Q: I am female and have had multiple sclerosis for 10 years. I have noticed that I always seem to have a relapse in fall and feel better in the spring. I had a sore throat and cold in September and maybe this upset my immune system, but looking back, it seems that this happens nearly every year, even if I don’t get a cold. Does this happen to any of your patients?
A: Other people have noticed there seems to be a seasonal variation in MS symptoms, so Dr. Joep Killestein at the VU Medical Centre in Amsterdam decided to study the phenomenon.
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He took 28 patients who had either the relapsing-remitting type of MS or the secondary progressive variety and collected blood samples from them for 18 months. He also observed the lesions using an MRI to determine if there were any changes. He found clear fluctuations in the number of lesions, but these did not seem to correlate in any way with the symptoms the patients reported or the season of the year.
However, the blood tests clearly showed that the T-cells in the blood were more active during the autumn months as measured by the production of cytokines. These are soluble molecules that control how immune cells work in the body.
Joep concluded that “viral infections are more common in particular seasons and may be a possible explanation of the fluctuations of immunological and radiological effects in MS.”
This study also provides further evidence that MS is a disease of the immune system where the patient’s own system attacks parts of the brain and spinal cord.
Do you have school-aged children? One of the reasons that people get more colds in September is that the children are back in school, and infections can easily be brought home.
The answer to why you get relapses in the fall even when you don’t have a cold is that you may be infected by the virus but your immune system fights it off so you do not notice any cold or flu symptoms.
In this case, the level of T-lymphocytes in the blood is still elevated.
It is interesting that people suffering from other autoimmune diseases such as rheumatoid arthritis and lupus also notice these seasonal variations. Most people put it down to changes in the weather or barometric pressure, but there is no convincing evidence to prove this.
Eye checks for cataracts
Q: My father, who is in his 80s, has had cataracts removed in both eyes. My optometrist tells me that he still needs to get his eyes checked.
I do not understand this as I thought that the plastic artificial lenses in his eyes do not change. He just needs glasses for reading and he can see everything else fine.
A: Although it is true that the plastic lenses do not change in the same way as your natural lenses, there is still some follow-up needed after cataract surgery.
The tests look for glaucoma and a film that can grow over the plastic lens.
Also, the retina at the back of the eye needs to be checked. The eye can show changes due to macular degeneration, diabetes or high blood pressure.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
