5 surprising causes of multiple sclerosis (you might not know)

When my brother was diagnosed with multiple sclerosis (MS) in 2007, one of the most challenging factors to come to terms with was that no one could tell him what caused it, and as a result, there was no cure. 

However, even then, as a budding scientific researcher, I decided I wasn’t going to accept that as an answer for my brother, so I started to explore more about the underlying causes of MS, and I was surprised by what I learned.

Over the last 17 years, I have continued to review the scientific literature on the potential causes of MS, and now I see that MS isn’t one thing. It may present itself in a similar fashion, but there are multiple reasons that people develop MS.

MS is a complex and often unpredictable disease that affects the central nervous system. While much research has focused on the role of genetics and immune system dysfunction in MS, emerging evidence suggests that several lesser-known factors might also contribute to the development of this condition. Here, I explore my findings of five surprising potential causes of MS that you might not be aware of.

1. Vitamin B12 deficiency

Vitamin B12 is crucial for maintaining the health of nerve cells and producing myelin, the protective sheath around nerves. A deficiency in B12 can lead to symptoms similar to those of MS, such as fatigue, numbness, and cognitive disturbances. 

In some cases, low B12 levels may mimic or exacerbate MS symptoms. Ensuring adequate B12 intake through diet or supplements could be an important step in managing neurological health and potentially mitigating some MS-related symptoms.

And remember, vitamin B12 isn’t one thing. 

Methylcobalamin, a bioactive form of vitamin B12, is considered the most important for MS because it supports nerve health by aiding in the maintenance and repair of the myelin sheath, which protects nerve fibres. Methylcobalamin is readily absorbed and utilised by the body, and studies suggest it may help reduce neurodegeneration and improve nerve conduction, potentially alleviating some neurological symptoms associated with MS.

Adenosylcobalamin, another active form of vitamin B12, plays a crucial role in energy metabolism and the production of red blood cells. A deficiency in adenosylcobalamin can lead to enlarged red blood cells (macrocytosis) and impaired oxygen transport, potentially affecting circulation. 

Given that circulation and adequate oxygen delivery to the brain and nervous system are critical in MS, maintaining sufficient levels of adenosylcobalamin may help support overall neurological health and reduce some symptoms related to poor blood flow and cellular energy metabolism in MS.

2. Aquaporin-4 cross-reactivity

Aquaporin-4 (AQP-4) is a key water channel protein located in the brain and spinal cord. In some cases, proteins found in common foods like corn, soy, tomatoes, and spinach can cross-react with AQP-4. 

This means that the immune system might mistake these food proteins for AQP-4, potentially triggering an autoimmune response that attacks the body’s own tissues. This process, known as molecular mimicry, could contribute to the development of MS or other neuroautoimmune disorders.

A leaky blood-brain barrier (BBB) is a significant factor in the development and progression of MS. The BBB is a protective layer of cells that regulates the entry of substances from the bloodstream into the central nervous system (CNS). When the BBB becomes compromised or "leaky," it allows immune cells, antibodies, and other inflammatory molecules to enter the brain and spinal cord, where they can attack myelin – the protective sheath around nerve fibres – leading to the characteristic lesions and neurological damage seen in MS.

As aquaporin-4 (AQP-4) is a water channel protein primarily found in the brain, particularly in astrocytes, which help maintain the BBB, if the immune system targets this tissue it can lead to a leaky blood-brain barrier. 

In some autoimmune conditions like neuromyelitis optica spectrum disorder (NMOSD), antibodies specifically target AQP-4, leading to inflammation and disruption of the BBB. 

While MS primarily involves different mechanisms of immune attack, studies suggest that altered expression or damage to AQP-4 might contribute to the breakdown of the BBB in MS, facilitating immune cell entry and promoting further inflammation and demyelination in the CNS. Thus, AQP-4 may play a role in maintaining BBB integrity and preventing the immune system from mistakenly attacking the CNS in MS.

Clinically, I have seen my clients with MS see improvements in their symptoms by removing foods that cross-react with AQP-4, and at my clinic, we also offer testing which can confirm whether your immune system is targetting your tissue at the BBB.

3. Clostridium perfringens - epsilon toxin

Clostridium perfringens, a bacterium commonly found in the gut, produces epsilon toxin (ETX). Research has linked ETX to MS due to its effects on the blood-brain barrier and myelin. 

ETX can increase the permeability of the blood-brain barrier, allowing potentially harmful substances to enter the central nervous system and contribute to inflammation and damage. This toxin’s role in MS lesion formation makes it a noteworthy factor in understanding the disease’s pathology.

You can determine your levels of clostridium by running a stool test, which is offered at The Autoimmunity Nutritionist Clinic. 

Raised levels of clostridium perfringens can lead to a range of symptoms beyond its potential connection to MS. Symptoms of elevated clostridium levels may include gastrointestinal issues such as diarrhoea, abdominal pain, bloating, and gas. In some cases, it can cause more severe conditions like food poisoning or enteritis, particularly in those with weakened immune systems. 

Additionally, high levels of clostridium may contribute to systemic inflammation, fatigue, and cognitive disturbances due to the release of toxins that can affect both the gut and the central nervous system. To help eradicate clostridium, a combination of dietary changes, probiotics, and natural antimicrobials may be effective. 

Incorporating probiotics such as lactobacillus and bifidobacterium can help restore healthy gut flora and reduce pathogenic bacterial overgrowth. Consuming a diet rich in fibre from vegetables, fruits, and whole grains can also support a healthy gut environment. Natural antimicrobials like garlic (allicin), oregano oil (carvacrol), and turmeric (curcumin) have antibacterial properties that may help reduce clostridium levels. 

In more severe cases, a healthcare provider may recommend targeted antibiotics, such as metronidazole or vancomycin, to directly address the bacterial overgrowth.

4. Shingles virus (varicella-zoster virus)

When my brother experienced his first major symptom of MS – a numb, "dead" feeling in his arm – he struggled to move it properly. At the time, my Nana was visiting for Christmas, and she had shingles. It might have been a coincidence, but knowing now about the link between the virus that causes shingles and MS, I’m not so sure anymore.

The varicella-zoster virus (VZV), which causes chickenpox and can later reactivate as shingles, has been associated with MS. 

When VZV reactivates, it can cause inflammation and damage to the nervous system. Some studies suggest that VZV may remain dormant in the nervous system and contribute to MS when it reactivates. Understanding this connection could provide insights into MS development and highlight the importance of managing viral infections.

Research increasingly suggests that autoimmune conditions are more closely linked to pathogens than previously thought. Certain viruses, such as Epstein-Barr virus (EBV), VZV, and others, may contribute to autoimmune responses through mechanisms like molecular mimicry, persistent infections, or chronic inflammation. 

As we learn more about these connections, it becomes clear that pathogens likely have a more substantial influence on autoimmune diseases than we once realised.

5. Dairy sensitivity

My brother has always been a fan of cow’s milk. When we were children visiting our Nana, I would go for the fizzy pop on offer, while my brother would choose a glass of milk. The debate continues on which of these is better for our genetic susceptibility to autoimmune diseases – but what do you think?

However, certain proteins found in cow’s milk, such as butyrophilin, may trigger immune responses that cross-react with myelin proteins in some individuals. This cross-reactivity could lead to an immune attack on the nervous system, potentially contributing to MS. 

While more research is needed to fully understand the relationship between dairy sensitivity and MS, reducing dairy intake might be beneficial for those who suspect they have sensitivities.

Symptoms of dairy sensitivity can vary but often include digestive issues such as bloating, gas, diarrhoea, abdominal pain, and nausea after consuming dairy products. Other signs can include headaches, skin reactions like eczema or acne, sinus congestion, and respiratory symptoms such as a runny nose or wheezing. Some people may also experience fatigue, joint pain, or mood changes, which can indicate a broader inflammatory response to dairy proteins.

Food sensitivity testing can provide more insight into whether you have a dairy allergy, and I find that my clients who use this type of testing see relief from their symptoms by taking out the foods identified in these types of tests, which we offer at The Autoimmunity Nutritionist Clinic. 

As you can see, the causes of MS are multifaceted and involve a complex interplay of genetic, environmental, and immune factors. 

While research continues to uncover potential triggers for MS, understanding these lesser-known factors – such as vitamin B12 deficiency, AQP-4 cross-reactivity, clostridium perfringens toxin, the shingles virus, and dairy sensitivity – can provide new avenues for prevention and management. If you or someone you know has MS and hasn't yet considered these factors, it might be worthwhile to explore them. Identifying the underlying causes of your condition can make it much easier to address symptoms and restore balance.