Navigating Causes, Symptoms, and Solutions of Multiple Sclerosis

 Author: Megan Jones (Adv.Dip.NutMed, BHsc.NutMed)

Multiple Sclerosis (MS) is a chronic autoimmune condition in which the body attacks itself by mistake.[1] 

In MS, the immune system cells that normally protect the body from viruses, bacteria, and unhealthy cells attack myelin in the central nervous system. This leads to a breakdown of the protective sheath that covers nerve fibres in the brain and the spinal cord, affecting cognitive, emotional, motor, sensory, or visual function [2].  It is often diagnosed between the ages of 20 to 40, and it is estimated that over 2.5 million people worldwide currently have the disease [3].

The progression, severity, and symptom manifestation of MS all remain unpredictable,[4] and while there is still no cure, ongoing research by medical professionals and scientists yields new insights into MS treatment and management regularly.[5]

Complementing medical care with healthy habits like prioritising sleep, managing stress, and engaging in regular exercise can significantly impact quality of life for those with the disease.[6] [7] [8] [9]

In this article we take a deep dive into the potential causes of the disease and how lifestyle measures play a pivotal role in supporting its management.

Read on to discover how incorporating a simple daily serve of Nuzest’s Good Green Vitality can provide the nutrients crucial for optimal energy production, as well as for facilitating better sleep and stress management within the body – all key areas of focus for living well with MS. [10]

What causes MS?

While the exact causes of MS are not fully understood,[11] scientists can confirm that a combination of genetic, environmental and immune factors are thought to control MS onset and progression.[12]

Genetic factors:

Since the 1970s, several genome-wide association studies have been performed, and now over 200 gene variants have been uncovered and linked to MS predisposition.[13]

Variations in several HLA genes have been associated with increased multiple sclerosis risk, but one particular variant of the HLA-DRB1 gene, called HLA-DRB1*15:01, is the most strongly linked genetic factor.[14] [15] The HLA-DRB1*15:01 gene contributes to the activation of immune cells, signalling the body's immune system to confirm if a cell is part of the body (self) and therefore shouldn't be attacked.

Immune factors:

Inflammatory cells must be activated for MS to develop and although the underlying cause remains unclear, the inflammatory hallmark of MS is lymphocyte (white blood cell) deposition in the central nervous system (CNS) and the cerebrospinal fluid (CSF). When dysregulated T and B (both lymphocyte) immune cells infiltrate the central nervous system, they instigate an autoimmune response against the myelin sheath.[16] [17] This immune dysregulation leads to neurological dysfunction characteristic of MS, including sensory disturbances and motor impairments.[18]

Environmental factors:

Many environmental factors are thought to play a significant role when it comes to triggering the immune system to attack the myelin sheath, and have been linked with the development of the disease. These include:

• Lack of vitamin D
• Epstein-Barr virus
• Poor gut health
• Smoking
• Family history
• Geographical location
• Stress [19] [20] [21] [22] 

Lifestyle modifications

While symptom management is an essential component of comprehensive care in MS, equally important are lifestyle modifications that enhance central nervous system reserve and function. These modifications are the foundation for health maintenance, an improved sense of well-being and increased energy. [23] [24] [25]

While no single lifestyle change can stop the progression of MS, lifestyle changes such as incorporating regular exercise, better quality sleep and stress management techniques like meditation and mindfulness have been reported to:

• reduce symptoms
• lower the number of relapses
• improve overall health
• adapt to and compensate for the effects of MS. [26] [27]

Exercise:

Many studies highlight the benefits of exercise for individuals living with MS.  Tailored physical activity programs have been shown to elicit remarkable improvements across a broad range of areas of cardiorespiratory fitness, muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function in MS patients [28].  An essential part of managing MS, exercise can also help with improved functional ability – things like mobility, mood, pain tolerance, bladder and bowel dysfunction and prevention of other diseases.[29]

It is worth noting however, that it’s a good idea to talk to an accredited health professional, such as an exercise physiologist or physiotherapist, so they can identify the most suitable exercise program for where you are at with the disease.

Sleep:

Sleep is essential for optimal functioning, especially during periods of stress or when combating an illness, while poor sleep quality is common in MS. Poor sleep quality may lead to problems with mood, energy, and even an increase in MS symptoms and may also lead to cognitive decline. Studies have shown that improving sleep quality may result in clinically meaningful improvements in health outcomes for those with MS. [30] [31]

In addition to the general discomfort caused by MS symptoms, people with this condition are more likely to have one or more co-existing sleep disorders.

The most common MS-related sleep disorders are insomnia, restless legs syndrome,[32] sleep-disordered breathing, narcolepsy, and REM sleep behavior disorder. Often, these manifestations stem from lesions in particular regions of the brain or spinal cord, meaning that symptoms can differ between individuals based on the location and severity of their lesions.[33] [34] [35] [36]

Establishing a consistent sleep schedule, limiting screen time before bed, avoiding too many fluids before bedtime, keeping the bedroom dark, quiet and cool, and creating a relaxing bedtime routine are key components of good sleep hygiene, promoting better sleep quality and overall well-being.[37]

Stress management:

While stress remains an inevitable part of our lives, we can learn to manage it more effectively. What’s more, stress affects the body’s ability to fight disease. Research also indicates that stress can influence the susceptibility to neurodegenerative disorders such as MS.[38]

Stress can both affect MS relapses and worsen MS symptoms through excessive inflammatory responses and degeneration, so it’s important to learn ways of managing it as much as possible.[39] [40]

Techniques to help manage stress and to reduce the fight or flight response such as meditation, cognitive behavioural therapy (CBT), establishing a social support network or journalling have all been shown to have positive psychological effects and help to reduce stress. [41]

Top 5 nutrients to help with energy production and stress support for those with MS

Vitamin B12:

Ensuring an adequate intake of vitamin B12 is crucial for individuals living with MS. B12 is a vitamin necessary for maintaining the health of the myelin sheath, while supporting nerve health overall, as well as playing a key role in energy production and metabolism – potentially helping to alleviate fatigue and promote overall wellbeing. Some studies have shown a higher rate of B12 deficiency in MS patients. Vitamin B12 cannot be made by the body and so it is crucial to obtain it either from diet, supplementation or B12 injections.[42] [43] [44]

Did you know? Nuzest’s Good Green Vitality contains 100 mcg of B12 as methylcobalamin (the active and most bioavailable form of the vitamin) per serving, which exceeds the recommended daily value.

CoQ10:

CoQ10 is crucial for cellular energy production, while studies have shown that supplementing MS patients with CoQ10 elicits a reduction in peripheral markers of oxidative stress (which have been associated with development of inflammation, demyelination and neurodegeneration), along with an improvement of fatigue and in feelings of depression.[45] [46]

If you are looking to increase your CoQ10 intake, just one serve of Nuzest’s Good Green Vitality will provide you with 15mg towards your daily goal.

Magnesium:

Since psychological stress triggers inflammatory activity in the body, which in turn can affect the immune system and exacerbate regulate the disease processes of MS, ensuring adequate levels of magnesium through diet and/or supplementation is crucial for those living with the disease.[47]

Magnesium is involved in hundreds of biological processes like cell functioning and energy utilisation, while it has also been shown to help with the leveling of cortisol — one of the stress hormones in the body. Studies have shown that magnesium supplementation can significantly reduce different inflammatory markers within the body. [48] [49] [50] [51]

Our Good Green Vitality can give you a boost of magnesium, with each daily serve containing 100mg!

Vitamin D:

Vitamin D plays a crucial role in immune function within the body. Higher levels of vitamin D are associated with reduced risk for developing MS, while supplementing with vitamin D also may lower the risk of relapse and may decrease new scarring in the nervous system.[52] [53] [54]

A single daily serve of our Good Green Vitality contains 20mcg of vitamin D3, sourced from lichen so it is suitable for vegans and vegetarians.

Omega-3 fatty acids:

Omega-3 fatty acids have been shown to reduce inflammatory markers in the body, while keeping cell membranes soft, pliable and resistant to degeneration as well. For these reasons they have been found to play an important role for those with MS.

Their beneficial effects on reducing the relapse rate and improving the quality of life for MS patients make them an important addition to diet or supplementation regime.[55] [56] [57]

Did you know that just 1 daily serve of Nuzest’s Good Green Vitality can help in achieving significantly higher levels of essential fatty acids due to the flaxseed, spirulina, red marine algae, kelp and alpha-lipoic acid content.

 References:

[1] https://pubmed.ncbi.nlm.nih.gov/29763024/

[2] https://www.who.int/news-room/fact-sheets/detail/multiple-sclerosis

[3] https://autoimmunhighlights.biomedcentral.com/articles/10.1007/s13317-018-0109-x

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365982/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187186/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575303/

[7] https://www.researchgate.net/publication/333860278_Lifestyle_medicine_-_An_evidence_based_approach_to_nutrition_sleep_physical_activity_and_stress_management_on_health_and_chronic_illness

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767964/

[9] https://www.researchgate.net/publication/258182844_Exercise_Diet_and_Stress_Management_as_Mediators_Between_Functional_Disability_and_Health-Related_Quality_of_Life_in_Multiple_Sclerosis

[10] https://www.nationalmssociety.org/managing-ms/living-with-ms

[11] Pietrangelo A, Higuera V. Multiple sclerosis by the numbers: facts, statistics, and you [cited 2020.01.14]. Available from: https://www.healthline.com/health/multiple-sclerosis/facts-statistics-infographic#1

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532002/

[13] https://www.annualreviews.org/content/journals/10.1146/annurev-pathol-052920-040318#right-ref-B6

[14] https://www.neurology.org/doi/10.1212/NXI.0000000000200190

[15] https://www.nature.com/articles/s41467-018-04732-5#:~:text=The%20human%20leukocyte%20antigen%20(HLA,for%20multiple%20sclerosis%20(MS).

[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916779/

[17] https://onlinelibrary.wiley.com/doi/full/10.1111/imm.13198

[18] https://autoimmunhighlights.biomedcentral.com/articles/10.1007/s13317-018-0109-x

[19] https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02579-z#ref-CR5

[20] https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02579-z

[21] Dehghani R, KazemiMoghaddam V. Potential causes of the increased prevalence of multiple sclerosis in Iran: a review study. Pars J Med Sci. 2015;13(2):17–25.

[22] Richards, J. L., Yap, Y. A., McLeod, K. H., Mackay, C. R. & Mariño, E. Dietary metabolites and the gut microbiota: an alternative approach to control inflammatory and autoimmune diseases. Clin. Trans. Immunol. 5, e82 (2016).

[23] https://pubmed.ncbi.nlm.nih.gov/27261684/

[24] https://www.ucsfhealth.org/education/maintaining-a-healthy-lifestyle-with-multiple-sclerosis

[25] https://www.ucsfhealth.org/education/maintaining-a-healthy-lifestyle-with-multiple-sclerosis

[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302199/

[27] https://www.healthline.com/health/multiple-sclerosis/lifestyle-changes-to-slow-ms-progression

[28]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602953/

[29] https://www.nationalmssociety.org/managing-ms/living-with-ms/diet-exercise-and-healthy-behaviors/exercise#:~:text=Benefits%20of%20Exercise%20for%20Multiple%20Sclerosis&text=Benefits%20include%20improved%3A,Cardiovascular%20fitness

[30] https://doi.org/10.1136/jnnp-2022-329227

[31] http://link.springer.com/10.1007/s11910-018-0809-7

[32] https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms/5-tips-for-living-better-with-ms-patients-and-caregivers

[33] https://linkinghub.elsevier.com/retrieve/pii/S1389945718303873

[34] Damasceno, A., Moraes, A. S., Farias, A., Damasceno, B. P., dos Santos, L. M., & Cendes, F. (2015). Disruption of melatonin circadian rhythm production is related to multiple sclerosis severity: A preliminary study. Journal of the neurological sciences, 353(1-2), 166–168.

[35] https://onlinelibrary.wiley.com/doi/10.1111/jsr.12880

[36] https://pubmed.ncbi.nlm.nih.gov/22895593/

[37] https://www.sleepfoundation.org/sleep-hygiene/healthy-sleep-tips

[38] https://www.ncbi.nlm.nih.gov/books/NBK507250/

[39] https://www.sciencedirect.com/science/article/abs/pii/S1568997213000438?via%3Dihub

[40] https://www.sciencedirect.com/science/article/abs/pii/S2211034822006496

[41] https://pubmed.ncbi.nlm.nih.gov/31298582/

[42] https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

[43] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789617/

[44] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421121/

[45] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381428/#:~:text=When%20supplementing%20MS%20patients%20with,of%20fatigue%20and%20depressive%20symptoms

[46] https://pubmed.ncbi.nlm.nih.gov/25603363/

[47] https://pubmed.ncbi.nlm.nih.gov/36248830/

[48] https://health.clevelandclinic.org/magnesium-for-anxiety

[49] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8838086/

[50] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316205/

[51] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968354/

[52] https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/vitamin-d-and-ms/faq-20058258#:~:text=Research%20has%20shown%20that%20maintaining,less%20likely%20to%20have%20MS%20

[53] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567111/

[54] https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.00781/full

[55] https://pubmed.ncbi.nlm.nih.gov/31462182/

[56] https://pubmed.ncbi.nlm.nih.gov/33837698/

[57] https://www.semanticscholar.org/paper/Effect-of-omega-3-fatty-acids-and-fish-oil-on-a-Alammar-Albeesh/bb894365ebfbc3eb071f1fbd0c8d5be104926bba