Why Don't Neurologists Give Advice about MS Diets?
In a nutshell, they don't have the time, training, or expertise to advise on what people should eat
My first neurologist was lovely. She once said, “What’s good for the heart is good for the brain.”
That’s still absolutely good advice.
But the context was a bit iffy.
I was asking about molecular mimicry and the risk of triggering an MS attack. She said I should keep eating dairy because I needed the calcium.
Um. Right.
Today, we know that dairy is not the source of calcium. Dairy contains calcium because cows eat grass.
If we eat green leafy vegetables, we get plenty of calcium (we need 1,000 milligrams a day, at a minimum). Plants are the best source of calcium because they are easily absorbed.
Aside from that occasion, in my experience, neurologists have never recommended any particular diet.
It’s a missed opportunity because people with MS often dismiss food as a way to manage their condition. What we eat can massively influence our lived experience with multiple sclerosis, including our symptoms and disease outcomes.
Here are a few reasons why neurologists don’t typically give nutrition advice:
Diet is not their specialty
Neurologists specialize in the diagnosis and treatment of neurological conditions like MS. They receive extensive training in neurology but don’t usually have training in nutrition.
Time constraints
Neurologists often have limited time with each patient due to high patient loads and the complexity of neurological conditions. Delivering nutrition advice would add time and resources, which might not be feasible during a typical consultation.
You have an MS Team (it’s someone else’s job)
In many cases, addressing nutrition-related concerns may require a multidisciplinary approach involving nutritionists, dietitians, or other healthcare professionals who understand food.
Neurologists may refer patients to these specialists for tailored nutrition advice. Or they may give you the standard health guidelines. These are a basic blanket, which may or may not be appropriate for you.
Their focus is on medical management
Neurologists primarily focus on medical management, including prescribing medications, performing procedures, and coordinating care for neurological conditions.
They may provide general advice on lifestyle factors that could impact neurological health, such as maintaining a balanced diet.
Keep a journal to record dates and details
At the end of the day, one thing neurologists don’t have is your lived experience.
While correlation is not causation, it pays to have an open mind and an open notebook to write down your thoughts and details of any flareups and sensations.
It’s easy to miss patterns if we rely on our memory. A notebook or journal can help us see patterns later. This can be helpful for ourselves and our treating team. Keep notes about what you ate in there.
If you believe a flare-up follows stress, a specific food, or another trigger, speak to your neurologist about it. But don’t wait for them to tell you what to do.
Use your lived experience to help guide the conversation. Don’t be afraid to stand in your authority. You’re in charge.
Listen to your body
If there is a food you feel doesn’t agree with you. cut it out. A general elimination diet cuts out known triggers of disease flareups. These foods include dairy, gluten, and refined sugar, and oils.
You can slowly reintroduce foods one at a time to check which if any to add to your Eat Never list.
Speak to other people with lived experience
Often it’s good to speak with other people who also have lived experience. They know what it’s like and may have good ways to describe symptoms and novel ways of managing their MS.
Most of the effective MS diets have been developed by people (doctors) who have MS, so they have some ‘skin in the game’ so to speak.
That includes Dr Terry Wahls and the Wahls Protocol, the Best Bet Diet, and Prof George Jelinek’s OMS diet.
And of course, it includes the Food Medicine Diet for MS, which is the easiest MS diet to stick to.
Parting Words
First of all, decide to take charge. You’re the boss so do a good job. Listen to your own body. Nobody knows your body better than you.
Secondly, do some basic research to learn the fundamentals. Make your wellness a passion project. We are what we eat, and our diets massively influence how we feel, function, and recover.
Thirdly, talk to others with MS. Find out how they get by. Do they feel well? How do they swing it? We do much better on a high-quality diet. The science shows it. The recipes and techniques, that’s where other people can really help.
Be well XO