Big news for those who are battling multiple sclerosis (MS): Researchers have discovered a biomarker that may lead to a blood test in the next couple of years that can quickly identify the subtype of MS a person has. The current diagnostic criteria for MS can be both expensive and time-consuming — and can involve MRIs and spinal taps.
Researchers hope the biomarker will offer clues — earlier in the process — about how to individualize treatment for each patient with MS, which currently has no cure.
“The unique information that we will receive from the biomarker within an individual, means that it could also be possible [to] develop biomarker[-]guided personalized treatment for each patient,” notes Macquarie University researcher and lead study author Edwin Lim, PhD.
To figure out exactly what this news means for the roughly 400,000 people in the United States and 2.5 million people worldwide who live with MS, we decided to reach out to MS expert Terry Wahls, MD.
Wahls, who conducts clinical trials that test the effect of nutrition and lifestyle interventions to treat MS, is herself a patient with secondary progressive multiple sclerosis. Although Wahls was confined to a tilt-recline wheelchair for four years, she reversed her MS by using dietary and lifestyle interventions — and now rides her bike daily. She writes about her journey in The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine. Although her MS is in remission, she has noted that “reversing my MS doesn’t mean the disease is completely cured. It will return if I waver in my diet.”
When we reached Wahls, she called the biomarker “a major breakthrough . . . in our battle against MS,” but also noted that many conventional docs will probably push patients even sooner onto disease-modifying drugs. Dietary and lifestyle interventions — not drugs, said Wahls — should be the first line of defense.
Here’s what she had to say:
Experience Life | How did you react to news that scientists have discovered the first blood biomarker for MS?
Terry Wahls | My son sent me the link. I will be talking to our team to see if this is something that we would be able to measure in our clinical trials as a marker that tracks with the clinical response. We freeze plasma and serum in our studies so that we can go back and conduct some mechanistic studies to better understand the mechanisms by which people are recovering.
EL | Do you think this will improve how doctors commonly diagnose MS?
TW | The standard diagnostic criteria for MS involves the documentation of MS lesions across time and space. Most often people see the doctor for symptoms and then the doctor obtains an MRI and or spinal tap looking for evidence of prior MS lesions.
The blood test has the ability to reduce the need for MRI and or spinal taps.
Many conventional doctors will push for earlier diagnosis and earlier start to the potent disease-modifying drugs. I would prefer the approach we are taught for the metabolic diseases. When someone is first diagnosed with high blood pressure or diabetes, the recommendation is to use diet and lifestyle. That is what should happen for all of our early-stage diagnoses for chronic diseases, including things like optic neuritis, but that is not standard of care. I don’t think anyone is talking about diet and lifestyle for optic neuritis.
EL | How is MS currently treated by most doctors, and do you think this biomarker discovery will affect that treatment?
TW | Most doctors recommend disease-modifying drugs. I recommend diet and lifestyle changes as the first intervention in place of disease-modifying drugs. I would use this as a way to inspire people to be more aggressive with making diet and lifestyle changes to reduce inflammation and protect their brains earlier.
EL | How about the way you treat MS through your functional-medicine approach? Does the blood biomarker have implications for your approach, which looks beyond disease to actual root causes?
TW | The sooner I can get people to examine the root cause of why they have developed troubling symptoms . . . [which can be] pain, fatigue, brain fog, balance problems, vision issues . . . the better. . . . My approach . . . simply digs into the lifetime of diet, lifestyle choices, environmental exposures, and current symptoms. That usually tells me plenty of factors that are contributing to the improper function of cells and early organ dysfunction. It is those dysfunctions that are leading to symptoms. Then I help the person prioritize which diet/lifestyle changes they will make to improve the function of the cells [and] the health of their human habitat.
We do not need a diagnosis to begin to optimize the health of the human ecosystem. By approaching [patients’] health through this ecosystem lens, we are often very successful at reducing symptoms, reducing need for prescription medication, and improving the quality of life across a wide variety of autoimmune, metabolic, neurodegenerative diseases. That is why I had a nine-month waiting time to get into the lifestyle clinic at the VA.
EL | If you were to give some advice to conventional-medicine doctors on the way they view MS treatment, what would it be?
TW | Last I heard, the number of genes that are associated with MS continues to grow and is now over 200. Now each of those genes increases the risk ever so slightly. The genetics indicate that it is a complicated interaction between genetics vulnerability, that is the efficiency of our enzymes, and a lifetime of food choices, physical activity levels, toxin exposures, infection history and social environment.
I can’t change my genes. But there is a considerable amount that I can do about the quality of the food I eat, what foods I eat/avoid, my physical activity level, the level of toxins stored in my body, my stress hormone levels, the mix of bacteria/yeasts in my bowels, and my social network.
I teach people how to review the timeline of their health, their environmental exposures — to identify the likely factors that had the largest impact on their health. Then we begin crafting a program to address those health factors and health behaviors as a family.
EL | Anything else you’d like to add about the treatment of neurodegenerative diseases like MS?
TW | Our lab and my clinics have been very successful at helping people adopt and sustain major health behavior changes that in turn have been associated with reduced pain, improved mood, improved cognition, and reduced need for medication. We encourage people to try the diet and lifestyle changes for 100 days at 100 percent to determine if the diet/lifestyle changes can have an impact. Doing it 100 percent for the 100 days is the best way to know how effective it can be.
For most of our people, they have been suffering for years, often decades. When they come to see us — they are ready to give diet and lifestyle a try. The results are immensely gratifying to watch.
You can follow Dr. Wahls on Facebook and on Twitter at @TerryWahls. To learn more about Wahls’s MS clinical trials, reach out to her team at MSDietStudy@healthcare.uiowa.edu.
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