage to brain areas involved in emotional control or as a result of the stress of the illness
  • mood swings
  • dizziness, balance problems, or vertigo (a spinning sensation)

Sexual problems

Both men and women can experience sexual dysfunction as a symptom of MS. Problems might include:

  • decreased sex drive
  • reduced genital sensation
  • fewer and less intense orgasms

Additionally, women may notice reduced vaginal lubrication and pain during intercourse.

  • Selma Blair, 47, shaved her head before undergoing chemotherapy as part of her treatment for multiple sclerosis.
  • In a new Instagram post, Blair opened up about totally embracing her “thinnish, patchy charcoal” hair regrowth.
  • Experts explain why a person’s hair can actually change and grow back differently after chemotherapy.

Selma Blair shaved her head this summer before undergoing chemotherapy as part of her treatment for multiple sclerosis. Now, her hair is growing back—and it’s different from what it once was.

In a new Instagram post, Blair explained that she originally cut her hair short to “transition myself and my son for impending baldness. Easy. Baldness came. I didn’t shave head to that end. Of course it fell out. Shiny. Pale dome. Nice enough,” she wrote. Blair said it took two months for her hair to grow back, and then it came in “fine and pale and very sparse.” She ended up shaving it because it “looked too sad.”

When her hair grew back again, Blair said it was “patchy in color,” so she dyed it brown. “Ridiculous! I really only succeeded in dying my scalp,” she said. So, she cut it again and now she has a “thinnish, patchy charcoal head.”

“I will see how a pixie grows in. Or I will buzz again. It seems to be too much to have long hair again. So I will leave it short and grey, something I have never before wanted to do,” she said. “I equated it with giving up. And maybe giving up long, brown hair, complete with time consuming and expensive highlights and lowlights isn’t necessarily a give up. Give in. Embrace. Sure. I’ll try it.”

It’s actually not uncommon for your hair to come back differently post-chemo, says Jamie Alan, Ph.D., an assistant professor of pharmacology and toxicology at Michigan State University. But, while it happens often enough, experts don’t really know why.

Related Stories

“The chemo drugs settle into the hair follicles, arresting growth,” Alan explains. The change in a patient’s hair could be due to a direct impact from chemo drugs on the hair follicles, or the drug could cause changes in the genes that control hair texture and color, she says.

But “how it comes back, when it comes back, and other variables are unpredictable things,” says Jack Jacoub, M.D., a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, Calif. He’s even had older patients who had grey hair that grew back darker after chemotherapy. “Hair changes are one of the most interesting things to see as people get through their treatment,” he says.

For some people, their hair will return back to its “normal” state with time. For others, it won’t. Either way, it looks like Blair is embracing the journey with a sense of humor. “I have a passing resemblance to one of the #jonasbrothers,” she wrote in another recent post. “I mean, it is a car selfie, but which brother? I like this look.”

Like what you just read? You’ll love our magazine! Go here to subscribe. Don’t miss a thing by downloading Apple News here and following Prevention. Oh, and we’re on Instagram too.

Korin Miller Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *