new findings

What we know is never concrete and whole.

Nothing makes that more apparent than the recent discovery that our brain has lymphatic vessels that were previously undetected. Thousands of specialists may now have to rethink their understanding of the brain. For those unsure, one of the lymphatic system's functions is defence against foreign particles, microorganisms, and diseases via the immune system. One big filtration system. So, if that filtration system has some weird issue in a vital organ such as, let's just say, the BRAIN - bad things can happen.

It's a pretty big "wow!" moment and turns our understanding of the brain on its [apologies] head. The brain has a drainage system that no one knew about? Seriously? No one knew the tub had an open plug? All along, we thought that the blood brain barrier, something akin to a conniving barbapapa, from what I can tell, was the only entrance to the brain's home.

Another function of the lymphatic system is that of absorbing fat soluble vitamins, like vitamin D and transporting those substances to venous circulation. Still with me? Could drainage be the problem after all? Does this somehow explain why people with MS respond so well to vitamin D? Does this explain why or how CCSVI works for some? (the lymphatic system would eventually drain into the jugular)

What is happening?! How can all of this be? It's exciting and confusing at once!

Sure, anatomy textbooks have needed updates before (Belgium found a new knee ligament just a few years ago), but this feels like a potentially huge leap forward for research. If there are lymphatic vessels in the brain, the blood brain barrier has a backdoor and we may be able to start understanding why - yes, why - some MS drugs actually work. Or, maybe, maaaaybe even start  getting a better handle on causation. Dare I even conjure a whammy on that one?

Imagine if neurologists, immunologists, radiologists, and pharmaceutical companies all got on the same page! Don't roll your eyes at me; it could happen, right?

This finding may have a more immediate impact on people with Alzheimer's than it will for MS, but it is a very compelling piece of science either way. People with Alzheimer's are shown to have huge chunks of protein in the brain for no known reason. Now the number one suspect is a relatively straightforward drainage problem. So far, these lymph vessels have been found in mouse model studies and confirmed in human autopsy.

So, now we wait to see what comes of this.

Because something will. 

To paraphrase Buddhist canon, "three things cannot be long hidden: the sun, the moon, and the truth".

xo

where's my tauntaun?

It's a bit of a strange time. Our wedding is months away, but people want to talk about it a lot. I'm a little averse to that since it's generally meant to be one big party and I'd rather not put too much pressure on the day to be ideal. It's a semi-fancy party in the woods and I'm trying to keep framing it that way. No wonder people get so stressed out about wedding planning.

It has also been a time of remembrance for me. A childhood friend of mine passed away far too young and I've been thinking of her a lot. Remembering youthful shenanigans. I'm not one to share this sort of thing but it feels wrong to do an update without acknowledging her passing. xo

On to more mundane news…

It has been a long, cold winter. While the rest of the province is hiding somewhere beneath mounds of snow, we're able to see over the banks in all directions, but are freezing our rumps off. December was the coldest winter on record here in decades. We're at the point where an unexpected 0 degree day felt glorious. I didn't even wear a coat. 

Sadly, the extreme cold means there's little opportunity for socializing. Yes, I said sadly. And yes, I am still very introverted. I love my partner with all of my heart and can't imagine living here without her, but boy, we need outlets. f'realz. We're great together, but we're just not people who can have supper and then watch TV until bedtime every evening. We've dusted off the crib board, started a ginormous puzzle, I've even taken up crocheting. We're just…bored. When it's reasonably warm (read: not -30s) we can snowshoe, thankfully. Going to the gym work days at lunch is also helping burn off some energy, but I find myself searching for signs of Spring at every turn. Oh, to be able to comfortably walk the dog! Listen to me - I'm hoping for the days of muddy dog belly!

Abbey seems content with the cold and snow.

That cold is particularly uncomfortable, as is any extreme heat, because I have A) Raynaud's and B) dysautonomia - an MS accompaniment that is behind my inability to thermoregulate. There's pretty interesting research coming out about treating dysautonomia - a condition that is also seen in Parkinsonian disorders. It's basically an electrical stimulation of nerve fibres administered to potentially regain balance in the hypothalamus, the portion of the brain responsible for thermoregulation.

In other research news, dextromethorphan, a drug found in cough medicines is showing to protect loss of myelin in animal models. I'm not one for animal model reports as they rarely make it to phase I human trials, but this one is pretty intriguing as it could means a low cost drug alternative for those without the means to purchase other, exorbitantly-priced MS medications.

And one more from the research mines - also animal model stage - cinnamon is showing to suppress clinical symptoms of what is the mouse equivalent of MS. Kinda neat - bring on the spice!

That's all for now. I'm off to shovel, check the fire, and crochet yet another something.

highlights

MS awareness month is right around the corner again and in light of that, I thought I'd point to some of the latest research that's bubbling around MS circles.

A foodbourne toxin may trigger MS 

Data presented at a meeting of the American Society for Microbiology adds to growing evidence that suggests a toxin produced by the bacterium Clostridium perfringens [seriously, say that 3 times, I had to look it up twice just to spell it] —  commonly found on raw meat and poultry — appears to attack the same cells that are targeted in MS. It's an interesting link that is inspiring further research. The trigger is still unknown and the theories include everything from environmental metal (from dentistry metals to mercury in fish) to high salt diets or Epstein-Barr virus.

Vitamin D can slow the progression of MS

As mentioned here, researchers at Harvard found that having high vitamin D serum levels at early stages of MS tended to reduce disease activity and progression. 

Stem cell research  is sowing seeds for hope

The idea of blasting my current immune system before introducing stem cells isn't all that appealing to me (yet?) but it's one of the few treatments shown to help those with more aggressive forms of MS than I have. Nerventra, coming from Teva, is also showing some promise.


…and back on the farm, my folks stayed for a lovely 10 days and are now visiting with my aunt before heading home. It's amazing how much of a challenge it is to stick to my regular rest/exercise/nutrition routines when we have company, but I did okay. Maybe a few more hops than usual. I can usually manage to control any food temptation but it's hard to resist the siren song of a cold beer. 

As I mentioned above, May is MS awareness month, and I've started a small campaign for MS Walk pledges. I'm at my initial goal already, which is amazing and reinforces the support I already feel from family and friends. I am fortunate enough to be able to do this walk every year and may try to drag some friends along again this time. I realize some are hesitant to donate to larger organizations and I know a lot of funding goes astray to pay employees and fund marketing, but in the end, the MS Society does good work and is there when we need it. Thank you to those who have donated so far or have dropped me a personal note of support. Here's hoping the universe is listening and all that karma comes back your way.
xo

the science of food and supplements - whoo!

Soooo, coming up to a month off of Avonex and all is well so far. I'm still planning on going through the province, but that takes time and some paperwork that I don't have yet. 

In light of not being on a disease-modifying therapy at the moment (thanks to Blue Cross) and relying on diet, exercise, and rest, I want to talk a little about supplements and specific dietary choices I make to support them. I mention a few in this post from last year, but thought I'd elaborate since "what do you supplement?" is a big question in MS circles. So, likely a boring post for everyone else. Sorry 'bout that!

Let me start by saying there are, give or take, 96,560.6 kilometres of blood vessels in the average adult human body. The endothelium is the gatekeeper - the protector of those thousands of kilometres of blood vessels, and it is highly active in regulating the body's inflammatory processes. Endothelial dysfunction has been linked to a wide variety of diseases. MS is one of those diseases. So, I primarily supplement to reduce inflammation and protect my endothelium. 

I've mentioned before that I'm a vegetarian. I'm lacto/ovo which means I consume some dairy products (primarily cheeses that don't use animal rennet) and eggs. Aside from the fabulous dishes we consume at home, these are choices I make to support regular meals:

B12 supplement
Why? I don't eat red meat, which is the highest source of B12, and this vitamin plays a key role in the normal functioning of the nervous system. Specifically important to someone with MS, a disease that attacks the nervous system. It's found in Swiss cheese, eggs, and some fortified soy products too.

Vitamin D supplements 
Why not just tan? Take a look at this post and you'll get an inkling of the importance of vitamin D for someone with MS. There is a lot of research into the link between vitamin D and MS and it all points to increased intake being a positive thing. I take 5000 IU a day. I also spend a lot of time outdoors, but living in Atlantic Canada means we spend 5 months a year without strong levels of the UVB needed to synthesize vitamin D from sunlight. Vitamin D also helps absorb calcium. Which leads me to...

Calcium
No brainer. Aside from the well-known roles calcium plays in tooth and bone health, it also plays a significant role in muscle contraction. Spasms can be a painful symptom of MS for many and I'd like to stave that off for as long as possible. Spasticity in MS comes from an imbalance in the electrical signals coming from the brain and spinal cord, often caused by myelin damage. While I can't predict which areas of my brain and spinal cord will demyelinate, I can prepare my body to fight it as much as possible. So, I take a small calcium supplement - beans, leafy greens, and tofu take care of the rest.

Supporting food
Seeds/nuts and leafy greens for the magnesium intake. Vitamin D is somewhat inefficient without magnesium to help process it. 

Next up is Turmeric/Bromelain
What the heck are those, you ask (who am I kidding - who even reads this far?)? Both support liver function. Bromelain is a powerful anti-inflammatory found naturally in pineapple and can help fight osteoarthritis. There are strong links between MS and osteoarthritis - both being diseases of inflammation and while I don't want to get too deeply into that here, let's just say that I do not want another incurable degenerative disease on my plate. 

The curcumin in turmeric modulates the body's inflammatory response by down-regulating the activity of enzymes involved in inflammation mechanisms. I've stared at that sentence trying to simplify it further, but no can do.
More info here.

Milk thistle
Whut? Milk thistle is a spiky little flowering thistle whose active ingredient, silymarin, modulates oxidative stress and prevents cell death in the liver. While the research into silymarin has mixed results, many studies show liver protectant qualities.
More info here.

Green tea
Yep, plain old green tea. The active ingredient, EGCG, is an Nrf2 activator. Basically, Nrf2 is a powerful protein that is latent within our cells and it can't move or  get to work until released by an Nrf2 activator like EGCG. When it's released it can migrate and bond to DNA located at the regulation mechanism for the antioxidant system that is available in all cells. This process allows for production of important antioxidants, lowering overall oxidative stress. I drink green tea all day long. If you didn't follow that, I'm sorry. Drink green tea. It's tasty.
More info here.

Dietary choices
Fruits and veg. We aim to get 7 servings of fruit or vegetables a day. It's not hard when you consider that 1/2 cup of tomato sauce or salsa is a serving. Half a cup of any fruit. Half an avocado. This is great reading on the importance of this step. Yay for lowering risk of death! Not risk of abc disease or disorder xyz, but actual death. Full stop. Seriously, how can anyone argue against these kinds of findings?

So that's about it. That's how I protect my protector. It's not a big deal to stay on top of, and the research is out there for each and every supplement, so...why not, right?

In other news, mom and Lindy arrive in two days. I'm superduper excited to see them - I think this city will feel like a real vacation for them - there's not a lick of snow left on my property now. They're still buried in Newfoundland. 

PS. Doggins is doin' great. Small gait issue with the rear right, but that may always exist after the cruciate and then the meniscus damage. She's happy as a clam, though. As are we all.
xo

PPS. Signed up for the MS WALK in Saint John this year. Looking forward to it! 

The important thing is not to stop questioning. Curiosity has its own reason for existing.

- Albert Einstein

Big numbers

This is a research post, but bear with me, it is really interesting and promising. 

The Harvard School of Public Health has put out a new study that followed people with MS for 5 years. Stay with me, it'll get interesting, I swear. It found that people with increases of a certain amount of average serum vitamin D levels (50 nmol/L, to be exact) within the first 12 months after diagnosis showed the following benefits:

• ·      57% lower risk of relapse
• ·      57% lower risk of new active brain lesions
• ·      25% lower yearly increase in T2 lesion volume, and
• ·      0.41% lower yearly loss in brain volume from months 12 to 60

Those numbers are amazing. 57% lower risk of relapse is significantly higher than even the disease-modifying drugs are noted at.

The study had 465 participants and started off on a completely different foot – measuring beta interferon efficacy. But, with a great bit of luck (or planning, I’m unsure which) all participants had at least one measurement of their serum vitamin D levels during the first year of study. The team then followed participants through a combination of MRI scans and neurologic examinations for 5 years in total.

What’s really key here is that the researchers were not supplementing vitamin D, they were only measuring it as part of the pool of blood samples they were collecting to track the efficacy of the drug…nothing at all to do with the vitamin D side of things.

So, why is this relevant? Because it gives yet more evidence that vitamin D levels are somehow important in disease progression. The higher the serum vitamin D blood levels are, the less disease progression and brain atrophy and fewer active lesions and relapses. Low serum vitamin D levels early in the disease course are a risk factor for long-term MS activity and progression in pretty significant terms.

I supplement vitamin D and have for years now with my neurologist’s blessing. I live in a high latitude, and when it’s not summer, it’s winter. It's hard to get appropriate exposure to UV through those wintery months even if I'm outside every day. I don't high dose, even though toxicity is rare. I take just enough to keep my levels up.

Bonus: the supplementation also keeps my mood up. Vitamin D deficiency is also linked to depression and mood disorders.

Will link when I can find the actual study and not the millions variations of the same media release.