Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system where the body’s immune system mistakenly attacks the myelin sheath, which is the protective covering of nerve fibres.
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The earliest signs of the serious disorder presents itself as lifestyle issues such as overwork, poor sleep, or stress, which is often sidelined without being paid much attention, Dr Atampreet Singh, senior director and head of neurosciences at ShardaCare-Healthcity, told HT Lifestyle.
He went in to share what early MS can actually look like for many patients, what can increase the risk, and how a healthy lifestyle helps after diagnosis.
Early signs of multiple sclerosis
While the classic textbook presentations of MS include sudden vision loss in one eye and a limb going numb or weak, there are also subtle signs such as MS-related fatigue, brain fog, and weakness, noted Dr Singh.
“MS-related fatigue is qualitatively different from ordinary tiredness. It tends to arrive without clear cause, worsens significantly with heat and does not improve proportionally with sleep,” he stated.
“Cognitive symptoms, often called ‘brain fog’, can manifest as difficulty retrieving words, trouble concentrating on a single task, or a sense that mental processing has simply slowed. Weakness may appear only on one side of the body, or be noticed as clumsiness that seems out of proportion to fatigue,” continued the neurologist.
“Tingling, a sensation of tight banding around the torso, or brief electrical sensations that shoot down the spine when bending the neck are all early features that deserve neurological attention rather than reassurance.”
According to Dr Singh, the following symptoms, particularly if they occur in someone between the ages of 20 and 50, warrant prompt neurological evaluation:
- An episode of vision loss or double vision lasting more than 24 hours
- Numbness or tingling affecting one limb or one side of the body
- A sudden or progressive weakness in the legs, or difficulty walking
- Symptoms that worsen in heat and resolve with cooling
- Electrical sensations down the spine when the head is flexed forward
- Persistent, unexplained fatigue combined with any of the above
What increases the risk of MS
MS is an autoimmune disease with a complex interplay of genetic susceptibility and environmental triggers, with a number of lifestyle factors significantly increasing the risk. According to Dr Singh, some of them are as follows.
Smoking: Smoking approximately doubles the risk of developing MS and, critically, accelerates the conversion from a relapsing-remitting course to secondary progressive MS by up to five years. The biological mechanism involves both direct inflammatory effects on the central nervous system and vitamin D metabolism disruption. Stopping smoking after diagnosis is one of the highest-impact decisions a patient can make.
Vitamin D deficiency: Low vitamin D levels are among the most replicated risk factors for MS. People born or raised at higher latitudes, where sun exposure is limited, have substantially higher MS rates.
Obesity in adolescence: Being overweight during the teenage years – a period of significant immune system development – has been linked to a nearly twofold increased risk of MS in adulthood. Adipose tissue promotes a pro-inflammatory state that may prime susceptible individuals for autoimmune disease.
How lifestyle helps control MS
“For people living with MS, lifestyle choices exert meaningful effects on relapse frequency, symptom burden, and long-term disability accumulation,” noted Dr Singh. He highlighted the following as part of a healthy lifestyle.
Exercise: Historically, patients were cautioned to avoid physical exertion for fear of triggering relapses, but modern evidence suggests the opposite. Regular aerobic exercise improves fatigue, reduces depression, supports cognitive function, and may have neuroprotective effects through the release of brain-derived neurotrophic factors. Even modest activity, such as thirty minutes of swimming or cycling three to four times a week, produces measurable benefits.
Diet: While no single dietary pattern has been proven to modify the disease course definitively, anti-inflammatory diets – rich in omega-3 fatty acids, fibre, and plant-based foods, and low in processed foods and saturated fats – are consistently associated with better patient-reported outcomes.
Sleep: A particularly underappreciated variable, MS itself disrupts sleep through pain, spasticity, bladder urgency, and mood disturbance. But poor sleep in turn worsens fatigue, cognitive symptoms, and emotional resilience. Treating sleep disorders often produces disproportionate improvements in daytime function.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
