Can my diet and lifestyle affect what happens to me?
Studies of special diets for MS have been inconclusive to date but I recommend a heart healthy diet such as the Mediterranean diet. This type of diet has been shown in general to be good for health. Moreover, a recent study (Palladino R, 2020) indicates that patients with MS are at increased risk for heart attacks and stroke. This makes a heart healthy diet and exercise all the more important.
Vitamin supplementation, except in people who have low levels of vitamin D, or other laboratory documented vitamin deficiencies has not been shown to improve the outcome of people with MS. Vitamin D levels need to be checked at onset of MS and then at least yearly. It is important to maintain a healthy weight as obesity can lead to other medical problems such as diabetes, hypertension, or cardiovascular disease which can magnify neurological problems. Exercise as tolerated is similarly important though some people with MS are sensitive to increases in body temperature which can occur with very strenuous exercise. Elevated body temperature can slow the conduction of nerve impulses in your brain and spinal cord leading to temporary worsening of MS symptoms and fatigue. Cigarette smoking needs to be stopped as this worsens MS.
Besides a relapse, what can make MS worse?
There are several treatable issues that make MS worse. Although these will be discussed in more detail in future posts, I will mention a few of the most important issues here. Infections worsen neurological symptoms. Urinary tract infections are common in all MS patients and those patients with more severe disease are prone to skin infections and pneumonia. Most of the time, these symptoms improve with treatment of the infection but sometimes even treated infections can cause a lasting worsening. For this reason, it is important that you see your physician as soon as possible if you think you might have an infection.
Lack of physical activity weakens your muscles, worsens your balance and coordination, and increases the likelihood of getting an infection, or another medical condition such as diabetes or heart disease which will complicate your MS. Diet is important, though mainly in terms of preventing malnutrition on one hand, obesity on the other hand and vascular disease. Aside from a heart healthy diet, no special diets have been shown to be helpful in MS. Bad habits, such as smoking, excessive alcohol, and drug abuse will worsen most neurological conditions including MS. Each must be stopped.
Other medical problems that worsen MS are depression and anxiety, hypertension, high cholesterol, diabetes, cardiovascular disease, and obesity. Isolation frequently leads to a lack of physical activity and may contribute to depression and anxiety. As we age, there are natural changes in the immune system, cognition, joints, and muscular systems that coexist and worsen the effects of neurological disorders.