The Progression of MS and Possible Risks
By: Nurse Kim
MS may progress over time, but because disability progresses slowly over a long period of time, you may not notice MS progressing in your body. To do your best to prevent this from happening, stay in constant contact with your healthcare provider, make sure you’re tracking MS progression appropriately, and find the right treatment.
Think about a garden. At first you may not notice the weeds growing, but as time goes on, they grow at a faster pace and eventually the garden is overrun with them. Similar to weeds in a garden, MS progresses at an increasing rate and isn’t always easy to notice.
When MS is progressing in the body, everyday activities may seem slightly more challenging. It’s important not to dismiss this as a product of old age or attribute it to other factors. You may not have had a relapse or you may have little-to-no symptoms, but new lesions may still show up on your MRI.1 That’s why knowing some of the risks of MS progression, possible environmental causes, how to talk about it, and how to monitor it on your own are very important when it comes to managing MS.
Risks of MS progression
If you aren’t treating MS, or are using a treatment that has become ineffective, these are some of the risks:
A decreased sense of smell (Hyposmia): Also known as “olfactory bulb dysfunction.”2,3 It may occur in 20-45% of people experiencing MS progression.3 As lesions form in the central nervous system, the olfactory mass of the brain may be affected, causing a decrease in the sense of smell.3 Anosmia is a complete loss of the sense of smell.2
A decreased sense of taste (Hypogeusia)4: Also known as “taste dysfunction.” A study called Taste Dysfunction in Multiple Sclerosis measured the correlation between lesions and the sense of taste and it was found that the size and location of lesions in the brain are linked to taste deficits.5
Factors that may contribute to MS progression
Ineffective Treatment: If you’re not on the right relapsing MS treatment, it’s very likely that MS will progress at a quicker rate.6 Signs that your treatment may not be working well enough include relapses, new lesions, and disability progression.
Smoking: According to The National Multiple Sclerosis Society (NMSS), smoking has been linked to increased risk of developing MS as well as risk of disability progression.7,8 It may also cause you to develop antibodies that lower the effectiveness of certain treatments.8 Visit www.smokefree.gov for assistance quitting smoking.
Vitamin D Deficiency: The results of several studies suggest that people with MS who are lacking in vitamin D have more exacerbations and may be more at risk of progression than people who have enough vitamin D.9
Stress: According to research, higher levels of stress may be associated with an increased risk of developing some types of lesions.10
Talking to your healthcare provider about MS progression
You may not always notice if MS is progressing, but having a conversation with your healthcare provider can help you determine if your current treatment is doing enough to slow the progression of MS or if a change is necessary. Here are several questions you may want to ask your healthcare provider to start this conversation.
How have you been tracking the progression of MS?
When it comes to MS progression, where am I today compared to where I was one year ago?
At this time, am I doing enough to slow the progression of MS in the future?
Has my current treatment been studied for disability progression?
What types of treatments are known for slowing disability progression?
Monitoring MS progression
In addition to speaking with your healthcare provider, you can keep track of MS progression by self-reflection. Compare your physical abilities now to your physical abilities from one year ago. Think about your day-to-day activities and if they have become more challenging.
Also keep up with your annual MRIs to monitor MS progression, as these test results reveal new or growing lesions, which are invisible symptoms of MS progression.
Knowing the signs of MS progression and possible disabilities associated with MS can give you a better idea of what you should bring up in conversations with your healthcare team. You may also want to attend events in your area or online to learn about some Sanofi Genzyme relapsing MS treatments and their clinical study results on disability progression.
Now take a moment to think about where you are with MS.
Have you noticed any changes in your physical abilities in the past year? Are you getting annual MRIs and routinely visiting with your healthcare provider? Are there certain MS progression risk factors you need to eliminate from your lifestyle? Is your current treatment meeting your expectations?
Be mindful of MS and keep a constant dialogue with your healthcare provider. It’s never too late to be more proactive about MS, and with the right treatment, MS progression may be slowed.
- MS progression isn't always easy to notice.
- Factors like ineffective treatment, smoking, vitamin D deficiency, and stress can all contribute to MS progression.6-7,9-10
- It's important to stay in constant contact with your healthcare provider to keep track of MS progression.
References: 1. Multiple Sclerosis Coalition. Magnetic Resonance Imaging (MRI). https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/MRI. Accessed May 21, 2018. 2. NIH MedlinePlus. Smell – impaired. https://www.nationalmssociety.org/smoking. Accessed May 21, 2018. 3. Lucassen EB, Turel A, Knehans A, Huang X, Eslinger P. Olfactory dysfunction in multiple sclerosis: A scoping review of the literature. Mult Scler Relat Disord. 2016;6:1-9. 4. National Institute on Deafness and Other Communication Disorders (NIDCD). Taste disorders. Available at: https://www.nidcd.nih.gov/health/taste-disorders. Accessed May 21, 2018. 5. Doty RL, Tourbier IA, Pham DL, et al. Taste dysfunction in multiple sclerosis. J Neurol. 2016;263(4):677-688. 6. Giovannoni G, Butzkueven H, Dhib-Jalbut S, et al. Brain health: time matters in multiple sclerosis. Mult Scler Relat Disord. 2016;9 Suppl 1:S5-S48. 7. National Multiple Sclerosis Society (NMSS). Unhealthy Habits. Available at: https://www.nationalmssociety.org/smoking. Accessed May 19, 2018. 8. National Multiple Sclerosis Society (NMSS). Study suggests smoking increases a person's immunity to interferon, which could reduce benefits of MS therapy. Available at: https://www.nationalmssociety.org/About-the-Society/News/Study-Suggests-Smoking-Increases-a-Person%E2%80%99s-Immuni. Accessed May 19, 2018. 9. Holick MF, Cook S, Suarez G, Rametta M. Vitamin D deficiency and possible role in multiple sclerosis. Eur Neurol Rev. 2015;10:131-8. 10. R. Berkovich, Chapter 22 - Treatment of acute relapses in multiple sclerosis, In Translational neuroimmunology in multiple sclerosis, edited by Ruth Arnon and Ariel Miller, Academic Press, San Diego, 2016, Pages 307-326.