CBD for Autoimmune Disorders: Efficacy and Safety

Multiple Sclerosis: What You Need To Know

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system, including the brain, spinal cord, and optic nerves. Symptoms can range from muscle weakness to vision loss. They tend to worsen during flares and improve during times of remission.

It is not possible to predict how multiple sclerosis (MS) will progress in any individual.

Some people have mild symptoms, such as blurred vision and numbness, and tingling in the limbs. In severe cases, a person may experience paralysis, vision loss, and mobility problems. However, this is not common.

It is difficult to know precisely how many people have MS. According to the National Institute for Neurological Disorders and Stroke (NINDS), 250,000–350,000 people in the United States are living with MS.

The National Multiple Sclerosis Society estimates the number could be closer to 1 million.

New treatments are proving effective at slowing the disease.

Scientists do not know exactly what causes MS, but they believe it is an autoimmune disorder that affects the central nervous system (CNS). When a person has an autoimmune disease, the immune system attacks healthy tissue, just as it might attack a virus or bacteria.

In the case of MS, the immune system attacks the myelin sheath that surrounds and protects the nerve fibers, causing inflammation. Myelin allows the nerves to conduct electrical signals quickly and efficiently.

Multiple sclerosis means "scar tissue in multiple areas."

When the myelin sheath disappears or sustains damage in multiple areas, it leaves a scar, or sclerosis. Doctors also call these areas plaques or lesions. They mainly affect:

the brain stem

the cerebellum, which coordinates movement and controls balance

the spinal cord

the optic nerves

white matter in some regions of the brain

As more lesions develop, nerve fibers can break or become damaged. As a result, the electrical impulses from the brain do not flow smoothly to the target nerve. This means that the body cannot carry out certain functions.

There are four types of MS:

Clinically isolated syndrome (CIS)

This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs at a later date, a doctor might diagnose relapse-remitting MS.

Relapse-remitting MS (RRMS)

This is the most common form. Around 85% of people with MS are initially diagnosed with RRMS. RRMS involves episodes of new or increasing symptoms, followed by periods of remission, during which symptoms go away partially or totally.

Primary progressive MS (PPMS)

Symptoms worsen progressively without early relapses or remissions. Some people may experience times of stability and periods when symptoms worsen and then get better. Around 15% of people with MS have PPMS.

Secondary progressive MS (SPMS)

At first, people will experience episodes of relapse and remission, but then the disease will start to progress steadily.

Find out more here about the different types and multiple sclerosis stages and what they mean.

Because MS affects the CNS, which controls all the actions in the body, symptoms can affect any part of the body.

The most common symptoms of MS are:

Muscle weakness: People may develop weak muscles due to lack of use or stimulation due to nerve damage.

Numbness and tingling: A pins and needles-type sensation is one of the earliest symptoms of MS and can affect the face, body, arms, and legs.

Lhermitte's sign: A person may experience a sensation like an electric shock when they move their neck, known as Lhermitte's sign.

Bladder problems: A person may have difficulty emptying their bladder or need to urinate frequently or suddenly, known as urge incontinence. Loss of bladder control is an early sign of MS.

Bowel problems: Constipation can cause fecal impaction, which can lead to bowel incontinence.

Fatigue: Fatigue can undermine a person's ability to function at work or at home, and is one of the most common symptoms of MS.

Dizziness and vertigo: These are common problems, along with balance and coordination issues.

Sexual dysfunction: Both males and females may lose interest in sex.

Spasticity and muscle spasms: This is an early sign of MS. Damage to nerve fibers in the spinal cord and brain can cause painful muscle spasms, including in the legs.

Tremor: Some people with MS may experience involuntary quivering movements.

Vision problems: Some people may experience double or blurred vision or a partial or total loss of vision. This usually affects one eye at a time. Inflammation of the optic nerve can result in pain when the eye moves. Vision problems are an early sign of MS.

Gait and mobility changes: MS can change the way people walk due to muscle weakness and problems with balance, dizziness, and fatigue.

Emotional changes and depression: Demyelination and nerve fiber damage in the brain can trigger emotional changes.

Learning and memory problems: These can make it difficult to concentrate, plan, learn, prioritize, and multitask.

Pain: Pain is a common symptom in MS. Neuropathic pain is directly due to MS, while muscle spasticity or stiffness may cause localized pain.

Less common symptoms include:

headaches

hearing loss

itching

respiratory or breathing problems

seizures

speech disorders

swallowing problems

There is also a higher risk of urinary tract infections, reduced activity, and loss of mobility. These can impact a person's work and social life.

In the later stages, people may experience changes in perception and thinking, as well as sensitivity to heat.

MS affects individuals differently. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. Sometimes, symptoms worsen rapidly, within weeks or months.

A few people will only have mild symptoms, and others will experience significant changes that lead to disability. However, most people will experience times when symptoms worsen and then get better.

Find out more about the early signs of MS here.

Scientists do not really know what causes MS, but risk factors include:

Age: Most people receive a diagnosis between the ages of 20 and 40 years.

Sex: Most forms of MS are twice as likely to affect women than men.

Genetic factors: Susceptibility may pass down in the genes, but scientists believe an environmental trigger is also necessary for MS to develop, even in people with specific genetic features.

Smoking: People who smoke appear to be more likely to develop MS. They also tend to have more lesions and brain shrinkage than non-smokers.

Infections: Exposure to viruses, such as Epstein-Barr virus (EBV) or mononucleosis, may increase a person's risk of developing MS, but research has not shown a definite link. Other viruses that may play a role include human herpes virus type 6 (HHV6) and mycoplasma pneumonia.

Vitamin D deficiency: MS is more common among people who have less exposure to bright sunlight, which is necessary for the body to create vitamin D. Some experts think that low levels of vitamin D may affect the way the immune system works.

Vitamin B12 deficiency: The body uses vitamin B when it produces myelin. A lack of this vitamin may increase the risk of neurological diseases such as MS.

Previous theories have included exposure to canine distemper, physical trauma, or aspartame, an artificial sweetener, but there is no evidence to support these. There is probably no single trigger for MS, and it is likely that multiple factors will contribute to its occurrence.

How does MS affect women? Click here to find out more.

A doctor will carry out a physical and neurological examination, ask about symptoms, and consider the person's medical history.

No single test can confirm a diagnosis, so a doctor will use several strategies when deciding whether a person meets the criteria for a diagnosis.

These include:

MRI scans of the brain and spinal cord, which may reveal lesions

spinal fluid analysis, which may identify antibodies that suggest a previous infection or proteins consistent with a diagnosis of MS

an evoked potential test, which measures electrical activity in response to stimuli

Other conditions have symptoms that are similar to those of MS, so a doctor may suggest other tests to assess for other possible causes of the person's symptoms.

If the doctor diagnoses MS, they will need to identify what type it is and whether it is active or not. The person may need more tests in the future to check for further changes.

Learn more here about the tests for diagnosing MS.

There is no cure for MS, but treatment is available that can slow the progression of the disease, reduce the number and severity of relapses, and relieve symptoms.

Some people also use complementary and alternative therapies, but research does not always confirm the usefulness of these.

Treatment options include:

Medications to slow progression

Several disease-modifying therapies (DMTs) have Food and Drug Administration (FDA) approval for treating the relapsing forms of MS. These work by changing how the immune system functions.

A doctor may give some of these by mouth, by injection, or as an infusion. How often the person needs to take them and whether they can do this at home will depend on the drug.

The following DMTs currently have FDA approval:

Injectable medications Oral medications Infused medications

Current guidelines recommend a person begin using these drugs when in the early stages of MS, as there is a good chance that they can slow the progression of MS, especially if the person takes them when symptoms are not yet severe.

Doctors may recommend highly effective therapies from the start of treatment or start a person on lower-efficacy drugs and escalate the dose or strength.

Adverse effects of immunosuppressant drugs include a higher risk of infections. Some medications may also harm the liver. If a person notices adverse effects or if their symptoms worsen, they should seek medical advice.

Relieving symptoms during a flare

Other drugs are useful when a person experiences a worsening of symptoms during a flare. They will not need these drugs all the time.

These medications include corticosteroids, which reduce inflammation and suppress the immune system. They can treat an acute flare-up of symptoms in certain types of MS. Examples include Solu-Medrol (methylprednisolone) and Deltasone (prednisone). Steroids can have adverse effects if a person uses them too often, and they are not likely to provide any long-term benefit.

Other medications and approaches can treat specific symptoms. Those symptoms include:

Behavioral changes: If a person has vision problems, a doctor may recommend they rest their eyes from time to time or limit screen time. A person with MS may need to learn to rest when fatigue sets in and to pace themselves so they can complete activities.

Problems with mobility and balance: Physical therapy and walking devices, such as a cane, may help. The drug dalfampridine (Ampyra) may also prove useful.

Tremor: A person may use assistive devices or attach weights to their limbs to reduce shaking. Medications may also help with tremors.

Fatigue: Getting enough rest and avoiding heat can help. Physical and occupational therapy can help teach people more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counseling may help boost energy by improving sleep.

Pain: Pain relief medication, such as gabapentin, may help with body pain. Doctors may also prescribe muscle relaxants to reduce painful spasms.

Bladder and bowel problems: Some medications and dietary changes can help resolve these issues.

Depression: A doctor may prescribe a selective serotonin reuptake inhibitor (SSRI) or other antidepressant drugs.

Cognitive changes: Donepezil, a drug for Alzheimer's, may help some people.

Learn more here about how to manage an exacerbation of MS.

Complementary and alternative therapies

The following may help with different aspects of MS:

heat and massage treatment for pain

acupuncture for pain and gait

stress management to boost mood

exercise to maintain strength and flexibility, reduce stiffness, and boost mood

a healthful diet with plenty of fresh fruits, vegetables, and fiber

quitting or avoiding smoking

What is a healthful diet for a person with MS? Find out here.

Medical cannabis

Cannabis-based treatments may help relieve pain, muscle stiffness, and insomnia. However, there is not enough evidence to confirm this.

People considering this approach should note that there is a difference between using street cannabis and medical cannabis. Also, not all forms of cannabis are legal in all states.

A person should ask their doctor for advice before using cannabis, as some forms can have adverse effects. Smoking cannabis is unlikely to be beneficial, and it may make symptoms worse.

Some people have suggested that biotin may help. Find out more here.

Rehabilitation and physical therapy

Rehabilitation can help improve or maintain a person's ability to perform effectively at home and work.

Programs generally include:

Physical therapy: This aims to provide the skills to maintain and restore maximum movement and functional ability.

Occupational therapy: The therapeutic use of work, self-care, and play may help maintain mental and physical function.

Speech and swallowing therapy: A speech and language therapist will carry out specialized training for those who need it.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.

Vocational rehabilitation: This helps a person whose life has changed with MS make career plans, learn job skills, and get and keep a job.

Plasma exchange

Plasma exchange involves withdrawing blood from a person, removing the plasma, replacing it with new plasma, and transfusing it back into the person.

This process removes the antibodies in the blood that are attacking parts of the person's body, but whether it can help people with MS is unclear. Studies have produced mixed results.

Plasma exchange is usually only suitable for severe MS attacks.

Stem cell therapy

Scientists are looking into the use of stem cell therapy to regenerate various body cells and restore function to people who have lost it due to a health condition.

Researchers hope that one day, stem cell therapy techniques may be able to reverse the damage done by MS and restore functionality in the nervous system.

MS is challenging to live with but is rarely fatal. Some severe complications such as bladder infections, chest infections, and difficulty swallowing could lead to death.

A multiple sclerosis prognosis does not always result in severe paralysis. Two-thirds of people with MS are able to walk. However, many of them will require assistance such as a cane, wheelchair, crutches, or a scooter.

The average life expectancy for a person with MS is 5 to 10 years lower than the average person.

Here are some frequently asked questions about MS.

How does someone cope with MS?

MS presents psychological and emotional challenges. The National Multiple Sclerosis Society suggests the following tips for coping:

reduce and manage stress, such as with meditation or journaling

focus on the positive

view challenges as opportunities for creative problem solving

foster and nurture relationships with others

share coping methods with family members

Can someone live a normal life with MS?

MS can cause unique challenges and health complications that may cause someone to require lifestyle modifications and adjustments.

This may include walking aids and ongoing treatment, including medication and therapy to manage changes, such as cognitive or vocational rehabilitation.

What is the average life expectancy with MS?

Life expectancy for a person with MS is around 5–10 years lower than average, according to the UK's National Health Service.

However, every person's outlook will be different. A person's doctor can provide them with more accurate information about life expectancy.

Is MS treatable if people catch it early?

There is no cure for MS. However, early treatment can help to slow disease progression, relieve symptoms, and reduce the severity of relapses.

MS is a potentially severe health condition that affects the nervous system. Progression of MS is different for each person, so it is hard to predict what will happen, but most people will not experience severe disability.

In recent years, scientists have made rapid progress in developing drugs and treatments for MS. Newer drugs are safer and more effective, and they offer significant hope for slowing disease progression.

As researchers learn more about genetic features and changes that occur with MS, there is also hope that they will be able to predict more easily which kind of MS a person will have and establish the most effective treatment from the earliest stage.

A person who receives appropriate treatment and follows a healthful lifestyle can expect to live the same number of years as a person without MS.

It is important to have support from people who understand what it is like to receive a diagnosis of and live with MS. MS Healthline is a free app that provides support through one-on-one conversations and live group discussions with people who have the condition. Download the app for iPhone or Android.

Learn more here about how MS can affect life expectancy.

Read this article in Spanish.

Central Nervous System News And Research

Utilizing firefly liquid handling for laboratory developed tests

Joby Jenkins

In this interview, News Medical speaks with SPT Labtech about utilizing the firefly for Laboratory Developed Tests (LDT), specifically for the field of NGS library prep-based LDT.

A List Of Autoimmune Diseases And Their Symptoms

There are over 100 autoimmune conditions, including celiac disease, type 1 diabetes, and psoriasis. These occur when the immune system mistakenly attacks parts of the human body.

This statistic comes from the Autoimmune Association.

Autoimmune diseases are common, affecting more than 23.5 million people in the United States. Females and those with a family history of autoimmune diseases are more likely to develop them.

This article provides a list of autoimmune diseases and their symptoms.

The following sections will discuss some autoimmune conditions affecting the skin.

Psoriasis

Psoriasis causes patches of flaky, inflamed skin. This occurs due to the skin producing too many new skin cells. Psoriasis is usually not a serious condition, but it can be painful or distressing.

The symptoms of psoriasis include:

thick, inflamed patches of skin, usually on the head, elbows, and knees

scaly skin

itching

pain

poor sleep quality

People with psoriasis sometimes also develop psoriatic arthritis, which causes joint inflammation. This affects roughly 20% of people with psoriasis.

Treatment options include biologics, methotrexate, topical ointments, and UV light therapy.

Vitiligo

Vitiligo is a chronic condition that causes the skin to lose its color. One type of vitiligo, called non-segmental vitiligo, is an autoimmune disease.

Dermatologists believe that it occurs when the immune system attacks melanocytes, which are cells that produce melanin.

It is not uncommon for vitiligo to occur alongside other autoimmune conditions, such as lupus and Sjogren's syndrome.

The symptoms of vitiligo include:

white or light patches of skin on the hands, feet, arms, and face

white or gray hair on the scalp, brows, or eyelashes

discoloration on the inside of the mouth and nose

Vitiligo is not harmful to the body, but it can be very distressing for some people, especially those with darker skin. Certain treatments can slow or stop the discoloration, including medications and UV light therapy.

Scleroderma

Scleroderma causes an abnormal growth of connective tissue in the skin and blood vessels, leading to skin that is hard and thick.

In some people, the condition is mild, but in others, scleroderma can affect internal organs and be life threatening.

Symptoms include:

Raynaud's phenomenon, which causes the fingers to change color when they are cold

calcium deposits in the connective tissues

thickening and tightness of the skin on the fingers and toes

loss of motility in the esophagus, which may make it difficult to swallow

red spots or blood vessels on the face

progressive shortness of breath

ulcers on the fingertips, which can lead togangrene

There is currently no cure for scleroderma. Treatment is directed at managing symptoms and complications. Sometimes, a doctor may also recommend immunosuppressants, especially for fibrosing (scarring) lung disease.

The following sections will discuss some autoimmune conditions affecting the blood.

Hemolytic anemia

Hemolytic anemia occurs when the immune system destroys a person's red blood cells. This causes an oxygen deficiency, leading to symptoms such as:

Doctors treat hemolytic anemia with corticosteroids, which reduce inflammation, and immunosuppressant drugs, which lower immune system activity.

A doctor might also consider a splenectomy, which refers to the surgical removal of the spleen. The spleen removes damaged red blood cells from circulation, so by removing it, a person is less likely to have low red blood cell levels.

However, autoimmune processes can also affect other blood cells. When they affect platelets, it can lead to thrombocytopenia. When they affect white blood cells, it can give rise to leukopenia, lymphopenia, and neutropenia.

The following sections will discuss some autoimmune conditions affecting the digestive system.

Celiac disease

In celiac disease, a person's immune system reacts to gluten, which is a protein that foods such as bread, pasta, and barley contain.

If a person with celiac disease eats gluten, they may experience:

Repeated exposure to gluten may damage the intestinal lining. However, most people with celiac disease can prevent these symptoms by removing sources of gluten from their diet.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) causes chronic inflammation of the digestive tract, giving rise to pain and irritation.

The most common forms of IBD are Crohn's disease (CD) and ulcerative colitis (UC).

The symptoms of IBD can include:

People with IBD, specifically CD, may see an improvement in symptoms and their quality of life by changing their eating habits. Medications such as aminosalicylates, corticosteroids, and immunosuppressants — including biologics — can also help. Meanwhile, a total colectomy may cure a person of UC.

The following sections will discuss some autoimmune conditions affecting the hormones.

Type 1 diabetes

In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. Insulin is a hormone that controls blood sugar levels.

Without the hormone, a person's blood sugar level remains high, causing symptoms such as:

People with type 1 diabetes can manage the condition with daily insulin injections to balance out the amount of carbohydrates they eat.

Unlike type 2 diabetes, a person cannot prevent type 1 diabetes by making diet or lifestyle changes. However, monitoring diet and exercise levels can help reduce symptoms.

Graves' disease

Graves' disease causes the thyroid gland to become overactive and produce too much thyroid hormone. This can cause a range of symptoms, including:

There are several treatment options for Graves' disease. Antithyroid medications can lower thyroid hormone levels, and radioactive iodine damages the thyroid cells so that they do not produce as much hormone. In severe cases, a doctor may recommend removing part or all of the thyroid gland.

Hashimoto's thyroiditis

Hashimoto's thyroiditis is an autoimmune condition wherein the immune system attacks the thyroid gland, causing it to produce less thyroid hormone.

This usually leads to an underactive thyroid, which causes symptoms such as:

fatigue

hair loss

muscle aches

facial swelling

constipation

weakness

weight gain

heavy menstrual periods

sensitivity to cold

joint pain

The main treatment for Hashimoto's thyroiditis is a daily dose of levothyroxine, which increases thyroid hormone levels.

The following sections will discuss some autoimmune conditions affecting the nervous system.

Multiple sclerosis

In multiple sclerosis (MS), the immune system mistakenly attacks the myelin sheath that protects the nerves. This causes damage, affecting the transmission of information to and from the brain and spinal cord and the nerves they connect with.

The symptoms of MS include:

paralysis

tremors

weakness in the extremities

difficulty with coordination, balance, speaking, and walking

numbness or tingling in the arms, legs, hands, and feet

vision loss

There is currently no cure for MS, but some medications may reduce the symptoms and the underlying disease process. The type of medication that the condition responds to will vary from case to case.

Guillain-Barre syndrome

Guillain-Barre syndrome occurs when the immune system attacks healthy nerves, disrupting the electrical signals the nerves send to the brain. This may cause:

Guillain-Barre syndrome is a rare condition that can be severe, but with medical support, recovery is possible.

To treat and prevent further nerve damage, a doctor may use plasma exchange, high dose immunoglobulin therapy, and high dose steroids.

The following sections will discuss some autoimmune conditions affecting the joints.

Rheumatoid arthritis

Rheumatoid arthritis occurs when the immune system attacks the lining of the joints (synovium), causing inflammation and discomfort. Rheumatoid arthritis can affect many joints, but it commonly affects the hands, wrists, and knees on both sides of the body.

Symptoms include:

pain or aching in the joints

stiffness in multiple joints, especially in the morning

tenderness and swelling

fever

fatigue

weakness

weight loss

eye inflammation

lung disease

lumps of tissue under the skin, often near the elbows (rheumatoid nodules)

anemia

Doctors tend to treat this condition using antirheumatic drugs, including biologics, that slow disease progression and prevent joint deformity.

Below are frequently asked questions relating to autoimmune conditions.

What triggers autoimmune disease?

There are over 100 autoimmune diseases, often with varying triggers. However, infections, exposure to irritants, and lifestyle factors such as smoking and obesity are common triggers.

Can you live a long life with an autoimmune disease?

With proper treatment and management techniques, many autoimmune diseases are not fatal, and people can expect to live long, active lives.

Can a dermatologist diagnose an autoimmune disease?

Autoimmune diseases can present in different ways and vary in ease of diagnosis.

Certain diseases, such as psoriasis and scleroderma, primarily affect the skin, and dermatologists may be able to diagnose these.

However, other conditions may require input from several healthcare professionals to reach a correct diagnosis.

What are the most common autoimmune diseases?

There are more than 100 known autoimmune diseases. Some of the most well-known autoimmune diseases include:

multiple sclerosis

type 1 diabetes

psoriasis

rheumatoid arthritis

lupus

What does an autoimmune flare-up feel like?

Symptoms of an autoimmune flare-up will depend on the body area it affects. For example, rheumatoid arthritis flares will cause pain and swelling in joints, while psoriasis flares may cause swelling and scaling on the skin.

There are many autoimmune diseases. Some cause distressing symptoms that affect a person's quality of life but otherwise are not life threatening. Other autoimmune conditions are more serious and can cause lasting tissue damage.

In many cases, management strategies such as taking medication, modifying the diet, and making lifestyle changes can help reduce the symptoms.

A doctor can help diagnose and recommend treatments for specific autoimmune conditions.

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