When did you get multiple sclerosis? I'm not asking when you were diagnosed. I'm asking when your immune system started to attack your brain. It's so common to say, I was diagnosed on this day, but I had symptoms long before then. So who knows when MS really started? Well, according to a recent study, it may have been even earlier than those first symptoms. Research suggests that your brain shrinks five years before the first symptoms appear. And for many of us, we don't get an official diagnosis until years after the symptoms even start.

If you want a more personalized approach to creating your MS diet and lifestyle, check out my private coaching program. It includes a comprehensive assessment, personalized strategies, and lifestyle support. Each month, I only accept three new clients. So if you're interested, apply now at Alenebrennan. com/ coach. Now onto today's episode. There are 1 million people diagnosed with multiple sclerosis in the US.

Hearing that our brain starts shrinking up to five years before first symptoms appear is alarming and discouraging. It's like discovering you had a balance on your Nobody wants to hear that their brain is shrinking. And what does that even mean? How does it affect you? Well, it's common with multiple sclerosis. Lucky us, right? Prior to my MS diagnosis, I never thought about my brain shrinking. But when I started hearing about it, my first question was, why does the brain shrink, especially for those of us with MS? So that's where I'm starting with us today.

It turns out there are several reasons why our brain may shrink with multiple sclerosis. Neurodegeneration being one of them. MS is considered both an inflammatory and a neurodegenerative disease. Neurodegeneration is basically the process of loss of nerve cells and their connections. So over time, the cumulative loss of neurons and axons can cause the brain to shrink or atrophy. Another reason the brain may shrink with MS is repeated cycles of demyelination, the loss of myelin, and remyelination, the recovery of myelin. It can disrupt the normal structure and function of the brain. This ongoing process can contribute to tissue damage and atrophy. And then, of course, there's just good old aging that can affect our brain. Now, normal aging is associated with some degree of atrophy. So add MS into the mix and this experience can accelerate the brain volume loss compared to healthy individuals. So neurodegeneration, demyelination, age factors, and then there's also the presence of lesions.

Now it's important to remember that not everyone with MS will experience the same degree of brain shrinkage. The rate of atrophy can vary widely. The extent of the brain atrophy is influenced by factors such as the type of MS a person has. So if it's primary progressive, secondary progressive, those are often associated with more pronounced atrophy over time compared to somebody with relapsing remitting. Disease duration can also make a difference. So the brain atrophy tends to progress more as the duration of the disease increases. So the longer somebody has MS, the more likely you are to experience that. Individuals who have had MS for a longer period of time may have more significant brain volume loss. And the age of your diagnosis can impact the baseline brain volume.

Older individuals with MS may already have some age-related brain volume loss, making it challenging to differentiate between MS-related atrophy. And then of course, there's the disease activity. So frequent relapses, active inflammation in the central nervous system can contribute to more rapid brain atrophy. Effective disease-modifying treatments that reduce inflammation may slow down the rate of brain volume loss. I wonder how many times I'm saying brain volume loss on this podcast episode. I find it interesting, though, to learn all about this. It's just, you know, we can know that MS is the body's own immune system attacking the central nervous system and it attacks the myelin sheath, the coating, protective coating around our nerve fibers.

I guess I would say be more committed to my healthy habits. Because I know personally, but I know this is true for you guys too, because I hear from so many of you, when you start to feel a little bit better, you may start to slip on some of your healthy habits because you start to think, well, maybe I don't actually have to do all of that, right? But then in time, we start to not feel good again. Like the fatigue may start to slip in again,

that affects our experience with MS. It just, like I said, I guess it just helps me to feel more committed to my healthy habits because I know what's at stake. And living with an invisible disease, it's very easy to have those moments where you think, well, maybe that's not going to be the case for me. Maybe I actually don't have MS. Has anyone ever thought that? Oh, that would be a dream come true. But this helps me to better understand what's going on in my body, even if it's a silent action that's happening. Okay. So let me get back to this list here. So

There's treatment response. So the response to diseased modifying therapies can impact brain atrophy. Some disease modifying therapies are more effective at slowing the disease progression and brain volume loss than others. Genetic factors can influence disease severity and the rate of brain atrophy as well. Some genetic markers are associated with higher risk of brain volume loss. And then last but not least, there's overall health. So lifestyle factors.

Let me say that one one more time. Overall health can play a role in brain health and atrophy. That includes lifestyle factors such as diet, exercise, stress management, and sleep quality. My friends, the food that we eat can impact brain atrophy. Managing stress can impact brain atrophy. Your quality of sleep, your form of exercise. This is really empowering. Again, I just go back to what I just shared that learning about this, hearing about this

So I have another list for us here. I'm going to run through, which by the way, I know a lot of the things I'm sharing today are kind of like in list form. If you're more of a visual person, I know I very much am. I always include, I guess what you would consider my show notes on my website. So you can always head over to AleneBrennan. com and just click on the blog link or go to AleneBrennan. com/blog.

Of those of us living with MS will experience an impact in cognitive function. What does that mean? We can experience difficulties with memory, attention, problem solving, and processing speed. These cognitive changes can affect daily activities and quality of life. This is one of the reasons why I love getting together in community and talking about this because it's one of those moments where it's like, yes, I experienced that too. And when I try to tell the average person that, they hear it and they're just like, 'oh my goodness, I'm so forgetful as well.' I always forget people's names too.

Motor skills, coordination, and balance. Obviously, this can increase our risk for falls and other mobility issues. Disease progression is another way that brain shrinkage can affect us. The extent of brain atrophy is often associated with disease progression. As the brain loses tissue, it can become less effective at compensating for MS-related damage. This can lead to increased

statistics that I see so often that those of us living with MS are at a higher risk for experiencing anxiety and depression. And I think that that's relevant just by the sheer nature of MS being invisible, being unpredictable, that can be very isolating. But then hearing that the shrinkage of the brain can also impact this, it feels like it's just a layered impact then.

This is why it's so important for us to have social connections. This is why it's so important for us to prioritize friendships and getting together with people.

Different. You can choose how you want that to look in your life, but they are so, so important. We kind of have a lot stacked against us when it comes to the emotional side of living with an invisible, unpredictable, incurable disease. I know I'm just a ray of sunshine today, but I want to share the facts because I want us to hear the importance of this message;

impact. Next would be treatment response. MS atrophy can affect how individuals respond to MS treatments. Those with more extensive brain atrophy may be less responsive to disease-modifying therapies and treatment decisions may need to be adjusted accordingly. So there's a big motivator for me, if I'll just say for me, if I know that I can influence in any way this rate at which my brain is shrinking through diet, lifestyle, sleep, stress management, exercise. And by doing so, it can position me to make disease modifying therapies more effective, even if it's by 1%, I'm making that up. But even if it is that small, that's worth it to me. And that's one of the things where I think it's so important for us to not be so hung up on the fact that

make the disease modifying therapies, should you choose to take one, even just a little bit more effective, it's worth it. And then lastly, quality of life. Overall brain atrophy can have a significant impact on quality of life for us living with MS. It can limit the ability to work, to engage in social activities and to maintain independence. So I don't know about you, but this list has me motivated. We can look at this as super depressing, or we can look at this as something that

all these factors, combined, contribute to. We need to keep in mind that everyone with MS has a unique experience, and therefore everyone's impact and rate of brain atrophy is going to be slightly different. So please know that as I share these things today, these are generalized statements, which are really hard to make when it comes to MS and specifically brain atrophy. Okay, my next question, because I got many of them, how do I manage this?

Strategies that we can take to slow down the progression of brain shrinkage and promote brain health. Now, obviously we want to be working with our doctors on this, but here are just some basic practical things that you can do. First, disease-modifying therapies, should you choose to take them, they can be helpful to reduce inflammation and slow disease progression, potentially preserving brain tissue. Having regular MRIs can be really helpful.

And this is an opportunity to fuel your body with the nutrients that it needs to support its health and maintain good brain health. And I always like to give a little plug and a reminder that it doesn't need to be a complete overhaul. Is that really effective? And will you get most results faster from that approach? Yes, but that's not always the most sustainable.

Practicing stress management techniques such as mindfulness, meditation, deep breathing exercises, and yoga can all be really helpful. I keep adding in little side notes here, but I think it's helpful just to realize that stress management doesn't have to be a daily 40-minute meditation. It can be a single deep breath that you're taking throughout your day. It can be five minutes of stretching at the end of the day, even if it's during commercial break of a favorite show. My point is that stress management doesn't have to be unattainable. It's more often the things that are most effective are the small things that you're incorporating throughout your day. So if you take just a few deep intentional breaths throughout your day, that can be a really high-quality healing time in your body. Cognitive training. Oh, this is a fun one. So there are different exercises that you can do that challenge your brain that will help you to maintain and improve cognitive functions. This is where activities like puzzles and word games, and all kinds of different things. There are board games, there's different apps that you can do, there's online programs, but they may seem silly and you might be quick to dismiss them, but give them a try.

Experiencing loneliness has a higher rate of disease activity. I don't think that that's just with MS. I'm pretty sure that that is overall different health conditions, but loneliness is definitely connected with poor health. So let's get social and let's give our health a nice little boost. And I'm going to say it again. Remember that how we manage MS is highly individualized. What works for one person may not work for another. That's why I'm so passionate about empowering us to be health advocates for ourselves and to take action. We don't want to put all the power in somebody else's hands to give us one solution.

never have chosen MS, but it's here. So I am going to do my best to make sure that I feel my best in my body and that I am best positioned to still do all the things that I want to do in this world. So that's all the things that we talked about of choosing a good high quality diet, managing stress, practicing appropriate level of exercise, getting good quality sleep,

lasts as long as it possibly can. But we can't be disillusioned by that to think that MS is not happening in our body then. We need to get out of bed every single day and do our best to manage our health. This is not about being perfect, but it's just showing up and doing your best each day. So maybe today that's having one serving of vegetables at dinner tonight. Or maybe it means that you're going to get to bed.

health. This is your life. And I want to help you get the most out of it. This is about reclaiming your body, mind, and life from MS. 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.