The relationship between multiple sclerosis (MS) and alcohol is not fully understood. Although alcohol may temporarily worsen some symptoms, it can also calm an overactive immune system.

MS is a condition that disrupts communication within the brain and spinal cord. The symptoms can range from mildly disabling to severe.

This article looks at various alcoholic beverages and the effects that alcohol can have on the symptoms of MS.

It also examines how alcohol may interact with MS medications and discusses the possible effects of other beverages, including coffee and water, on the condition’s symptoms.

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Researchers have not extensively studied the effect of alcohol on MS symptoms.

Results of the limited studies are neither conclusive nor consistent as they show both positive and negative associations. This was the conclusion of a review of 30 papers published between 1983 and 2016.

The authors noted that some scientists considered alcohol a risk factor for MS but others contended that consuming small amounts was associated with less severe disability due to MS.

The review concluded by noting that more studies are necessary to confirm the relationship between MS and alcohol and to determine if any amount of alcohol is recommendable.

Alcohol may affect people with and without MS differently. The sections below look at some potential negative effects of alcohol on MS.

Worsened MS symptoms

One alcoholic serving may result in a temporary worsening of coordination and balance issues for a person with MS, making these symptoms more severe and disabling.

Alcohol may also increase urinary urgency and frequency, which are often complaints in people with MS, according to one study.

Depression

Another negative effect involves alcohol’s depressive effect on the brain and spinal cord. According to the National Multiple Sclerosis Society, depression is common in people with MS, and may be more severe in those with MS than in those without the condition.

Alcohol can also have both physical and emotional depressive effects.

Physically depressive effects include slowing the reactions in the brain and spinal cord. This can lead to physical weakness, slow thinking, and slow responses. This is a temporary effect until the alcohol wears off.

A person can also have brief emotional feelings of depression after the effects of alcohol wear off.

In people with MS, alcohol may worsen all these symptoms.

Interactions with medication

Many medications can interact adversely with alcohol, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Some examples of adverse interactions include the following:

  • Alcohol’s sedative effects can increase the impact of tranquilizers, opioids, and muscle relaxants.
  • Alcohol can lead to drowsiness, dizziness, difficulty breathing, and a higher risk of overdose.
  • Alcohol can increase the risk of bleeding from the stomach and intestines resulting from nonsteroidal anti-inflammatory drug (NSAID) use.
  • Alcohol can increase the risk of liver damage from acetaminophen (Tylenol).
  • When a person uses alcohol alongside antidepressants, it may increase feelings of depression and hopelessness.
  • Over-the-counter drugs and dietary supplements can interact negatively with alcohol. For instance, alcohol can increase the potentially drowsy effect of chamomile and valerian.

Some medications for treating certain symptoms of MS include the following:

  • muscle relaxants
  • antidepressants
  • anti-inflammatory agents, such as NSAIDs
  • non-narcotic pain drugs
  • opioids

The sections below look at some potential positive effects of alcohol on MS.

Suppressed immune response

MS is a chronic inflammatory condition. Scientists believe that an overactive immune system is what causes the condition. Because of this, MS therapies often aim to suppress the immune response.

Some research looked into whether or not alcohol could suppress the immune response to relieve MS symptoms. The authors discovered that although regular alcohol intake suppressed one aspect of immunity, it increased another aspect.

Due to a lack of conclusive evidence, they concluded that it was not possible to recommend a therapeutic dosage or frequency of alcohol for consumption in people with MS.

Neuroprotection

Some researchers have looked at whether the potential neuroprotective effects of red wine might benefit people with MS.

The authors found that people with higher alcohol intake had lower MS disability scores, which indicates less neurological disability.

On the other hand, they noted that these individuals had higher accumulations of a harmful substance in the brain that may have links with the progression of MS.

There is not enough evidence to confirm that any alcohol offers neuroprotection for people with MS.

Reduced effects of smoking

One study found that alcohol consumption might reduce the harmful effects of smoking. Because of this action, the authors said that their findings did not support advising people with MS to avoid alcohol consumption altogether.

The study was very small and the researchers did not have an explanation for the results.

Alcohol is an intoxicant that is present in drinks including beer, spirits, and wine. It is also a depressant through its interactions with the brain.

Alcohol content varies among beverage types. However, the amount of liquid in a glass does not indicate the amount of alcohol it contains.

The table below shows how the NIAAA lists some beverage types and their alcohol content:

Amount of beverageType of beverageAlcohol percentage
12 ounces (oz)regular beerabout 5%
12 ozsome light beersabout 4.2%
5 ozwineabout 12%
8–9 ozmalt liquorabout 7%
1.5 ozdistilled spirits, such as brandy, vodka, or rumabout 40%

Instead of drinking beer or other alcoholic beverages, a person with MS may wish to consume drinks that may be healthier. The sections below will look at some of these in more detail.

Water

According to the Multiple Sclerosis Foundation (MSF), it is important for people with MS to stay hydrated.

If a person drinks sufficient fluids for their body’s needs, their urine will generally be pale yellow or colorless. Darker urine is a symptom of inadequate fluid intake.

Water is a healthy beverage, and it offers various benefits for a person with MS, including:

  • reducing some bladder and bowel symptoms
  • decreasing the side effects of medications
  • lowering injection site reactions
  • preventing the effects of dehydration on MS, such as fatigue and mental decline

Coffee

One study indicated that people who have MS do not need to avoid coffee. After reviewing the body of research on this topic, the authors found that a higher intake of coffee and caffeine seemed to have a protective effect against MS.

The MSF notes that coffee has properties that fight inflammation and stimulate the nervous system. These effects may be helpful in conditions involving the nervous system, such as MS.

Green tea

Green tea and one of its active ingredients — epigallocatechin 3-gallate EGCG — can help modulate immune cell function, researchers say. This may help improve the symptoms of some autoimmune diseases, such as MS.

Here are some questions people often ask about alcohol and MS.

Do alcohol and MS mix?

It is unclear what effect alcohol has on people with MS. Alcohol affects individuals differently, whether or not they have MS. Overall, experts recommend avoiding excessive alcohol consumption, but people who wish to consume alcohol can try a small amount if they feel comfortable with it.

Can alcohol make MS worse?

Alcohol can exacerbate some symptoms of MS, such as those related to urinary frequency, depression, thinking, and balance. Alcohol can also interact with medications, affecting how they work or increasing the risk of adverse effects, such as liver damage.

Is red wine bad for MS?

In a 2017 study, people who consumed three glasses of red wine per week appeared to have lower levels of neurologic disability than those who consumed no alcohol. However, MRI scans also showed that those who drank red wine also had a higher volume of high-intensity lesions than those who did not drink red wine. Doctors need more research to confirm how red wine affects people with MS.

There is insufficient research to confirm the positives and negatives of alcohol consumption in people with MS.

Some research suggests that alcohol consumption may temporarily worsen MS symptoms such as balance problems and urinary urgency. Due to alcohol’s effect on the brain and nervous system, it may also worsen the depression that many people with MS experience.

Although some studies indicate that smaller amounts of alcohol could be associated with less severe MS, it is not yet clear whether or not there is a causal relationship.

For this reason, a person with the condition may wish to focus on drinking healthier beverages, such as water, coffee, and green tea.