Summary
Using a literature review, researchers from Belgium and the Netherlands have summarized the information about factors associated with reducing relapse rate and disability in multiple sclerosis. D'hooghe MB, Nagels G, Bissay V, De Keyser J., Mult Scler. 2010 Jul;16(7):773-85. Epub 2010 May 18.
Details
A growing body of literature indicates that the natural course of
multiple sclerosis can be influenced by a number of factors.
Strong evidence suggests that relapses can be triggered by
infections, the postpartum period and stressful life events.
Vaccinations against influenza, hepatitis B and tetanus appear to
be safe. Surgery, general and epidural anaesthesia, and physical
trauma are not associated with an increased risk of relapses.
Factors that have been associated with a reduced relapse rate are
pregnancy, exclusive breastfeeding, sunlight exposure and higher
vitamin D levels. A number of medications, including hormonal
fertility treatment, seem to be able to trigger relapses. Factors
that may worsen progression of disability include stressful life
events, radiotherapy to the head, low levels of physical activity
and low vitamin D levels. Strong evidence suggests that smoking
promotes disease progression, both clinically and on brain
magnetic resonance imaging. There is no evidence for an increased
progression of disability following childbirth in women with
multiple sclerosis. Moderate alcohol intake and exercise might
have a neuroprotective effect, but this needs to be confirmed.