High salt content in food is related to higher risk of further neurological damage in RS, as shown by a study published in September 2014 in the UK.

Previous research shows that salt can change the autoimmune reaction which contributes to the multiple sclerosis progress but it hasn’t been clear whether it affects the course of the disease itself.

Teaspoon of salt per day

The researchers analysed the urine of 70 people with relapse-remittent form of multiple sclerosis to find the level of salt, creatinine (a substance created in muscles and excreted by kidneys), and vitamin D in relation to their disease. The monitored subjects collected a urine sample three times a day for a period of 9 months and noted any changes in their daily diet. Their neurological health was then monitored for another two years.

The subjects consumed on average 4 grams of salt per day (one teaspoon); a low salt intake is below 2 grams and high is considered over 4.8 grams. Men tend to use more salt than women.

Taking into account other factors, such as smoking, age, gender, time lapsed form being diagnosed, weight and intake of vitamin D, the relation between salt intake level and deterioration of symptoms was shown. People who used a lot of salt had three occurrences of symptoms deterioration (attacks) and the probability of another attack was four times higher than for patients who used less salt. 

Using roentgen and CT the scientists then looked into whether the disease progressed and again found a link between salt intake and radiology confirmation of MS (almost 3.5 higher for people with higher salt intake).

More research needed

However, this study only noted the measured values and the researchers did not in any way affect the situation, therefore it is impossible to draw any final conclusions on the cause and effect. This research will be followed by another study in which the scientists will research whether reducing salt consumption can reduce the symptoms of multiple sclerosis and slow down the progress of the disease. 

Article source: http://www.sciencedaily.com/releases/2014/08/140828184807.htm

Study: M. F. Farez, M. P. Fiol, M. I. Gaitan, F. J. Quintana, J. Correale. Sodium intake is associated with increased disease activity in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry, 2014; doi:10.1136/jnnp-2014-307928 

Multiple sclerosis is a chronic, degenerative and inflammatory auto-immune brain and spinal cord disease which attacks mostly younger people. It is medicable but incurable.

The accessibility of modern effective drugs has significantly improved recently, thanks to payers, regulators and doctors. The disease progress can be influenced not only by drug therapy but also by responsible behaviour of the patient, and understanding and support from his/her surroundings. Therefore it is necessary to get as much information about the disease as possible.

Multiple sclerosis is a complicated disease and the patient needs the care from many experts: neurologist, physiotherapist, ergo-therapist, urologist, ophthalmologist, psychologist, psychiatrist and many more. It is not just about the medical treatment, for example, women with multiple sclerosis need consultancy if they decide to have a baby, the care for such patients also includes social and legal advice, recommendations on living conditions, etc.

For the newly diagnosed patient the announcement of such diagnosis represents a very difficult and new situation, but it is necessary to realise that it’s not the end of the life and that the patient can by his/her own responsible approach to the treatment influence the disease course. The more the patient actively fights the disease, the longer the patient can work without significantly changing his or her lifestyle. The doctors say that passive behaviour in patients creates room for activity of the disease. It is proven that regular exercise significantly delays the time when the patient needs to start using some compensation tools, such as walking cane. It is important for the patients and their closest people not to succumb to some myths, such as that the disease always means that they will have to be in a wheelchair soon. That is why there is the website Give yourself a chance, supported by the current media campaign Give Yourself a Chance (Dej si šanci).

The most important person in the care of a multiple sclerosis patient is the neurologist. “For multiple sclerosis, the old adage that the sooner you start treating a disease the more can the doctor do, applies twice as much. That is because we now have drugs for MS in its inflammatory stage when the neurodegenerative process is not so strong yet. The sooner we start treatment, the bigger the hope we may stop the disease or at least prolong the period before the patient becomes disabled,” explains MUDr. Eva Medová of the Neurology Department of the General Teaching Hospital in Prague.

For people with multiple sclerosis, rehabilitation care is very important, mostly due to a weakening of lower limbs or balance disruptions. The treatments are individual according to the patients’ needs: to maintain fitness, improve walking, strengthen the pelvic muscles, reduce deglutition problems, or improve coordination. “It really is individual, depending on the patient’s actual problems,” says MUDr. Martina Kövári, Head of the Department of Rehabilitation and Sports Medicine of the Teaching Hospital in Motol. People with multiple sclerosis may have the same disease but the symptoms are different for each patient.

Rehabilitation cannot stop the disease but it may reduce its symptoms. Also, exercise strengthens the organism’s immunity which is necessary in multiple sclerosis. Another plus of a regular exercise is that the patients realise what they can manage and this improves their self-confidence. “Also, during exercise you produce endorphins and people feel happy afterwards,” says PhDr. Kamila Řasová of the Rehabilitation Department of the Královské Vinohrady Teaching Hospital. “By improving the physical aspects we influence the limbic system responsible for emotions. So we influence the psyche of the patients and their immune processes and we are able to stabilise the disease,” she says.

Those patients used to get lighter regime but today we know that what they need is a structured load,” says professor PaedDr. Pavel Kolář, head physician of the Department of Rehabilitation and Sports Medicine of the Teaching Hospital in Motol. The aim of physiotherapy is for the patient to remain self-reliant as long as possible, including the ability to work. Therefore physiotherapists work together with ergo-therapists so that each patient can receive a tailor-made compensation tool.

Many patients also need the help of a psychologist or psychiatrist. “They suddenly find themselves in a difficult situation. When you encounter a serious disease, most people are in shock. They panic, they are afraid. They need to come face to face with a big complication – the loss of health. With a hurt like this we need to go to someone, to share it, we shouldn’t try to carry this load all on our own. I work with the patients so they realise that they can have a full life even with a handicap, and that multiple sclerosis is not the end of the life,” says psychotherapist Renata Malinová – Schubertová of the Neurology Department of the General Teaching Hospital in Prague.

What is multiple Sclerosis

Multiple sclerosis is one of the most frequent diseases of the central nervous system in young people. This chronic, inflammatory, autoimmune disease attacks the brain (including optic nerves) and spinal cord. According to the scientists, the risk factors in MS are infection by EB virus (such as infectious mononucleosis), lack of vitamin D (the disease occurrence correlates with distance from the equator), and smoking. The role of stress in the occurrence of this disease is not quite clear, however stress in general changes the state of the autoimmune system. It can then react against the structures of its own body. The disease is not hereditary, however in the families of the patients there is bigger susceptibility to autoimmune diseases (only three to five per cent of children of MS patients manifest this disease). There are 17 to 18 thousand MS patients in the Czech Republic.

The symptoms of the disease differ, one of the possible symptoms is reduced sensitivity in limbs and tingling. The disease can also be signalised by problems with sight: double or blurred vision, problems recognising colours, involuntary and uncontrollable eye movements, etc. MS can also manifest in problems with speech – pronunciation and flow. There are many other symptoms, including myasthenia, chronic fatigue, coordination and balance problems, and incontinence. The actual course of the disease is also individual and hard to predict. It differs for each person and the symptoms can also change over time. About 10% of patients can have very minor symptoms even after years of the illness, for others the situation may begin to deteriorate after few years of normalcy. However, this can be delayed by early treatment and healthy lifestyle under medical supervision.

MS often manifests in people aged between 20 to 40 years. Twice as many women suffer from this disease, this may be caused by hormones. In many patients the disease brings about not just physical problems but also depression. However, overcoming the initial feeling of despair and disappointment is the first step for the patient to begin an active life with MS. To manage the disease it is necessary to find a doctor and start treatment immediately. Interesting fact is that the disease affects almost solely people of European descent, e.g. the occurrence is ten times lower in Afro-Americans. The disease is mostly spread in Europe, North America, Australia and New Zealand. In Europe it occurs more often in Scotland, Norway, Faeroe Islands, and also in Sardinia and Sicily. There is actually a genetic origin of this disease, it occurred in the Vikings and spread through generations; this explains the increased occurrence in North Europe.

There has been great progress in MS treatment recently, thanks to preparations that can reduce the number of attacks in most patients (sometimes the attacks are called relapse, i.e. renewed deterioration of health), and slow down the processes leading towards disability. This treatment is most effective during the early stage of the disease, that is why it is important to visit a doctor as soon as possible if you have the first suspicion of MS in you or your close ones. The longer the treatment is postponed, the lower the effect of the treatment. Drugs to slow down the disease and reduce symptoms are used in MS treatment but also other medical treatments, such as physiotherapy of the locomotor system, ergo therapy (enabling regular daily activities), logopaedic care for speech impediments, psychotherapy or neuro-psychological memory and concentration training. Half of the people suffering from MS also have depressions which can later be treated by both drugs and psychotherapy.

Myths about multiple sclerosis

Multiple sclerosis usually manifest between 20 and 40 years of age, which means during the period when women usually plan their pregnancy. Before, women used to be warned against this step but today doctors have proven that pregnancy does not affect the disease progress and does not affect the healthy development of the embryo. A woman who wants a child should however cooperate with the doctors: the pregnancy should come during a stabilised period of the disease. The disease often goes into remission during pregnancy in many cases. If the MS mother’s situation is stabilised, she can even breastfeed for a period of time. MS does not threaten the mother or the child: the probability of stillbirth or premature birth are the same as in the rest of the populace. The risk of the child having the same disease is higher but not high – three to five per cent.

People suffering from multiple sclerosis often believe that physical activity worsens the disease progress and that they should not exert themselves. However, medical studies show that exercise actually improves the patient’s life to a certain extent and has a positive impact on the disease progress. For example, people without regular exercise have more difficult recovery from MS attacks, they are more susceptible to depression, often have heart and vascular diseases, or osteoporosis. Therefore MS patients are recommended to have regular exercise set by a physiotherapist: swimming, running, cycling or cross-country skiing are recommended, the patients can also do circuit training or workout exercises. What is important is to have adequate load which strengthens the body but does not exhaust (a simple criterion is that one hour after the exercise we should feel well rested). Exercise should be limited in case of attack or infectious disease.

Many people with multiple sclerosis can do their jobs without much limitations; hard manual work is not suitable however. Their physical condition may vary during the day and even patients without any visible handicap tire faster than healthy people. However, with frequent short breaks at work they should be OK and able to perform just as all the other workers. In any case, MS diagnosis is not in itself a reason for a permanent disablement or even disability pension, all depends on the severity of the neurological findings. A person suffering from MS just needs to adapt his or her work rhythm to the disease. Their body balance may be upset by causes other people cannot comprehend, even for example external temperature.

Serious motoric disorder necessitating the use of a wheelchair occurs in some 15 – 20% of the patients. It is never obvious in advance who will suffer from the more severe consequences of the disease. For each person the MS progress is different and may manifest in different ways over time, and the symptoms may not always worsen over time. Some people experience minor problems from time to time, others suffer from serious attacks with severe consequences. The disability is significantly impacted by modern biologic treatment. The necessity to use a walking stick to walk 100 metres may be delayed by as many as 12 years for most patients, provided the drugs are administered early. However, in every case stands that a person with minor to no symptoms who suffers from a great fear of the future has a worse life than a person who may have obvious disability but is reconciled with the situation and tries to live a full life with everything that goes with it.

For most patients, multiple sclerosis is diagnosed between 20 and 40 years of age. This doesn’t mean that MS cannot manifest in a senior (or a child or young adult) but it is obvious that the most endangered group consists of people in productive age. Only in less than a one per cent of cases the first symptoms manifest at an age lower than 10 or higher than 59 years. The disease often breaks out in people who live their life in full, exceed their abilities and have a propensity to autoimmune diseases. In this group there is also the biggest danger of their not going to see a doctor with the first symptoms and the disease later manifests in form of a strong attack. The specific causes of MS however, are not yet known despite diligent professional research.

Multiple sclerosis and senile dementia are two completely unconnected diseases. MS attacks the white brain matter which is a brain communication network and attacks the grey matter much less. That is why MS does not lead to gradual dementia. Therefore the intelligence of a MS patient does not change over time, however we cannot say that this disease does not affect mental abilities: some patients can have problems with concentration, attention or memory. Such issues may often be corrected by a logopaedic treatment and regular neuropsychological training (memory, attention, concentration training etc.). If a person suffering from MS is able to retain a positive lookout they can overcome most of the above issues more easily. It is known that the disease progress is speeded up by long-term physical overload of the organism, untreated repeated infections, overwork and stress. Today, there are some 2.5 million MS patients globally, in the Czech Republic the number is between 17 and 18 thousand.

Living with multiple sclerosis