Living with Multiple Sclerosi
Hábitos de vida
Diet. It has not been scientifically demonstrated that a special diet would be beneficial to treat or slow down the progression of the disease. A balanced and varied diet is recommended, rich in fruit and vegetables, and avoid excess fats and sugars, in order to reduce the risk of developing additional comorbidities.
Vitamin D deficiency may increase the risk of multiple sclerosis. For this reason, vitamin D supplementation may be recommended in some cases.
It is advisable to eat four to five meals a day and drink between one and two litres of water daily.
Toxic habits. Studies suggest that smoking, as well as exposure to smoke, increases the risk of developing the disease and accelerates its progression. Likewise, drinking alcohol in excess affects coordination, equilibrium, and speech, and with this the existing symptoms may become worse. Even so, there is no evidence that alcohol affects the course of the disease. Moderate caffeine consumption does not appear to be harmful.
Exercise. Physical exercise in itself does not modify the course of the disease, but it can prevent many complications that arise from inactivity and could alleviate fatigue. Physical activity helps to regulate sleep patterns, appetite and bowel and urinary functions, and has both physical and psychological benefits. Yoga, swimming, tai chi or any other sport can be useful.
Rest and Sleep. Many people with multiple sclerosis experience sleep problems. They may have difficulty falling asleep or, conversely, sleep more than usual. This may be related to fatigue, depression, muscle spasms, or other symptoms of the disease.
Getting enough uninterrupted, good-quality sleep helps the body restore its energy levels. If fatigue is persistent, planning regular rest periods throughout the day may improve overall well-being.
Sexual Health. Neurological symptoms may sometimes directly affect sexual function, causing reduced sexual desire, altered genital sensation, reduced vaginal lubrication, or erectile dysfunction. Other symptoms, including fatigue, spasticity, weakness, and urinary problems, may also interfere with sexual activity.
Emotional factors can also affect sexuality, such as changes in body image, reduced self-esteem, or feelings of dependency. Do not hesitate to seek advice from healthcare professionals, as treatments are available that can help maintain a healthy sex life.
Travel. When planning a trip, it is advisable to consider the following:
- The terms of your travel insurance, if applicable.
- Recommended vaccinations. Consult your healthcare professional well in advance to determine whether they are appropriate for you.
- The climate at your destination, especially if you are sensitive to heat.
- Regarding your medication, check the storage and transport requirements. Bring enough medication for your trip, along with an extra supply. If travelling by air, always carry your medication in your hand luggage and ask your healthcare professional for a medical certificate to facilitate airport security procedures.
Pregnancy. Multiple sclerosis does not affect fertility, pregnancy, or childbirth, and pregnancy itself does not worsen the course of the disease. However, the risk of relapses usually decreases during pregnancy and increases in the immediate postpartum period. Disease-modifying therapies are generally not recommended during pregnancy or breastfeeding, although treatment decisions should always be individualized.
Social and Emotional Support. After receiving a diagnosis, it is helpful to share your feelings with people close to you who can provide support. Seek professional help if you feel persistently sad, hopeless, or experience high levels of anxiety.
Connecting with other people living with multiple sclerosis can also be beneficial. Sharing experiences, practical advice, and coping strategies can provide reassurance and support. Multiple sclerosis patient associations can offer peer support as well as professional guidance in a range of areas.
Managing Treatment Side Effects
1. Injectable treatments (self-administered at home)
Interferons
- Flu-like syndrome. This may include fever, headache, joint pain, fatigue, or general malaise during the hours following the injection. These symptoms are usually more noticeable at the beginning of treatment and gradually improve over time. What can you do?
- Administer the injection at night.
- Take 600 mg of ibuprofen one hour before the injection.
- If symptoms persist, a further dose may be taken the following day, provided there is no medical contraindication.
- Injection-site reactions. The best way to prevent these reactions is by using the correct injection technique and rotating injection sites appropriately. Even so, the following may occur:
- Redness.
- Pain or swelling.
- Itching.
- Subcutaneous induration.
- Bruising.
Follow the advice provided by your MS nurse and contact them if you have any concerns.
Glatiramer acetate
- Immediate post-injection reaction. This consists of chest tightness, shortness of breath and/or palpitations. Although uncommon and potentially alarming, it usually occurs immediately after the injection and is not dangerous. What can you do?
- Sit or lie down.
- Try to relax.
- Wait approximately 15 minutes for the symptoms to resolve.
- Injection-site reactions. The same recommendations apply as for interferons.
Ofatumumab
- Flu-like syndrome. This may occur after the first injection and includes fever, headache, joint pain, fatigue, and general malaise.
- Increased risk of infections. Treatment may increase the risk of respiratory infections, urinary tract infections, herpes infections, and other infections.
2. Oral treatments
Teriflunomide
- Gastrointestinal symptoms. These may include flatulence, increased bowel movements, softer stools and occasional diarrhoea.
- Hair thinning or mild hair loss. You may notice that your hair becomes thinner or sheds slightly more than usual, although this is generally not noticeable to others. If significant, hair-strengthening products may help. This usually improves after approximately six months.
- Increased blood pressure. Although uncommon, blood pressure should be monitored regularly.
Dimethyl fumarate and diroximel fumarate
- Flushing. Redness of the face and chest may occur. This does not affect everyone and varies in severity.
- Stomach or abdominal pain. Symptoms are usually mild and short-lived.
How can these effects be reduced?
- Always take the medication with food.
- Include some fatty food in the meal.
- Follow the recommended dose-escalation schedule when starting treatment.
If side effects are severe or persistent, contact your healthcare professional.
Fingolimod, Ozanimod and Ponesimod
- Transient bradycardia at treatment initiation. After the first dose, you will need to remain in hospital for approximately six hours so your heart rate can be monitored. No special precautions are usually required after this. If treatment is interrupted for more than 15 days, first-dose monitoring will need to be repeated.
- Macular oedema. Inflammation of the macula, the central part of the retina responsible for sharp vision, may occur. Regular ophthalmological examinations are recommended, and any changes in vision should be reported promptly.
- Lymphopenia. A reduction in blood lymphocyte levels may occur, increasing the risk of infections.
Cladribine
- Lymphopenia. This treatment may reduce blood lymphocyte counts, increasing susceptibility to infections.
- Hair thinning or mild hair loss. This may occur during treatment.
3. Intravenous treatments
Some treatments, including natalizumab, alemtuzumab, ocrelizumab, ublituximab, and rituximab, are administered by intravenous infusion, usually in a day hospital.
During the infusion, healthcare professionals will monitor for any infusion-related adverse reactions and provide the necessary information and support.
Outside the infusion period, these treatments may increase the risk of infections, particularly respiratory infections, urinary tract infections, and herpes infections.
Substantiated information by:
Published: 20 February 2018
Updated: 13 July 2026
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