Multiple Sclerosis is a complex disease with a long list of symptoms. Every MS patient experiences these symptoms differently with their severity and duration varying greatly. The lengthy list of symptoms and unpredictability in how they may manifest makes it easy to want to blame everything on MS. But, the reality is, if you have MS you can still experience other problems, just like anybody does. In fact, in a 2017 survey by MultipleSclerosis.net, 88% of participants noted one or more health conditions besides just MS.
These additional health issues are classified as comorbidities, two or more disorders or illnesses occurring in the same person. Recognizing comorbid conditions is extremely important in finding the proper treatment as well as preventing any adverse effects these conditions may have on your MS. And though ultimately you should see your doctor for proper diagnosis, my hope is the information below will help you to stop blaming your symptoms on MS and proactively address your health conditions.
Physical Conditions
You may already know that problems breathing when you are asleep can lead to all sorts of issues — fatigue, poor memory and concentration, difficulties with problem-solving, and many more. These symptoms, specifically fatigue and the problems that come from it, are also very common signals of MS. But, in my experience with my own patients as well as through continuing research, we’ve learned that sleep disorders are highly prevalent amongst MS patients and may be a major contributors to the fatigue that they are experiencing.
Sleep-disordered breathing can cause some major problems for those who have them. But, for MS patients, the prevalence of sleep-disordered breathing is of particular concern because of its impact on fatigue and problems with “higher functions.” Additionally, a common characteristic of sleep-disordered breathing is that it is a “pro-inflammatory condition”, chronically activating your immune system. This isn’t good for anyone but is especially problematic for MS patients.
I’ve been looking for an MS-specific sleep disorder for 20 years, and haven’t found it yet. I’ve seen MS patients with Restless Legs Syndrome (secondary RLS), Periodic Limb Movement Disorder, Nocturnal Spasms, Insomnia, Narcolepsy, REM behavior disorder, and others. Each of these disorders is treated in their own way and is something that anyone can have, with or without MS.
Good quality sleep is important for mental functioning in everybody, and especially for MS patients. If you think you may suffer from a sleep disorder, don’t blame it on the fatigue associated with MS. Bring it up to your doctor and ask for a referral to have a sleep test done. The results of this could not only help you find treatment for your sleep disorder but also provide relief for some of your MS symptoms.
Other physical conditions common in MS patients that can affect the quality of life for MS patients are: hypertension, chronic lung disease, high cholesterol, osteoporosis and risk for fractures.
Autoimmune Diseases
Research surrounding autoimmune diseases and MS have led to somewhat inconsistent findings. But, overall, we have seen comorbidities of MS with the following autoimmune diseases:
- Inflammatory Bowel Disease (IBD): IBD includes both Crohn’s Disease, chronic inflammatory disease of the digestive tract, and Ulcerative Colitis, a type of inflammatory bowel disease that causes sores in the colon.
- Bullous Pemphigoid (BP): BP is a rare skin condition that causes large, fluid-filled blisters.
- Uveitis: Uveitis is the inflammation of the anterior chamber of the eye which can lead to vision loss and blindness.
Mental Disorders
Mental disorders are very common amongst MS patients. The lifetime prevalence of depression in people with MS is nearly 50%, which is higher than the general population. Anxiety affects nearly 1/3 of MS patients. These conditions often go undiagnosed or untreated which can have quite a negative effect on an MS patient’s quality of life as well as can contribute to the worsening of other symptoms.
While the relationship between depression and anxiety is still not very well understood, your symptoms should still be carefully assessed and treated just as they would for any other symptom or disease. Bring your symptoms up to your doctor, who can help you navigate the best treatment.
Coping with Comorbidities
MS Patients already have a long list of symptoms to deal with including physical disability, emotional changes, loss in vision, and reduced quality of life. Add another condition and this adds to the list giving them more symptoms to deal with, a more complicated treatment regimen and further reducing their quality of life.
If you have MS and one or more additional health conditions, the most important thing for you to do is properly identify and treat each condition.
On top of proper diagnosis and treatment, living a healthy lifestyle is very important.
- Regular physical activity and exercise: Exercise seems to make a big difference in the lives of the patients I see. The key is to “be active but don’t overdo.” Stay active, but don’t heat up the body core temperature too much, and don’t get dehydrated.
- Get enough Vitamin D: Your Vitamin D intake should be measured in MS patients, and supplementation added if necessary.
- Moderate your alcohol consumption
- Stop smoking
- Eat right and maintain a healthy weight
- Get plenty of sleep
- Take your medication as prescribed
Most importantly, whether you have MS or have MS and other conditions, stay positive. While I know this isn’t always easy to do, with the right diagnosis and right treatments, we can help give you the maximum quality of life while living with MS and additional conditions.
