Neurology. 2014 Jul 15;83(3):293. doi: 10.1212/01.wnl.0000452303.37990.ff.
Effects of Bacille Calmette-Guérin after the first demyelinating event in the CNS.
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- Author response. [Neurology. 2014]
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- PMID:
- 25024446
- [PubMed - indexed for MEDLINE]
- see also faustmanlab.org and pubmed.org faustman dl
Informed Patient
Exercise, Diet and Sleep Can Improve MS Symptoms
Researchers Find Lifestyle Changes Can Help People With Multiple Sclerosis
ENLARGE
As a way to alleviate her MS symptoms, Vicky Foster, rides her
horse Rocky on her Quinlan, Texas property while her boyfriend Kevin
Stauff follows.
Dylan Hollingsworth for The Wall Street Journal
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Researchers are increasingly looking to lifestyle, diet and exercise, including salsa dancing, to help mitigate the often-debilitating effects of MS, which include problems with muscle control, balance, vision and thinking.
A diagnosis of MS can lead to depression and fear of stigma because the disease has the potential to progress to permanent disability. As many as 500,000 people in the U.S. and a total of more than 2.3 million world-wide are affected by the disease, according to the nonprofit National Multiple Sclerosis Society. It usually strikes in people’s prime, between the age of 20 and 50, and more than two times as many women develop MS, a gender difference that has been increasing over the past 50 years.
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And contrary to perception, MS isn’t always a steady degenerative downward spiral. Though there is no cure, about 85% of cases are known as “relapsing-remitting,” which means attacks with acute symptoms are followed by recoveries that can last for long periods of time.
According to the Multiple Sclerosis International Federation, the prevalence of MS globally increased from 2.1 million to 2.3 million between 2008 and 2013. There is no evidence that incidence is rising, but because of better diagnosis capabilities people are being recognized as having MS earlier.
A growing number of treatments have emerged over the past few years to treat relapsing-remitting MS including three oral medications that suppress or alter the activity of the immune system—Novartis’ Gilenya, Genzyme’s Aubagio, and Biogen Idec’s Tecfidera. These drugs are easier to take than injected medicines and they are a far cry from unproven therapies such as bee venom, which many patients took two decades ago to alter their immune systems when MS was virtually untreatable before the 1990s.
The focus also is shifting to lifestyle changes that can alleviate symptoms and possibly extend the time span between attacks.
Next week, Novartis is launching an awareness campaign about how to actively manage the disease, including a motivational music video with a new song “I Can Do This,” by entertainer David Osmond, 35, who was diagnosed with MS in 2006. Mr. Osmond, who takes the Novartis drug, shares tips including getting regular exercise.
Multiple sclerosis can be managed
in new and innovative ways that focus on diet and lifestyle. National MS
Society's Timothy Coetzee discusses on Lunch Break with Lee Hawkins.
Photo: iStock/craftvision
“The things people do day in and day out can make a huge impact on the quality of life,” says Timothy Coetzee, chief of advocacy, services and research for the society. MS causes the body’s immune system to attack the protective covering surrounding nerve fibers in the brain, spinal cord and eye. Its cause isn’t known, and though genetic factors may increase the risk, there is no evidence it is directly inherited. Environmental factors such as low vitamin D and cigarette smoking have also been shown to increase risk.
Vicky Foster, 53, a high-school guidance counselor, was 35 in 1997, with two children ages 5 and 8, when she began experiencing numbness on her left side and vision problems. For many years she gave herself injections of interferon beta, which affects the immune system and reduces relapses. But she sometimes skipped shots because they were painful and caused flu-like symptoms. After discussing medication options with Shanan Munoz, a neurologist at the University of Texas Southwestern Medical Center’s MS clinic in Dallas, Ms. Foster started on MS drug Gilenya last January, and says she has been compliant with the daily oral dose and hasn’t had a relapse since.
Ms. Foster runs, rides horses and likes to travel and go line dancing. “I never let MS define me,” she says. She takes vitamin D and C supplements, watches her salt intake and avoids hiking or doing yard work in extreme Texas summer heat, which can her exacerbate symptoms.
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Vicky Foster of Quinlan, Texas goes running to help manage her MS symptoms.
Dylan Hollingsworth for The Wall Street Journal
Others are borrowing methods used in helping to restore memory and learning in people who have had traumatic brain injuries. Nancy Chiaravalloti, director of neuropsychology and neuroscience at the Kessler Foundation in West Orange, N.J., led a study, published in June in Brain Imaging and Behavior, of a technique for helping people create mental images to absorb and recall information. The study found it improved MS patients’ memory after 10 sessions, with effects still evident six months later.
“Many with of those with MS are in the prime of their lives and struggling with cognitive issues that lead to a plethora of difficulties like less participation in society, depression and difficulty staying at work,” says Dr. Chiaravalloti.
Researchers are also learning more about how sleep problems and high-salt diets may worsen MS. An Argentine study last year suggested people with high sodium diets were up to four times as likely to have more episodes of worsening MS symptoms than those who consumed the least salt. Studies also indicate that apnea—when airflow stops during sleep—can worsen MS fatigue.
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Vicky Foster line-dances in Rockwall, Texas. Dancing helps with her MS symptoms.
Kevin Stauff
Kate Milliken, who owns a business that makes personal-history documentaries and films educational segments for the MS society, takes Biogen Idec’s Tecfidera but has found that eliminating inflammation-causing foods, including dairy, eggs and cheese, helps keep her MS at bay. She does yoga and Reiki for stress reduction. She says she is no longer a “hard core” cyclist doing 40 miles at high speed but now bikes 30 miles “at a more gradual pace.”
After her diagnosis in 2006 at age 35, she feared she would remain single. But she married in 2009 and has two children. Women were long advised to avoid pregnancy because of the belief that MS might make symptoms worse. But studies have demonstrated the opposite is true: Pregnancy can actually reduce the number of MS relapses, especially in the second and third trimesters. Relapses tend to rise in the three to six months after delivery but don’t appear to contribute to any long-term disability. Ms. Milliken says that was her experience both times.
