Multiple Sclerosis - WHAT OTHER THINGS CAN CAUSE SYMPTOMS

Welcome back to Medicine and Health with Dr. Paul Anderson. I'm Dr. Paul, and today we're talking about multiple sclerosis. And we got 4 different parts we're doing. So we did a previous one on what is it, what are the signs and symptoms, how do you diagnose it, all of that. And here we're going to move into— because I made the case that a lot of times a lot of other things look like multiple sclerosis. So that's part of the job is to sort out what you do and don't have. So this section we want to look at what are other things that might mimic or look real similar to multiple sclerosis but may not be the disease itself. It might be some other problem. First thing we want to talk about though is this is general information for your education. This is not medical advice. You should not take anything I say as direct medical advice. You should always check with your healthcare providers before doing or starting or stopping anything in your life because they are the people that know you the best. And I'm a doctor, I'm just not your doctor. So it's not my role to tell you what to do. So please run any good ideas you get from our programs directly by your healthcare provider team or your healthcare provider if you just have one of them. But other things that might cause the same signs and symptoms. So just to go back in case you missed the first part, They're very global types of symptoms. Some of them are a little more specific than others. But when it comes to multiple sclerosis, they, a lot of the symptoms can cross over to other things. So one of the big ones, for example, is what they call the MS hug, which is a constriction feeling around the center of your body. You can have difficulty walking. You can have spasticity, meaning literally that, you know, a muscle will cramp or spasm. for no apparent reason. You can develop fatigue that can be very profound or just persistent or a little of both. You can have numbness and tingling that you can't explain. You can have muscle weakness or whole body weakness. You definitely can have neurological issues with your vision and your balance system. You also can have neurological issues with your voiding, with your bowel and bladder. really just about anywhere. You can have recurrent headaches, you can have pain, and you can have other cognitive things. You know, you might start to have, you know, some signs and symptoms of early dementia, depression, anxiety, any number of things. Well, if you think about that list, you probably think, well, you know, gee, this is one of those things where All of those symptoms might be just some other problem. So how do we sort that out? So when we're talking about multiple sclerosis and we have the sort of normal signs and symptoms that are going on, and then we have an investigation into those signs and symptoms, and, you know, from that first set of information we talked about, you've got these criteria. So one is a group of lab tests that aren't really there to diagnose multiple sclerosis, but are to kind of rule out other problems. One is imaging of the brain and the spinal cord to see if there's lesions there that would match up with MS, although those are not 100% connected to MS. You have to sort of stack up your evidence. And you've got a lumbar puncture, a spinal tap, looking at the immunologic activity in the cerebrospinal fluid. And Then you've got your history of your signs and symptoms. You put all that together, and the neurologist will say, well, you've, you hit it, you checked enough boxes. This, this looks like MS. But a lot of times the big job is to try and figure out, well, how many other things could cause all those diffuse symptoms I just gave you? Well, vision problems, headaches, neurocognitive things, anxiety, depression, numbness, tingling, weakness, fatigue, all of that. Gosh, you know, those could be almost anything. So like I said, laboratory testing, very critical to rule out other problems. What if, for example, you had diabetes and you didn't know about it, and you were starting to get a diabetic neuropathy? That could explain many of the symptoms. You also could have other types of visual issues somewhere between your eye and, and the nervous system that connects your eye and your brain. that are not MS that can create some of these problems. You could have other autoimmune diseases that would create many of those symptoms. You could have old traumas that would create many of those symptoms. You could also have other inflammatory triggers such as infections that you haven't had tested, toxicity of many things, and even, even some hormonal problems. So, One of the things I think that's important when you're thinking about multiple sclerosis and testing and ruling in and ruling out is to make sure that you can step back and say, okay, we've really turned over all the rocks here, and it doesn't appear that there's any other explanations for all of this trouble. So the things that I have seen And I just wanna say upfront that most of these are combinations. It's rare that you just have one, you know, overarching cause creating all of this. But one that's in the literature and is something that you're supposed to watch out for are other infections. Now, we think of infections like maybe, you know, acute viral infections or the flu, or maybe like strep throat or something, but there's other infections that can have neurological inflammation associated with them, and they can mimic MS-like problems. So those might be things such as chronic viral infections like Epstein-Barr, cytomegalovirus, that whole family, the HHV family. They generally like the nervous system. So that can be one area. The, the borreliosis, the Lyme family of infections, neuro— Borreliosis or neuro Lyme can act like this or mimic this. But you always want to keep in mind with Lyme that it's normally multiple organisms, multiple bugs, multiple infectious agents that create all of those symptoms. But many of them can be very, very neurological. Also, if you're looking in things that I've seen in the past, Toxicities can create a lot of neurological involvement, and even some toxicities can raise some of the markers that would indicate an autoimmune condition. So this is another place where I think it's wise to take a look. Now, usually for screening when it comes to toxicities, I always feel it's good to, number one, most of the toxicity screenings nowadays you can do with urine testing, which is real nice. And so you can get a urine sample and, and send it to the different labs that do this stuff. But you can get a heavy metal panel that would be urine testing, and you can look at it and you can norm the values to the NHANES scale, which is the CDC's large database of how much of these toxins are normally in people in the United States versus how much is in patient. So it's a real reproducible way to see where the toxin is. Um, also there are panels you can do for chemical toxins, which are very good at triggering autoimmune or autoimmune-like phenomenon. You can also look at biological toxins such as mycotoxins, which are in the environment or sometimes in you and caused by mold in the environment. And a lot of times people with either chemical or metal toxicity or mycotoxin and mold toxicity will have a lot of these sort of bizarre symptoms that, you know, can come and go, and they can be diffuse and not point to one area. So I think toxicity is a really big area to rule out or rule in. The next are hormonal issues. And would I say I've seen hormonal issues completely cause an MS-like picture? No, but I've seen them aggravate an MS-like picture. Now, I gave the example earlier of insulin control. So insulin's a hormone, and so if you have poor insulin control, you have inflammation, and maybe some diabetes you do or don't know about, you can get some of those symptoms that we were talking about that would be MS related. And so the point there would be is if you locate an infectious trigger, you locate a toxic trigger, you locate a hormonal trigger, that should be investigated and probably treated to see if that doesn't affect those symptoms. You also could have prior injury, uh, things such as traumatic brain injuries of any type, uh, whether it's a mild traumatic brain injury, which we now know are not as mild as they look, all the way through, you know, chronic traumatic encephalopathy, a CTE, like we see with higher speed, higher force impacts. Those things leave damage and scarring behind, and later in the course of your life, they can create neurological signs and symptoms that may or may not be connected to a primary neurological disease like multiple sclerosis. So really, really important there. The other thing is that this is a collage effect, if you will. And what I mean by that is that when you are looking at all these things that may be causing MS symptoms, but they're not multiple sclerosis, There's 2 collage effects. One is they may be ganging up on each other. So I've seen it where there's a little hormone trouble, there's some toxicity issues, there's some infectious issues, there's some other immunologic, you know, stimulation that's not MS, and it's a little of everything piling on together, which makes the diagnosis a little harder because you have to look at all of those areas. But the other collage effect that you'll see is sometimes it's a mixture of multiple sclerosis and these other problems. Now, we're going to talk about standard treatments and integrative treatments and stuff in upcoming sections, but basically the point there is first we have to get it diagnosed the best we can, and then we have to look at, is it all these other things making it look like MS? Is it all these other things plus MS and that together is causing a problem? Or is there another place that we need to look? But we are just about out of time for this little section here on multiple sclerosis causes that might not be MS. And so the biggest advice that I would just give a patient would be, let's at least look at these other things. Could be you have MS, but it could be you have other things. And just like if you had diabetes and 3 other problems, we'd still want to treat the 3 other problems, not just treat your diabetes. The same with MS. We want to take away everything that might make your MS symptoms and signs and disease worse. But we're out of time now. Please like, share, subscribe, do hit the notifications, and check us out on dranow.com. And I'll see you for the next section. Thank you.