Secrets from a doctor who has it
Multiple sclerosis (MS) is one of the most common nerve diseases. It’s also among the most frightening because there isn’t a cure. Patients imagine a future that includes extreme fatigue, muscle weakness, pain and, in some cases, premature death.
Many patients have a form of MS known as relapsing-remitting, in which the disease generally flares up every year or two. The relapses are followed by periods of remission.
However, there’s a way to reduce symptoms and the frequency of relapses by up to 95%. All you need to do is make some lifestyle changes. And these lifestyle changes may be more effective than medications at slowing, and sometimes stopping, the disease’s progression.
Numerous studies have shown that people who modify their diets and make other lifestyle changes often can remain symptom-free for decades. I’m a good example — I was diagnosed with MS in 1999, when I was 45. I’ve had no relapses.
What MS Does
MS, an autoimmune disease, damages the fatty myelin sheath that surrounds nerves in the brain and spinal cord. The immune system kicks in and produces inflammation that strips away the myelin and causes nerve scarring. This impairs the transmission of nerve impulses.
The central nervous system can sometimes regenerate damaged nerve tissue — but only if there’s minimal demyelination. The key way to reduce MS relapses is to reduce demyelination. Here are the strategies that work best…
Eliminate Saturated Fat
One long-term study of MS followed the same group of patients for 34 years. At the beginning, participants averaged one to 1.2 relapses a year. This is typical for most MS patients. The patients who switched to a diet that was very low in saturated fat averaged just 0.05 relapses within three years. This translates to about one relapse every 20 years.
MS patients tend to accumulate more saturated fat in their cell membranes than those without the disease. Saturated fat is thought to stimulate the Th1 response, the release of myelin-damaging inflammatory chemicals by immune cells.
Patients who switch to a vegetarian diet — and avoid processed foods, which often are high in saturated fat — can reduce their relapse rate by about 95%. In contrast, most medications achieve only about a 30% reduction.
I advise patients not to eat red meat, commercial baked goods or anything that is deep-fried. They also should avoid eggs (except for the whites) and dairy, including reduced-fat cheese and reduced-fat milk. There’s some evidence that a protein in dairy may be just as likely as saturated fat to trigger relapses.
Patients who consume the most omega-3 fatty acids from fish (or fish-oil supplements) have about 30% fewer relapses than those who get the least. These fatty acids can reduce relapses even in patients who continue to eat meat or other foods that are high in saturated fat. The omega-3s make cell membranes more fluid and flexible. This improves their responsiveness to chemical signals and helps them resist attacks on the immune system. Omega-3s also help the body suppress inflammation.
The optimal amount is thought to be about 20 grams (g) — a little less than three-quarters of an ounce — of fish oil daily. I eat fish three or four days a week. I usually choose oily fish, such as sardines or mackerel. I take fish-oil supplements only on the days when I don’t eat fish.
Omega-3s from Flax
Flaxseed oil is the best nonfish source of omega-3s. It has a slightly buttery taste that I enjoy. I put it on salads or pasta. It’s good for patients who don’t like fish or who want a less expensive alternative to fish-oil supplements.
There’s been a lot of debate about the use of flaxseed oil as a source of omega-3s. This is because only a small percentage of the alpha-linolenic acid in flaxseed oil is converted in the body into the healthful oils found in fish — EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). I recommend two tablespoons of flaxseed oil daily.
Patients with MS tend to feel better, and have fewer relapses, when they spend time in the sun. A study published in Occupational and Environmental Medicine in 2000 found that people with MS who got the most sun were 76% less likely to die from MS than those without sun exposure.
The body synthesizes vitamin D from sunshine. Vitamin D interacts with the receptors on white blood cells involved in the MS immune response. One study found that MS patients had the lowest relapse rates in mid-to-late summer, when UV exposure from sunlight is highest.
People are understandably nervous about getting too much sun. But in moderation, skin cancer risk is low. I advise patients to get 10 to 15 minutes of all-over sun (by wearing a bathing suit) three to five times a week. If you don’t live where you can do that year-round, take a vitamin D supplement.
The long-running Nurses Health Study found that women who took a daily multinutrient that contained 400 international units (IU) of vitamin D were 40% less likely to get MS than those who didn’t. Patients who already have MS are less likely to have relapses — and will probably have milder symptoms when they do — if they supplement regularly.
I recommend that MS patients take 5,000 IU of vitamin D on overcast days or on days when they don’t get outside. Use the D-3 form — it’s similar to the vitamin D from sun exposure.
Regular exercise improves energy and muscle strength and may reduce MS relapses. It also improves the body’s ability to cope with the physical challenges that occur during relapses.
I live in a climate that’s warm year-round, so I swim outdoors five or six days a week. It’s good exercise, and I get my “dose” of sunshine at the same time. Bonus: Being in water prevents overheating from exercise, a common problem for people with MS.
A 2006 review in Journal of Alternative and Complementary Medicine found that meditation helps relieve symptoms of autoimmune illnesses. It also improves mood, which helps patients to deal positively with MS.
I meditate every day for 30 minutes, usually when I get home from work. The evidence suggests that people who can find the time to do this twice a day probably get even more benefits.
Meditation doesn’t have to be a complex spiritual practice. You can just sit in a comfortable chair, relax and focus on your breathing. If you have stressful thoughts, notice them. Then let them go.