Multiple Sclerosis & Nutrition

Multiple Sclerosis (MS) is a complex autoimmune disorder affecting the central nervous system (CNS) and characterized by the degeneration of the protective myelin sheath surrounding nerve fibers. In MS, the immune system mistakenly targets and damages this myelin sheath, primarily due to the activation of inflammatory cytokines, which serve as messengers guiding the immune response. Unfortunately, this inflammatory reaction lacks a genuine threat, causing the immune system to attack one's own body.

Moreover, MS poses a challenge to the body's natural healing mechanisms. Oligodendrocytes, responsible for rebuilding the myelin sheath in the CNS, are also targeted by the immune system in MS, hindering the repair of nerve fibers and leading to the progression of the disease.

While the exact cause of MS remains elusive, it is evident that various factors contribute to its development. Genetics do play a role, but environmental factors are more prominent. People born in Northern European regions and those residing at higher latitudes face an elevated risk, often attributed to reduced sunlight exposure and subsequently low vitamin D levels. Smoking and the Epstein Barr virus (EBV) also play significant roles, with EBV infection doubling the likelihood of developing MS (1).

There are several nutritional approaches to managing MS. Vitamin B12 aids in synthesizing myelin components and is recommended at a daily dosage of 1,000mcg. Omega-3 fatty acids, found in abundance in fish oil, serve as protective nutrients, with daily intake of over 2g of EPA and DHA being beneficial for safeguarding the myelin sheath. Vitamin D is crucial, as regions with ample sunlight exposure tend to have lower MS incidence rates, although its effectiveness diminishes once the disease has manifested. L-carnitine plays a pivotal role in transporting fatty acids for energy production and can alleviate the fatigue often associated with MS (2g/day). A B vitamin complex is advisable, as biotin is involved in myelin sheath synthesis (300mcg/day), and vitamin B3 can help prevent demyelination (100mg/day of niacinamide).

The initial symptoms of MS result from nerve impulse irregularities and neuronal deterioration. These may include sensory disturbances, often manifesting as paresthesia (numbness and tingling) or dysesthesias (burning or pins and needles sensations), as well as diplopia, ataxia, incontinence, partial or complete visual loss, fatigue, cognitive difficulties, and emotional instability.

Diagnosing MS is a multifaceted process, as no single test can definitively confirm the condition. Diagnosis typically involves an MRI scan to detect sclerosis or lesions in the CNS, a spinal tap to examine oligoclonal bands and an evaluation of damage in at least two separate regions of the CNS within a three-month timeframe. The McDonald Criteria, established by the International Panel on Diagnosis of MS in 2017, defines specific guidelines for diagnosis, requiring both spatial dissemination (damage occurring in multiple CNS areas) and temporal dissemination (damage occurring on multiple occasions) for confirmation.

Reference:

Handel, A. E., Williamson, A. J., Disanto, G., Handunnetthi, L., Giovannoni, G., & Ramagopalan, S. V. (2010). An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis. PloS One, 5(9).