Does Alcohol Mess With Multiple Sclerosis?

Multiple sclerosis is a chronic autoimmune inflammatory disease of the central nervous system (CNS, the brain, and the spinal cord), causing damage to the nerve fibers and the myelin sheath and disrupting signals to and from the brain.

Multiple sclerosis more commonly affects women than men in the age group of 20 to 40 years.

It is estimated that approximately 1 million adults in the United States are living with the condition.

The exact cause of multiple sclerosis is unknown. However, some research suggests that genetic, environmental, and microbial factors and infection history play key roles in causing the condition.

Multiple sclerosis is a result of the inflammatory process enhanced by inflammatory cytokines and antibodies initiated by the T-cells, which enter the brain by disrupting the blood-brain barrier and attacking myelin (the sheath that protects the nerve cells or neurons in the brain and spinal cord) and the nerve fibers considering it as a foreign antigen.

Other factors that are speculated to be associated with the etiology of multiple sclerosis or are considered triggering factors may include:

• Viral infections, such as Epstein-Barr virus
• Family history of multiple sclerosis
• HLA genes, especially HLA DRB1 1501
• Low levels of vitamin D
• Weather, less exposure to the sunlight
• Environmental pollution
• Diet
• Obesity
• Smoking

The condition is unpredictable and affects everyone differently; however, some of the most common symptoms reported are:

1. Vision problems due to optic neuritis causing
   • Pain in one eye
   • Blurred vision
   • Double vision
2. Muscle weakness and spasms
3. Numbness or tingling in the legs or arms
4. Loss of balance
5. Gait changes
6. Poor coordination
7. Fatigue

1. Primary progressive multiple sclerosis: Symptoms develop slowly and worsen gradually with no periods of relapse or remission.
2. Secondary progressive multiple sclerosis: Continuous nerve damage results in progressively worsening symptoms with some relapses (worsening symptoms) or flares (increased severity of symptoms) with no remissions (stabilization or absence of symptoms for weeks, months, or even years).
3. Clinically isolated syndrome (CIS): First episode or initiation of symptoms is recognized as CIS, which may progress to full-blown multiple sclerosis.
4. Relapsing-remitting multiple sclerosis (RRMS): The most seen type of multiple sclerosis, people diagnosed with RRMS develop flare-ups, relapses, or exacerbations (new or worsening symptoms) that are followed by periods of remissions with no disease progression.

There is no single test available to provide a confirmatory and definitive diagnosis of multiple sclerosis; however, a neurologist (a specialist of treating conditions of the brain and the spinal cord) may perform tests, such as:

• Physical examination: To assess reflexes and muscle weakness.
• Blood tests: To rule out other conditions or any underlying nutritional deficiencies.
• Imaging tests: To look for lesions (damaged areas) in the brain or the spinal cord.
• Lumbar puncture: A spinal tap is done, in certain cases, to differentiate from other conditions.
• Evoked potentials test: To evaluate the nerve function by measuring the electrical activity of the brain and the spinal cord.

Currently, there is no permanent cure available for multiple sclerosis. However, treatment aims to manage symptoms, reduce relapses, and slow the disease progression.

The treatment plan may consist of the following:

• Disease-modifying therapies:
  • Drugs that help reduce flare-ups and slow down the disease progression, such as:
    • Alemtuzumab
    • Avonex
    • Betaferon
    • Cladribine
    • Dimethyl fumarate
    • Diroximel fumarate
    • Extavia
    • Fingolimod
    • Glatiramer acetate
    • Autologous hematopoietic stem cell transplantation
    • Natalizumab
    • Ocrelizumab 
    • Ofatumumab
    • Ozanimod
    • Plegridy
    • Ponesimod
    • Rebif
    • Siponimod
    • Teriflunomide
• Relapse managing medications: High-dose corticosteroids help reduce inflammation and damage to the nerve cells.
• Plasmapheresis: It helps remove the antibodies that may be attacking nerve cells.
• Physical rehabilitation: Regular physical activity helps maintain mobility and prevents disabilities.
• Counseling: A neuropsychologist provides emotional support to cope with the debilitating condition.

Other lifestyle choices that can lessen the severity of symptoms and improve quality of life include:

• Consume a healthy and balanced diet that includes fruits, vegetables, whole grains, healthy fats, and lean proteins and avoid added sugars, unhealthy fats, and processed foods
• Exercise regularly to keep the muscles strong and flexible
• Avoid stress using techniques, such as meditation, yoga, or counseling
• Avoid or quit smoking
• Limit intake of alcohol

1. Incontinence (loss of bladder or bowel control)
2. Permanent disability, leading to inability to walk without support, such as a cane, walker, or wheelchair
3. Memory issues
4. Sexual problems
5. Depression
6. Paralysis
7. Blindness