Multiple sclerosis could affect health years before classic symptoms
Aug. 4 (UPI) -- People with multiple sclerosis, or MS, begin experiencing new health issues up to 15 years before the classic signs of the illness appear, Canadian research shows.
"MS can be difficult to recognize as many of the earliest signs -- like fatigue, headache, pain and mental health concerns -- can be quite general and easily mistaken for other conditions," study senior author Helen Tremlett noted.
"Our findings dramatically shift the timeline for when these early warning signs are thought to begin, potentially opening the door to opportunities for earlier detection and intervention," said Tremlett, a professor of neurology at the University of British Columbia in Vancouver.
Her team published its findings Friday in JAMA Network Open.
MS is an autoimmune illness in which the body's immune system goes awry, attacking the protective myelin sheath that surrounds nerves within the brain and along the spinal cord.
Communication breaks down between the brain and the body, leading to progressive disability.
The new study that suggests MS may begin more than a decade before a clinical diagnosis.
Tremlett's group combed through British Columbia health data for 12,000 people with or without MS. Records went back as far as 25 years prior to an MS patient's diagnosis.
That's far longer than the five to 10 years covered in earlier studies looking at disease onset.
The main findings:
Fifteen years before the onset of classic MS symptoms, there was a noticeable uptick in patient visits to their general practitioner, or in visits to specialists for issues like fatigue, pain and dizziness, as well as mental health issues such as anxiety and depression.
Twelve years before symptom onset, visits to psychiatrists began to rise.
Eight to nine years before, visits to neurologists and eye specialists rose, perhaps linked to issues such as blurred vision or eye pain.
Three to five years before, researchers noted a rise in visits to emergency departments and/or radiology facilities.
One year before, visits peaked for a wide range of different physician types, such as neurologists, radiologists and emergency doctors.
"These patterns suggest that MS has a long and complex prodromal phase -- where something is happening beneath the surface but hasn't yet declared itself as MS," said study first author Dr. Marta Ruiz-Algueró, a postdoctoral fellow at UBC.
"We're only now starting to understand what these early warning signs are, with mental health-related issues appearing to be among the earliest indicators," she added in a news release.
The researchers stressed that the early issues that drove MS patients to seek out care can be caused by a myriad of health conditions. Simply experiencing these conditions does not mean a person will go on to develop MS.
Nevertheless, "By identifying these earlier red flags, we may eventually be able to intervene sooner -- whether that's through monitoring, support or preventive strategies," Tremlett said a university news release. "It opens new avenues for research into early biomarkers, lifestyle factors and other potential triggers that may be at play during this previously overlooked phase of the disease."
More information
Find out more about multiple sclerosis at the National Multiple Sclerosis Society
Copyright © 2025 HealthDay. All rights reserved.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Newsweek
an hour ago
- Newsweek
Millions Urged To Avoid Driving
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Millions of Americans have been urged to avoid driving amid concerns over high air pollution levels. Air quality alerts were issued across parts of Illinois, Colorado, Wyoming, and Arizona on Thursday, according to the National Weather Service (NWS). The warnings mean ground-level ozone and particulate concentrations are forecast to reach dangerous levels. In some areas, the pollution comes from drifting wildfire smoke. Why It Matters The NWS warned that both sensitive groups—such as children, seniors, and individuals with preexisting respiratory or heart conditions—and the general public might experience health effects linked to poor air quality in the affected regions. "Increasing likelihood of respiratory symptoms in sensitive individuals, aggravation of heart or lung disease and premature mortality in people with cardiopulmonary disease and older adults," the NWS said in its alert. "People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion." Haze from a Canadian wildfire blankets the Chicago area in July. Haze from a Canadian wildfire blankets the Chicago area in July. Ashlee Rezin/Chicago Sun-Times/AP What To Know In Colorado, an Action Day for Multiple Pollutants has been issued for Thursday until 4 p.m. MT for the Front Range Urban Corridor, covering cities including Denver and Boulder. "Hot weather and incoming wildfire smoke will allow particulate matter and ozone to reach the unhealthy [level] for sensitive groups category on Wednesday and Thursday," the NWS said. "If possible, please help us reduce ozone pollution by limiting driving gas and diesel-powered vehicles until at least 4 p.m." In Arizona, an ozone high pollution advisory has been issued for the Phoenix Metro Area. The Arizona Department of Environmental Quality (ADEQ) said in the NWS alert notice: "You are urged to car pool, telecommute or use mass transit. The use of gasoline-powered equipment should be reduced or done late in the day." In Illinois, an Air Pollution Action Day has been issued for the greater Chicago Metropolitan Area until midnight. This means that ozone and particulate levels are expected to be at or above the level that poses health risks to sensitive groups. "Active children and adults, especially people with pulmonary or respiratory disease such as asthma, should limit prolonged outdoor activity," the NWS said. In Wyoming, an air quality alert for wildfire smoke has been issued for portions of the southeast, including the cities of Laramie and Cheyenne, until noon. What People Are Saying The ADEQ said in the NWS alert notice: "Ozone is an air contaminant which can cause breathing difficulties for children, older adults, as well as persons with respiratory problems. A decrease in physical activity is recommended." The Colorado Department of Public Health and Environment said: "If smoke is thick or becomes thick in your neighborhood you may want to remain indoors. This is especially true for those with heart disease, respiratory illnesses, the very young, and older adults. "Consider limiting outdoor activity when moderate to heavy smoke is present. Consider relocating temporarily if smoke is present indoors and is making you ill. If visibility is less than five miles in smoke in your neighborhood, smoke has reached levels that are unhealthy." Jonathan Grigg, a professor of pediatric respiratory and environmental medicine at Queen Mary University of London, previously told Newsweek that there are "very clear links" between inhaling particles and earlier death from both respiratory and cardiovascular diseases. He added: "There are vulnerable groups and classically they are children because they've got an extra issue to do with their lungs developing, whereas our lungs are not developing as adults." What Happens Next The air quality alerts are currently set to remain in force until Thursday afternoon and evening. Regular updates regarding air pollution levels are issued on the NWS website and on the Environmental Protection Agency's AirNow interactive map.
USA Today
4 hours ago
- USA Today
Burning eyes, scratchy throats: Canadian wildfire smoke is making Americans miserable
Peggy Goodwin typically likes to spend as much time outside as possible in the too-short Michigan summers, riding her bike or taking a walk. But Goodwin, and the residents of the assisted living facility where she works, have been spending more time indoors lately as smoke from hundreds of wildfires burning in Canada drifts across the border. Goodwin said the skies have turned hazy, the smell of barbecue lingers in the air, and her eyes burn and water if she's outside too long. "It's just not pleasant," she said. Canadian wildfire smoke has worsened air quality in many parts of the United States, putting a damper on Americans' summer plans and raising health concerns, particularly for vulnerable groups like children, older adults and those with respiratory conditions. The smoke can irritate the eyes, nose and throat and contain particulate matter small enough to be inhaled. The National Weather Service has issued air quality alerts in states including Minnesota, Wisconsin, Michigan, Illinois, Pennsylvania, New York, Vermont, New Hampshire and Massachusetts. See map: Smoke from Canada wildfires prompt air quality alerts in US "Once inhaled, these particles can affect the lungs and heart and cause serious health effects,' the Environmental Protection Agency has said. 'It almost makes me gasp' Carol Schuchart has been eagerly checking the weather reports to see when she and her two dogs might be able to venture outside again in Hanover, Pennsylvania, where she runs a wedding planning and coordination business. Schuchart, who has fibromyalgia, said she's been having trouble breathing since the haze has settled in. "It's hard to go outside and enjoy when that air quality is bad and you have trouble breathing, you know," she said. "So I tend to stay in when it's like this." Meanwhile, Dorothy Curran said she was shocked to see the Minneapolis skyline obscured by wildfire smoke during a recent commute to work. When she stepped outside, Curran said she felt a tightness in her chest. "I was just feeling very scratchy, having a lot of coughs," she said. "And I think a lot of people were feeling that, even without respiratory conditions." For those who do have health issues, the smoke can cause even more concern. As of Aug. 6, the EPA labeled air quality throughout the Plains, Mid-Atlantic and Northeast regions "unhealthy for sensitive groups." Wildfire smoke safety tips: How to keep you, your family and beloved pets safe Curran, a pediatric pulmonologist and a professor at the University of Minnesota, said she's been getting more and more calls from parents seeking refills on medication for their children with asthma or other underlying health conditions. "Things that I've been hearing about are shortness of breath with activity, cough, especially a dry cough," she said. "Very rarely, we've been seeing that trigger more airway reactivity or narrow airways leading to wheezing and presenting to the emergency department." Breathing in wildfire smoke can be dangerous because it can contain hazardous chemicals and particulate matter, which is comprised of small particles of solids or liquids suspended in the air, USA TODAY has reported. While larger particles can irritate the eyes, nose, and throat, particles as small as 2.5 micrometers, PM 2.5, can "penetrate deep into the lungs, where they can impair lung function, cause illnesses, such as bronchitis, and increase asthma attacks," according to Yale Medicine. For Joel Williams, the smoke prompted an asthma flare up that landed him in the hospital for more than three weeks. Williams, a retired police officer who lives in Bloomington, Minnesota, said he started wheezing earlier this summer as the sky turned orange and the air began to smell like a fireplace. He said he tried the usual remedies ‒ breathing treatments, extra prednisone and even antibiotics ‒ but the wheezing persisted. Williams said he was eventually admitted to the hospital where he stayed for 23 days. "I am a very active person," he said. "To miss a whole month just sitting in a hospital bed was uncool." Since his release, Williams said he's been staying indoors more, wearing masks and using an air purifier as he waits for conditions to improve. He urged others affected by the smoke to take similar precautions. "I can almost tell as soon as I step out the house, it almost makes me gasp, even with a mask on," he said. "So that tells you how bad this stuff is." Contributing: Michael Loria, Christopher Cann
Los Angeles Times
14 hours ago
- Los Angeles Times
Rethinking Multiple Sclerosis: Why Everything We Thought We Knew Is Changing
The story we used to tell about multiple sclerosis was simple. Clean. Maybe a little too clean. We taught it in lecture halls and explained it to patients. The script was always the same: MS is an autoimmune disease where the body's T-cells—the special forces of the immune system—go rogue. They mistake the nervous system for an invader and attack the myelin sheath, the fatty insulation that keeps our nerve signals moving fast. Strip away that insulation, you get short circuits. Relapses. Disability. It was a neat narrative. T-cells were the clear villain. But the real world is messy. And the clues that our story was wrong came from our own treatments. New therapies came along that absolutely hammered B-cells—another part of the immune army we'd mostly ignored in the MS story. And they worked. Frighteningly well [4]. That begged a huge question. If this was a T-cell war, why was taking out the B-cell infantry so brutally effective? It forced a complete reset. Turns out, B-cells aren't just standing around. They're key players, maybe even the ringleaders that get the T-cells riled up and keep the fires of chronic inflammation burning [1] [2]. This wasn't some minor academic correction. It changed everything. It meant our entire working model of the disease was incomplete. We'd been staring at one piece of the puzzle, thinking it was the whole picture. The neat story was wrong. This disease is a product of a murky conspiracy between a person's genes and some environmental trigger we still can't nail down [3] [10]. A virus from childhood? A chronic deficiency? We have a list of suspects, but no convictions. What we do know is that once it kicks off, it's a cascade of damage. And it's not just about the myelin anymore. It's about the nerve itself. The wire, not just the insulation. First job is getting the diagnosis right. For that, we have the MRI. It's our window into the damage [9]. We hunt for lesions—the scars of past attacks—in the brain and spinal cord. But one picture isn't enough. To be sure it's MS, we have to prove the damage is happening in different places and at different times. Dissemination in space and time. That's the mantra. The McDonald criteria are the rules of the game for this, and they've been sharpened over the years to be faster and more accurate [13]. The 2017 update, for example, cut down the waiting time for a diagnosis. Good. Because time is brain. The sooner we know, the sooner we can act. We even have advanced imaging now that lets us see past the obvious lesions to the subtle, fraying wires underneath it all [15]. But the sharper picture from our MRIs showed us something else. Something uncomfortable. The old textbooks taught us MS was a disease of white people with Northern European roots. That was the classic patient profile. Another part of our simple story. And another part that was dead wrong [8]. The data coming out now paints a very different picture. In the United States, Black individuals don't just get MS—they have the highest incidence of the disease [14]. Hispanic communities are also hit hard. This isn't a footnote. It's the headline. It tells us that MS risk is shaped by more than just ancestry. It's shaped by society. It's about where you live, your access to care, and the systemic biases baked into the world [14]. It's a humbling reality check. A disease doesn't happen in a biological vacuum. It happens in the real world [7]. The last two decades? An absolute explosion in treatments [2] [5]. We went from having almost nothing to a whole arsenal of drugs. The new high-efficacy therapies, especially those B-cell killers, can slam the brakes on relapses and new MRI lesions [4]. They are powerful weapons against the inflammatory part of MS. But stopping the inflammation, we're learning, is only half the job. MS isn't one thing. It's two. A two-headed monster. It is an inflammatory disease, yes. But it is also a neurodegenerative one [2] [6]. From day one, nerve fibers are being quietly damaged and permanently lost. Axonal transection. That's the technical term. It means the nerve fiber is cut. It doesn't grow back. This is the stealthy process that drives progressive disability, the slow worsening that can happen even when a person feels fine. For years, we saw this as a two-act play: an early, inflammatory stage, followed by a later, degenerative stage. Another simple story. Also wrong. We now know they are partners in crime. Inflammation and neurodegeneration are happening at the same time, a vicious cycle running from day one [12]. This changes the mission entirely. The new mandate isn't just to cool down the immune system. It's to protect the brain itself. Neuroprotection. That's the holy grail now [11] [12]. We need drugs that not only stop the attacks but also shield the neurons from the fallout and, maybe, help the brain heal itself. We aren't there yet. But that's where everything is headed. The goalpost moves. It's not just 'no new attacks' anymore. It's 'save the brain.' Preserve function for the long haul. It means we have to finally toss out the simple stories and face the complicated, challenging reality of what this disease truly is. [1] Yamout, B. I., & Alroughani, R. (2018). Multiple Sclerosis. Seminars in neurology, 38(2), 212–225. [2] Hauser, S. L., & Cree, B. A. C. (2020). Treatment of Multiple Sclerosis: A Review. The American journal of medicine, 133(12), 1380–1390.e2. [3] Ghasemi, N., Razavi, S., & Nikzad, E. (2017). Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell journal, 19(1), 1–10. [4] Galota, F., Marcheselli, S., De Biasi, S., Gibellini, L., Vitetta, F., Fiore, A., Smolik, K., De Napoli, G., Cardi, M., Cossarizza, A., & Ferraro, D. (2025). Impact of High-Efficacy Therapies for Multiple Sclerosis on B Cells. Cells, 14(8), 606. [5] Martin, R., Sospedra, M., Rosito, M., & Engelhardt, B. (2016). Current multiple sclerosis treatments have improved our understanding of MS autoimmune pathogenesis. European journal of immunology, 46(9), 2078–2090. [6] McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA, 325(8), 765–779. [7] Kapica-Topczewska, K., Kulakowska, A., Kochanowicz, J., & Brola, W. (2025). Epidemiology of multiple sclerosis: global trends, regional differences, and clinical implications. Neurologia i neurochirurgia polska, 10.5603/pjnns.103955. Advance online publication. [8] Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis - a review. European journal of neurology, 26(1), 27–40. [9] Elahi, R., Taremi, S., Najafi, A., Karimi, H., Asadollahzadeh, E., Sajedi, S. A., Rad, H. S., & Sahraian, M. A. (2025). Advanced MRI Methods for Diagnosis and Monitoring of Multiple Sclerosis (MS). Journal of magnetic resonance imaging : JMRI, 10.1002/jmri.29817. Advance online publication. [10] Jakimovski, D., Bittner, S., Zivadinov, R., Morrow, S. A., Benedict, R. H., Zipp, F., & Weinstock-Guttman, B. (2024). Multiple sclerosis. Lancet (London, England), 403(10422), 183–202. [11] Thompson, A. J., Baranzini, S. E., Geurts, J., Hemmer, B., & Ciccarelli, O. (2018). Multiple sclerosis. Lancet (London, England), 391(10130), 1622–1636. [12] Coclitu, C. I., Constantinescu, C. S., & Tanasescu, R. (2025). Neuroprotective strategies in multiple sclerosis: a status update and emerging paradigms. Expert review of neurotherapeutics, 25(7), 791–817. [13] Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., Fujihara, K., Galetta, S. L., Hartung, H. P., Kappos, L., Lublin, F. D., Marrie, R. A., Miller, A. E., Miller, D. H., Montalban, X., Mowry, E. M., … Cohen, J. A. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet. Neurology, 17(2), 162–173. [14] Langer-Gould, A. M., Cepon-Robins, T. J., Benn Torres, J., Yeh, E. A., & Gildner, T. E. (2025). Embodiment of structural racism and multiple sclerosis risk and outcomes in the USA. Nature reviews. Neurology, 21(7), 370–382. [15] Sbardella, E., Tona, F., Petsas, N., & Pantano, P. (2013). DTI Measurements in Multiple Sclerosis: Evaluation of Brain Damage and Clinical Implications. Multiple sclerosis international, 2013, 671730.
