Multiple Sclerosis and Dietary Changes

As a neurologist and subspecialist in multiple sclerosis, I am dedicated to helping patients with MS live their best lives. Many patients have questions about how dietary changes can impact their life. You will find that a well-balanced diet fuels your body and becomes a trusted companion in navigating the challenges posed by MS. It’s a flavorful quest where each meal becomes a small victory, a step towards a healthier, more vibrant life.

Dietary considerations are very important in most chronic medical conditions. From a nutritional perspective, what we expose our system to can have an important impact on our symptoms and sometimes in the course of the chronic medical condition. Multiple sclerosis is no different.

Here are answers to common questions about diet and MS.

Should I Be Supplementing My Diet with Vitamins and Other Supplements?

As a rule of thumb, I do not recommend multivitamins to all my patients with multiple sclerosis. I tend to screen for specific vitamin deficiencies. If a patient has one or more vitamin deficiencies, I recommend direct supplementation of that vitamin. I recheck the vitamin level in the future to adjust the dose.

What about Vitamin D? Which Vitamin D and How Much Should I Take?

Most patients with multiple sclerosis will be deficient or relatively deficient in vitamin D. I tend to recommend vitamin supplements with vitamin D3, which can be obtained over the counter. The goal is to have a vitamin D3 level from 60-80 ng/mL. To reach this goal, patients may need to take 2000-5000 international units of vitamin D3, particularly if they live in Nebraska or the Midwest.

Can I Take Too Much Vitamin D3?

Yes, and many of the symptoms of vitamin D3 toxicity may mimic chronic symptoms of multiple sclerosis, such as muscle aches, fatigue and even weakness.

Can Diet Decrease Inflammatory Activity and Relapses?

So far, there is no good evidence that dietary changes alone can directly modify the course of the disease and prevent inflammation and relapses (flares). However, maintaining a healthy body weight has been shown to decrease the risk of MS-related disability. A good diet and healthy body weight decreases the risk of other serious conditions such as cardiovascular and cerebrovascular conditions. This leads to improved overall health and decreased disability.

What Else Can Diet Do for Me and My Multiple Sclerosis?

Dietary changes have been shown to improve the overall quality of life and fatigue and, in some instances, hand dexterity. More than 50% of patients with multiple sclerosis suffer from MS-related fatigue. Unfortunately, the medications we use to treat fatigue in multiple sclerosis do not have great evidence backing their efficacy. Therefore, dietary changes have an important place in treating MS-related fatigue.

What Is the Best Diet for Multiple Sclerosis?

I always say that there is no one-size-fits-all when it comes to MS drugs/treatment, and I also apply this to diet. I recommend that my patients select one diet they can adhere to and follow long-term. Very restrictive diets and strict products may not be easy to obtain or even affordable.

Diets like the Mediterranean diet are easier to follow because they do not require complex planning and are more intuitive to follow. Other diets may also benefit multiple sclerosis, such as paleolithic, low-fat and intermittent fasting.

Where Can I Learn More About Diet and Multiple Sclerosis?

A good place to start is the National Multiple Sclerosis Society. The diet and nutrition section on this website has plenty of written information and pre-recorded webinars about diet and multiple sclerosis.