What Causes Multiple Sclerosis?

And what lifestyle factors give us back control

Multiple sclerosis (MS) is the most common chronic inflammatory neurodegenerative disease of the central nervous system. 

It's also a young disease. It's young in that it was only discovered by Jean-Michael Charcot in 1868 and young in that it affects more young people than any other neurological disease.

In an MS attack, the body mistakenly attacks our own ‘myelin’, thinking it’s an invader. Myelin is a protective fatty insulation around our nerves. Sclerosis means scarred. 

Although the exact cause of MS is not fully understood, research suggests that a combination of genetic, environmental, and viral factors contribute to its development.

The good news is that disease outcomes are not predictable. There is so much we can control.

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Let’s take a look at the genetics of MS.

Genetics

The largest genetic study of MS examined more than 47,000 people with MS and found 233 genes of interest.

Genetic factors provide the foundational risk for MS. Certain gene variants, such as those in the HLA-DRB1 gene, are strongly associated with an increased risk of developing MS.

These genetic predispositions influence susceptibility and can affect disease severity and progression.

However, it's important to understand that genes do not determine the outcome on their own.

Genes are one piece of the puzzle, but they're not the full picture.

This article in Nature (Neurology) in 2023 describes how multiple sclerosis seems to be a rare complication from infection with Epstein-Barr virus (EBV). 

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Epstein-Barr: a nasty little virus.

 A notorious troublemaker in the world of viruses, Epstein-Barr (EBV) has been linked to the ‘kissing disease', which is similar to glandular fever, as well as:

• Stomach cancer

• Nasopharyngeal carcinoma (a cancer behind the nose and back of the throat)

• Hodgkin’s Lymphoma

• Non-Hodgkin’s Lymphoma

• Lupus

• Rheumatoid arthritis

• Chronic fatigue syndrome 

• Multiple sclerosis

• and quite a few more 

I got glandular fever (thanks Epstein-Barr) in high school at the time of my final exams. My eyelids were horribly puffed up. The fatigue was crippling. When the contagious period ended, I dragged myself out of bed, went to classes, and was asleep again by four in the afternoon. 

EBV is also extremely widespread with more than 90 percent of the world having been infected.

We know EBV is another piece of the puzzle that causes multiple sclerosis.

Is Epstein-Barr the smoking gun?

EBV has been researched for a long time in relation to multiple sclerosis.

After infection, EBV hides in B cells undetectable by the immune system.

We know that Epstein-Barr Virus contains proteins that can mimic myelin. When our immune system tries to fight off EBV, it might start recognising similar-looking structures on myelin as a target, leading to an autoimmune response.

Molecular Mimicry

Molecular mimicry is the old imposter syndrome.

It happens when our immune system makes a mistake differentiating between ‘self’ and ‘other’. 

Self is good. Other is enemy.

What happens is like friendly fire. In other words, anything but friendly.

The collateral damage is our shredded myelin, which is supposed to insulate the transmission of thoughts from our brain so we can move our arms, legs, speak, act, think, and so on.

When we are bombed with friendly fire, the transmission gets interrupted, becomes patchy, slows down, or stops.

MS is a profound miscommunication.

This excellent medical animation shows how the adaptive immune system works.

How to use lifestyle and epigenetics to live the best life with MS

We can't change our genes. We can't change having EBV.

We can't accurately predict the outcomes of disease progression. There's still not good evidence for a model for people with MS. MS is highly variable.

After ten years of relapsing remitting MS, some people are in wheelchairs. Others are running marathons.

What can we do?

Lifestyle and epigenetics are where we get to play.

What is epigenetics?

Epigenetics don't change our DNA, but they influence the way our genes are expressed.

We can suppress genes (called DNA methylation) and influence the coding or meaning of other genes by how tightly or loosely coiled they are (called histone modification).

Effectively, we can switch our genes on or off.

These epigenetic modifications can be made by our lifestyle. This includes things like diet, exercise, relaxation, mindset, and behaviour.

Climb over to the driver’s seat. Here are some levers you can adjust.

Food

There are several effective MS diets. All of these diets have one thing in common: they eliminate dairy based on the molecular mimicry hypothesis and the lived experience of the authors of these diets. Eliminating dairy will also reduce inflammation in the body.

Effective MS diets are:

• The Wahls protocol

• Overcoming Multiple Sclerosis (OMS)

• Professor Roy Swank’s Diet

• McDougall Diet

• Best Bet Diet

There is evidence that all of these diets are effective. The problem is they’re hard to stick to.

(I suggest trying the Food Medicine Diet for MS because it’s easier.)

The Dairy Theory

It’s plausible that Epstein-Barr Virus (EBV) could create conditions in the immune system that might lead to confusion between dairy proteins (like butyrophilin) and myelin, contributing to autoimmune attack. 

Here’s how this might happen.

Butyrophilin, a protein found on the surface of milk fat, also has a molecular structure very similar to myelin. If the immune system is already primed to attack myelin due to EBV-induced mimicry, it might also start attacking butyrophilin. This cross-reactivity could mean that consuming dairy might trigger or worsen MS symptoms.

There is evidence supporting this cross-reactivity, including this 2022 study.

The single best thing I ever did was cut out dairy from my diet. When I cut out dairy, my MS attacks stopped.

If you don’t want any particular diet, eat real food as much as you can. This will help reduce inflammation.

Feed your Gut Microbes

Your gut microbiome, which consists of trillions of microorganisms living in your digestive tract, has enormous impact on your health. It affects digestion, immune function, and even mental health.

It is understood that the gut is a major training ground for your immune system.

Your gut microbes like fibre. When we feed them fibre, they reward us with short-chain fatty acids, and neurotransmitters like serotonin (the happy hormone).

A healthy gut microbiome is an immense benefit for people with MS.

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Behavioural Factors

Two simple things to start.

1. Get enough sunshine, and

2. Get enough sleep.

Sleep cleans your brain. The waste can't be transferred to the lymphatic system without enough sleep and it can't be flushed without exercise.

Vitamin D (Sunshine Pills)

Vitamin D is a hormone in the blood. It helps you absorb calcium from your food and is essential for your immune system, skin, muscles and brain. 

To get enough Vitamin D3 (cholecalciferol), I take a high-dose supplement during winter and autumn. It is 7000 International Units. That’s right for me and my area, but you should check with your healthcare provider about what would work best for you.

Dealing with Fatigue (Exercise for more energy)

Energy is one of those funny things where the more you use, the more you get. Exercise is my secret weapon to clearer thinking and more energy.

If fatigue is a problem, this is what you can try.

• Dancing

• Housework

• Yoga

• Stretching

• Lifting cans of food (like weights)

• Press-ups against a wall

• Walking

My 78-year-old gym buddy sits down and then stands up. Over and over.

Do what you enjoy, big or small.

Movement cranks the pump of the body’s lymphatic system. It can’t pump without you moving your body.

If smoking is a problem…

Smoking is known to make MS worse and accelerate disease progression.

If smoking is a problem for you, let’s try to make things easy. Step one: Mindset.

1. Cultivate a vision of yourself as a fresh-breathed, incredibly attractive, non-smoker with the most kissable mouth in the world.

2. Play Paul McKenna’s Guide to Quit Smoking. It’s free. Play it every day. It will help train your subconscious to think differently about smoking. (Don’t think this will work? Read the testimonials under the YouTube video.)

3. Try to stop smoking. Or halve the number of cigarettes you smoke each day. Then reduce it again after a week. Taper off this way.

How I deal with stress

How can we live a life without stress? Is that even possible?

Try Yoga Nidra

Stress makes cortisol (the ageing hormone) in your body has been linked to MS relapses.

Yoga Nidra is a guided relaxation technique that induces a state of conscious deep sleep. With the aid of headphones, you close your eyes and follow a series of instructions designed to bring the mind and body into a state of deep relaxation.

Progressive muscle relaxation is a mindfulness technique that’s part of yoga nidra. You focus on relaxing different parts of your body, one at a time. It’s blissful.

For stress relief, to top-up your sleep, or any time you get a chance, yoga nidra is my ‘go to’ meditation technique.

Step into Nature

Trees produce phytoncides. These help our immune systems to produce natural killer cells. This is great if you have cancer as NK cells eat tumours.

But time in nature is also great for MS in these ways:

• lowers cortisol (the stress hormone)

• improves the healing ability of the immune system

• reduces activity in the amygdala (fight or flight)

• improves cognitive performance (clearer thinking)

• and more

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Get in the Driver’s Seat

Of course, there are effective medications for us to use.

That’s always your choice and often a good idea.

But these things are fundamental. So do them as well and give yourself the best life with MS.

Being diagnosed with MS doesn’t mean you’re going to end up in Hellish Town. We can’t choose our genes, but we can influence how they are expressed and we can switch them on or off with our lifestyle, behaviours, mindset, and habits.

Hellish Town is not where we are all headed. MS is not predictable!

We get to change the car, the road, the map, the whole travel experience and you can even change the destination on the GPS.

But we have to do it intentionally.

We can’t control everything, but there is so much we can control.

That means we can’t be passengers in our lives. We need to drive.

Final Word

Most of the elements that make up the human body, including carbon, oxygen, and nitrogen, were forged in the hearts of ancient stars. We are all linked to the cosmos in a profound way.

Whoever you are, whatever situation you are in, know this. You are valuable. You are magnificent. You are meant to be here. You are loved.

Thank you for reading.

Be well.

xo

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First published at https://bestlifewithms.com/what-causes-multiple-sclerosis/ on 20 August 2024.