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7 Things a Neurologist Wants You to Know About Multiple Sclerosis

Bust the myths—and get the truth—about MS.

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By Emily Willingham

Multiple sclerosis (MS) is a complex autoimmune condition that may affect up to 1 million people in the US, according to the National Multiple Sclerosis Society. Because it can look so different from person to person, myths about MS abound, from whether or not it’s treatable to what the future holds for someone with the condition.

Neurologist Ellen Lathi, MD, director of the Elliot Lewis Center for MS Care in Wellesley, Massachusetts, helps clear up some of the most common misunderstandings about MS and what the outlook is for patients.

MYTH: One thing causes MS

2 / 8 MYTH: One thing causes MS

Although having a close family member with MS can slightly increase a person’s risk for it, the genetic component is only a piece of the puzzle of factors leading to the condition. Dr. Lathi says that between identical twins, if one has MS, the other has a 20 to 30 percent chance of also developing it. For close family members, the risk increase is much smaller, at under 5 percent. That leaves considerable room for environmental factors. So what are they?

“The best example is probably vitamin D,” says Dr. Lathi. This hormone “plays a role in the risk of MS, perhaps dating back to in utero and certainly in childhood, adolescence and young adulthood,” she says, referring to a possible link between reduced levels and MS risk.

MS risk differs by geography, as well. Though it's been questioned, it's widely believed that distance from the equator is a factor—that the further away you live, the higher your likelihood of developing the condition.

Dr. Lathi also cites smoking as another environmental factor. She notes that although birth month has been tied to MS risk, the association might trace back to vitamin D and the mother’s reduced exposure to vitamin D-triggering sunlight during a winter pregnancy. Women who have concerns about vitamin D levels in pregnancy should talk with their healthcare practitioner.

MYTH: It's mostly older people who develop MS

3 / 8 MYTH: It's mostly older people who develop MS

"This is an old wives' tale,” says Dr. Lathi. The group MS affects most is women of childbearing age, although it can strike any age group and men or women, she says. “People are often diagnosed in the prime of their lives,” in their 20s to 40s, she says.

MS can follow different patterns, Dr. Lathi says. The most common disease course involves relapses and remissions and tends to strike younger women more than older people or men. Another MS pattern, one that affects about 15 percent of people with MS, is a more consistently progressive course. This type tends to have an older average age of onset and affect men and women equally.

Many patients experience both, starting with the relapsing–remitting pattern and then shifting to a progressive pattern that still involves detectable disease flares, says Dr. Lathi. Still another patient group may have only one episode of MS-like symptoms and until another one occurs, will be described as having a “clinically isolated syndrome” rather than MS.

MYTH: You'll end up in a wheelchair

4 / 8 MYTH: You'll end up in a wheelchair

Patients with MS tend to visualize a life of “severe disability,” says Dr. Lathi. But that outcome is not inevitable.

From onset of the condition, the median time to severe disability is about 23 years, Dr. Lathi says. While some with MS end up in a wheelchair, about two-thirds will be capable of walking, though they may need an aid, like a cane, to get around. Others, due to weakness or balance issues, may need a wheelchair or scooter to manage.

MYTH: Getting pregnant isn't safe

5 / 8 MYTH: Getting pregnant isn't safe

Dr. Lathi calls this idea “nonsense” and says it’s a concept “left over from years and years ago.” Having the MS diagnosis “should not affect a patient’s decisions about family planning,” she says. “Women with a disability can have a normal pregnancy if they choose to have a family. Pregnancy is not a bad thing for MS.” In fact, some women find their MS symptoms ease during pregnancy.

Other women may be affected, depending on the status of the MS. They may have a greater risk for a small-for-gestational-age baby, or difficulty walking in late-stage pregnancy due to gait problems. Women also may experience more relapses than usual in the six months after delivery.

Have concerns?

  • If you're considering pregnancy or are already pregnant, talk with your healthcare practitioner about what special steps, if any, to consider, including questions about your MS therapies.
  • Online support groups are also available for parents or impending parents with MS. MSConnection is a good place to start looking.
Myth: Exercise is bad for MS

6 / 8 Myth: Exercise is bad for MS

“We recommend an individualized exercise plan for everyone with MS,” says Dr. Lathi. Patients will sometimes say that they can’t exercise because of their fatigue, but “a consistent exercise plan is one of the best ways to combat fatigue,” she says. It also may help keep disability delayed or at bay.

Some people with MS do feel a transient worsening or flare of their symptoms when they get hot during exercise, Dr. Lathi notes. Although the effect is temporary and does not cause progression or nerve damage, people with MS whom heat affects negatively should use strategies to stay cool, she says. These tactics can include sticking around an air conditioning on hot, humid days or even buying a cooling vest.

MYTH: MS progresses quickly

7 / 8 MYTH: MS progresses quickly

The idea that MS is swiftly fatal “couldn’t be farther from the truth,” says Dr. Lathi. While life expectancy for people with MS is seven years shorter than average, it's improved significantly over time. "We believe this is due to treatment breakthroughs, improved healthcare and lifestyle changes," she adds.

Because some MS-related complications can be managed or even prevented, it's important to live healthfully and get necessary care, including screenings for diseases like cancer.

In rare cases, MS can be fatal in patients who have a rapidly progressing form of the condition.

MYTH: MS can't be treated

8 / 8 MYTH: MS can't be treated

The form of MS that flares and then shows remission is treatable, says Dr. Lathi. The goal with MS drug therapy is to reduce the flares, or relapses, and slow progression of disease. A variety of these disease-modifying drugs are available, and patients should speak to their healthcare practitioners about their choices, including side effects, she says.

But the therapies aren’t failsafe. “Even with these medicines, people with (relapsing) MS continue to experience disease activity and worsening disability,” says Dr. Lathi. For people with the progressive pattern of disease, the first-ever US Food and Drug Administration (FDA)-approved drug became available only in March 2017, she says. Patients with relapsing or progressive MS can receive the drug, called Ocrevus, in infusions delivered every six months. It is the 15th FDA-approved disease-modifying drug for MS, says Dr. Lathi.

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