In this DocTalk, Valley’s multiple sclerosis specialist Sargon Bet-Shlimon, MD, answers 9 frequently asked questions. An abbreviated overview of the talk can be found below the video.
What diet should follow if you have MS?
No diet has been proven to have any disease-changing effect in multiple sclerosis. The longer answer is that you may read about anti-inflammatory foods or anti-inflammatory diets, but none of that has really been proven to make a difference in terms of MS. However, I always tell patients that it’s okay to experiment and try these diets out. The fact that we don’t have good evidence that these diets really change the outcome of MS doesn’t necessarily mean that they couldn’t.
One other piece of advice that I usually give patients is to consider a heart-healthy diet; the best studied one is the Mediterranean diet. There isn’t a direct effect on MS itself from these kinds of diets. But, we know that when cardiovascular risk factors like heart disease, high blood pressure, and diabetes are not well controlled, people tend to do worse with MS. So, taking measures to protect your cardiovascular health, including good diet, exercise, and seeing your primary care provider regularly, are all good steps to take.
What about exercise? What kind should you do if you have MS?
I usually tell my patients that the most important thing is to find a form of exercise that you enjoy doing and that you can do on a regular schedule. When it comes to MS, make sure that you are doing exercises that work with any physical limitations you might have related to MS. It’s also important to know that people with MS will often have temporary worsening of some of their symptoms when they’re exercising more strenuously. This is because of increases in your core body temperature. It’s not unique to exercise and it can happen in other situations, but the important thing to know is that those changes are temporary and they don’t indicate new damage or harm coming to you from MS.
Are there natural or holistic remedies that can help treat MS?
Patients will sometimes report that different types of complimentary or alternative medicines, like acupuncture or chiropractic treatments, may help with certain symptoms of MS, with other neurologic conditions. The important thing to note is that these approaches don’t have a disease modifying effect, which means that they won’t alter the course of the MS disease. Also, they shouldn’t be considered a replacement for the treatments and medications that we do use.
Is MS contagious or hereditary?
MS is not contagious; it’s not an infectious disease. MS is not hereditary in the sense that you are definitely going to pass MS on from parent to child in the way that we think of some hereditary diseases. But, there is a very small genetic component of increased risk if you have a first-degree relative with MS. It’s relatively small, and that’s why we don’t consider it to be a hereditary disease.
If someone has MS, is it going to get worse?
It depends a lot on the person and how active their MS is. It also depends on other factors, like how long they’ve had it, whether they’re being treated for it, and their age. So, it’s a good question, but it’s probably a better question answered on an individual basis.
How do drug treatments help MS and is there a cure?
Unfortunately, there is no cure for multiple sclerosis, but we do have a number of disease-modifying therapies, which are treatments that change the course of the disease. They do this by reducing the chances that people would develop new attack symptoms, or new scarring and damage that we can see on imaging studies, like MRIs. The overall effect of this is that it reduces the chances that people would develop bothersome symptoms or disability in the long term.
What is the life expectancy for someone who has MS?
We don’t have really useful information on life expectancy in MS, especially in the era of newer treatments that have been out for relatively shorter periods of time. However, more likely than not, life expectancy in MS is not reduced all that much; not more than single digit years. I think the more important thing to realize is that in MS, we are more concerned about a patient developing bothersome symptoms or disability, rather than a big impact on life expectancy.
Is it okay for someone with MS to get pregnant? Does it affect fertility?
MS does not impact fertility and does not increase the risk of miscarriages, which is good news. With regards to considering pregnancy, there’s a lot of different factors that play in, like treatment considerations, MS disease-related considerations, and timing of pregnancy. I always recommend that patients discuss any plans for pregnancy with their MS neurologist, as well as their obstetrician.
Is there a connection with having MS and other autoimmune conditions?
This is a challenging question to answer because we don’t have a lot of good quality data on this. There have been a lot of reports of different autoimmune diseases that occur with multiple sclerosis, but we don’t have a lot of information on whether those conditions actually occur at a higher rate relative to the general population. It also may depend on certain other factors, like some autoimmune conditions may be more associated with MS than others, but I don’t think we can clearly say that across the board there is an increased risk of autoimmune disease in MS. That is because of limitations with the studies and data that we have available right now.
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