Five Advance Warnings of Multiple Sclerosis

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Five Advance Warnings of Multiple Sclerosis

First things first, a quick check-in with regard to how much you know about multiple sclerosis (MS):

  • Do you know what causes it?
  • Do you know how it happens?
  • Do you know how it can be fixed?

If your answer to the above questions is “no”, then take solace in the fact that modern science doesn’t know either.

What we do know is that it’s an autoimmune condition, and that it results in the degradation of myelin, the “insulator” of nerves, in the central nervous system.

  • How exactly this is brought about remains unclear, though there are several leading hypotheses including autoimmune attack of myelin itself, or disruption to the production of myelin.
  • Treatments look to reduce/mitigate inflammation, and/or treat other symptoms (which are many and various) on an as-needed basis.

If you’re wondering about the prognosis after diagnosis, the scientific consensus on that is also “we don’t know”:

Read: Personalized medicine in multiple sclerosis: hope or reality?

this paper, like every other one we considered putting in that spot, concludes with basically begging for research to be done to identify biomarkers in a useful fashion that could help classify many distinct forms of MS, rather than the current “you have MS, but who knows what that will mean for you personally because it’s so varied” approach.

The Five Advance Warning Signs

Something we do know! First, we’ll quote directly the researchers’ conclusion:

❝We identified 5 health conditions associated with subsequent MS diagnosis, which may be considered not only prodromal but also early-stage symptoms.

However, these health conditions overlap with prodrome of two other autoimmune diseases, hence they lack specificity to MS.❞

So, these things are a warning, five alarm bells, but not necessarily diagnostic criteria.

Without further ado, the five things are:

  1. depression
  2. sexual disorders
  3. constipation
  4. cystitis
  5. urinary tract infections

❝This association was sufficiently robust at the statistical level for us to state that these are early clinical warning signs, probably related to damage to the nervous system, in patients who will later be diagnosed with multiple sclerosis.

The overrepresentation of these symptoms persisted and even increased over the five years after diagnosis.❞

~ Dr. Céline Louapre

Read the paper for yourself:

Association Between Diseases and Symptoms Diagnosed in Primary Care and the Subsequent Specific Risk of Multiple Sclerosis

Hot off the press! Published only yesterday!

Want to know more about MS?

Here’s a very comprehensive guide:

National clinical guideline for diagnosis and management of multiple sclerosis

Take care!

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  • Water’s Counterintuitive Properties

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Why are we told to drink more water for everything, even if sometimes it seems like the last thing we need? Bloated? Drink water. Diarrhea? Drink water. Nose running like a tap? Drink water❞

    While water will not fix every ill, it can fix a lot, or at least stop it from being worse!

    Our bodies are famously over 60% water (exact figure will depend on how well-hydrated you are, obviously, as well as your body composition in terms of muscle and fat). Our cells (which are mostly full of mostly water) need replacing all the time, and almost everything that needs transporting almost anywhere is taken there by blood (which is also mostly water). And if we need something moving out of the body? Water is usually going to be a large part of how it gets ejected.

    In the cases of the examples you gave…

    • Bloating: bloating is often a matter of water retention, which often happens as a result of having too much salt, and/or sometimes too much fat. So the body’s homeostatic system (the system that tries to maintain all kinds of equilibrium, keeping salt balance, temperature, pH, and many other things in their respective “Goldilocks zones”) tries to add more water to where it’s needed to balance out the salt etc.
      • Consequently, drinking more water means the body will note “ok, balance restored, no need to keep retaining water there, excess salts being safely removed using all this lovely water”.
    • Diarrhea: this is usually a case of a bacterial infection, though there can be other causes. Whether for that reason or another, the body has decided that it needs to give your gut an absolute wash-out, and it can only do that from the inside—so it uses as much of the body’s water as it needs to do that.
      • Consequently, drinking more water means that you are replenishing the water that the body has already 100% committed to using. If you don’t drink water, you’ll still have diarrhea, you’ll just start to get dangerously dehydrated.
    • Runny nose: this is usually a case of either fighting a genuine infection, or else fighting something mistaken for a pathogen (e.g. pollen, or some other allergen). The mucus is an important part of the body’s defense: it traps the microbes (be they bacteria, virus, whatever) and water-slides them out of the body.
      • Consequently, drinking more water means the body can keep the water-slide going. Otherwise, you’ll just get gradually more dehydrated (because as with diarrhea, your body will prioritize this function over maintaining water reserves—water reserves are there to be used if necessary, is the body’s philosophy) and if the well runs dry, you’ll just be dehydrated and have a higher pathogen-count still in your body.

    Some previous 10almonds articles that might interest you:

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  • 20 Easy Ways To Lose Belly Fat (Things To *Not* Do)

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    Waist circumference (and hip to waist ratio) has been found to be a much better indicator of metabolic health than BMI. So, while at 10almonds we generally advocate for not worrying too much about one’s BMI, there are good reasons why it can be good to trim up specifically the visceral belly fat. But how?

    What not to do…

    Autumn Bates is a nutritionist, and her tips include nutrition and other lifestyle factors; here are some that we agree with:

    For more, including to learn what she has against peanut butter, enjoy her video:

    Click Here If The Embedded Video Doesn’t Load Automatically

    Want to know more?

    Check out our previous main feature:

    Visceral Belly Fat & How To Lose It

    Take care!

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  • Some women’s breasts can’t make enough milk, and the effects can be devastating

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many new mothers worry about their milk supply. For some, support from a breastfeeding counsellor or lactation consultant helps.

    Others cannot make enough milk no matter how hard they try. These are women whose breasts are not physically capable of producing enough milk.

    Our recently published research gives us clues about breast features that might make it difficult for some women to produce enough milk. Another of our studies shows the devastating consequences for women who dream of breastfeeding but find they cannot.

    Some breasts just don’t develop

    Unlike other organs, breasts are not fully developed at birth. There are key developmental stages as an embryo, then again during puberty and pregnancy.

    At birth, the breast consists of a simple network of ducts. Usually during puberty, the glandular (milk-making) tissue part of the breast begins to develop and the ductal network expands. Then typically, further growth of the ductal network and glandular tissue during pregnancy prepares the breast for lactation.

    But our online survey of women who report low milk supply gives us clues to anomalies in how some women’s breasts develop.

    We’re not talking about women with small breasts, but women whose glandular tissue (shown in this diagram as “lobules”) is underdeveloped and have a condition called breast hypoplasia.

    Anatomical diagram of the breast
    Sometimes not enough glandular tissue, shown here as lobules, develop.
    Tsuyna/Shutterstock

    We don’t know how common this is. But it has been linked with lower rates of exclusive breastfeeding.

    We also don’t know what causes it, with much of the research conducted in animals and not humans.

    However, certain health conditions have been associated with it, including polycystic ovary syndrome and other endocrine (hormonal) conditions. A high body-mass index around the time of puberty may be another indicator.

    Could I have breast hypoplasia?

    Our survey and other research give clues about who may have breast hypoplasia.

    But it’s important to note these characteristics are indicators and do not mean women exhibiting them will definitely be unable to exclusively breastfeed.

    Indicators include:

    • a wider than usual gap between the breasts
    • tubular-shaped (rather than round) breasts
    • asymmetric breasts (where the breasts are different sizes or shapes)
    • lack of breast growth in pregnancy
    • a delay in or absence of breast fullness in the days after giving birth

    In our survey, 72% of women with low milk supply had breasts that did not change appearance during pregnancy, and about 70% reported at least one irregular-shaped breast.

    The effects

    Mothers with low milk supply – whether or not they have breast hyoplasia or some other condition that limits their ability to produce enough milk – report a range of emotions.

    Research, including our own, shows this ranges from frustration, confusion and surprise to intense or profound feelings of failure, guilt, grief and despair.

    Some mothers describe “breastfeeding grief” – a prolonged sense of loss or failure, due to being unable to connect with and nourish their baby through breastfeeding in the way they had hoped.

    These feelings of failure, guilt, grief and despair can trigger symptoms of anxiety and depression for some women.

    Tired, stress woman with hand over face
    Feelings of failure, guilt, grief and despair were common.
    Bricolage/Shutterstock

    One woman told us:

    [I became] so angry and upset with my body for not being able to produce enough milk.

    Many women’s emotions intensified when they discovered that despite all their hard work, they were still unable to breastfeed their babies as planned. A few women described reaching their “breaking point”, and their experience felt “like death”, “the worst day of [my] life” or “hell”.

    One participant told us:

    I finally learned that ‘all women make enough milk’ was a lie. No amount of education or determination would make my breasts work. I felt deceived and let down by all my medical providers. How dare they have no answers for me when I desperately just wanted to feed my child naturally.

    Others told us how they learned to accept their situation. Some women said they were relieved their infant was “finally satisfied” when they began supplementing with formula. One resolved to:

    prioritise time with [my] baby over pumping for such little amounts.

    Where to go for help

    If you are struggling with low milk supply, it can help to see a lactation consultant for support and to determine the possible cause.

    This will involve helping you try different strategies, such as optimising positioning and attachment during breastfeeding, or breastfeeding/expressing more frequently. You may need to consider taking a medication, such as domperidone, to see if your supply increases.

    If these strategies do not help, there may be an underlying reason why you can’t make enough milk, such as insufficient glandular tissue (a confirmed inability to make a full supply due to breast hypoplasia).

    Even if you have breast hypoplasia, you can still breastfeed by giving your baby extra milk (donor milk or formula) via a bottle or using a supplementer (which involves delivering milk at the breast via a tube linked to a bottle).

    More resources

    The following websites offer further information and support:

    Shannon Bennetts, a research fellow at La Trobe University, contributed to this article.The Conversation

    Renee Kam, PhD candidate and research officer, La Trobe University and Lisa Amir, Professor in Breastfeeding Research, La Trobe University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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    The premise of the book is as stated in the subtitle: using mindfulness and neuroplasticity to manage our stress response.

    As such, it’s divided into three parts:

    1. Understanding your stress (and different types of stressors)
    2. Calming your amygdalae (thus, dealing with your stress response while the stressor is stressing you)
    3. Moving forward with your prefrontal cortex (and thus, gradually improving automatic stress responses over time, as we learn new, better responses to do automatically)

    The content ranges from the neurophysiological to “therapist’s couch” stuff; Dr. Greenberg having her PhD in psychology has prepared her to write both of those different-but-touching fields with equal competence. In-line citations are given throughout, for those who want to look up studies.

    The style is direct and informative, with little to no attention given to making it an entertaining read. As a result, it’s information dense (which is good), and/but not necessarily a “couldn’t put it down” page-turner.

    Bottom line: if you’d like to improve your ability to deal with stress, this book is as good as any.

    Click here to check out The Stress-Proof Brain, and stress-proof yours!

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  • Gut Feelings – by Dr Will Cole

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    More and more, science is uncovering links between our gut health and the rest of our health—including our mental health! We all know “get some fiber and consider probiotics”, but what else is there that we can do?

    Quite a lot, actually. And part of it, which Dr. Cole also explores, is the fact that the gut-brain highway is a two-way street!

    The book looks a lot especially at the particular relationship between shame and eating. The shame need not initially be about eating, though it can certainly end up that way too. But any kind of shame—be it relating to one’s body, work, relationship, or anything else, can not only have a direct effect on the gut, but indirect too:

    Once our “eating our feelings” instinct kicks in, things can spiral from there, after all.

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    In short: if you’d like to have a better relationship with your food, improve your gut health, and/or reduce inflammation, this is definitely a book for you!

    Click here to check out Gut Feelings on Amazon today!

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  • Alpha, beta, theta: what are brain states and brain waves? And can we control them?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There’s no shortage of apps and technology that claim to shift the brain into a “theta” state – said to help with relaxation, inward focus and sleep.

    But what exactly does it mean to change one’s “mental state”? And is that even possible? For now, the evidence remains murky. But our understanding of the brain is growing exponentially as our methods of investigation improve.

    Brain-measuring tech is evolving

    Currently, no single approach to imaging or measuring brain activity gives us the whole picture. What we “see” in the brain depends on which tool we use to “look”. There are myriad ways to do this, but each one comes with trade-offs.

    We learnt a lot about brain activity in the 1980s thanks to the advent of magnetic resonance imaging (MRI).

    Eventually we invented “functional MRI”, which allows us to link brain activity with certain functions or behaviours in real time by measuring the brain’s use of oxygenated blood during a task.

    We can also measure electrical activity using EEG (electroencephalography). This can accurately measure the timing of brain waves as they occur, but isn’t very accurate at identifying which specific areas of the brain they occur in.

    Alternatively, we can measure the brain’s response to magnetic stimulation. This is very accurate in terms of area and timing, but only as long as it’s close to the surface.

    What are brain states?

    All of our simple and complex behaviours, as well as our cognition (thoughts) have a foundation in brain activity, or “neural activity”. Neurons – the brain’s nerve cells – communicate by a sequence of electrical impulses and chemical signals called “neurotransmitters”.

    Neurons are very greedy for fuel from the blood and require a lot of support from companion cells. Hence, a lot of measurement of the site, amount and timing of brain activity is done via measuring electrical activity, neurotransmitter levels or blood flow.

    We can consider this activity at three levels. The first is a single-cell level, wherein individual neurons communicate. But measurement at this level is difficult (laboratory-based) and provides a limited picture.

    As such, we rely more on measurements done on a network level, where a series of neurons or networks are activated. Or, we measure whole-of-brain activity patterns which can incorporate one or more so-called “brain states”.

    According to a recent definition, brain states are “recurring activity patterns distributed across the brain that emerge from physiological or cognitive processes”. These states are functionally relevant, which means they are related to behaviour.

    Brain states involve the synchronisation of different brain regions, something that’s been most readily observed in animal models, usually rodents. Only now are we starting to see some evidence in human studies.

    Various kinds of states

    The most commonly-studied brain states in both rodents and humans are states of “arousal” and “resting”. You can picture these as various levels of alertness.

    Studies show environmental factors and activity influence our brain states. Activities or environments with high cognitive demands drive “attentional” brain states (so-called task-induced brain states) with increased connectivity. Examples of task-induced brain states include complex behaviours such as reward anticipation, mood, hunger and so on.

    In contrast, a brain state such as “mind-wandering” seems to be divorced from one’s environment and tasks. Dropping into daydreaming is, by definition, without connection to the real world.

    We can’t currently disentangle multiple “states” that exist in the brain at any given time and place. As mentioned earlier, this is because of the trade-offs that come with recording spatial (brain region) versus temporal (timing) brain activity.

    Brain states vs brain waves

    Brain state work can be couched in terms such as alpha, delta and so forth. However, this is actually referring to brain waves which specifically come from measuring brain activity using EEG.

    EEG picks up on changing electrical activity in the brain, which can be sorted into different frequencies (based on wavelength). Classically, these frequencies have had specific associations:

    • gamma is linked with states or tasks that require more focused concentration
    • beta is linked with higher anxiety and more active states, with attention often directed externally
    • alpha is linked with being very relaxed, and passive attention (such as listening quietly but not engaging)
    • theta is linked with deep relaxation and inward focus
    • and delta is linked with deep sleep.

    Brain wave patterns are used a lot to monitor sleep stages. When we fall asleep we go from drowsy, light attention that’s easily roused (alpha), to being relaxed and no longer alert (theta), to being deeply asleep (delta).

    Can we control our brain states?

    The question on many people’s minds is: can we judiciously and intentionally influence our brain states?

    For now, it’s likely too simplistic to suggest we can do this, as the actual mechanisms that influence brain states remain hard to detangle. Nonetheless, researchers are investigating everything from the use of drugs, to environmental cues, to practising mindfulness, meditation and sensory manipulation.

    Controversially, brain wave patterns are used in something called “neurofeedback” therapy. In these treatments, people are given feedback (such as visual or auditory) based on their brain wave activity and are then tasked with trying to maintain or change it. To stay in a required state they may be encouraged to control their thoughts, relax, or breathe in certain ways.

    The applications of this work are predominantly around mental health, including for individuals who have experienced trauma, or who have difficulty self-regulating – which may manifest as poor attention or emotional turbulence.

    However, although these techniques have intuitive appeal, they don’t account for the issue of multiple brain states being present at any given time. Overall, clinical studies have been largely inconclusive, and proponents of neurofeedback therapy remain frustrated by a lack of orthodox support.

    Other forms of neurofeedback are delivered by MRI-generated data. Participants engaging in mental tasks are given signals based on their neural activity, which they use to try and “up-regulate” (activate) regions of the brain involved in positive emotions. This could, for instance, be useful for helping people with depression.

    Another potential method claimed to purportedly change brain states involves different sensory inputs. Binaural beats are perhaps the most popular example, wherein two different wavelengths of sound are played in each ear. But the evidence for such techniques is similarly mixed.

    Treatments such as neurofeedback therapy are often very costly, and their success likely relies as much on the therapeutic relationship than the actual therapy.

    On the bright side, there’s no evidence these treatment do any harm – other than potentially delaying treatments which have been proven to be beneficial.The Conversation

    Susan Hillier, Professor: Neuroscience and Rehabilitation, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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