Alcohol + MS: To Sip or Skip this Holiday Season

December 6, 2023

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Alcohol + Multiple Sclerosis on the Wahls Protocol with Alene Brennan

Can alcohol trigger MS symptoms or even a flare? Is there a “safe” amount to drink? Is one alcohol better to have than another? These questions may be popping up this holiday season when you tend to be around alcohol more often. So, do you sip or skip a holiday beverage? Today, I’m sharing research, recommendations and even some personal stories, so you can make an informed decision that works for you this holiday season.

In the Dark About Alcohol + MS

I have to admit when I was first diagnosed with Multiple Sclerosis, it never really crossed my mind that alcohol could impact MS.

My attention immediately went to food, stress, supplements, and exercise. 

Maybe it’s because I didn’t want to create yet another restriction in my life because “I have MS.” 

And I’ll be honest I like the occasional glass of wine, margarita or even on a super rare occasion a lycheetini.

But the longer I live with MS and see firsthand all the ways my everyday choices have a direct impact on how I feel, alcohol loses its appeal.

But I still like to have the option to drink if I’m out for dinner or at a holiday party.

Comparing it to Alcohol + Migraines

It’s how I felt when I was figuring out alcohol and migraines

I shared before that I’ve gotten debilitating migraines since childhood so when i started to drink, I very quickly realized that it was a migraine trigger for me. 

That was a painful lesson to learn but let me tell you, it was also one of the fastest lessons I learned, because the connection was undeniable.

Just one or two drinks could trigger a debilitating migraine attack.

Even in college, I would limit my alcohol intake because I didn’t want to spend the entire week in a dark room – which let’s be honest, a college dorm room is the last place you want to be with a migraine, plus I didn’t want to be missing classes, falling behind in assignments, or in the hospital because that would happen too… again for just one or two drinks, it just wasn’t worth it to me.

But I eventually figured out that red wine and beer were hard no’s for me but white wine and some cocktails, I was good with… in moderation of course. 

So I wanted to know were some drinks better than others when it comes to MS?

The Stakes are Higher with Multiple Sclerosis

Especially because the stakes just feel higher with MS versus a migraine. 

I feel like Multiple Sclerosis is a beast that I don’t want to wake, and if alcohol has the potential to wake MS, I’m not interested… until the holiday party rolls around and I want to enjoy a glass of wine.

So, what’s the deal?

Does alcohol affect MS? Is it okay in moderation? Will it trigger a flare?

Well, here’s what I learned in my own research. As always, take what resonates, leave what doesn’t.

The Link Between Alcohol + Multiple Sclerosis

First, how exactly does alcohol affect MS?

Here’s a shocker… the relationship between alcohol and multiple sclerosis isn’t fully understood.

What is understood about Multiple Sclerosis?

I feel like living with Multiple Sclerosis can feel like one big mystery box – you never really know what’s inside until you open it.

Some research suggests that alcohol can temporarily worsen symptoms.

While other studies suggest alcohol can actually calm an overactive immune system, potentially easing certain aspects of MS.

Apparently out of 30 papers published between 1983 and 2016, results of alcohol and MS were either inconclusive or inconsistent.

Basically, some show positive associations. Others show negative associations.

Here’s a quick look into their pros and cons list.

Potential Negative Impacts of Alcohol + MS

Here are some potential concerns that alcohol can raise with MS.

Worsened MS symptoms

Research suggests that one drink could temporarily worsen symptoms, specifically coordination and balance issues.

That makes sense, because MS or not, alcohol can throw off your balance, so if that’s something that you’re already prone to, alcohol will likely heighten it.

When I think about alcohol, it’s something that makes you feel tired and not as mentally sharp, something that we’re already too familiar with – hello MS brain fog and fatigue – alcohol will only make them worse.

I mean fatigue is one of the most common and frustrating symptoms of MS, why take something that will make it worse?

So If I’m in a season where I’m experiencing more fatigue, alcohol loses its appeal because I just see it as something that will pull me down even further.

Choosing a Place of Empowerment

That said, I try to focus on the upside, like I’m choosing not to drink because I know that these decisions add up and they’re either keeping me fatigued or they’re helping me to get out of the fatigue.

Urinary Frequency + Urgency

The other thing is alcohol can also increase urinary urgency and frequency. This is another symptom I’m prone to and it’s annoying to constantly run off to the bathroom. I mean we’re already in the bathroom enough, we don’t need anything increasing those trips.

And if you’re combining symptoms like fatigue, balance, and urinary frequency together, that’s a recipe for disaster. You’re feeling like you have to make a mad dash to the bathroom you’re your balance is off. I’ll pass thanks.

Alcohol can also impact your mood. For some people, they get cheery, but for others, it can heighten feelings of depression – something that’s already all too common in the MS community.

Now the effects can be temporary until the alcohol wears off.

Alcohol, MS + Gut Health

But from a nutrition perspective I have to add in that alcohol can disrupt your gut microbiome which I’ll talk more about in a minute, but that’s not a temporary thing that is automatically corrected when the alcohol wears off.

Depending upon how much alcohol you’re having and how frequently you’re drinking, and when that adds up, the harder it is to correct.

Now, let’s look at some of the potential benefits… the PROS to drinking alcohol.

Potential Benefits to Alcohol + MS

Suppressed immune response

Well apparently, some research suggested that alcohol could potentially suppress the immune response and actually RELIEVE MS symptoms.

Talk about a nice alternative to DMTs – I’ll cheers to that!

I mean could you imagine if your medicine was a glass of wine every night?

But of course, there’s a catch.

There’s always a catch with something that good!

They discovered that while regular alcohol intake suppressed one aspect of immunity, it increased another aspect.

So, this isn’t exactly a sound recommendation I’m betting on to manage my diagnosis.  


The next theory was that alcohol could offer some neuroprotection.

When I first read this, I was like, really?? Because I always thought that alcohol kills brain cells, that’s not quite my definition of neuroprotection.

Nonetheless, researchers looked into red wine for potential neuroprotective effects.

Apparently, they found that people who consumed three glasses of red wine per week appeared to have lower levels of neurologic disability than those who consumed no alcohol.

However,… again here’s the catch!… MRI scans also showed that those who drank red wine also had a higher volume of high-intensity lesions than those who did not drink red wine.

The Conclusion…

So, the more I read, the more I realized that they have absolutely no idea if and how much alcohol impacts MS.

From a Nutrition Perspective

Here’s my take, for what it’s worth, as a nutrition coach living with MS who enjoys an occasional drink.

Here’s the reality that we all know – alcohol isn’t contributing to our health in any way. 

The question is how can we minimize the negative impacts?

When I think of the negative impacts I think of the sugar throwing blood sugar levels out of balance which creates inflammation. 

I also think of the hit that my liver takes because it’s our biggest detoxification organ. So it already carries a heavy load, and alcohol is only taxing it more. 

I also think of the impact on my gut. We work so hard to optimize our gut health because we know that it is very closely connected to the health of our overall body and specifically brain health. 

Well alcohol isn’t doing our gut any favors. It can encourage the bad bacteria to grow which has a domino effect on the rest of our health. 

So how do I address these?

Unbalanced Blood Sugar Levels

First when it comes to blood sugar levels I try not to eat something with protein or fat when I’m having a drink. This not only helps to support balanced blood sugar levels but it also can help to slow down the absorption of alcohol. 

So if you’re having a drink, it’s ideal to have something to eat with it, specifically fat or protein. 

And please keep in mind that these are my general thoughts, these are not personalized recommendations, so you need to filter this information through your own health needs. 

Taxing Your Liver

Regarding the impact on your liver, I might drink a little more lemon water the day before and after I’m having a drink because the lemon not only helps to better hydrate our cells, but it also can support the body’s natural detoxification process. So there’s your inspiration to drink some lemon water this holiday season. 

Disrupting Gut Health

And regarding the gut microbiome, I guess two things come to mind, I’m going to try not to add insult on top of injury by having alcohol and a dessert – even if it’s allergy friendly – but never say never because i did have a slice of allergy friendly pumpkin pie and thanksgiving when i had wine. 

So I’m not suggesting that I do everything perfectly, but these are things that I try to keep in mind but not be super rigid about. 

The other thing I try to be mindful of from a gut health perspective is eating really well when i’m at home during the holidays. 

My Personal Alcohol Habits

I’d rather eat really well at home to give myself some leeway to have a glass of wine at a holiday party. 

Personally, I really don’t every go beyond two glasses and that’s more from a migraine and fatigue perspective. 

I know that I’ll wake up the next morning feeling crummy and I’ll be annoyed that I’m losing a perfectly good day because of something I drank last night. 

I also try to keep it in the context of how I’m feeling overall.

It often feels like I’m putting a new puzzle together every day when it comes to choosing my food and beverages.

My Personal Nutrition Framework

I have a general framework – I don’t compromise on gluten, dairy, soy, nuts or eggs – but the rest of my decisions like alcohol or even a dessert are based on how I’ve been feeling and how much stress I’m currently under.

If I’m experiencing a bout of fatigue, I’m keeping things as clean as possible.

I’ll pass on the cocktail or get one drink and just nurse it the whole night.

Wahls Protocol + Alcohol

Now let’s take a look at what the Wahls Protocol Says about alcohol.

The recommendations depend upon which level you’re following.

Wahls Protocol: Level 1

You can have non-grain-based alcohol (like wine, preferably organic wine, or gluten free beer), up to one serving per day.

Wahls Protocol: Level 2

Again, the non-grain-based spirits such as run, wine and gluten free beer are allowed, but Dr. Wahls recommends not to consume alcohol daily.

She says women should have no more than one small glass of wine or beer or one shot of spirits no more than a few times a week.

Men should have no more than two small glasses.

Wahls Protocol: Level 3

Dr. Wahls says, “I prefer that you completely eliminate alcohol at this stage, or at least reserve it for very special occasions only. 

If you do have a drink, choose a low-carb drink like vodka or very dry wine.

The main reason to minimize alcohol is that your body will metabolize the calories in the alcohol first, before any other energy sources, including fat.

As I mentioned earlier, your liver has to work hard to process alcohol, and you don’t want to tax your liver needlessly when you are trying to heal.”

Alcohol + Sleep 

And I can’t leave this other aspect out because it’s a problem that I hear from so many of you about… sleep

You may be tempted to have a drink to unwind at the end of the day – especially during the busy holiday season – but alcohol can interfere with your sleep. 

It can increase your chances of waking in the middle of the night and having trouble falling back asleep.

What’s Your Take?

Does alcohol affect you and your experience living with Multiple Sclerosis? Share in the comments below so that we can learn from you too!

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I'm Alene, your MS Sister.

When I was diagnosed with MS in 2016, I was scared and felt alone. But as a Nutrition Coach, I knew there was more to healing than what I was being told. I took action and within six months the lesions I had on my brain shrunk and went inactive. Now, seven years later there has been no new lesions and no new activity. As a nutritionist specializing in multiple sclerosis, I help women take back control of their future.

That’s my story, but I’m not alone. It's your turn to start Thriving with MS. I’m here to show you the way. 

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