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MS and Comorbidities: When MS Isn’t Your Only Health Condition

MS and Comorbidities: When MS Isn’t Your Only Health Condition

Dealing with MS and more

In addition to living with multiple sclerosis (MS), many people with the condition also are dealing with other serious health issues. In our 2017 MS in America survey, 88% of respondents noted other health conditions besides MS. The most common health issues among people with MS from our survey were neuropathy (48%), being overweight or having obesity (40%), mood disorders (33%), hypertension or high blood pressure (30%), and migraines (30%).

Comorbidities versus secondary conditions

Experts classify the various additional health issues that someone with MS can have as cormorbidities or secondary conditions. Comorbidities are a condition that is separate from the original condition, like hypertension, mood disorders, or sleep disorders. Secondary conditions are physical or mental disorders that develop as a direct or indirect consequence of the original disease. Common secondary conditions related to MS include osteoporosis and fractures.1
All of these additional health challenges can greatly impact an individual’s quality of life, but comorbidities can also affect a person’s MS.1

Mental disorders are common in MS

Mood disorders like depression, anxiety, and bipolar disorder are more common in people with MS than in the general population. The lifetime prevalence of anxiety in people with MS is up to 36%, and bipolar disorder also occurs more frequently in people with MS than the general population.1

In people with MS, the lifetime prevalence of depression is nearly 50%, which is about three times higher than in the general population. The reason why depression is so much more common in people with MS isn’t well understood, but experts believe that having MS lesions in certain areas of the brain may play a role. The emergence of depression may also be an indicator of disease activity, so it is not clear whether mental conditions like depression and anxiety are truly comorbidities or a secondary condition caused by MS.1

Our 2017 MS in America survey also found that 42% of people with MS were initially misdiagnosed with depression, suggesting that the two conditions are more entwined than some doctors may realize.

Despite the fact that mood disorders are more common in people living with MS, these conditions frequently go undiagnosed or untreated, leading to a significant negative impact on quality of life and overall health. Treatment for mood disorders in people with MS is similar to that for the general population, including pharmaceutical drugs, psychotherapy, or both.1

Other physical conditions add to the burden of MS

Physical comorbidities are also common among people with MS, and as a person ages, their risk of developing physical comorbidities increases. Physical comorbidities are also higher among people with lower socioeconomic status.1

One area of research is the presence of other autoimmune diseases among people with MS. The findings from research have been inconsistent, with some finding a link and others not. However, prior to being diagnosed with MS, people with MS are more likely to have had uveitis (inflammation of the middle layer of the eye which can lead to vision loss), inflammatory bowel disease (Crohn’s disease or ulcerative colitis), and bullous pemphigoid (a rare skin disease that causes large blisters) than the general population.1

Other physical comorbidities that have been found to occur more often in people with MS include hypertension (high blood pressure), arthritis, irritable bowel syndrome, chronic lung disease, and hyperlipidemia (high levels of fat in the blood). More than 5% of people with MS also have fibromyalgia, insomnia, irritable bowel syndrome, obstructive sleep apnea, and restless legs syndrome.1

Sleep disorders, also more common among people with MS than the general population, are a particular concern among people with MS as they greatly impact fatigue. Fatigue was cited in the 2017 MS in America survey as the symptom that has the greatest impact on a person’s daily life. It is estimated that between 25% to 54% of people with MS experience a sleep disorder, such as insomnia, nocturnal movement disorders, respiratory disorders during sleep (like sleep apnea), narcolepsy, REM sleep behavior disorder, disturbances of circadian rhythm, and restless legs syndrome.1

MS also increases a person’s risk of developing osteoporosis as a secondary condition. Osteoporosis is a condition in which the bones become brittle and more fragile, and it affects 1 in 3 people with MS. Several of the risk factors for MS are also risk factors for osteoporosis, including being female, having a vitamin D insufficiency, and smoking. However, additional factors of MS increase a person’s risk of developing osteoporosis including inactivity, immobility, and exposure to medications like corticosteroids, antidepressants, and anticonvulsants.1

The risk of fractures among people with MS is also higher than the general population, particularly in the femur (thigh bone), tibia (lower leg bone), and hip. Factors that increase an individual’s risk of fracture include a history of falls, increasing age, being underweight, and the use of some medications.1

The impact of other conditions on MS

Having additional health conditions negatively impacts a person with MS in several ways:

  • They have more symptoms to deal with
  • Their quality of life is reduced
  • Their physical disability is greater
  • They may have more difficulties sticking to treatment regimens1

What you can do

If you are coping with MS and one or more additional health conditions, getting proper treatment and making healthy life choices is more important than ever. Healthy behaviors that can have a positive impact on MS also can improve other comorbidities common to people with MS. Some of the healthy steps you can take include:

Respondents from the 2017 MS in America survey found that rest or sleep had the greatest impact on their MS symptoms. In addition, if you suspect you may have another condition, like depression, it’s important to seek out diagnosis and treatment. While having a chronic condition like MS means a loss of control in some ways, taking steps to improve your overall health can help you take back some control over your body.

  1. Marrie RA, Hanwell H. General health issues in multiple sclerosis: comorbidities, secondary conditions, and health behaviors. Continuum (Minneap Minn). 2013 Aug;19(4 Multiple Sclerosis):1046-57. doi: 10.1212/01.CON.0000433284.07844.6b.

Comments

  • Lucylucylucy
    5 months ago

    I was diagnosed with Type 1 (insulin dependent) diabetes 29 years ago. It definitely will affect every part of one’s body including my MS (diagnosed about 10 years ago) when not controlled.
    A good diet,exercise and general outlook on things play a huge part in my well-being,general outlook probably being the most important and beneficial to me personally.
    If it ever gets to the point where I cannot exercise any longer I will deal with that.
    I’ve plenty of practice managing diabetes. 😉

  • itasara
    5 months ago

    MS hasn’t been my biggest problem. I was 57 at diagnosis and I am 70 now. I think my biggest problem is just aging and a general lack of motivation. I have some sx that could be either MS or Aging or both. Hard to know really.

  • DaleneK
    1 year ago

    I was diagnosed with MS over 30 years ago, since then I have been diagnosed with Primary Immune Disease, Diabetes, Sleep Apnea, Restless Leg Syndrome and Neuropathy. I feel like a walking medical study!

  • DaleneK
    1 year ago

    I forgot to add (cog fog, chemo brain) that a year ago I was diagnosed with stage 3 breast cancer. I will defeat that beast! All signs are hopeful on that front!

  • Kelly McNamara moderator
    1 year ago

    Hi @dalenek. It can be so frustrating to feel this way, but thank you for sharing! It helps other community members know that sometimes they’re not so alone! – Kelly, MultipleSclerosis.net Team Member

  • flora68
    2 years ago

    I had a spinal injury at age 48 that was life-changing; I had (have) severe central canal stenosis at 4 levels with a lot of assorted neuropathies and a height loss of 3 inches from collapsed discs, and it all happened a couple of years BEFORE the first signs of MS.

    So by the time I was diagnosed with MS at age 52, I already had a walker because of my BACK, NOT from MS. So getting the MS diagnosis wasn’t even remotely “life-changing” for me; it just meant that, if and when the time came (and it did), I knew it’d be easier to get disability because MS sounds so much more dramatic than “a bad back” sounds.

    I am pushing age 67 now and my spinal issues (from an injury) are STILL a lot bigger challenge for me than my MS has ever been. In fact, I’ve got a whole list of co-morbidities, but the point is, just because you have something epic like MS, that doesn’t mean you don’t also have a boatload of other stuff to deal with too.

  • Kelly McNamara moderator
    1 year ago

    Hi @flora68. Your comment rings so true! Sometimes friends and family forget just because someone is diagnosed with MS, doesn’t mean they’re not also be managing a bunch of other co-morbidities! – Kelly, MultipleSclerosis.net Team Member

  • Kristina
    2 years ago

    I actually got the other disease, Type 1 Diabetes, 2 months before being diagnosed with MS. 1998 was not my favorite year ever!

  • CatDancer
    2 years ago

    Yup, spot on. The mood stuff is wild! Speaking of co-morbities. Here’s one to ponder: Having a nasty Traumatic Brain Injury, and years later add a cherry on top by being diagnosed with MS. That still blows my mind. It’s like experiencing a TBI in reverse. Thanks for the post <3

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