Multiple sclerosis is an autoimmune disease that affects a relatively small portion of the population, though estimates have recently increased based on new discoveries. A lot about the disease is still a mystery to science and the medical profession, but over time, despite not having a cure for it, there have been a number of treatments employed that help patients manage symptoms and, in some cases, slow the progression of the disease.
What causes multiple sclerosis, and what are the factors that play a role in the development of the disease? Some of this remains unanswered, but there are some definitive ideas and some very real risk factors that come into play.
What causes MS?
An autoimmune disease is one in which the body’s immune system mistakenly attacks some other part of the body, determining it to be a “foreign” substance that poses a threat to the body’s health. It hasn’t been determined what causes this malfunction of the immune system for most autoimmune diseases, though treatments have been created for many of these.
In the case of multiple sclerosis, the immune system creates antibodies that attack myelin. Myelin is a fatty protein substance that coats the central nervous system (CNS), which are the nerves that run through the brain and spinal cord. This coating acts as a protection and a conductor, taking the electrical impulses of the nerves more swiftly from one point to another for proper reaction in the body.
When the myelin is attacked, several problems occur:
- Myelin is destroyed, which reduces protection to the nerves and decreases the speed of nerve response.
- Inflammation occurs as a natural reaction to the attack, meaning that the swelling cuts off or delays proper communication through the nervous system.
- Without the proper protection, nerves in the CNS are damaged, sometimes significantly, and cannot be repaired.
- Lesions appear on the brain that further the problems with communication and lead to additional damage.
These are essentially the causes of MS symptoms, which can lie dormant for a certain amount of time (remission) in some types of multiple sclerosis but eventually return (relapse) and, eventually, never disappear. In fact, with progression, those symptoms come and stay, getting worse with time.
Diagnosing multiple sclerosis
Doctors run a number of tests to determine if the symptoms are due to MS or to another disease or ailment that produces the same issues. In order to make a true diagnosis, the physician must prove that the patient’s problems meet three specific criteria, thus leading to the regimen of testing.
- There must be evidence of damage to the CNS in at least two different places (this could include the optic nerves, since they are part of the central nervous system).
- The evidence of damage must be proven to have occurred in at least two separate episodes (relapses), taking place at two different times. A single episode of symptoms may be diagnosed as clinically isolated syndrome and later upgraded to MS when a second occurrence is proven.
- All other potential diseases and conditions that could have caused the damage and related symptoms must be ruled out.
When these criteria are met, the patient will likely be diagnosed with multiple sclerosis, the type determined, and treatment begun.
Risk Factors for Getting Multiple Sclerosis
Up until recently, doctors believed about one out of every thousand people were affected by multiple sclerosis, a very small percentage of the population. However, new research has led that prediction to change. In mid-July of 2018, doctors increased the projected number of people in the United States who had MS from 400,000 to a million, more than doubling the number. Essentially, that means it is now believed that one out of every four hundred people could suffer from MS.
While it’s hard to predict whether or not a person is at risk for multiple sclerosis, there are certain proven factors that seem to increase that risk significantly. Some can be avoided, while others are beyond control. The eight biggest risk factors are:
- Age – While anyone at any age could be diagnosed, those most at risk are between the ages of 15 and 50.
- Gender – Those born as women are three times as likely as men to develop multiple sclerosis.
- Family history – While there is no direct inheritance of genes proven, those with a parent or sibling who has MS are at a higher risk for developing the disease.
- Infections – Some types of viruses, while not proven to cause MS, have been linked to its development, including Epstein-Barr, which is the virus that causes mononucleosis.
- Race – Those at the lowest risk for developing MS are of Asian, African, and Native American descent. By contrast, Caucasians of Northern European descent are the race at highest risk of developing MS.
- Climate – While this is hard to explain, MS is more prevalent in areas with a temperate climate, with the highest percentage of cases in Canada, the Northern United States, southeast Australia, much of Europe, and New Zealand.
- Existence of other Autoimmune Diseases – Those with IBS (inflammatory bowel disease) and thyroid disease are at slightly higher risk for MS, while Type 1 Diabetes doubles the risk of developing the disease.
- Smoking – While smokers seem to be at equal risk for clinically isolated syndrome (CIS, or a single episode of MS symptoms), those who smoke and experience that first episode are at a higher risk for a relapse that proves multiple sclerosis.
Multiple sclerosis can affect anyone, and it’s a very tough disease with no cure in sight. However, avoiding the risk factors within control can help reduce the likelihood of developing this degenerative disease. Avoid serious infections when possible, and get vaccinated, especially if you already have one or more uncontrollable risk factors. Stop smoking or avoid starting, and maintain a healthy diet and exercise schedule, which promotes improved immune system function and overall body health. This will also keep weight troubles to a minimum, meaning that if MS develops, additional weight to carry won’t cause complications with the disease.