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What Is the Prodromal State of MS and Why It Still Matters After Diagnosis (S1E19)

November 6, 2023

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A timeline or progression graphic showing subtle early symptoms leading to a diagnosis, illustrating the "prodromal state" of Multiple Sclerosis before official recognition

What Is the Prodromal State of MS?

Have you ever looked back at your pre-diagnosis symptoms and thought, I knew something was off? Maybe you dealt with brain fog, chronic fatigue, digestive issues, or unexplained pain. You went to the doctor, explained it all, and were told it was just stress or lack of sleep. You were dismissed.

What you experienced may have been the prodromal state of MS. This refers to the early or preclinical stage of disease, where symptoms are real but don’t yet meet the criteria for diagnosis. Research suggests this stage can last 2 to 15 years before a full-blown autoimmune diagnosis like MS, lupus, RA, or celiac disease.

During this time, the disease is brewing under the surface. Fatigue, numbness, tingling, and cognitive issues may appear, but test results are often inconclusive.

Why It Matters Even After Diagnosis

You might be thinking, that sounds like my story, but I already have MS. Why does this matter now?

It matters for two big reasons.

1. It Validates What You Felt

You were not imagining things. You were not being dramatic. You were not just stressed. Your body was trying to tell you something, and you were right to listen.

Many people are told they are hypochondriacs before they ever get an MS diagnosis. In fact, 25 percent of people with autoimmune disease were initially labeled as one. That’s a huge number. If that was your experience, let this serve as a powerful reminder to trust your gut. You know your body better than anyone else.

2. You Still Have Influence Over Your Health

Just because you now have a diagnosis does not mean the prodromal state no longer matters. In fact, it may still apply. Once you are diagnosed with one autoimmune disease, you are more likely to develop another. That is why it is important to stay proactive, not just reactive.

This is where diet and lifestyle can make a meaningful difference. Dr. Terry Wahls suggests that in the early stages, lifestyle changes can sometimes normalize cellular function, reverse damage, and prevent disease from fully developing. And even after diagnosis, those same changes can help slow progression or improve symptoms.

The Missed Opportunity in Conventional Medicine

Western medicine typically does not treat a disease until a diagnosis is confirmed. Understandably, this avoids unnecessary treatments. But it also means we miss valuable time where gentle intervention could have helped.

Other approaches, like Ayurvedic medicine, begin treatment at the first sign of imbalance. They use food, herbs, and simple lifestyle changes to help the body restore itself before a major illness sets in. That early action is something we can all learn from, especially when managing chronic conditions.

You Don’t Need a Diagnosis to Start Healing

One of the biggest takeaways from understanding the prodromal state is this: you do not need to wait for a diagnosis to start making healthy changes. Even now, small steps matter. Whether that’s drinking more water, eating more vegetables, or cutting back on processed food, every choice builds toward better health.

And if you already have MS, ask yourself this:

  • What if changing your diet improved your fatigue?
  • What if stress management helped you sleep better and heal more fully?
  • What if adding movement each day helped improve your balance and mood?

These are realistic possibilities. Not guarantees, but real potential outcomes worth working for.

Don’t Wait for a Symptom to Get Worse

Autoimmune activity doesn’t pause just because we feel okay. Our environment, diet, stress, and lifestyle are constantly influencing our immune system. That’s why consistent care is essential.

You don’t need to overhaul your life overnight. You can start small.

  • Swap soda for water
  • Add a serving of vegetables to your plate
  • Take a short walk outside
  • Go to bed 30 minutes earlier

These changes might seem simple, but they are powerful when done consistently.

The Power Is Not Just in Your Doctor’s Hands

Conventional medicine plays an essential role in MS care, but so do you. Your voice, your actions, and your daily habits have power. Even now, with a diagnosis, your choices matter.

The Law of Diminishing Intent reminds us that the longer you wait to do something, the less likely you are to ever do it. So if you’ve decided to take care of your health, let this be the moment you start doing it.

As the riddle says:
Five frogs are sitting on a log.
Four decide to jump off.
How many are left?
Still five. Because deciding is not the same as doing.

Keep Building Health Every Day

Healing is a gradual process, just like the disease was. Even if you don’t see instant results, your actions are still changing your body day by day. Every healthy meal, every good night’s sleep, every stress reduction technique is part of the healing process.

Be patient. Stay consistent. And know that progress is still happening even when it’s invisible.

Final Thoughts

Understanding the prodromal state reminds us that MS doesn’t appear overnight. It is a gradual process that gives us chances to intervene, to shift, to heal. That truth can empower us to take action today and every day forward.

Want More Encouragement Like This?
Tune into this week’s special episode of My MS Podcast: 🎧 S1E19: The Prodromal State of MS.
Listen now to My MS Podcast

Did you know that 25% of people living with an autoimmune disease were initially labeled as a hypochondriac? 25%. You knew something was off in your body, but you didn't know what. You went to countless doctor's appointments trying to explain the symptoms, the pain, fatigue, brain fog, digestive issues, headaches, but they were all vague symptoms and therefore didn't have a clear answer to explain why you were experiencing them. So you were dismissed. Your doctor suggested that they were just symptoms of stress or lack of sleep.

backslash coach. Now onto today's episode. There are 1 million people diagnosed with multiple sclerosis in the US. So that makes you one in a million. And you have a special purpose in this world that no diagnosis can take away from you. So if you are ready to reclaim your body, mind and life from multiple sclerosis, welcome to my MS podcast. I'm your host, Alene Brennan. Did you know that there was a name for the stage before you're diagnosed? That time when you're dealing with all of those seemingly random symptoms, but fail to be heard by your doctor. It's called the prodromal state, and it refers to the early or preclinical stage of a disease. It's a period of time when you may experience vague symptoms, but not yet diagnosed.

And here's the kicker. The prodromal state can last for two to 15 years prior to a full-blown autoimmune diagnosis of MS, RA, lupus, psoriasis, celiac, so many more. During the prodromal state of MS, you may experience symptoms such as fatigue, numbness or tingling, or cognitive issues. But these symptoms may not be severe or consistent enough to meet the criteria for a definitive MS diagnosis. So the diagnosis is brewing, but not yet recognized on test. And when it comes to Western medicine, we don't treat until there's a diagnosis. Which I guess is understandable in some aspects, but here's why I think it's rather frustrating. The prodromal state is often considered a window of opportunity for early intervention and treatment to potentially delay or even prevent the onset of full-blown multiple sclerosis.

What a valuable window of time. It holds so much power and potential, but instead of leveraging it, you're led to feel like you're the crazy one. That your symptoms are all in your head, but clearly it's not. The symptoms are real and they shouldn't be ignored. I had the opportunity to study Ayurvedic medicine during my yoga teacher training. It's a style of medicine that's practiced in India, but it's spread at this point around the world. Well, they look at health from almost the complete opposite perspective. They don't wait to treat a disease. Their main focus is not just keeping you disease-free, but ensuring that you have vibrant energy and vibrant health. And the first sign of that diminishing, they treat. And they treat first through food, herbs, and lifestyle habits. They use the things that are familiar to your body, and they use them early when the body is most likely to be receptive to them. The body doesn't need such a heavy lift because they're starting early. Dr. Terry Wall suggests that this pre-disease state, the prodromal state, is precisely when diet and lifestyle changes, here's what she says, can often normalize cellular function, reverse the damage, and lead to disappearance of autoantibodies and resolution of symptoms. So disease diagnosis never happens. Take that in for a minute.

That is incredible. But it can also feel like it's coming a day late and a dollar short if you're already diagnosed with multiple sclerosis, right? I'm in that camp. So how is this relevant to you? It's relevant for two reasons. First and foremost, it validates the fact that you knew something was off in your body and you were right. This prodromal state shows signs that something is out of balance in your body. You felt that, you knew it, but it wasn't enough to be clinically significant to warrant a diagnosis.

It then and you know it now, and you were right. The more you can build this relationship and trust with your body, the more likely you are to hear it when it whispers. Not when it's starting to scream with a megaphone. Your body communicates with you every single day. But we live in a world with so many distractions, it's easy to not hear it. And quite honestly, when we do hear it and try to convey that to our doctors, if we're dismissed, it can start to plant a seed of doubt, if you're hearing it right. But my friends, we need to reestablish that trust in the messages that our body is sending us; You may say, great, thanks, Allie. I like the idea of trusting my body when I know something is off.

But thinking back to that time pre-diagnosis, what could I have done differently? I went to the doctor. I explained the symptoms. I got dismissed. Maybe you even got a second or a third opinion and were still brushed off. Well, patient advocacy is certainly something that I speak a lot about and something I am extremely passionate about and focus a lot on that in my coaching programs. I teach clients how to best prepare for appointments so that they can establish a collaborative relationship with their healthcare providers. It shouldn't be us against our doctor. This should be a collaborative relationship. It can take some time and intentionality, but it's possible and it's definitely worth it. My point here is: speak up until you get the answers that you need.

But in the meantime, don't sit around and wait, giving away your power and your health to your doctor. You still have the ability to influence your health with diet and lifestyle. Don’t tell yourself the lie that only your doctor can quote unquote fix your health problems. You don’t need a diagnosis to start improving your diet and lifestyle. Any doctor will tell you that a healthy diet and lifestyle are beneficial to your overall health. It may not be a cure, but as Dr. Walls suggests, it’s not completely out of the question for it to stop something in its tracks or at least delay the progression of it. Isn’t that worth it? But again, going back to your question, how is this relevant to me now, given that I already have a diagnosis?

Well, did you know that having an autoimmune disease makes you more likely to get another autoimmune disease? Apparently once your body learns how to attack itself, it can't unlearn that. That's pretty wild and kind of disturbing. So what if you're in the prodromal state now of a different autoimmune disease? My friends, we always need to stand guard when it comes to our health. We have a tax on our health every single day. The toxins in the air that we breathe, the toxins in the food that we eat, the toxins in the water that we drink, the chronic stress that we experience every single day, the lack of sleep we get, the sedentary lifestyles, the lack of sun exposure, the list goes on. You can't just sit back and believe that your body doesn't need your help.

It needs your help, and it needs your help now. Because whether it's trying to fight something off or delay the onset of something, or just simply trying to stand guard against all of these assaults, so to speak, that it experiences throughout the day. We need to make sure that we are nourishing our bodies with the food that it needs to heal. And here's the thing, it can start with one serving of vegetables. Virtually every diet out there emphasizes eating more vegetables and less processed foods. So start there. It doesn't need to be complicated. Keep it simple. Swap one of your glasses of soda out for a glass of water. Pick something and start there. You don't need to do a complete overhaul.

If you don't have a diagnosis, what if it delayed the onset of one? And regardless of whether you have a diagnosis or not, what if diet and lifestyle helped you to avoid something coming at you that you otherwise would have been impacted by? But because you started eating healthy and improving your lifestyle, you were able to avoid it. We will never know how big or small those things are that we avoid, but what a blessing it is to think about that. Those possibilities are there, but the longer you wait, the further you push those possibilities away from you. And the longer you wait, the less likely you are to ever make changes. That's the law of diminishing intent.

It says that the longer you wait to do something you should do now, the greater the odds are that you will never actually do it. Here's a little riddle that describes it so well: Five frogs were sitting on a log. Four decided to jump. How many frogs are left? One, right? Nope. Five. Why? Because there's a difference between deciding and doing. Have you ever decided that you were going to change your diet but haven't started doing it yet? This is why understanding the prodromal state is relevant to you today, even after a diagnosis. We never know what is brewing inside our bodies. Personally, it lights a fire in me to be as proactive as I can with a healthy diet and lifestyle. Am I perfect? Absolutely not. I'm far from it.

And I am continually reminding myself that perfection is a myth. So stop chasing it. Instead, allow yourself to do your very best each and every day and just try to get one step closer towards your goal today. Try to do one step better today than you did yesterday. This gradual progress builds, momentum starts to pick up, and eventually you start to see the results come through. Because the reality is your body is changing every single day. The question is, are you helping it move closer to health or disease? It's a pretty strong question, I'll admit it, and it's not my personality to ask such direct questions, but I'm willing to ask it in hopes that it can help inspire you to start taking action today. There are no guarantees in life, especially when it comes to our health. But personally, I want to know that I did my best to at least stack the odds in my favor. And I wish that for you too. Well, my friend, we've reached the end of this episode. Pick one lesson from today's discussion and put it into action now. It's time to reclaim your body, mind, and life from multiple sclerosis. And for more resources, events, and programs, head over to AleneBrennan. com. See you on the next episode of my MS podcast.

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I'm Alene, your MS Sister.

In 2016, I heard the words “You have MS.”
I thought my life was over.

Like many women, I read the books, joined the Facebook groups, and searched online, only to end up more confused and burned out.

Everything changed when I stopped chasing perfection and focused on small, sustainable habits.

Within six months, the lesions on my brain shrunk and went inactive. Nearly a decade later, I’ve had no new activity and I’m living fully as a wife, mom, and business owner.

Those simple habits gave me back my energy, confidence, and life. Now, I help other women with MS do the same.

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I’m Alene, your MS Sister, a nutritionist specializing in Multiple Sclerosis and proof that you can change your future with MS. My framework slowed my own progression, and I’ll show you how too.

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