Multiple sclerosis: 5 things to know about MS
However, the National Institute of Neurological Disorders and Stroke (NINDS) suggest that the number may be closer to 250,000–350,000, noting that it is difficult to know the exact figure.
This article looks at five important facts that people should know about MS.
1. The cause is unknown
MS is more likely to appear in women aged 20–40 years than in other age groups.
Many scientists believe that MS is an autoimmune disease, which develops when the immune system attacks its own healthy tissues.
In MS, the body attacks myelin, which is the fatty substance that acts as a protective cover to nerve fibers. This disrupts communication between the brain and the rest of the body.
Doctors do not know why the immune system attacks myelin, but they believe the following factors may increase the risk:
- having a family history of MS
- having a history of other autoimmune conditions
- having had certain viral infections
- being 20–40 years old
- being female
- living in a temperate climate away from the equator
Also, people with MS often have low vitamin D levels.
Recent studies suggest there is also a moderate to high risk prevalence of MS in the regions of North African and the Middle East.
A person may have a genetic feature that makes them more likely to develop MS, but they may need exposure to an environmental factor to trigger it.
2. Symptoms can range in severity
In MS, the communication problems between the brain and body can lead to major damage to the nerves. Symptoms can range from mild, which may be inconvenient and annoying, to debilitating.
However, 2 in 3 people with MS will not lose the ability to walk, and the condition is rarely life-threatening.
In fact, life expectancy with MS has increased over recent years, according to the National Multiple Sclerosis Society. This is due to emerging therapies and scientists having a better understanding of the condition.
Some of the most common symptoms of MS include:
- pain, tingling, and numbness
- muscle spasms
- difficulty walking or balancing
- vertigo and dizziness
- problems with thinking and memory
- changes in vision and hearing
In this article, learn more about "brain fog," which can cause a person with MS to feel unable to think clearly.
MS can also lead to:
- bladder and bowel problems
- sexual dysfunction
- difficulties with speech and swallowing
- mood changes and depression
The symptoms and progression rate of MS vary from person to person. For example, some symptoms may not be noticeable in the early stages of MS.
Also, some people never develop all the symptoms, whereas others will experience severe symptoms that impact their quality of life.
Symptoms fluctuate and can be hard to predict. They can also worsen over time. In relapsing-remitting MS (RRMS), a person will experience a worsening of symptoms for a while, or a flare, followed by a period of partial or complete recovery.
However, the lesions that cause the problems remain, so the symptoms will usually return.
In progressive forms of MS, the symptoms gradually worsen, without any periods of significant recovery. In some aggressive forms of progressive MS, symptoms worsen quickly, and the condition can be life-threatening. However, this is also rare.
Advanced MS can involve paralysis, but most people will not experience this.
In this article, learn more about late-stage MS and how to manage it.
Coping with fatigue
David Bexfield, who received a diagnosis of MS in 2006, started a group called ActiveMSers.
He told Medical News Today that people with MS should pay attention to their bodies and do what helps them feel good.
"Thankfully, I don't have many bad days," he said. "Daily exercise has helped keep my fatigue in check, one of the most debilitating symptoms of this disease."
"Few people understand how MS fatigue can be utterly pancaking. Imagine pulling an all-nighter, make that three of them in a row, and then running a marathon. Backwards. On stilts. While juggling chainsaws."
"Once you get that in your mind, realize that's not even close to what it feels like. When MS fatigue hits, everything is exhausting: reading, thinking, even listening. And lying down to take a nap doesn't help."
Bexfield's other piece of advice was to get help when possible:
"Check your ego at the door. Handicap parking placards, walking aids, protective undergarments — I've used them all. They've helped take me down the street, onto the hiking trail, and around the globe. Take advantage of the helpful tools available to you."
3. It can be difficult to diagnose
An MRI may reveal damage that results from MS.
Diagnosing MS can be challenging because many of its symptoms overlap with those of other conditions. This means that it can take time for a doctor to reach a diagnosis.
They will review a person's medical history and perform a physical examination.
Then, they may recommend the following tests to help reach a diagnosis, including ruling out other conditions:
- blood tests, to rule out other conditions
- lumbar puncture, to test cerebrospinal fluid for antibodies that may suggest an autoimmune condition
- MRI scans, which can detect lesions on the brain or spinal cord
- an evoked potential test, which measures how well messages travel through the nervous system
June Halper, a nurse practitioner and the CEO of the Consortium of Multiple Sclerosis Centers, told MNT:
"Advances in MS management focus both on disease modification as well as symptomatic management. While treatment regimens have become more complex and more challenging to the person with MS, there is now a clear message of hope for the future"
Getting an early diagnosis can improve the chances that treatment with disease-modifying therapies (DMTs) can slow the progression of MS.
Current guidelines recommend that doctors discuss suitable DMTs with the individual as soon as possible after a diagnosis.
4. It affects more women than men
More than twice as many women develop MS as men, according to the NINDS. However, experts do not know why.
Symptoms usually appear between the ages of 20 and 40, but MS can develop at any age.
At this age, women with MS can experience complications with their sexual and reproductive health, especially during pregnancy.
Medical student Jen Finelli described working with a female who had MS and her unique struggles while preparing to get pregnant:
"We had a sweet, sweet patient on one of my rotations who had MS attacks so severe she went blind, and she was concerned when she became pregnant, because she needed her medications to prevent these horrible attacks. She told us that she'd quit her medications to protect her baby if she had to!"
"Thankfully, [that patient] didn't have to make that sacrifice," she added, "but because of the autoimmune nature of the disease, patients must verify their medications with their ob-gyn and their MS specialist before becoming pregnant."
Learn more about how MS can affect women.
5. Vitamin D and other therapies may help
Vitamin D, from sunlight or supplements, may help.
Treatment options for MS have expanded, and people now have better ways of managing their condition than ever before.
However, some people prefer to use alternative remedies and supplements, such as vitamin D supplements. People with MS often have low levels of vitamin D, and researchers have suggested that upping vitamin D levels may help.
So far, studies have shown that additional vitamin D treatment is safe for people with MS, and that it may help prevent and treat the condition.
However, the authors of a 2018 review suggest that there is not yet enough evidence to confirm that vitamin D supplementation is useful.
Other lifestyle options that may boost overall health and reduce the risk of a flare include:
- following a healthful diet
- staying as physically active as possible
- trying to avoid stress
- getting enough sleep
- not smoking or quitting smoking
The National Center for Complementary and Integrative Health suggest that yoga, tai chi, and reflexology are safe therapies that may help relieve some symptoms.
Acupuncture may also be safe and effective, as long as a qualified practitioner performs it.
Connecting with other people with MS can also help.
Dr. Ann Bass, clinical director at the Neurology Center of San Antonio, TX, recommends that people with MS "form a strong and lasting support network, which includes healthcare professionals, families, friends, support groups [...] that will assist them throughout their journey with this disease."
"They should establish, continually assess, and share their goals and expectations for their lives as well as for their MS treatments throughout the disease course."
Here you can find a free MS buddy app that will help you learn more about MS and connect with others.
DMTs to slow disease progression
New drugs on the market, including siponimod (Mayzent), show promise for slowing disease progression and reducing the incidence of flares in people with RRMS, the most common form of MS. These newer drugs also have fewer side effects than their predecessors.
Corticosteroid injections and other types of treatment can also reduce the impact and symptoms of flares.