Multiple Sclerosis - Is It Just an Autoimmune Condition?

The simple answer is no. But that’s not what you’re here to read. Multiple sclerosis (MS) is the result of a series of intricate changes within the body that ultimately lead to rapid decline physically, cognitively, and, of course, emotionally. Let’s look at the stats. The MS Society of Canada reports 77,000 people living with MS, one of the highest concentrations in the world.^[1] Many of these people are on disability, while others show very minimal symptoms. Some have genetic links to MS, while others have no family history and still develop the disease. Researchers continue to search for a cure, but how can we find a cure unless we fully understand the progression? And with a disease that presents itself along such a wide spectrum of people with different cultures, lifestyles, and abilities, can one cure really be enough to help everyone?

Development of Disease

MS is currently accepted as an autoimmune disease of the central nervous system. It is thought to be the result of damage to the myelin sheath surrounding the nerves, a protective layer that allows nerves to fire very quickly and produce movement, thought, reaction, etc. The immune system becomes faulty and begins attacking parts of the body that are normal.^[2] The more damage that ensues from the immune system, the more scar tissue is replaced around the nerves and the harder it is to send rapid nerve impulses. Depending where the damage forms in the brain, we may see slowed movement, poor coordination, extreme fatigue, weakness, tingling, changes in bladder and bowel control, and many more. The one thing this definition does not explain is how an individual with MS can be fine one day and completely debilitated the next. Maybe the legs are affected today, but the arms will be affected tomorrow. And maybe by the weekend, they will be walking perfectly fine again, with no symptoms at all! As naturopathic doctors, we see the whole body and assess all aspects of the person. Yes, the immune system is overactive in this case, but in our quest for the root cause, we always want to know more! What causes the immune system to change in this way? What factors accelerate this process, and how can we prevent it?

As all conditions treated naturopathically, we will begin with the gut and the liver. For those unfamiliar with the term “microbiome,” it refers to the balance of bacteria and microorganisms living in the gastrointestinal tract. This balance is central to every disease process in the human body and ultimately begins before we are born. Whether we are born vaginally or by C‑section does make a large difference as to the types of bacteria that live within us; however, our exposure to germs in the environment is important as well. Essentially, the bacteria in our microbiome determine how and what we fight against. A system that is exposed to a very clean environment will never learn how to properly fight dangerous microorganisms, and a system that is exposed to numerous rounds of antibiotics will also never be able to hold on to good bacteria and maintain immunity. 

Now, if we consider the powerful impact that our diet and environment have on our immune system, we can agree that just having a gene for a disease does not mean that gene will be expressed as that disease. In other words, a poor environment and unhealthy foods can create inflammation and cause that disease gene to be produced. By contrast, a positive environment and a healthy balanced diet can reduce the chance that disease gene will be expressed and even leave us disease-free. Naturopathic doctors see the change in certain proteins that happens with a poor diet and lifestyle. For example, genetically modified foods and processed foods contain many altered proteins that are more or less unknown to us. Could the change in immune recognition that happens with autoimmune disease be more of a normal immune system not recognizing an altered protein, instead of the common thought that the immune system itself has gone bad?

From a clinical perspective, modifying the diet in a patient with progressive MS does demonstrate positive results. In fact, the Swank diet was developed and widely accepted as the perfect low-fat diet to reduce neurological symptoms.^[3] However, could the success of the Swank diet be attributed to a reduction in processed and saturated fats, and by default an increase in home-cooked meals rich in vegetables and lean proteins? Until this point, we have considered diet, genetics, and the microbiome in the development of MS. But we still haven’t answered why some people experience the disease to a debilitating degree, while others do not. One of the most important aspect of MS health-care is not visible and rarely ever considered. Mental health issues, including depression and anxiety, are among the highest in this population, and stressors play the largest role in acceleration of the disease. In fact, depression exists in up to 50% of individuals with MS.^[4] As there is currently no cure for MS, many of these patients are left abandoned by the medical system, which only further enforces the feelings of helplessness and frustration.

From a biochemical perspective, high levels of stress increase levels of proinflammatory immune cells, including Th₁₇, an immune cell known to poke holes in the blood-brain barrier.^[5] This barrier is essential to keeping the fluid in the brain separate from the rest of the body and maintaining a sterile environment for optimal neurological function. Theoretically, the higher the stress and the longer the stress response is maintained, the larger the production of Th₁₇, and the more damage to the blood-brain barrier. This opens the doors for everything to enter into the brain, and the immune system to run after it, trying to keep it contained but actually creating more inflammation. Based on this series of events, it can be speculated that MS is no longer just an autoimmune disease, but instead has a significant link to chronic inflammation and altered proteins in the system.

Why You Should See a Naturopathic Doctor if You Have MS

Restoring Balance to the Microbiome: A naturopathic doctor will always start with the gut, because we believe it is the root of the immune system. Balance isn’t just about taking probiotics; it is also about removing an overgrowth of bad bacteria. NDs will feed your gut with glutamine, digestive enzymes, oregano oil, and likely several herbs to help your body reset and remember how to this work on its own.

Identifying Food Allergens: Most people have reactions to foods, and almost everyone has even a small reaction to specific foods like gluten. The only way to know is to take out the offending food for a while and allow the digestive tract to heal. Continuing to consume a food allergen will only continue to aggravate the immune system and progress the disease.

Creating a Gentle Exercise Program: This may include the help of other health-care professionals in your team, but yes, exercise must be part of a plan. Even if it is just walking or moving the arms in circles, the neurological connections that are created and maintained will get stronger in time.

Stress Management and Social Support: Guided meditations, yoga exercises, progressive relaxation, talk therapy, counselling, colouring books, art and painting, etc.—whatever it is that lowers stress, it is very important in progress and preventing relapse. Social support is very important, as individuals with MS can often feel isolated and alone with the loss of their independence. Natural herbal supports can also be used to manage anxiety and depression.

Acupuncture: Very likely, it is the best treatment modality for nerve health, and it works to increase circulation to nerve endings. Many patients report positive outcomes with numbness and tingling even after the very first treatment. This, combined with treatments like massage and stretching, will continuously improve muscle strength and coordination.

There is no secret; if you are coming to see a naturopathic doctor, you must be willing to put in the work. Positive changes don’t happen overnight, because the disease process also does not happen overnight. As a naturopathic doctor, I am proud of the options I have to present to patients with MS and all the support I am able to offer a population that otherwise is left without answers. There may currently be no cure for MS, but there is still a large amount of work that can be done to improve symptoms and increase quality of life.