Multiple Sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The immune system mistakenly attacks the protective sheath of the nerve fibers (myelin) in the brain and spinal cord. Depending on where the damage occurs, very different symptoms appear. In Germany, more than 280,000 people live with MS.

An important message up front: an MS diagnosis today is no longer what it was 20 years ago. With early, consistent treatment, many people with MS lead a largely normal life.

Conventional Medicine as the Foundation

Today there are about 20 approved drugs that influence the course of the disease. Especially right after a diagnosis, they are the most important foundation. Highly effective antibodies such as ocrelizumab can almost completely suppress relapses in many patients.

The next generation is BTK inhibitors such as tolebrutinib and fenebrutinib, tablets that reach the brain and are meant to also slow the gradual progression. The approval process has been bumpy: since June 2026, tolebrutinib has been approved in the EU for non-relapsing secondary progressive MS, while the US FDA rejected the application at the end of 2025 (NeurologyLive). Fenebrutinib was successful in large studies in relapsing and primary progressive MS, and the approval process in the US has been underway since September 2026 (Roche).

Research

• Repairing the nerve sheaths (remyelination): Old drugs such as the antihistamine clemastine and metformin are being studied for this. Caution: in a study by the US health agency NIH, patients with progressive MS got markedly worse more quickly on clemastine, and this arm of the study was stopped in 2024. In early 2026, the Paris Brain Institute showed that the known drug bavisant promotes the repair of the nerve sheaths in the lab and in mice. Studies in humans are being prepared.
• CAR-T cell therapy: This method from cancer treatment is already being tested in MS in first small studies, including in Germany, for example at LMU University Hospital in Munich. In the roughly 30 patients treated so far, the disease often stayed quiet for months. However, the studies are small and have no comparison group, and the long-term risks are unknown.
• Epstein-Barr virus: The link between this virus and the development of MS has been confirmed. This opens up the possibility of a vaccine and antiviral therapies.

More Intensive and Alternative Approaches

• Autologous stem cell transplantation (aHSCT): The immune system is largely reset with chemotherapy and rebuilt with the patient's own blood stem cells. For highly active relapsing MS, its effectiveness is well documented, and the procedure is increasingly offered in Germany and Europe as well. But it is an intensive procedure with real risks. The first step should be a conversation with a German MS center, not booking directly abroad.
• Coimbra protocol: very high doses of vitamin D. The success rates often quoted come mostly from personal reports, not from controlled studies. High-dose vitamin D can raise calcium levels dangerously and damage the kidneys. Only under close medical supervision.

What You Can Do Yourself

Everything below supplements the treatment but does not replace it:

• Vitamin D: In a large 2025 study with 303 patients with very early MS and too low a vitamin D level, high-dose vitamin D almost doubled the time until new disease activity appeared, mainly new lesions on MRI. It had no clear effect on the number of relapses. The point is a sufficient, medically monitored level, not maximum doses.
• Omega-3: linked to less fatigue and disability, especially plant-based omega-3.
• Diet: Mediterranean and plant-focused food shows the most consistent benefits.
• Exercise: Active people have a much lower risk of severe disability.
• Dental health: Gum bacteria are linked to a more severe course. Good oral hygiene and professional teeth cleaning help.
• Gut flora: affects how the disease starts and progresses, and a high-fiber diet supports it.
• Don't smoke, reduce stress, keep a healthy weight.

My Conclusion

Just like with my Parkinson's: the best strategy is a combination of modern medicine and a consistently healthy lifestyle. After a new diagnosis, first go to a good MS center and start an effective therapy early.