HealthCare Journey for Multiple Sclerosis
  • About Us
  • Home
  • Virtual MS Center
    • Q & A for Virtual MS Center
    • Read About Our Virtual MS Center Staff
  • News & Resources
  • Seminar Registration
  • Health & Wellness
  • Blogs
    • Physician Blog >
      • Healthcare Provider Blog
    • Physical Therapy Blog
    • Patient Blog
    • Caregiver Blog
    • Research Blogs >
      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
    • Treatment
    • MS Tips
  • Symptoms
    • Balance and Walking Issues
    • Breathing/Respiratory
    • Bowel Dysfunction
    • Cognitive Dysfunction
    • Crying/Laughing Uncontrollably (PBA)
    • Depression and Anxiety
    • Dizziness/Vertigo
    • Dysphagia
    • Fatigue
    • Foot Drop
    • Hearing or Smell or Taste Changes
    • Heat Sensitivity
    • Leg Weakness
    • Loss of Hand Dexterity and Coordination
    • Memory and Mutliple Sclerosis
    • Migraines
    • Numbness/Tingling/Altered Sensation
    • Nystagmus and Oscillopsia
    • Pain
    • Sexual Dysfunction
    • Sleep Issues
    • Spasticity/Spasms/Cramps
    • Speech/Swallowing
    • Urination/Bowel Problems
    • Vision
  • MS Clinics
  • MS Topics
    • Pregnancy and Infertility
    • Caregivers and Family Members
    • Employment and MS
    • Medical Costs and Insurance
    • Pediatric Multiple Sclerosis
  • Register With Us
  • Terms of Use/Privacy/HIPAA
  • MS HealthCare Journey

Welcome to the Virtual MS Center!

Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
CLICK HERE TO ASK YOUR QUESTION!

Platform Therapy for MS:  5 Essential Steps

11/5/2013

 
I am often asked to provide advice on diets, vitamin supplementation or other complimentary approaches to the management of MS.  While there may or may not be a role for some alternative approaches to MS management, I find that patients are often putting the proverbial ’ Cart ahead of the horse’, when they ask these questions. The question that should be asked is, how do I remain active, independent, socially engaged, and overall mentally and physically healthy with this disease? This is no small task given the barriers and challenges faced by MS patients. Some in the neurological community believe these goals can only be achieved with so called disease modifying therapies of which the older injectable therapies are usually regarded as the platform therapy on which all other treatments are built. While it is true that these pharmacologic disease modifying therapies have a significant role to play in MS disease management, I have a different idea of what represents a platform therapy. To me platform therapies represent those management strategies, often adjustments in lifestyle and health behavior, that will prevent the development of or modify those other medical conditions (known as co-morbid conditions) known to have a detrimental physical and mental effect on MS patients. So what are these health behaviors and co-morbid medical conditions? I think you know the answer but I will list them anyway (in no particular order):

1. Smoking
2. Obesity
3. Type II Diabetes Mellitus
4. Hypertension
5. Osteoporosis
6. Low vitamin D levels
7. Depression, anxiety and chronic daily stressors

Every one of these health behaviors or conditions has been shown to have a detrimental effect on MS outcomes . More importantly, some of these risk factors interact with one another in a synergist manner, meaning that their combined effects are worse than their individual effects. So what is my platform therapy prescription? It involves 5 crucial steps:

First, focus on improving your mental health; without modification of chronic symptoms of depression and anxiety, modification of common chronic stressors harmful to your MS and your health, and continued social interaction and participation, other therapies will fall short in achieving their goal. This can be a tall order. You will lay the foundation for this goal by stopping unhealthy behaviors, exercising regularly, eating well and taking care of other health concerns (see below). But this is often just the starting point. Now is the time to consider a closer examination of lifestyles, relationships, and career or work issues. While it can be difficult to find a therapist, either group or individual, that works for you, it is well worth the effort. Often online support groups now form the basis of support for many patients. Some patients will require medications as well but rarely in isolation. Most importantly, it is time to consider what is important and what is not important in your life in order to help in this process. But remember this is a lifelong process; do no be discouraged and always keep working to achieve peace and happiness.

Second, stop harmful health behaviors, notably smoking. Although alcohol consumption in moderate amounts has not been linked to more rapid progression of MS, alcohol abuse and other illicit forms of drug use, particularly cocaine and narcotics, are in my experience associated with worse outcomes..

Third, build a pattern of behaviors that is likely to achieve ideal body weight and maintain activity levels. This is extraordinarily difficult for many and often a lifelong struggle. I am not a big advocate of a particular diet; in fact it seems that the best results occur with increased activity level associated with a reduction in calories and a change in diet. Over the years, many of my patients have reported feeling better and losing more weight after switching to gluten free or gluten light diets. While there is no evidence that this diet specifically alters the course of MS, it certainly seems to have indirect benefits. In those patients morbidly obese (usually defined as 100 lbs over ideal body weight) despite efforts to reduce their weight, I am a strong advocate of bariatric surgery, although the safest and most appropriate bariatric procedure will require consultation with your physician and a qualified bariatric center. Increased activity levels are possible in everyone although some patients experience more barriers in achieving this goal, whether as a result of disability, lack of resources or social isolation. Ideally, I want all of my patients to perform aerobic exercise a minimum of 20 minutes a day, 5 days a week. I advise patients to start slow and low and increase gradually, if necessary. A personal fitness instructor or a physical therapist can help you design a program that meets your needs and your physician can advice you on any particular restrictions you may need to follow. Additional strategies must include progressive resistance training (basically weight lifting) to improve and maximize muscle function. Again a personal fitness instructor or a physical therapist can help you design an appropriate and safe program. Lastly, many patients report benefits in flexibility, strength and physical and mental well being as a result of group or individual yoga programs.

Fourth, supplement your diet with vitamin D3; the evidence is clear that low vitamin D3 levels are associated with the risk of developing MS and MS disease activity after onset. Whether vitamin D supplementation modifies the course of the disease remains unclear until larger studies are completed. Supplementation with 5,000 to 10,000 IU a day is safe in the vast majority of patients and should achieve your goal of obtaining a 25 hydroxyvitamin D level over 50, if not closer to 100.

Fifth, focus on modifying co-morbid health states like hypertension, osteoporosis and diabetes if these conditions are present. All too often patients neglect their other physical and mental health concerns after a diagnosis of MS, either as a result of feeling overwhelmed or helpless to achieve the desire results of therapy because of the barriers imposed by their combined conditions. This is a mistake. Hypertension, osteoporosis and diabetes are all associated with a more rapid rate of MS progression. Diabetes in particular creates a number of management issues in MS patients and makes the disease more difficult to treat.


Lynne Bishop
11/5/2013 10:00:18 pm

I have found that limiting or eliminating eating wheat is key for me. Since I am sensitive to it, when I eat it, it produces an immune response in my body and my default symptom (leg spasms) invariably follows. I've also found pilates to be indispensable in increasing strength and improving balance. I am fortunate to have a pilates instructor who is also a PT, so I get the benefit of both areas of expertise. She also does a lot of facia release work with me. It has literally kept me "on my feet" some weeks!


Comments are closed.

    RSS Feed

    PLEASE NOTE: This information/opinions on this site should be used as an information source only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
    Read About Our Virtual MS Center Authors

    Archives

    September 2024
    June 2024
    March 2024
    January 2024
    December 2023
    November 2023
    October 2023
    September 2023
    July 2023
    June 2023
    May 2023
    April 2023
    March 2023
    February 2023
    January 2023
    December 2022
    October 2022
    September 2022
    August 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    July 2013
    June 2013

    Categories

    All
    Accessible Housing And Environmental Modifications
    Anxiety
    Balance
    Bowel Problems
    Caregivers
    Cognitive Function
    Compliance
    David Rintell Ed. D.
    Deborah Backus Blogs
    Depression
    Diagnosis
    Diet
    Dizziness
    Dosing
    Dr. Greenberg's Q&A
    Dr. Kinkel's Q&A
    Dr. Miravalle's Q&A
    Dr. Nielsen's Q&A
    Dr. Osborne's Q&A
    Exercise
    Experimental Treatments
    Eye Surgery
    Fatigue
    Fatique
    Flu Shot
    Foot Drop
    Herbs
    Immunosuppression
    JCV
    Lasik Surgery
    Lesions
    Lori Kostich's Q&A
    Lyme Disease
    Medications
    Migraines
    Mobility
    MRI
    MS Hug
    Other Diseases
    Pain
    PML
    PPMS
    Pregnancy
    Relapse
    Safety
    Sarah Wargo's Q&A
    Sexual Dysfunction
    Side Effects
    Smoking
    Spasticity
    Stem Cell Transplantation
    Steroids
    Stress
    Supplements
    Surgery
    Symptoms
    Treatment
    Urination
    Viruses
    Vision
    Vitamin D
    Vitamins
    Weakness


© 2023 HealthCare Journey, LLC. All Rights Reserved.
HealthCare Journey™ is a trademark of HealthCare Journey, LLC
Picture
  • About Us
  • Home
  • Virtual MS Center
    • Q & A for Virtual MS Center
    • Read About Our Virtual MS Center Staff
  • News & Resources
  • Seminar Registration
  • Health & Wellness
  • Blogs
    • Physician Blog >
      • Healthcare Provider Blog
    • Physical Therapy Blog
    • Patient Blog
    • Caregiver Blog
    • Research Blogs >
      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
    • Treatment
    • MS Tips
  • Symptoms
    • Balance and Walking Issues
    • Breathing/Respiratory
    • Bowel Dysfunction
    • Cognitive Dysfunction
    • Crying/Laughing Uncontrollably (PBA)
    • Depression and Anxiety
    • Dizziness/Vertigo
    • Dysphagia
    • Fatigue
    • Foot Drop
    • Hearing or Smell or Taste Changes
    • Heat Sensitivity
    • Leg Weakness
    • Loss of Hand Dexterity and Coordination
    • Memory and Mutliple Sclerosis
    • Migraines
    • Numbness/Tingling/Altered Sensation
    • Nystagmus and Oscillopsia
    • Pain
    • Sexual Dysfunction
    • Sleep Issues
    • Spasticity/Spasms/Cramps
    • Speech/Swallowing
    • Urination/Bowel Problems
    • Vision
  • MS Clinics
  • MS Topics
    • Pregnancy and Infertility
    • Caregivers and Family Members
    • Employment and MS
    • Medical Costs and Insurance
    • Pediatric Multiple Sclerosis
  • Register With Us
  • Terms of Use/Privacy/HIPAA
  • MS HealthCare Journey