The cause of Multiple Sclerosis (MS) is thought to be a genetic predisposition, modified by environmental factors. These are termed risk factors, and some can be modified. Most have been shown to increase the risk of developing MS and the clinical course. They include high salt intake, high-fat diet, smoking, vitamin D deficiency, and exposure to the Epstein-Barr virus.

High sodium and high fat diets have been shown to promote development of certain lymphocytes termed Th17 cells, which produce a damaging chemical (cytokine) which affects myelin.

Regarding smoking, nicotine is not the culprit. In fact, nicotine actually may have a neuroprotective effect in Parkinson’s. Cigarette smoke has 6000 other components.

Vitamin D has been long recognized to reduce risk of developing MS, relapses, and disease progression. It is not just a vitamin but rather has important effects in the immune system. These include preventing the activated T-cells that enter the brain and do damage from in fact being attracted to the brain.

Infection with the Epstein-Barr virus seems to enhance susceptibility to MS by activating the immune system. The virus is able to change the behavior of B-cells, which serve to activate T-cells, which then enter the brain and damage myelin.

Jack Florin, MD

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