Multiple Sclerosis Flashcards
Multiple Sclerosis
MS is an autoimmune disease:
* The myelin sheath is a fat and protein compound which wraps around a nerve to support nerve impulses.
* The myelin sheath is produced by cells called oligodendrocytes.
* In MS, autoreactive and inflammatory immune cells infiltrate the blood brain barrier and attack the myelin sheath.
* If sustained, this attack can lead to the loss of oligodendrocytes and neurodegeneration.
MS: Relapsing remitting form
- 85% of patients present with the relapsing remitting form of MS
- The disease alternates between relapse / myelin loss and periods of remission.
- The average age of diagnosis for relapsing remitting MS is 30.
MS: Primary progressive form
- 10-15% of patients present with the primary progressive form of MS
- There is a continuous and progressive loss of neurological function with no remission.
- The average age of diagnosis for progressive MS is 45.
MS: Signs and symptoms
- Visual impairment ― optic neuritis.
- Nerve tingling and numbness.
- Intestinal and urinary problems.
- Fatigue and weakness.
- Poor co-ordination and balance.
- Speech difficulties.
- Learning and memory issues.
- Difficulty walking.
- Emotional difficulties.
- Muscle spasm or tremors.
- Pain
MS: Risk Factors
- Vitamin D deficiency
- Obesity and raised BMI.
- Infections such as Epstein Barr virus.
- Childhood trauma / stress.
- Inflammation
- Homocysteine, mitochondrial dysfunction.
- Cigarette smoke exposure.
- Certain autoimmune diseases.
- Environmental toxins, e.g. dioxins, air pollution.
Vitamin D deficiency and MS
- Vitamin D helps shift adaptive immune system expression away from autoreactive T cells and toward anti inflammatory T regs.
- Doubling vitamin D level decreases MS relapse risk by 27%.
- MS patients with low vitamin D were found to have more brain lesions and increased numbers of relapses.
Vitamin K deficiency and MS
- Key aim of MS therapy is to promote the regeneration of oligodendrocytes and remyelination in the central nervous system.
- Oligodendrocytes and remyelination need Vitamin K as co-factor (GAS6)
Vitamin B12 and MS
- Studies show B12 supplementation improves neuron growth and survival and regenerates the myelin sheath.
- The phospholipids contained within the myelin sheath are methylated, and so require B12 to support methylation.
- Many MS patients present with high homocysteine and low B12
Obesity and MS
- Obesity makes the blood brain barrier more permeable leading to CNS inflammation.
- The adipokine leptin , raised during obesity, is associated with CNS inflammation.
- Leptin increases levels of Th17 autoreactive T cells.
- Obesity leads to an upregulation of M1 microglia overwhelming the protective M2.
Stress and MS
- Stimulating the Vagus nerve decreases proinflammatory microglia, autoreactive T cells and increases myelination and anti inflammatory T regs.
MS: Supplements
- Vitamin D (2000 iu)
- Vitamin K (90 mcg).
- Hesperidin (500 mg).
- Quercetin (500 mg).
- Sulforaphane (250 mg).
- Alpha lipoic acid (300 mg).
- Citicoline (250 mg).
- Omega 3 fatty acids (750 mg).
- Vitamin B12 (1000 mcg)
- Methyl folate (500 mcg).
Wahls diet
Paleo Diet
* Green leafy vegetables
* Sulphur rich vegetables, such as cabbage, onions and asparagus.
* Colourful fruits and vegetables due to their phytonutrient content, such as beetroot, oranges, berries and carrots.
* Omega 3 fatty acids. Sources: Salmon, herring, and sardines.
* Grass fed meats and organ meats.
* Seaweed.
* Dr Wahls’ diet is less strict on saturated fat intake. However grass fed meats are lower in saturated fat than intensively farmed animals.
Swank diet
- Low saturated fat diet under 15 g / day. (poorly metabolised fat disrupts myelin sheath)
- Fruit and vegetables
- No red meat permissible in the first year; pork also excluded.
- White meat poultry and white fish under 50 g / day.
