“Multiple sclerosis is a disease that causes breakdown of the protective covering of nerves. Multiple sclerosis can cause numbness, weakness, trouble walking, vision changes and other symptoms. It’s also known as MS.

In MS, the immune system attacks the protective sheath that covers nerve fibers, known as myelin. This interrupts communication between the brain and the rest of the body. Eventually, the disease can cause permanent damage of the nerve fibers.

• Age: MS typically makes its first appearance in people between the ages of 20 and 40. 

• Vitamin D Levels: Low levels of vitamin D and low exposure to sunlight are associated with an increased risk of developing MS. 

• Body Weight: Being overweight is more likely to develop MS and can lead to more severe disease and a faster onset of progression. 

• Smoking: Smoking is linked to more relapses, worse progressive disease, and worse cognitive symptoms in people with MS. 

• Gender: Women are up to three times as likely as men to have relapsing-remitting MS. 

• Family History: Having a parent or sibling with MS increases the risk. 
• Infections: Certain infections, including Epstein-Barr virus, have been linked to MS.“

MAYO CLINIC (Multiple sclerosis – Symptoms and causes – Mayo Clinic)

Treatment for Multiple Sclerosis:

Today multiple sclerosis (MS) is not a curable disease. Effective strategies can help modify or slow the disease course, treat relapses (also called attacks or exacerbations), manage symptoms, improve function and safety, and address emotional health.

The model of comprehensive MS care involves the expertise of many different healthcare professionals — each contributing in a unique way to the management of the disease and the symptoms it can cause. Sometimes this team works within a single center, offering “one-stop shopping” for people with MS. More often, people are referred by their MS physician to other specialists in the community.

In either case, the goal is comprehensive=coordinated care to manage the disease and promote comfort, function, independence, health and wellness to its OPTIMAL LEVEL.

There are several types of MS:

For an acute exacerbation of multiple sclerosis that can result in neurologic symptoms and increased disability or impairments in vision, strength or coordination, the preferred initial treatment is usually a type of steroid called a glucocorticoid. Patients who do not have a good response to steroidal therapy are often treated with plasma exchange. Plasma exchange is an extreme therapy that removes antibodies to myelin from the blood.

Some patients have disease that will have an acute exacerbation followed by a prolonged quiet period, which can last years or decades. This form of disease is referred to as relapsed remitting MS, or RRMS. Patients with relapsing MS=RRMS are often treated with immune-modulating drugs such as interferon or glatiramer acetate. Glatiramer is an exciting drug. It is a series of small proteins that are similar to myelin protein. It is thought to prompt the immune system to avoid attacking myelin.

Others have a disease that gets progressively worse over time.

There are two types of progressive disease:

1 In primary progressive MS, or PPMS, symptoms steadily worsen over time from the very beginning.

Progressive MS also referred to as disease-modifying therapies (DMTs).

Presently, these include 15 drug therapies to slow MS activity and progression, each of which is approved by the United States Food and Drug Administration (FDA) for relapsing forms of MS (and some are also approved for clinically isolated syndrome, prior to the diagnosis of MS). One of the medications, Ocrevus™ (ocrelizumab) is also approved for primary-progressive MS. In nearly all instances, these drugs are prescribed individually, so a patient only takes one DMT during any time period. Of these 15 approved drugs, eight are given at home via injection; four are given by a medical professional via intravenous (IV) infusion; and three are taken orally.

In brief, no clinical trial has shown convincing evidence of benefit in the treatment of primary progressive MS. All suggested treatments for PPMS are empiric. Several drugs that are more commonly used in the treatment of malignancy, cladribine and mitozantrone, appear to have some activity.

2 Secondary progressive MS, known as SPMS, begins as relapsed remitting disease and becomes progressive over time.

Available treatments of primary and secondary progressive MS are of limited efficacy and have significant side effects. An additional fact to consider is that most trials have not lasted longer than two or three years and give only hints about long-term results of treatment.

In brief, no clinical trial has shown convincing evidence of benefit in the treatment of primary progressive MS. All suggested treatments for PPMS are empiric. Several drugs that are more commonly used in the treatment of malignancy, cladribine and mitozantrone, appear to have some activity.

In contrast, there is definite modest benefit in some treatments for secondary progressive MS. These treatments include various regimens of steroid therapy (the anti-inflammatory effect) and the use of some drugs that modulate the immune system. Many of these drugs are more commonly used in treatment of cancer and rheumatoid arthritis such as cyclophosphamide, methotrexate and interferon.

MS should be treated by a neurologist who majors in MS with experience in managing it for years.  The doctor with knowledge is so important regarding the specific disease.  Do your research on experts treating this from NY to CA.

Remember the MS treatment is in parts to make up a whole plan:

1 Modifying the disease:

More than a dozen disease-modifying medications have been approved by the U.S. Food and Drug Administration (FDA) to treat relapsing forms of MS. These medications reduce the frequency and severity of relapses (also called attacks or exacerbations),  reduce the accumulation of lesions in the brain and spinal cord as seen on magnetic resonance imaging (MRI) and may slow the accumulation of disability for many people with MS. No medications have yet been approved to treat primary-progressive MS.

2 Treating the Exacerbations:

An exacerbation of MS is caused by inflammation in the central nervous system (CNS) that causes damage to the myelin and slows or blocks the transmission of nerve impulses. To be a true exacerbation, the attack must last at least 24 hours and be separated from a previous exacerbation by at least 30 days. However, most exacerbations last from a few days to several weeks or even months. Exacerbations can be mild or severe enough to interfere with a person’s ability to function at home and at work. Severe exacerbations are most commonly treated with high-dose corticosteroids to reduce the inflammation.

 3 Managing symptoms

In MS, damage to the myelin in the CNS and to the nerve fibers themselves interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the symptoms of MS, which vary depending on where the damage has occurred. MS symptoms can be effectively managed with a comprehensive treatment approach that includes medication(s) and rehabilitation strategies.

4 Promoting function through rehabilitation

Rehabilitation programs focus on function — they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions. Rehabilitation is an important component of comprehensive, quality healthcare for people with MS at all stages of the disease. Rehabilitation programs include cognitive and vocational rehabilitation, physical and occupational therapy, therapy for speech and swallowing problems, and more. 

5 Providing emotional support

Comprehensive care includes attention to emotional health as well as physical health. Mental health professionals provide support and education, as well as diagnose and treat the depression, anxiety and other mood changes that are so common in MS. Neuropsychologists assess and treat cognitive problems.

MS is only part of overall health for a pt diagnosed with this disease!  Comprehensive MS care is only a part — but not all — of a person’s overall health management strategies.

Like the general population, people with MS are subject to medical problems that have nothing to do with their MS — which means that regular visits with a primary care physician and age-appropriate screening tests are just as important for them as they are for everyone else. And the same goes for family members — your health and well-being are important too.

Updated 3/16/2023

“Women are more likely to get MS than men. People of all races and ethnicities can get MS, but it’s most common in White people.

Having a parent or sibling with MS increases the chances of a person getting MS, although MS itself isn’t an inherited disorder. Research suggests hundreds of genes and gene variants (also called mutations) combine to create vulnerability to MS.

Some of these genes have been identified, and most are related to functions of the immune system. Some of the known genes are like those that have been identified in people with other autoimmune diseases, such as inflammatory bowel disease, celiac disease, type 1 diabetes, rheumatoid arthritis, or lupus.

Several viruses have been found in people with MS, but the virus most consistently linked to the development of MS is the Epstein-Barr virus (EBV) which causes infectious mononucleosis.”

NIH – National Institute for Neurological Disorders and Stroke (Multiple Sclerosis (MS) | National Institute of Neurological Disorders and Stroke)

Multiple sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.

It can be a challenge for doctors to diagnose multiple sclerosis (MS). There’s no one test that can definitely show if someone has it. And there are many conditions with symptoms that can seem like MS.

But a neurologist who specializes in treating the disease should be able to look into how you’re feeling and help you figure out if your symptoms mean you have MS or another problem.

SYMPTOMS OF MULTIPLE SCLEROSIS:

Multiple Sclerosis symptoms vary from person to person but there are common symptoms with MS. Those could be the following:

*Fatigue-Occurs in about 80% of people, can significantly interfere with ability to function at home and work, and may be the most prominent symptom in a person who otherwise has minimal activity limitations.

*Difficulties with your walking gait-Related to several factors including weakness, spasticity, loss of balance, sensory deficit and fatigue, and can be helped by physical therapy, assistive therapy and medications.

*Numbness or Tingling-Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.

*Spasticity-Refers to feelings of stiffness and a wide range of involuntary muscle spasms; can occur in any limb, but it is much more common in the legs.

*Weakness-Weakness in MS, which results from deconditioning of unused muscles or damage to nerves that stimulate muscles, can be managed with rehabilitation strategies.

*Visual Problems-The first symptom of MS for many people. Onset of blurred vision, poor contrast or color vision, and pain on eye movement can be frightening — and should be evaluated promptly.

*Dizziness or Vertigo-People with MS may feel off balance or lightheaded, and for some even much less often have the sensation that they or their surroundings are spinning (vertigo).

*Bladder Problems-Bladder dysfunction, which occurs in at least 80% of people with MS, usually can be managed quite successfully through dietary and fluid management, medications, and catheterization.

*Sexual Problems-Very common in the general population including people with MS. Sexual responses can be affected by damage in the central nervous system, as well by symptoms such as fatigue and spasticity, and by psychological factors.

*Bowel Function-Constipation is a particular concern among people with MS, as is loss of control of the bowels. Bowel issues can typically be managed through diet, adequate fluid intake, physical activity and medication.

*Pain-Pain syndromes are common in MS. In one study, 55% of people with MS had “clinically significant pain” at some time, and almost half had chronic pain.

*Cognitive changes-Refers to a range of high-level brain functions affected in 50% of people with MS, including the ability to learn and remember information, organize and problem-solve, focus attention and accurately perceive the environment.

*Emotional changes-Can be a reaction to the stresses of living with MS as well as the result of neurologic and immune changes. Bouts of depression, mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their families.

*Depression-Studies have suggested that clinical depression — the severest form of depression — is among the most common symptoms of MS. It is more common among people with MS than it is in the general population or in persons with many other chronic, disabling conditions

Less common symptoms:

*Speech problems-this including slurring (dysarthria) and loss of volume (dysphonia) occur in approximately 25-40% of people with MS, particularly later in the disease course and during periods of extreme fatigue. Stuttering is occasionally reported as well.

*Swallowing problems — referred to as dysphagia — result from damage to the nerves controlling the many small muscles in the mouth and throat.

*Tremor, or uncontrollable shaking, can occur in various parts of the body because of damaged areas along the complex nerve pathways that are responsible for coordination of movements.

*Seizures — which are the result of abnormal electrical discharges in an injured or scarred area of the brain — have been estimated to occur in 2-5% people with MS, compared to the estimated 3% of the general population.

*Breathing Problems-Respiration problems occur in people whose chest muscles have been severely weakened by damage to the nerves that control those muscles.

*Itching-Pruritis (itching) is one of the family of abnormal sensations — such as “pins and needles” and burning, stabbing or tearing pains — which may be experienced by people with MS.

*Headaches-Although headache is not a common symptom of MS, some reports suggest that people with MS have an increased incidence of certain types of headache. 

*Hearing Loss-About 6% of people who have MS complain of impaired hearing. In very rare cases, hearing loss has been reported as the first symptom of the disease.

Stayed tune Part III in modern treatments with Types of Multiple Sclerosis tomorrow!

Updated 3/16/2023

“Multiple Sclerosis (MS) is a chronic neurological condition that affects the central nervous system, which is comprised of the brain and spinal cord.

Statistics indicate that, each week, more than 200 people are diagnosed with MS – approximately one person every hour of the day. Yet, unless you or someone you love is personally affected, you may know little about it, or hold common misconceptions about the illness.

For those living with the condition, education is the key to a better quality of life. Learning about available treatments, symptom management, and coping techniques gives those with MS the tools to live at their best.

In an effort to eliminate these fears, and in order to help those with MS achieve a better quality of life, MS Focus provides educational materials and sponsors educational events, for every audience, at every level of MS knowledge, completely free of charge.”

Multiple Sclerosis Foundation / MS Focus (Multiple Sclerosis Foundation – Get Educated)

To understand Multiple Sclerosis (MS) lets understand first it attacks the nervous system at the what we call the myelin shealth.  The myelin sheath does this first the Myelin is a fatty white substance that surrounds the axon of some nerve cells, forming an electrically insulating layer. It is essential for the proper functioning of the nervous system. It is an outgrowth of a type of glial cell. The production of the myelin sheath is called myelination or myelinogenesis.  The myelin sheath is a multi-layered membrane, unique to the nervous system, that functions as an insulator to greatly increase the efficiency of axonal impulse conduction.

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.

There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. They may include:

• Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk
• Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
• Prolonged double vision
• Tingling or pain in parts of your body
• Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
• Tremor, lack of coordination or unsteady gait
• Slurred speech
• Fatigue
• Dizziness
• Problems with bowel and bladder function

When to see a doctor

See a doctor if you experience any of the above symptoms for unknown reasons.

“Why Is Heart Disease the Leading Cause of Death in the U.S.?

• Heart disease has been the top cause of death for over a century.
• A recent study found that age-adjusted death rates have dropped 66% in 50 years; heart attack deaths down nearly 90%.
• Deaths from heart failure, arrhythmias, and hypertensive heart disease are rising.
• Advances in prevention and treatment help people live longer with chronic conditions.
• Risk factors like obesity, Type 2 diabetes, hypertension, and inactivity are increasing”

American Heart Association (Cardiovascular Disease – CVD | American Heart Association)

This year marks the 62nd Anniversary of American Heart Month. For the past 56 years, the American Heart Association (AHA) has used the month of February to partner with the media, medical providers and community organizations to spread the word about heart disease prevention and treatment. Heart disease is a leading cause of death for both men and women. Over the years, the American Heart Association has sponsored awareness and education campaigns as well as medical research funding, investing more than $3.5 billion into studies. According to the AMA, this is the most amount of funding of any entity outside the federal government.

The AHA provides the following reminders to encourage you to live a heart-healthy lifestyle:

• Watch your weight.
• Quit smoking and stay away from secondhand smoke.
• Control your cholesterol and blood pressure.
• If you drink alcohol, drink only in moderation.
• Get active – regular exercise is a verty important of heart health.
• Eat healthy.

Heart Health Facts

• Heart disease & stroke kill about 30 NC women/day.
• Nearly half of African American women live with heart disease.
• About 23% of adult men and about 18% of adult women smoke.
• Stroke is among the Top 5 Cause of Death for Women in almost every state.
• Overweight women are 18%-30% more likely to have babies with heart defects.
• 22% of schools do not require physical education.
• Nearly 10 million kids and adolescents ages 6 – 19 are considered overweight or obese.
• Roughly 17% of children and adolescents ages 6 to 17 years—or about one in six—have obesity, according to 2022–2023 data from the National Survey of Children’s Health (NSCH)—a national survey funded and directed by the Health Resources and Services Administration’s Maternal and Child Health Bureau that has been fielded annually by the United States Census Bureau.
• Research from the 2024 review in the Journal of the American Medical Association shows that about 21% of U.S. adolescents ages 12 to 17 years have obesity.
• Each day, only 2% of children receive the right amount of fruit and veggies.

“Eating disorders most commonly affect teens and young adults, although they can affect people of all ages, including both women and men.

More than 90 percent of people with an eating disorder are female. Teenagers, especially girls, face challenges like societal pressures, emotional changes and the effects of puberty on their bodies, which can make them more vulnerable to eating disorders. As kids go through the physical changes of puberty, they may become more aware of how their bodies are changing. When this happens – especially when coupled with exposure to social media and experiences like bullying – it can make some teens feel insecure about their appearance. Over time, these feelings can lead to body image issues and even symptoms of eating disorders.

The overall lifetime prevalence of eating disorders is estimated to be 8.6 percent among females and 4 percent among males in the United States.”

Stony Brook Medicine (Anorexia vs. Bulimia: Symptoms, Differences and Treatment Options – Stony Brook Medicine Health News)

1.) Binge Eating

Binge Eating Disorder (BED) is newly-recognized and is characterized by recurrent episodes of binge eating that occur twice weekly or more for a period of at least six months. During bingeing, a larger than normal amount of food is consumed in a short time frame and the person engaging in the bingeing behavior feels a lack of control over the eating.

In BED, bingeing episodes are associated with at least three characteristics such as eating until uncomfortable, eating when not physically hungry, eating rapidly, eating alone for fear of being embarrassed by how much food is being consumed, or feeling disgusted, depressed or guilty after the episode of overeating. These negative feelings may in turn trigger more bingeing behavior. In addition, although BED behaviors may cause distress by those affected, it is not associated with inappropriate compensatory behaviors such as those found in Bulimia Nervosa or Anorexia Nervosa. Therefore, people with BED often present as either overweight or obese because they consume so many extra calories.

2.) Anorexia Athletica

Anorexia Athletica is a constellation of disordered behaviors on the eating disorders spectrum that is distinct from Anorexia Nervosa or Bulimia Nervosa. Although not recognized formally by the standard mental health diagnostic manuals, the term Anorexia Athletica is commonly used in mental health literature to denote a disorder characterized by excessive, obsessive exercise. Also known as Compulsive Exercising , Sports Anorexia, and Hypergymnasia, Anorexia Athletica is most commonly found in pre-professional and elite athletes, though it can exist in the general population as well.

People suffering from Anorexia Athletica may engage in both excessive workouts and exercising as well as calorie restriction. This puts them at risk for malnutrition and in younger athletes could result in endocrine and metabolic derangements such as decreased bone density or delayed menarche.

Symptoms of Anorexia Athletica may include over-exercising, obsession with calories, fat, and weight, especially as compared to elite athletes, self-worth being determined by physical performance, and a lack of pleasure from exercising. Advanced cases of Anorexia Athletica may result in physical, psychological, and social consequences as sufferers deny that their excessive exercising patterns are a problem.

3.) Over Exercise

 “Over exercise” is a general term referring to exercising to the point of exhaustion. Over exercise can occur once in a while as when someone overdoes it on a single work-out, or it can be a habitual behavior. When over exercising becomes the norm, this may be an indication that a person is actually suffering from what is called Obligatory Exercising, Compulsive Exercising, or Anorexia Athletica. When someone over exercises to the point where it is a problem, he or she may experience physical, psychological and social consequences.

4.) Overeating 

Overeating is not a specific diagnosis of any sort but may rather refer to a discrete incident of eating too much such as during holidays, celebrations, or while on vacation, or it may refer to habitual excessive eating.

People who engage in overeating regularly tend to eat when not hungry and may eat alone because they are embarrassed about the portions of food they are consuming. In addition, they may spend exorbitant amounts of time fantasizing about their next meal. Another sign that overeating has become a problem is if excessive amounts of money are wasted on food. In general, people who overeat are overweight or obese though people with normal body weights may overeat from time to time as well.

Overeating becomes problematic when it manifests as a compulsive or obsessive relationship with food. At this point it may be treated with behavior modification therapy or as a food addiction. One program available that supports people in recovering habitual, problematic overeating using the context of an addiction is Overeaters Anonymous (OA). OA is set up similarly to Alcoholics Anonymous (AA) and is a twelve step program in which members acknowledge that they are powerless over food. OA is open to anyone who has an unhealthy relationship with food and who wishes to stop.

5.) Night Eating

 Night Eating Syndrome (NES) is an emerging condition that is gaining increased recognition among medical professionals. Its clinical importance is in relation to obesity as many people who suffer from NES are overweight or obese and being overweight or obese comes with many negative health risks. Although not classified as one of the types of eating disorders, as a syndrome, NES is considered a constellation of symptoms of disordered eating characterized most prominently by a delayed circadian timing of food intake.

People with NES tend to not eat in the morning and consume very little during the first half of the day. The majority of their calories are then consumed in the evening hours, so much so that sleep may be disturbed so that a person can eat. People with NES may be unable to get back to sleep after eating or may experience frequent awakenings throughout the night for feedings. However, people with NES are fully awake and aware of their eating episodes.

It is distinct from bingeing disorders in that the portions consumed are generally those of snacks rather than huge meals. In addition, it differs from Bulimia Nervosa since there are no compensatory or purging behaviors present to offset increased calorie intake.

6.) Orthorexia

Orthorexia Nervosa (also known as “orthoexia”) is a term coined by physician Steven Bratman in an article he wrote for Yoga Journal in 1997. It is not a traditionally recognized type of eating disorder but it does share some characteristics with both Anorexia Nervosa and Bulimia, most specifically obsession with food.

Orthorexia refers to a fixation on eating “pure” or “right” or “proper” food rather than on the quantity of food consumed.

Having Orthorexia Nervosa is like suffering from Workaholism or Exercise Addiction in which something that is normally considered good or healthy is done in excess and to the point that a person becomes obsessed with the activity. Like other obsessive disorders people with Orthorexia Nervosa experience cyclical extremes, changes in mood, and isolate themselves. Most of their life is spent planning and preparing meals and resisting temptation to the exclusion of other activities. They may even go to the extreme of avoiding certain people who do not share in their dietary beliefs or carry their own supply of food wherever they go.

Like other eating disorders, Orthorexia Nervosa may result in negative consequences. Social isolation, physical deterioration, and a failure to enjoy life can occur. There have even been a few deaths related to Orthorexia Nervosa when a person becomes so low in body weight due to restrictive eating or fasting that the heart fails.

7.) EDNOS – Eating Disorder Not Otherwise Specified

According to the Diagnostic and Statistical Manual, 4th Edition there exists a category of eating disorders that do not meet the specific criteria for the two defined disorders, Anorexia Nervosa and Bulimia. When people exhibit behaviors in the spectrum of disordered eating but do not meet all the criteria for Anorexia Nervosa or Bulimia, they are given a diagnosis of an Eating Disorder Not Otherwise Specified (EDNOS). Over one-half to two-thirds of people diagnosed with eating disorders fall into the category of EDNOS. More people are diagnosed with EDNOS than Anorexia Nervosa and Bulimia combined.

Binge Eating Disorder (BED) is the only type of eating disorder under the category of EDNOS. A person meets the definition of having EDNOS if they have exhibit all the criteria for Anorexia Nervosa but have regular menstruation or a normal body weight, or if they exhibit all the criteria for Bulimia but purge less than two times per week or for a duration shorter than three months, or if only small amounts of food are purged, or if a person spits out food rather than swallowing it.

People diagnosed with EDNOS can experience the same negative psychological, social, and physical consequences as a person diagnosed with Anorexia Nervosa or Bulimia. The seriousness of their condition is no different than that for people diagnosed with specific disorders. The only difference is that the person may experience a spectrum of disordered eating behaviors and these behaviors may change over time.

Although BED is the only one of the types of eating disorders categorized under EDNOS, people who are considered to have Sub Therapeutic Anorexia Nervosa or Sub Therapeutic Bulimia are also given a diagnosis of EDNOS. To have Sub Therapeutic Anorexia Nervosa or Bulimia means that a person displays some but not all of the criteria for the full-blown condition.