How to prevent MS?

Can You Prevent Multiple Sclerosis?

Common Viruses May Raise Your Risk of MS

The Epstein-Barr virus (EBV), a member of the herpes family of viruses, has been linked to MS, although it has not conclusively been identified as a cause of MS. Research published in August 2012 in the Multiple Sclerosis Journal has shown that levels of EBV antibodies were significantly higher in people who eventually developed MS than in people who didn’t develop MS.

But EBV is extremely common. In fact, the Centers for Disease Control and Prevention (CDC) reports that about 90 percent of adults in the United States have had this virus at some point in their lives. In children, EBV looks just like the common cold; in adolescents and adults, it can develop into mononucleosis.

Another virus that’s been linked to MS is human herpes virus 6 (HHV-6), according to the NMSS. In a study published in August 2014 in the journal PLoS One, researchers found that higher HHV-6 antibody levels in the body were associated with an increased risk of MS relapses. But HHV-6 has not been shown to trigger the onset of MS.

Geography, Sun Exposure, and Vitamin D Levels

The incidence of MS is higher in North America, southern Australia, and northern Europe, suggesting that the farther you live from the equator, the greater your risk for developing multiple sclerosis.

Why should geography matter? Researchers think the link between location and MS risk may be sun exposure or, more specifically, vitamin D levels in the body. Vitamin D is known as the sunshine vitamin because the human body generates it in response to sunlight.

Research indicates that adequate vitamin D levels may play a role in protecting against MS. Numerous studies are ongoing to increase scientists’ understanding of the role of vitamin D in preventing MS and to explore whether vitamin D supplementation can reduce disease activity in people who have MS.

One study published online in September 2017 in the journal Neurology found that women who had deficient levels of vitamin D — defined in the study as fewer than 30 nanomoles per liter — were more likely to develop MS.

The researchers used stored blood samples from more than 800,000 women in Finland, which were taken as part of prenatal testing. They identified 1,092 women who were diagnosed with MS an average of nine years after giving the blood samples and compared them with 2,123 women who did not develop the disease.

Of the women who developed MS, 58 percent had deficient levels of vitamin D, compared with 52 percent of the women who did not develop the disease.

Commenting in a press release from the American Academy of Neurology, study author Kassandra L. Munger, doctor of science in nutritional epidemiology at the Harvard T. H. Chan School of Public Health in Boston, said, “Our study, involving a large number of women, suggests that correcting vitamin D deficiency in young and middle-aged women may reduce their future risk of MS.”

Diet and Food Choices May Affect MS Risk

While no particular diet or food has been shown to prevent MS, researchers continue to study the ways in which nutrition might affect disease risk. According to Dr. Chitnis, vitamin D is the biggest diet-related factor in the possible prevention of MS. Vitamin D is naturally present in fatty fish and is added to milk, some cereal products, and a few other foods.

Among other dietary factors that may have an impact on MS, a study published in March 2016 in the Journal of Neurology, Neurosurgery, and Psychiatry found that a high consumption of coffee is associated with a lower risk of developing MS.

Additionally, resveratrol, a compound in red wine, showed promise in a study published in July 2017 in the journal Molecular Neurobiology — at least in mice. According to the study, resveratrol exhibits anti-inflammatory effects in the brain and may also promote restoration of the myelin coating that surrounds nerve cells. That coating is damaged by inflammation in people with MS.

Other dietary factors of interest to researchers as potentially modifiable risk factors for MS include B vitamins, iron, and polyunsaturated fatty acids.

Intermittent fasting — in which fewer calories than normal are consumed for several days per week — may be effective at reducing disease severity in MS, although whether such a diet could help prevent MS in those who are genetically susceptible is not known.

A study published in June 2016 in the journal Cell Reports showed that periodic cycles of a fasting-mimicking diet had beneficial effects in both mice and human participants with relapsing-remitting MS. While the human portion of the study was primarily intended to test the safety and feasibility of the diet approach, the participants reported improvements in their quality of life and in their health after following the fasting-mimicking diet for a seven-day cycle and then a Mediterranean diet for six months.

Avoiding Concussions in Adolescence May Prevent MS

Preventing brain injuries in young people is important for many reasons, and now it appears that preventing MS may be among those reasons. Researchers in Sweden used the national Swedish Patient Register and MS Register to look for associations between concussions (brain injuries) in childhood or adolescence and development of multiple sclerosis later in life. While they found no link between concussion occurring from birth to age 10 and MS, concussion between the ages of 11 and 20 was associated with a higher risk of MS — and individuals who’d had more than one concussion had an even higher risk of MS than those with just one recorded concussion. The study was first published online in September 2017 in the Annals of Neurology.

The researchers noted that not every adolescent who has a concussion will develop MS. Nonetheless, they also observed that their results emphasize the importance of protecting young people against head injuries.

The CDC has a variety of fact sheets on preventing brain injuries in children and teens, both while participating in sports and during nonsports activities.

Not Smoking Preventive on Many Levels

Growing evidence suggests that smoking not only increases the risk of developing MS but it also increases the severity and hastens the progression of the disease. Given its many health benefits, quitting smoking — or not starting in the first place — is an obvious step to take for anyone who wishes to lower their risk of MS.

Additional reporting by Christina Vogt and Ingrid Strauch.

The research triple whammy that will stop MS

Scientists are working on three ways to tackle MS: stopping the immune damage, promoting myelin repair and protecting nerves from damage.

We’re not there yet, but we believe that if we achieve these goals then we can stop MS.

What goes wrong in MS?

In MS, immune cells attack the protective myelin coating around our nerve cells. Myelin plays a vital role in how nerves work and also protects them from damage.

When myelin becomes damaged, messages find it harder to get through – or can’t get through at all. That’s what causes the symptoms of MS.

Step 1: stop the damage in its tracks

To stop MS early we need to prevent our immune system damaging myelin.

There has been incredible progress in this area of research, and we now have 12 available disease modifying therapies (DMTs) for relapsing MS that help do this.

Researchers are also testing the benefits of stem cell transplantation (HSCT), which aims to stop the immune system attacking myelin.

We’re starting to see progress in immune system research for progressive MS as well. Last year a treatment called ocrelizumab was shown to slow progression in primary progressive MS. And the latest results for the drug siponimod look promising for secondary progressive MS too. But these drugs can’t help if permanent damage has already been done.

Right now we’re funding nine projects that look at the role immune cells play in MS.

Step 2: repair myelin

Our bodies have an amazing capacity to repair myelin and get nerves working properly again. But this repair becomes less effective over time and doesn’t work as well as it should in MS.

Researchers are finding new ways to put myelin back on nerves. We’re funding 12 myelin repair projects, including our world-class research centres in Cambridge and Edinburgh.

Every discovery brings new opportunities for us to develop myelin repair treatments – and these could be effective for everyone with MS.

> Discover the latest myelin repair research

Step 3: protect nerves from damage

We need to make sure that our nerves are happy, healthy and protected from damage. And this is even more important when myelin isn’t around.

Researchers are using their knowledge of nerves to design new ways to keep them alive and healthy. They’re aiming to find treatments that can prevent nerve loss, which could slow or stop the progression of MS.

We’re funding seven projects to help us on our way to having neuroprotective treatments for MS.

We’re excited because clinical trials of potential treatments for people with progressive MS are already underway. This includes our MS-SMART trial, as well as drugs like simvastatin.

> Find out more about neuroprotection

Why me?

You may wonder whether you did something to cause your MS or if you could have stopped MS from happening to you. The answer to this is ‘no’ as the causes of MS are not well understood so no one could have advised you how to prevent your MS.

The cause of MS is a very active area of research and it seems likely that a number of different factors must come together to trigger MS. It’s thought that genes make up around half the risk of getting MS. More than 230 genes have been found that each increase the risk of developing MS to a small degree. None of them directly causes the condition itself and someone with MS will have a combination of many of these genes.

Other factors are in the world around us and there is some evidence that lack of sunshine may play a part. Other possibilities include being exposed to certain common viruses, smoking, obesity and long-term exposure to certain solvents.

However no one knows for certain. It’s thought there is still some kind of trigger which hasn’t been identified yet that causes (or activates) MS in those who have a higher risk because of their genes.

Will my family get MS?

MS is not considered an inherited condition as it’s not passed on in a predictable way like some conditions, such as haemophilia or muscular dystrophy, and many people have no previous family history of MS. Some genes make it more likely that someone develops MS but having these genes is definitely not enough on its own as other factors are needed to trigger the condition. This means that the risk of another member of your family getting MS is small.

Can I have children?

MS rarely affects a woman’s ability to get pregnant, carry a child or give birth. A woman with MS is less likely to have a relapse during pregnancy, although the risk of relapse increases during the six months after the birth. Pregnancy does not affect how someone’s MS develops in the long term.

There is no evidence that MS affects male fertility directly although sometimes symptoms include erectile dysfunction.

If you’re planning to have children, it’s best to discuss this with your MS nurse or your GP, especially as most medications are not recommended during pregnancy.

How much will MS affect me?

After diagnosis, it’s natural to wonder what MS might mean for your future. Everyone’s MS is different so no one can predict how much your MS might, or might not, affect you.

MS is a lifelong condition but it is rarely fatal. Most people with MS live into old age although their lifespan, on average, is about six years less than the general population.

Life goes on, maybe not exactly as you’d planned or dreamed it would.

Will I become disabled?

It’s possible that MS may impact on what you can do in the future and you may need to adapt to these changes and learn to do certain activities in your life differently.

Although MS can cause some disability, most people never need to use a wheelchair on a regular basis. The treatment and care of people with MS is improving so people diagnosed with MS today can expect a better quality of life than was possible previously.

Some people find that their MS only has a small impact on their daily lives and they can continue with their usual hobbies and working life. They may show no obvious signs of their condition. Others have more intrusive symptoms which can have a much bigger impact and may result in reducing working hours or needing more help around the home.

If you already know someone with MS, you may be tempted to assume that your MS will be the same as theirs. This is unlikely as everyone’s MS is different. This is true even if you are closely related to them.

If you are more severely affected you may get more infections than healthier people and can develop complications that affect breathing and circulation. This can decrease your life expectancy so it’s important to keep as well as possible and seek treatment promptly.

Could a sunny climate prevent MS?

Multiple sclerosis is an autoimmune disease wherein the immune system turns against healthy cells in the central nervous system, attacking myelin, or the “coating” around nerve cells. Scientists now investigate a key factor that may influence the chance of developing this condition.

Share on PinterestA new study explores the importance of exposure to sunlight throughout a person’s lifetime when it comes to determining MS risk.

People living with multiple sclerosis (MS) tend to experience a progressively decreased quality of life, as the condition — which is characterized by fatigue, impaired balance and coordination, and vision problems — takes hold.

Though its exact causes are unclear, known risk factors for developing MS are genetic makeup, lifestyle, and environmental factors.

Some of these include sex (women are likelier to be diagnosed with MS than men), smoking habits, and low overall levels of vitamin D.

Now, researchers from the University of British Columbia in Vancouver, Canada have uncovered a factor that may help to lower the risk of MS: where individuals (women, in particular) spent their childhood and early adulthood.

In a paper published yesterday in the journal Neurology, Helen Tremlett and colleagues found that spending a lot of time in sunny climates early on in life may help to protect against the onset of MS later on.

Although geographical latitude was known to contribute to the risk of MS, because lack of sufficient exposure to sunlight can determine a deficit of vitamin D, this is the first time that researchers have studied the impact of this factor throughout a person’s lifetime.

“While previous studies have shown that more sun exposure may contribute to a lower risk of MS,” says Tremlett, “our study went further, looking at exposure over a person’s life span.”

“We found that where a person lives and the ages at which they are exposed to the sun’s UV-B rays may play important roles in reducing the risk of MS.”

Helen Tremlett

Sunny locations and vitamin D

In the new study, Tremlett and team analyzed data from 151 women who had been diagnosed with MS (with an average onset age of 40), as well as 235 age-matched women without the condition.

They all lived in the United States but were spread across locations with different climates. All the participants were asked to fill in questionnaires on how often and how much they had been exposed to the sun during summer, winter, and throughout their lives.

The researchers sourced all of this data through the Nurses’ Health Study, which is a long-term project investigating the risk factors for chronic diseases in women.

Based on the information provided by the participants, the research team split them into three different groups. These were:

  • participants who had experienced low exposure to UV-B rays
  • participants with moderate exposure to UV-B rays
  • participants with high exposure to UV-B rays

Despite the fact that this type of radiation has been associated with several harms — including the appearance of wrinkles and skin cancer onset — it is also key in the process through which our bodies generate vitamin D, which has been identified as a protective factor against MS.

Sun-filled childhoods halve MS risk

In determining how much UV-B exposure participants had received, and in dividing them into the above categories, Tremlett and team looked at where the women lived, taking into account location altitude, latitude, and average cloud cover.

In the analysis, the team also included how much sun exposure the participants had experienced in different seasons, defining “high sun exposure” as more than 10 hours per week in summer, and more than 4 hours each week during winter.

The researchers saw that the participants who lived in sunny climates and received the highest degree of UV-B exposure had a 45 percent lower risk of developing MS compared with their counterparts who reported very infrequent UV-B ray exposure.

Moreover, the scientists found that when exposure occurred also mattered. Thus, participants who had lived in sunny climates between the ages of 5 and 15 had a 51 percent lower risk of MS, compared with peers who had grown up in less forgiving climates.

Also, women who spent a lot of time outdoors in sunny climates as children (age 5 to 15) had a 55 percent lower risk of MS than women who had not benefited from the same amount of UV-B exposure at an early age.

“Our findings suggest,” explains Tremlett, “that a higher exposure to the sun’s UV-B rays, higher summer outdoor exposure, and lower risk of MS can occur not just in childhood, but into early adulthood as well.”

“In addition,” she says, “our research showed that those who did develop MS also had reduced sun exposure later in life, in both summer and winter which may have health consequences.”

We know that eating a diet that’s high in sugar and processed foods is bad for your health and can lead to serious diseases like diabetes and heart disease, but there are also some foods and chemicals found in processed foods that have been linked to an increased risk of developing leaky gut (intestinal permeability) which can lead to multiple sclerosis (MS) and other autoimmune diseases. With tips from prevention.com, we’ve compiled a list of ways to avoid these foods.

Four possible causes of multiple sclerosis.

Go Easy on Salt and Sugar

Buying whole foods instead of packaged and processed foods means that you can control the amount of salt and sugar you consume. While both are great flavor enhancers, you only need a small sprinkle of either to get the desired effects. Choosing unsalted and unsweetened food will allow you to track how much salt and sugar is in your diet, and allow you to choose healthier options like Himalayan salt instead of table salt, or organic honey instead of cane sugar.

Avoid Emulsifiers

Emulsifiers are used in processed foods to give them a creamier texture without using dairy products, so can often be found in non-diary ice cream, salad dressings, and even almond milk. Check the labels of products and avoid items which have the word “gum” after them. Two of the main offenders are lecithin and carrageenan.

Processed Meats

Processed meats such as hot dogs, chicken nuggets, imitation crab and other types of foods where the meat glue “microbial transglutaminase” has been used should be avoided. Stick to whole pieces of meat such as cuts of steak, chicken breasts, fillets of fish etc.

Seven strange and unusual symptoms of multiple sclerosis

Refined Carbohydrates

Refined carbohydrates like bread, pasta, and crackers can mess with blood sugar levels. In addition, nearly all of these products contain gluten which can often cause other health problems. Choose alternative grains such as quinoa, amaranth, and millet.

Avoid Titanium Dioxide

Titanium dioxide is a nanoparticle often used in paper and plastic packaging so it pays to decant products into glass jars when you get back from the grocery store. However, these nanoparticles are also used to help keep certain foods looking white, so can often be found in frosting, candies, and gum.

Build Up Resistance to Fermented Foods

Fermented foods such as sauerkraut and lacto-fermented pickles are very good for gut health but you need to build up a resistance to them first as they can cause bloating and gas.

Boost Gut Health

Turn to foods known to boost gut health to avoid developing leaky gut. Think probiotic foods like kefir, kimchi, yogurt and tempeh. Alcohol, on the other hand, is not good for gut health so you should limit the amount you consume.

Eating these foods can help you get your daily dose of vitamin D.

Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Escalate treatment to avoid MS relapses

BERLIN – Escalating treatment to a “highly effective” disease-modifying treatment (DMT) results in fewer relapses in patients with relapsing-remitting multiple sclerosis (RRMS) than does switching to another “moderately effective” therapy, according to data from a Danish cohort study.

Sara Freeman/MDedge News

Dr. Thor Ameri Chalmer

The annualized relapse rate (ARR) was 0.23 for patients who switched to a highly effective DMT, defined as either natalizumab (Tysabri) or fingolimod (Gilenya), whereas the ARR was 0.35 in those who were switched to a moderately effective DMT, defined as an interferon-beta, glatiramer acetate (Copaxone), teriflunomide (Aubagio), or dimethyl fumarate (Tecfidera).

This resulted in a relapse-rate ratio of 0.67 (95% confidence interval , 0.55-0.83) comparing high to moderate DMT, or a 33% lower relapse rate in the high DMT group, Thor Ameri Chalmer, MD, PhD, reported at the annual congress of the European Committee for Treatment and Research in Multiple Sclerosis.

Dr. Chalmer, who works at the Danish Multiple Sclerosis Center at Rigshospitalet, the University of Copenhagen, reported that the time to first relapse and the likelihood for having recurrent relapses were all lowered by escalating treatment rather than switching treatment. Indeed, there was a 38% increase in the time to first relapse (hazard ratio = 0.62; 95% CI, 0.50-0.76) and a 31% reduction in recurrent relapses (HR = 0.69; 95% CI, 0.57-0.83).

“The aim of this study was to use data from the MS Registry, find the patients who started on what we define as moderately effective DMT for the first time, and on this treatment experienced a disease breakthrough and then either switched to another moderately effective DMT or escalated to a highly effective DMT,” Dr. Chalmer explained.

Disease breakthrough was defined as at least one relapse occurring within 12 months of the treatment switch, or the treating neurologist defined the reason for switching as disease breakthrough. Dr. Chalmer acknowledged that this was one of the limitations of the observational study as patients could have been misclassified and switched treatment for another reason. The severity of the relapse was not recorded.

Data on more than 5,000 patients enrolled in the Danish Multiple Sclerosis Registry (DMSR) were considered, with a final propensity-match population of 788 included in the analysis; half had received highly effective DMT and half moderately effective DMT.

The DMSR contains data on virtually all patients with MS treated in Denmark, Dr. Chalmer observed; treatment with DMT is free of charge and it can be prescribed only in public MS clinics, he explained. Furthermore, all MS clinics are required to register information about treatment response at each clinical visit.

The mean age of patients in the study was 39 years, around 70% were female, and average disease duration was 5 years.

“I don’t see in your study what is really new,” Gilles Edan, MD, observed during a discussion. “We know that using more active, more efficient drugs gives more control on relapse.”

Dr. Edan, professor and head of the neurosciences department of University Hospital Pontchaillou, Rennes (France), added that these data “confirmed what has already been observed in the clinical trials.”

It is important to consider the safety and efficacy concerns on an individual level, Dr. Edan argued, questioning whether the more highly active drugs should be systematically used first-line rather than second-line in all patients with MS. He also noted that of course patients would need to be treated for very long periods.

Dr. Chalmer responded: “I agree some of the randomized trials have touched upon on this as well, but I think it’s really important to not just rely on one or two trials but to keep on doing the trials over and over again so that we show that we have the right results.”

Dr. Chalmer added that the present study looked only at efficacy and that the median follow-up time was 3.2 years. “Safety is important of course, but it was not the aim of this study.” Perhaps longer follow-up might have detected more differences in the EDSS outcomes, he added.

The study was funded by the Danish Multiple Sclerosis Society, the Foundation for Research in Neurology, Ejnar Jonassen, and Gangstedfonden. Dr. Chalmer disclosed he had received support for congress participation from Merck, Biogen, and Roche.

SOURCE: Chalmer T et al. Mult Scler. 2018;24(S2):99. Abstract 263.

Inherited conditions

To count as an inherited condition, MS would have to be passed on in a predictable way which it isn’t.

Inherited conditions are caused by faulty genes which are passed on from one generation to another. Typically, a child has either a one in two or a one in four chance of inheriting the condition from their parents. Examples of conditions inherited in a predictable way are haemophilia and muscular dystrophy.

In inherited conditions, identical twins will either both have the condition or both be free of it because they carry identical genes. This doesn’t happen in MS. If one identical twin has MS, the other twin only has about a one in four chance of having MS, again showing that MS is not a truly inherited condition.

Also, most people with MS have no history of MS in the family so it seems to have appeared from nowhere.

The role of genes in MS

Genes do play a part in MS. Some genes make it more likely that someone gets MS but having those genes is definitely not enough on its own. Other factors are needed to trigger MS in someone who carries genes that make them more susceptible to getting MS.

Recent research has found over 100 genes that contribute to susceptibility to MS. Each gene represents a tiny part of the risk so the more of these different genes that someone carries, the more their risk is increased. Consequently, there isn’t a simple genetic test to say whether someone is susceptible or not.

Other factors that play a part

So, what factors can trigger MS in someone who has got the genes that make them more susceptible? A whole range of factors have been investigated and the evidence for which factors might be triggers is patchy. The strongest contenders are:

  • lack of sunshine which is linked to lack of vitamin D
  • exposure to the very common Epstein Barr virus which causes glandular fever in some people
  • smoking

Adding it all together

The bottom line is that MS is not inherited but there is an increased risk in families who already have a member with MS because they carry some of the same genes. However, other factors are needed to trigger the condition and, overall, MS is still considered as a relatively rare condition compared with, for example, diabetes or breast cancer.

The risk of MS in a family member depends on how closely related they are. The more closely related, the more likely that both will have MS. In a recent study of over 42,000 people in Sweden who had a parent with MS, only 515 (1.2%) had also been diagnosed with the condition. This translates into roughly a one in eighty chance of a parent and their child both having MS. This compares with a roughly one in 400 chance in completely unrelated people.

Is MS hereditary or not?

Returning to the original question at the top of this blog: MS is not inherited in the true sense of the word and this is what many neurologists tell people with MS. However, there is an increased risk in families so it is not surprising to sometimes hear of two members of the same family both having MS.

If you’d like to read more
Risk of MS
Causes of MS
How genetic conditions are inherited
Latest MS research updates

MS can affect many aspects of daily family life, particularly if a person has symptoms such as fatigue, eyesight problems and cognitive changes. Couples may find that they have to review their roles within the household and this can be difficult. For example, a family with two incomes may have to learn to cope on one, or one of the partners may have to take on extra responsibilities for running the home or caring for children.

The impact of MS symptoms on family life

It is estimated that as many as half of people with MS experience mild cognitive problems. Because cognitive difficulties in MS are “invisible” symptoms, family members may misinterpret behaviours or reactions on the part of the person with MS. Difficulties with memory, problem solving and concentration may be interpreted as the family member not caring or not listening, being uninterested or unwilling to cooperate. Correct information can be the key to helping families understand and cope with cognitive problems.

Fatigue is another misunderstood invisible symptom of MS. Often a family member with MS appears to lack motivation when, in fact, the person is experiencing MS fatigue, a type of tiredness or exhaustion that is a symptom of the disease.

When the family has a clear understanding of fatigue and its impact on the person’s ability to function, they may be more keen to help with household tasks, reconsider family activities that may be strenuous for the member with MS, and, in general, re-organise the house and habits of the family in away that helps the person with MS conserve energy. It is important for the family to understand the importance of energy conservation strategies that can help the person with MS have more energy to spend with the family.

How families cope

Each member of a family has his or her own coping style. On finding out that a family member has MS, some people look for as much information about the disease as they can find and perhaps prefer to talk to others about their experience with MS.

Others may deal with news of the diagnosis by keeping busy with other activities in order to avoid thinking about MS.

Each person brings into the “MS experience” his or her own way of coping. Different coping styles within the same family can be complementary or contradictory. Contradictory coping styles may lead to conflict within the family.

Family members should be encouraged to cope with MS in their own individual styles, while respecting the coping styles of other members. However, communication is key, and if a family traditionally has dealt with problems by ignoring them, assigning blame or using some other, ineffective coping style, the family’s way of confronting MS will be the same, at least without the help of a family counsellor or psychologist.

MS can add stress to a relationship. The unpredictability and progressive nature of the disease, the changes and sacrifices that might be required and the impact of some symptoms are all obstacles that make it difficult for both the person with MS and their partner to cope. It may be useful for a couple to seek help from a counsellor.

MS affects every member of the family. Learning about the disease and its possible effect on the family can help people face challenges as they arise. Families that are informed about the different resources available can choose those that best suit their needs and lifestyle.

Download the family issue of MS in focus magazine (you will need Acrobat Reader to view these files):

Madrid, Spain, 10/2011. Saturday afternoon at the zoo is a time for Almudena and her husband to lavish attention on their son. The outing will fatigue Almudena, but she recognises the need for a 3-year-old boy to burn off energy and be out exploring the world. Credit: Lurdes R. Basol. Published here by kind permission of the European Multiple Sclerosis Platform.

Madrid, Spain, 10/2011. As Antonio’s world becomes more confined by the walls of their apartment, his wife Milagros Albertos feels her role is evolving from wife and partner to nurse or mother. She is losing important elements of her own identity and is often faced with difficult choices such as going out with friends or staying in to show her support. As their financial situation worsens, they are forced to consider moving in with Antonio’s mother. Credit: Lurdes R. Basolí. Published on this website by kind permission of the European Multiple Sclerosis Platform.

Multiple sclerosis and pregnancy

Multiple sclerosis (also called MS) is an autoimmune disorder that affects the central nervous system (the brain and spinal cord). Autoimmune disorders are health conditions that happen when antibodies attack healthy tissue by mistake. Antibodies are cells in the body that fight off infections.

If you have MS, your body attacks the myelin sheath. This is a covering that protects your nerve cells, kind of like insulation around an electric wire. Damage to the myelin sheath slows down or stops messages between your brain and the rest of your body. This can cause mild to severe symptoms that affect your muscles, speech and vision. MS is usually mild, but over time some people with MS can’t write, speak or walk.

About 1 in 1,000 people in the United States has MS. Women are about 2 to 3 times more likely than men to have it. It’s usually diagnosed during childbearing years, between the ages of 20 and 40. But it can happen at any age.

The good news is that if you have MS and get the right medical care, chances are you can have a healthy pregnancy and a healthy baby.

How do you know if you have MS?

Signs and symptoms can include:

  • Muscle weakness, stiffness or cramps
  • Tingling, numbness or pain in your body
  • Tremor (shaking) in your arms or legs
  • Loss of balance
  • Problems walking or moving your arms or legs
  • Speech problems
  • Vision problems
  • Fatigue (feeling tired all the time)
  • Dizziness
  • Bladder or bowel problems
  • Thinking and memory problems
  • Depression. This is a medical condition in which strong feelings of sadness last for a long time and interfere with your daily life. It needs treatment to get better.

These signs and symptoms can be mild or serious. If you have any of them, tell your health care provider. She may refer you to a neurologist. This is a doctor with special training in diseases of the nervous system. The nervous system is made up of your brain, spinal cord and nerves. Your nervous systems helps you move, think and feel.

To check for MS, you may have these tests:

  • Physical exam
  • Blood tests
  • Tests to see how your nervous system works (also called evoked potential tests)
  • A spinal tap. This is when your provider pushes a small needle into your lower back to remove a small amount of cerebrospinal fluid. Cerebrospinal fluid is found around your brain and spinal cord. You provider sends the fluid for testing at a lab.
  • Imaging tests, like magnetic resonance imaging (also called MRI). MRI is a medical test that makes a detailed picture of the inside of your body. The test is painless and safe for you and your baby. MRI can show changes in the brain that are seen in MS, like abnormal tissue changes (also called lesions) and loss of brain tissue (also called atrophy).

MS can be hard to diagnose because there’s no specific test for it and the symptoms are different for each person. Some people have times when they’re feeling well (called remission) and times when new symptoms appear or old symptoms get worse (called flare-ups). Your health care provider looks at all of your test results and health information together to know if you have MS.

What problems can MS cause in pregnancy?

Having MS doesn’t seem to affect getting pregnant. During pregnancy, many women find their MS symptoms stay the same or even get better, especially during the third trimester. But if you have MS, you may be more likely than other women to have:

  • A small-for-gestational-age baby. This means a baby who is smaller than normal based on the number of weeks he’s been in the womb.
  • Trouble pushing your baby out during labor and birth. This can happen if your MS symptoms affect your pelvic muscles and nerves.
  • A cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Experts aren’t sure why women with MS are more likely than other women to have a c-section. It may be because of muscle problems that may delay labor.

Women with MS may be more likely to have a flare in the first 3 to 6 months after giving birth. But researchers think that being pregnant doesn’t affect the overall course of MS later in life.

How is MS treated?

There’s no cure for MS, but medicines can help control the symptoms. Many women don’t need medicines during pregnancy because their symptoms get better. If you have MS and are pregnant or thinking about getting pregnant, talk with your health care provider about the medicines you take for MS. Some may not be safe to use during pregnancy or breastfeeding.

For example, many people with MS take a medicine called beta interferon (Avonex®, Betaseron® and Rebif®). This medicine can help lessen flares and slow down the spread of nerve damage and the course of MS, but it’s not safe to take during pregnancy. Beta interferon may increase the risk of miscarriage (when a baby dies in the womb before 20 weeks of pregnancy) and stillbirth (when a baby dies in the womb after 20 weeks of pregnancy). Cancer-fighting medicines called immunosuppressives are sometimes used to treat MS, but they’re also not safe to use during pregnancy. Your provider can switch you to a safer medicine.

Other therapies for MS are important, especially during pregnancy. For example, finding a support group for people with MS or talking to a counselor can be helpful. A support group is a group of people who have the same kind of concerns. They meet together to try to help each other. Exercise or physical therapy also can help. Physical therapy is an exercise program created just for you to help improve your strength and movement.

What causes MS?

We don’t know what causes MS, but genes may play a role. Genes are parts of your body’s cells that store instructions for the way your body grows and works. Genes are passed from parents to children.

About 15 in 100 (15 percent) people with MS have one or more family members with MS. People who have a family history of MS are more likely to have MS than people who don’t. White people, especially whose families come from northern Europe, have the highest risk of having MS. People of Asian, African or Native American backgrounds have the lowest risk of having MS.

Researchers are studying to see if viruses, infections or other health conditions may be linked to MS. For example, if you have type 1 diabetes or thyroid disease, you may be slightly more likely to have MS than people who don’t have these conditions.

Your environment and lifestyle also may play a role in causing MS. For example, people who smoke are more likely to get MS than people who don’t. And MS is more common in people who don’t get enough sunlight or vitamin D. For example, it’s more common in areas farther away from the equator where there’s less sunshine. Sunlight helps the body make vitamin D.

More information

  • National Institute of Neurological Disorders and Stroke

Last reviewed: January, 2014

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