Since being diagnosed my fiance's doctor told him to go gluten free, dairy free, and red meat free. This has allowed to him to lose over 50 pounds within 4 months and has made a world of the difference in how he feels. He also now takes Metanx, daily multivitamin, Vitamin D, and fish oil. We are reading the Wahls Protocol now, she has an amazing Ted Talk about her experience, and all the additional reading we have done suggest a Paleo Diet. The doctor has said he is doing so well that he might be able to lower the dosage of Rebif and eventually go off of it because he is sticking to the diet so well. I highly recommend giving this a try it has given us such a great quality of life.
Ellen Mowry, MD:
One thing that is fairly common when people receive a new diagnosis, is to make a lot of changes at the same time. Your fiancé made three major dietary changes, started four supplements, and started Rebif all at the same time. So, it’s hard to know if all of those particular changes had an impact on his MS. If he had tried two of the modifications would that be better or worse? Maybe it is the gluten-free diet that’s helping him the most? Or maybe it’s actually the Rebif? The goal of Rebif and other disease modifying therapies is to slow down or stop progression, in which case you may see fewer symptoms. While the decision to reduce or terminate a therapy needs to be made by a patient and his or her doctor, you could argue that the Rebif itself may have been a big contributor to his improved health.
It could be that your fiancé’s weight loss is impacting the functioning of his immune system, if he was overweight prior to starting the diet. Recent studies looking at body mass index – a measure of carrying enough, not enough or too much weight – have demonstrated that children or adolescents who are overweight or obese have an increased risk of developing MS. The fat that we carry in our bodies produces a lot of hormones. It makes chemicals that can increase inflammation and impact the immune system. So, fat itself may be an active contributor to the functioning of the immune system in someone whose immune systems isn’t working correctly, perhaps making some of these chemicals or hormones and revving up the immune system in a bad way.
With respect to each of these diets or any of the supplements, there really are very limited data to support any one of them as a definite helper for people with MS. There have been only very small studies of removing gluten from the diet. There has been one observational study – meaning it wasn’t randomized – looking at people who went on a gluten-free diet and they didn’t see any link between the diet and changing MS activity. However, that doesn’t necessarily mean that it won’t be helpful – it just means we need more research.
Unfortunately, the same is true for dairy and red meat: there really just aren’t great data. This answer can be frustrating – and it can be tempting to take matters into your own hands when food and supplements are readily available. However, it’s important to consider that anything you put into your body with the intention of changing your disease or your health is being used like a medication. And so, the same way that approved MS medications have to go through a rigorous research process, including clinical trials, so should diets and supplements. If something has the potential to impact your disease in a positive manner, it also has the potential to do harm. We owe it to people with MS to study promising diet changes or promising supplements really carefully to make sure that when we make recommendations, we’re not contributing to the worsening of the disease.
Denise Nowack, RD:
If you’re concerned about your weight, it’s also important to look at what may be contributing to weight gain or inability to lose weight. Is your diet a contributor? And are your symptoms contributors? Depression can contribute to being overweight. Mobility and activity limitations can contribute to being overweight. Fatigue can be a contributor to being overweight. So just look at where symptoms may play a role and ask the question: when you experience this, how does this impact that way you eat? When you’re tired, what gets in your way of eating well?
A Word About Gluten…
Gluten is the protein component of wheat, rye and barley. Most of us have the ability to easily digest this protein. However in people who may be genetically vulnerable, the protein (gluten) creates an autoimmune reaction resulting in a condition called Celiac Disease. This triggers the body to attack itself inflaming and ultimately destroying the microvilli of the small intestine. Typical symptoms of true celiac disease include chronic diarrhea, fatigue, malabsorption that can lead to risk of osteoporosis due to non-absorption of calcium. This affects about 1% of the population.
Gluten Sensitivity is believed to be a separate non‐immune mediated condition that has similar but less severe symptoms. In gluten sensitivity gluten is an irritant and the body acts to repel this irritant, but does not attack its own tissue. Some people only have a response to wheat but not all grains and that could relate back to an allergic reaction to just wheat.
Scientific studies have shown that celiac disease occurs much more frequently in people with MS than in the general population, leading to speculation that a gluten‐free diet might help relieve MS symptoms. This may be true for those who are truly gluten intolerant, but not the MS population in general. If you are allergic to gluten grains, you will know for sure by observation and testing. Maintaining a detailed nutritional notebook is a great starting tool.