These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Multiple Sclerosis
Question: My brother is having an MRI to test for MS this afternoon. What exactly is MS and if he is diagnosed with it, what can be done? What kind of life can he expect to lead?
Answer: MS is a condition where the body “turns on itself” meaning that it directs the
inflmmatory response against the coveing of nerves rather than the usual targets such
as bacteria and viruses. There are new therapies for MS and if your brother should turn
out to have MS he should get under the care of a neurologist(if he’s not already seeing
one), as MS is a neurological disorder. MS is unpredicatable and therefore, it is very w
difficult for anyone to say exactly what the future will hold.
Oral Steroids
Question:I have MS, in December and again in June I had oral steroids for approx. 3 weeks each session. Both times I was subject to severe side effects including heavy gum bleeding and an incredible plaque buildup. I recently found out that I have had major bone loss in my jaws and most of my teeth will need to be removed. My neurologist believes that I haven’t had enough steroids to produce this effect but he was reluctant to put me on steroids after a recent exacerbation. If I had this much bone loss to my jaw I must have had bone loss elsewhere, I cannot seem to get an answer from anyone regarding calcium supplements at to amounts and which kind, I am very confused.
Answer:Steroids have mixed blessings. While they decrease inflammation and immune response they also accelerate most of the aging processes of the body. One of these is osteoporosis.
Osteoporosis is commom as one ages and occurs more rapidly if there is no sexual hormones(like estrogen, progesterone and testosterone)available. There have been numerous studies documenting the bone loss inherent in use of steroids. In general, it is related to dose and duration-higher doses for longer periods are more of a problem. Most physicians who use steroids for any long duration recommend use of vitamin D and calcium supplements during steroids and bone density measurements. The evidence that this helps is sketchy;but, leans towards improvement with this treatment. Studies are in progress concerning use of calcitonin and alendronate sodium during steroid treatment.
