Impact of alcohol on MS

Our community has spoken! We have heard from you that one of the most common questions you receive from people living with MS is whether alcohol consumption has an effect on MS symptoms and/or treatment. We have collected an overview of the available information:

• Alcohol consumption has been linked with increased risk and worse outcomes in MS, but the relationship between alcohol and MS is not fully understood. Studies have found both positive and negative associations, with some research reporting alcohol to be a risk factor for MS, whilst other studies have found that consumption of small amounts of alcohol offered some protection against developing MS.[1] To date, there is not enough evidence to say whether alcohol affects a person’s risk of developing MS. 
• Some research suggests that short-term alcohol use may affect the immune system in beneficial ways, such as by dampening the immune response that can lead to inflammation [2] The same research suggests that long-term or heavy drinking may impair the immune system, however, and could increase the inflammatory response characteristic of MS. 
• A study carried out in 2017 showed that moderate drinking (≥3 glasses of red wine per week) was associated with a lower Multiple Sclerosis Severity Score and a lower Expanded Disability Status Scale score than mild or no alcohol use [3]. The researchers suggested the results may be because of red wine’s brain-protecting effects, although they called for further studies. 
• The side effects of alcohol use, such as impaired coordination or slurred speech, can be similar to symptoms of MS. If a person with MS already has trouble with speech, balance, cognition, or urinary continence because of MS, alcohol may compound these issues. Alcohol may result in a temporary worsening of coordination and balance issues for a person with MS. Alcohol may also increase urinary urgency and frequency, which are frequent complaints in people with MS. Alcohol can also have a depressive effect on the brain, a symptom often experienced  

• Although alcohol is not thought to decrease the effectiveness of disease-modifying therapies (DMTs), alcohol has known interactions with many medications, which can lead to unwanted health effects. Health care professionsls should discuss with their patients any potential risks of drinking alcohol with the medications prescribed. 
• Glatiramer acetate can cause alcohol intolerance as an infrequent side effect. Caution is recommended with alcohol if this medication is prescribed. A number of DMTs can cause abnormal liver function test results or serious liver injury, and caution with alcohol may be recommended when using these drugs. 

 At last, while the effects of alcohol consumption on MS are not yet fully understood by scientists, it is important to address the use of alcohol with your patient! If necessary, please refer to the referenced studies to deepen your knowledge on the matter.

Sources:  

1. Fragoso and Cardoso, J Mult Scler 2017, 4:2
2. Fahim M, et al. Int J Physiol Pathophysiol Pharmacol. 2020; 12: 58–69
3. Diaz-Cruz C, et al. Mult Scler Relat Dis. 2017;17:47-53