In Brain Tune Up!, Video Blog

Multiple Sclerosis (MS) is a chronic and often unpredictable disease that affects the central nervous system. Its symptoms vary widely from person to person, making it difficult to diagnose. For those who suspect they or a loved one may have MS, the process of getting a diagnosis can be overwhelming and confusing. In this blog post, demystifying the diagnosis process is a goal, covering everything from the initial symptoms to the various diagnostic tests available. Whether you are someone who suspects they may have MS or simply seeking to learn more about this condition, this post is for you.




I’m a neurologist who combines modern and traditional medicine to treat patients with multiple sclerosis (MS). I work closely with Dr. Terry Walls, who is known for her Walls Protocol. We often collaborate, and she sends me patients. I see quite a bit of MS in my clinic, and many people travel to Ozark, Missouri, to see me and work with my team to benefit from a complete approach to multiple sclerosis.

Multiple sclerosis (MS) is a condition that affects at least one million people in the United States, although this number may be higher than reported. While some people with a family history of MS may develop the condition, genetics only play a small role in its development.

Let’s say you have two twins who are exactly the same in terms of their genes. If one of them has multiple sclerosis, there’s only a 25% chance that the other twin will also get it. This means that the environment and lifestyle choices are very important in determining whether someone will develop MS, along with any genetic or biochemical factors they may have.


Other things that can increase someone’s risk of MS include low levels of Vitamin D, exposure to the virus that causes MS (called the Epstein-Barr virus), being overweight as a child, and smoking cigarettes. These are some of the most common risk factors.


MS is more common in women than in men. Unlike some diseases that tend to affect older people, such as Alzheimer’s and Parkinson’s, MS is actually a disease that affects young people. Of course, there are always exceptions, as we sometimes see young people with those other diseases too. But MS is particularly common in younger people, and sometimes even kids can get it. As an adult neurologist, I usually see patients who develop MS around age 34 on average.


Is it Remissible? 


Some people with MS wonder if their symptoms will ever improve on their own, without treatment. Studies have been done to look at this, and researchers are still studying how MS progresses over time. For people who are taking strong medications to control their MS, there is hope that they may be able to stop taking these drugs in the future. These medications are called disease-modifying therapies, and they may help slow down the progression of MS.

I’m talking about someone who is not necessarily participating in the functional medicine or The Brain Tuneup oriented lifestyle medicine program that we offer at Sharlin Health and Neurology.

In other words, if we do nothing but take the medicine and make no other changes, what is the likelihood the person will eventually go into remission? If someone with MS hasn’t had any signs of the disease by the time they turn 65, like symptoms or changes on their MRI scans for about a year, then the chances are pretty good that they’re in remission. In fact, they might be able to stop taking their disease-modifying medication without any issues.

Functional and Regenerative Approaches to MS 


If you want to improve your overall health and prevent disease, it’s important to focus on things like nutrition, sleep, exercise, and managing stress. These are the foundations of a healthy life. By taking a functional and regenerative medicine approach, you can focus on cellular health and use movement as a way to improve your overall well-being. Building strong connections with others can also make a big difference. 


Taking a deeper dive into the type of labs we do in the Brain Tuneup program will really give you the extra edge. You’re trying to increase the chances of controlling your disease, either with or without medicine. Some people still need medicine, but using a functional and regenerative medicine approach improves their outcome. Medicine only slows disease progress 50% to 60% of the time.


When we talk about MS, we focus on long-term disability. Imagine having a series of attacks that leave you with ongoing symptoms. You might get treated with steroids or a drug like Solu Medrol (Methylprednisolone), hoping to feel better. But with MS, each attack can make things worse. Even if you don’t fully recover, you keep adding to your disability until you might need a cane, a walker, or a wheelchair. Some people even end up bedridden.

Life Expectancy and Chances of Disability 


There’s been a lot of progress in treating MS since I became a neurologist in 1993, so I see fewer people with severe disabilities. There’s a lot of hope for people with MS. In fact, their life expectancy is now only about five years lower than that of people without MS in the United States.


We all want to live a long and healthy life. The progress made in conventional MS treatment is impressive, but many of us want to take it to the next level. We don’t want to rely solely on medicine and feel like we’re just along for the ride with our illness. We want to take control and make informed decisions about our health. It’s time to move from the passenger seat to the driver’s seat and be in charge of our MS journey.


The Brain – Your Own Command Deck


Let’s talk about the brain (and the heart) in general. 

Think of your brain as the command center of the Enterprise in Star Trek. Just like Captain Kirk or Jean-Luc Picard sitting at the captain’s chair and controlling everything on the ship, your brain controls everything in your body.

If we compare the brain to the heart, and there’s certainly plenty of heart disease out there if you think about it, there are only two or three ways that someone who has heart disease really becomes symptomatic. 

  1. They might have chest pain, a very classic sign 
  2. They may experience shortness of breath, especially with physical exertion.

The heart is like a pump in your body. You might hear about common heart diseases like coronary artery disease, which can cause a heart attack. But there are many types of heart disease, like ones you’re born with, ones from a hard hit to the chest, or even cancer. No matter what kind of heart disease you have, you might feel chest pain, shortness of breath, or other symptoms like your heart racing or beating slowly. These symptoms can happen when you’re active or at rest.


Let’s go back to the brain, the control center of your body. Your brain does so much for you! It helps you feel, smell, think, speak, and experience the world through your senses. And when it comes to moving your body, it’s not just about using your muscles. Your brain helps coordinate your movements, making them graceful and easy. You don’t even have to think about which muscles to use or how much, it happens automatically.


“You might have MS”


Very often, I have consults that are referred to me in my office, and I call them “You might have MS.” 


MS tends to affect women more often than men, especially younger women. However, you can still get MS at an older age if you had your first attack when you were younger. Symptoms of MS can range from visual changes to weakness or numbness. It’s important to remember that these symptoms are related to the brain, but not all brain symptoms mean you have MS. Your primary care doctor or emergency room doctor may refer you to a neurologist if they suspect MS, but it’s important to get a proper diagnosis because not all symptoms are indicative of MS.



  • Not all numbness is MS.
  • Not all pain is MS.
  • Not all visual change is MS. 
  • Not all difficulty getting your words out is caused by MS. 
  • Not all weakness is MS. 
  • Not all in coordination is MS. 


Have you ever wondered how doctors diagnose multiple sclerosis? It’s actually a crucial step in managing the disease. As with many other medical conditions, neurologists and other doctors follow specific diagnostic criteria. We can’t just guess the diagnosis or pull it out of a hat.

2017 Revised McDonald Criteria


The 2017 Revised McDonald Criteria was originally published in the British Journal Lancet. At the core of this diagnostic criteria is the idea that the symptoms and signs what we sometimes call lesions or those spots on the brain, and then in the spinal cord are separated by space and time. 

About space

MS is a disease exclusively of the central nervous system—the brain and spinal cord, not peripheral nerves, not muscles, et cetera.

The nervous system stretches from the brain to the end of your spine, about two-thirds of the way down your back. When there’s damage in one area versus another, we call it a lesion. This can happen due to inflammation, destruction of the protective coating around nerve cells (myelin), or even a direct attack on the nerve cells or axons. When this occurs, the affected area can be destroyed, leaving behind a hole, or “black hole,” on an MRI. Autopsies of brains with many lesions can resemble Swiss cheese. It’s important to avoid such damage.


Think about the separation of space and time.


So by and large, if you had a single lesion in the brain that was sort of reminiscent of MS, would that be enough to meet the space criteria? and the answer is no, it would not. 


The MRI is crucial in defining the physical space affected by MS. The updated McDonald criteria now consider discrete attacks, not just symptoms like vision loss (optic neuritis). While optic neuritis can be a standalone condition, it often falls within the MS spectrum. To be diagnosed with MS, there must be evidence of one or more attacks or lesions in more than one area of the brain, separated by space. A single lesion with no prior evidence wouldn’t qualify as MS. So, MRI helps us pinpoint the specific areas affected by the disease.


Now, what about time?
MS often presents as what we call relapsing-remitting. That means that you might have an attack one day. And it lasts several weeks and then goes away, and then two years later, maybe you have another attack or three years later, and so on.

One of the key features of MS is the separation of time between attacks. Everyone with MS will eventually experience their first attack, similar to how someone with a history of migraines will have their first migraine at some point. Technically, a diagnosis of migraine requires five or more attacks, but we don’t necessarily wait for five attacks to diagnose it. Similarly, a complete neurological evaluation is necessary to exclude other conditions in the MS diagnosis.

When someone is diagnosed with MS, it’s usually after they’ve experienced their first attack. Doctors will perform a physical exam and an MRI to see if there are any signs of MS in the brain or spinal cord. Sometimes there can be spots or lesions that come and go without any symptoms. If there is evidence of a lesion during an attack and it lights up on the MRI with the contrast medicine, it means there is inflammation in the brain. If there are other lesions that don’t light up, it suggests they are older. This helps doctors determine the timeline of the disease.

Examining the Cerebrospinal Fluid


When doctors check for multiple sclerosis, they can examine your spinal fluid. They’re looking for something called oligoclonal bands, which are like a sign of an immune response happening in your central nervous system. This is different from your bloodstream. Even if you have a disease like COVID with immune globulins in your bloodstream, that’s not the same as oligoclonal bands. We want to make sure the immune response is happening in your brain by comparing your spinal fluid to your blood. That’s why we test both when looking for MS.

  • Oligoclonal bands indicate a unique immune response in the central nervous system.
  • Along with a characteristic lesion and a supportive history and physical exam, meeting these criteria confirms the multiple sclerosis diagnosis.
  • The space and time criteria must both be met for diagnosis.

Again, the presence of oligoclonal bands is a way to establish the time dimension required for the diagnosis.

Be informed, don’t self-diagnose


I want to share some important nuggets with you. 


If you think you might have MS, please go see a neurologist. It’s not a good idea to try to diagnose yourself because it can be risky. There are some symptoms that are concerning, like numbness, weakness, pain, feeling off balance, or brain fog. But just because you have those symptoms doesn’t automatically mean you have MS. It’s important to see a doctor and get a proper diagnosis. The doctor might check for other conditions like B12 deficiency, Lyme disease, or Anticardiolipin antibody syndrome. They will look at the big picture before making a diagnosis. 


We are excited to collaborate with you and provide our exceptional range of services that make our clinic stand out. Our expertise extends beyond general neurology, as we integrate the principles of functional medicine into your neurology experience. This creates our unique brand of neurology called Brain Tuneup, ensuring you receive comprehensive care that addresses all aspects of your well-being. Let us help you achieve optimal brain health and a better quality of life.


Understanding the ins and outs of a Multiple Sclerosis diagnosis can be a complex process, but with the right knowledge and guidance, it can also be an empowering one. After reading this post and gaining insights from it, we hope you feel better equipped to navigate this journey. If you or a loved one has concerns about MS, schedule a free discovery call with us today to learn more about the functional and regenerative approaches to treatment that could improve your quality of life. Don’t let misinformation or self-diagnosis stand in the way of finding the right care and support for your unique situation.


If you or someone you care about is experiencing symptoms that could be a sign of Multiple Sclerosis, we can help you get to the root of the issue. Let’s schedule a Discovery Call to discuss your symptoms in more depth and create a personalized plan to address your concerns.


Also, don’t forget to join our Private Facebook Group to connect with others on a similar journey. Follow this link to join today.


DISCLAIMER:  The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional

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