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The holiday season often comes with clinking glasses and festive toasts. But if you’re living with Multiple Sclerosis (MS), the decision to sip or skip that holiday cocktail might feel a bit more complicated.

I’ll be the first to say, when I was newly diagnosed, I wasn’t thinking about alcohol. My focus went to food, stress, supplements, and exercise. Honestly, I didn’t want to stack one more restriction onto the MS pile, especially not something as social and celebratory as a glass of wine. But over the years, I’ve noticed how even small choices directly impact how I feel, and alcohol has become one of those choices I weigh carefully.

So, is it safe to enjoy alcohol with MS? Let’s break it down together.

The Research on Alcohol and MS Is Still Unclear

The truth is, there’s no clear answer. Research has been mixed at best. Some studies suggest that alcohol might suppress parts of the immune system or even offer neuroprotective benefits. Others report that alcohol can worsen MS symptoms, from fatigue to coordination to bladder urgency.

That said, one drink can feel very different when you live with MS. Let’s explore the pros and cons.

Potential Downsides of Alcohol for MS

• Worsened symptoms: Alcohol can amplify fatigue, worsen balance issues, and increase brain fog.
• Bladder irritation: Alcohol is a diuretic, which can increase urinary urgency.
• Mood swings: Alcohol can heighten depression or anxiety, both common in the MS community.
• Gut disruption: Alcohol can negatively affect gut health, which is closely tied to MS-related inflammation.
• Blood sugar spikes: Alcohol often comes with added sugar, which can increase inflammation.
• Sleep disturbance: While a drink may help you fall asleep, it can disrupt your ability to stay asleep.

In short, alcohol doesn’t contribute to your health. The more helpful question becomes, how can you reduce its impact if you choose to have a drink?

How to Drink Mindfully with MS

If you do decide to enjoy a drink this holiday season, here are a few ways to make it easier on your body:

• Pair alcohol with fat or protein: This helps balance blood sugar and slow absorption.
• Hydrate with lemon water before and after: Lemon water supports your liver and helps you stay hydrated.
• Choose non-grain-based alcohol: Wine, gluten-free beer, and spirits like vodka are better tolerated for some.
• Limit it to special occasions: One or two drinks at most, not daily.
• Eat clean at home: Balance occasional indulgence with nourishing meals between events.

Personally, I base my decisions on how I’m feeling. If fatigue is high, I skip it. If I feel good and want to be present with friends or family, I may choose a drink with a balanced meal and water in hand.

Alcohol and the Wahls Protocol

Dr. Terry Wahls offers alcohol guidelines based on her protocol levels:

• Level 1 and 2: Non-grain-based alcohol is allowed, but not daily. Women should stick to one drink, men to two, and only a few times per week.
• Level 3: Alcohol is discouraged, or should be reserved for special occasions only. If you do drink, choose low-carb options like dry wine or vodka.

The bottom line is that alcohol places added stress on your liver, which is already working hard to support your healing. It can also derail your progress if it becomes a regular habit.

The Role of Gut Health

One of the most significant factors for me has been gut health. Alcohol feeds bad bacteria and can create inflammation in both the gut and brain. Since MS is a neurological condition influenced by inflammation, I see alcohol as something to approach with extra caution.

Research from Harvard showed that individuals with MS have a different gut microbiome than the average person. Supporting your gut means protecting your brain. That’s enough for me to think twice about drinking.

What This Means for You

Living with MS is a daily balancing act. Every choice matters. You are not aiming for perfection, just making informed decisions that align with your values and your body’s needs. Alcohol may not be off-limits forever, but how and when you choose to have it makes all the difference.

If you want to enjoy something festive without the alcohol, I’ve got you covered. Visit alenebrennan.com/blog for a free holiday mocktail recipe that’s refreshing and supportive of your health goals.

Happy holidays to you and your family. Wishing you energy, clarity, and confidence in the choices you make this season.

Want More Encouragement Like This?
Tune into this week’s special episode of My MS Podcast: Alcohol + MS. Listen now to My MS Podcast