Multiple Sclerosis (MS) is a condition in which a slow de-myelination occurs of the nerves surrounding the brain and spinal chord occurs. Myelin is an important covering of nerve cells that allows for effective electrical impulse conduction. Inflammation is also an important factor in MS with weak evidence of an autoimmune component. The progression of MS can be highly variable ranging from rapid decline to a slow deterioration or even long periods without change.
What are the symptoms of MS?
The symptoms of MS are also varied in intensity. A weakness in one or both hands may be evident differing between each limb. Alternatively muscle spasms may exist, either of which may lead to gait disturbances and a lack of coordination and balance. Similarly a loss of sensation may involve the lower limbs that spread to the genitals and waist region.
Eye symptoms including pain and double vision may exist and occur intermittently.
Fatigue may also be a considerable problem in MS patients.
The debilitating nature of MS also means that Depression is common amongst sufferers.
What Diet should I follow?
A variant of the Low Inflammation Healthy Eating Plan is believed to assist in a minority of MS patients. Additional foods to be restricted from this approach included red and white meats, all dairy products, all cereals, coffee, tea and chocolate and bananas and green vegetables. However considering the restrictive nature of such a diet and the long term nature of MS it is a difficult eating approach that may risk deficiencies in key nutrients, particularly due to the limitation in green vegetables.
For this reason the Low Inflammation Healthy Eating Plan may be a preferred option with a focus on fish and eggs for protein (and Omega 3 oils) and the restriction of red meats to 1-2 serves per week.
Are there any Foods I should Eat?
The oily deep sea fish such as Salmon, Tuna, Mackerel, Herring and Sardines should be encouraged for brain health.
Blueberries and a variety of coloured fruits and vegetables are important to increase anti-oxidant and phytonutrient availability.
High Magnesium foods such as dark leafy greens, bananas, nuts and seeds are helpful to assist relax muscles if spasm exists.
Lecithin should be added to the diet.
Should I Lose Weight?
Any loss in weight with parallel improvements in muscle strength and coordination will help long term coordination and fitness. An growing evidence suggests low grade inflammation may be association with obesity in many people this may also help down regulate the inflammatory environment in MS sufferers.
The Low Inflammation Healthy Eating Plan should assist with weight loss. Alternatively, find a formularised weight loss programme you are comfortable with, preferably supported by peers. However if your mobility has declined leading to a significant decrease in the energy you use up during the day, you may require professional assistance in trying to prevent a gradual increase in weight.
What about Nutrient/Herb Supplementation?
A nutrient and herb programme should always be integrated carefully into mainstream care. The importance of a carefully networking team cannot be overstated.
Nutrients and herbs to consider include:
Fish Oils (EPA/DHA) are important in maintaining healthy brain function and decreasing any inflammatory component that may be contributing to the disease process. It may also be helpful in addressing the Depression many patients with MS experience. This may be combined with Cod Liver Oil which has additional benefits in providing additional Vitamin A and D to assist immunity.
Vitamin D appears to assist the regulation of the immune system in MS sufferers. As mobility decreases it is also important in reducing the side effect of reduced bone strength (Osteoporosis) that may occur. If Osteoporosis is present consider the additional supplementation advice in this section that may include a comprehensive quality product containing a blend of additional Calcium, Magnesium, Vitamin K, Boron etc.
Broad based anti-oxidant protection (Vitamins A,C,E, Selenium etc) may also be warranted due to ongoing inflammation.
Where Depression exists consider discussing the information in this section with your practitioner.
Should I Exercise?
Exercise is critical in maintaining neuromuscular co-ordination, gait and balance, strength, cardiovascular health and quality of life. Physiotherapy may be of assistance in coordinating your exercise programme and in providing any walking aids that may be required if function deteriorates. The risk of a fall is a significant danger to consider and all effort should be made to minimise falls risk (see Osteoporosis).
Care should be taken, however, to respect fatigue during any exercise programme. Exercise programmes may need to be carefully timed and designed, respecting time of day (fatigue usually develops as the day progresses) and temperature (MS is exacerbated by the cold).
What if my day to day functioning deteriorates?
You may require help from Occupational Therapy and Nursing Assistance to assist with or find ways of completing tasks. Do not hesitate to ask for assistance when this becomes necessary.
How about Sleep?
Sleep disorders may be a significant factor in the fatigue that MS sufferers experience. If you have Sleep difficulties refer to the Sleep Health section of this work. In particular Restless Legs may be a problem. A quality Magnesium supplement (chelated forms, with important cofactors such as the B Group vitamins and Malic Acid) can assist in most cases.
A reduction in Sunlight may be a significant factor in MS sufferers. MS prevalence is associated with the distance of a population group from the equator. Furthermore sunshine is critical to Vitamin D activation, important for both immune system and bone function.
You should therefore aim to achieve adequate sunlight exposure during part of your day without sun protection (sunscreen blocks Vitamin D conversion) by participating in outdoor activities. You can always use sun screen after achieving your necessary sun time (at least 15 minutes, more in northern [Canada, Scotland, Scandinavia etc] or southern latitudes [below Canberra in Australia, South Island of New Zealand]).
It is controversial whether winter sun exposure in northern or southern latitudes is sufficient to activate Vitamin D. Vitamin D creation during summer months may therefore be important. As Vitamin D is fat soluble weight loss in winter may be helpful in aiding its release.
Smoking...the answer’s Obvious?
Toxins associated with smoking may contribute to MS, therefore it is important that you quit smoking.
If you cannot quit without assistance, this being the majority of smokers, it may be sensible to join a multidisciplinary programme. Peer support if often essential to the success of any quit smoking plan.
Remember, or although pharmaceutical approaches that replace nicotine via chewing gum, patch or otherwise are helpful, eventually they must be weaned otherwise you may simply be trading the risk of lung cancer for other diseases.
How about Group Support and Counselling?
Counselling can be very important in dealing with MS and has been demonstrated to assist with improved physical activity, fatigue, stress management, mental health and spiritual growth. Patient support groups such as the MS Society (Australia) can provide very helpful support roles.
What about other Mind-Body Therapies and Stress Management?
Stress may exacerbate MS and therefore should be minimised. Furthermore as many patients with Parkinson’s Disease experience Depression it is important to consider Mind-Body therapies and Stress Management techniques along with Psychological treatment where appropriate.
Interventions to consider include:
Psychological treatments ( in particular, CBT)
Other Effects Based Stress Managements techniques
Cause Based Stress Management Techniques
Developing Emotional Intelligence
Achieving Life Balance
Developing Spiritual Intelligence
Other treatments that have been demonstrated to be effective in helping Parkinson’s patients with Depression include Music Therapy, Visualisation and the Alexander technique.
What about the Environment?
Patients with MS should be assessed for the presence of Heavy Metal toxicity. Imbalances in Iron, Aluminium, Mercury and Copper and Zinc have all been identified in MS sufferers. Plasma levels, Hair Mineral Analysis and/or Comprehensive Urinary Element Profile testing can all be helpful.