A Brief Review of Research on Ketogenic Diets as a Treatment for Multiple Sclerosis (MS)

Estimated reading time: 4 minutes

When I tell people they can learn how to treat their cognitive and mood symptoms (also experienced as Brain Fog), I ultimately mean it.

Let’s learn about ketogenic diets and Multiple Sclerosis. There has actually been quite a bit of research done on low-carb diets and MS

Research Study on Relapsing-Remitting MS and Ketogenic diets

A randomized, parallel-group, 3-arm pilot trial was done to assess the safety and feasibility of a fasting-mimicking diet (FMD) or Ketogenic on health-related quality of life measurements (HRQOL) in Relapsing-remitting MS.

60 patients were randomly assigned to a control diet (n=20), KD for 6 months (n=20), or a single cycle of a modified FMD for 7 days (n=20) followed by a Mediterranean diet for 6 months.

The FMD and KD cohorts displayed clinically meaningful improvements on the HRQOL summary scales at 3 months, which included:
Overall Quality of Life
Change in Health
Physical Health Composite
Mental Health

Tons of info about the plausible mechanisms of these changes are available in the article here:

https://www.sciencedirect.com/science/article/pii/S2211124716305769

Pilot study using Keto in Relapsing-Remitting Multiple Sclerosis

Another 2019 study, titled “Pilot study of a ketogenic diet in relapsing-remitting MS” found that a modified-Atkins style #ketogenic diet was safe, feasible to study, and well-tolerated in people suffering from this type of MS.

The authors reported that it improved fatigue and depression, promoted weight loss, and reduced serologic proinflammatory adipokines. If you know anything about brain immunology, you know that’s a pretty big deal! Because chronic body inflammation drives neuroinflammation, which then drives neurodegeneration. So this is a relevant and impressive finding and shows great treatment benefit.

https://nn.neurology.org/content/6/4/e565.abstract

Intention-to-treat KD intervention for Multiple Sclerosis

The same authors reproduced the finding in 2022 in this study, finding the ketogenic diet specifically was safe and tolerable over 6 months, yielding statistically significant improvements in body comp, depression (p<0.001), neuro disability (p<0.001), fatigue (p<0.001), quality of life (p<0.001) and adipose-related inflammatory markers (p<0.001;p<0.002).

https://jnnp.bmj.com/content/93/6/637.abstract

Seriously people. Go back to that paragraph and look at the power of those findings! Statistically significant minimums are p<0.05, and the p<0.001 findings are nothing short of stunning and full of hope for people with MS! Let’s take a moment to celebrate those!

Ketogenic diet and immunology markers in Multiple Sclerosis

If you still aren’t convinced, maybe this next one will impress you. It found that at 6 months, a ketogenic diet used to complement current therapies reduced sNfL levels, suggesting potential neuroprotective effects in MS. What is sNfL, and why is this good? sNfL refers to “neurofilament light chain,” which is a biomarker used to measure nerve damage and disease activity in the context of Multiple Sclerosis (MS).

This is EPIC, considering in MS we are trying to protect from autoimmune destruction of the myelin sheaths in the brain, right?

Seems like an important therapeutic effect to me 🤷

https://nn.neurology.org/content/9/1/e1102.abstract

But what about Terry Wahls and the Wahls Protocol for Multiple Sclerosis?

And yes, I am very aware of Terry Wahl’s work! For those of you who are not familiar, she is a physician who was diagnosed with MS in 2000 & developed her own personalized keto-Paleo diet called the Wahls Protocol and has successfully managed her Multiple Sclerosis with it!

Here is a 2014 study she (Wahls) is an author on that was a small, uncontrolled pilot study that found significant improvement in #fatigue in those with secondary progressive MS

https://www.liebertpub.com/doi/abs/10.1089/acm.2013.0188

Group average fatigue severity decreased from 5.7 at baseline to 3.32 (p=0.0008) at 12 months. Look at that p value, people!

My understanding is that Wahls does a modified-paleolithic diet in which ketone production may be a part, and she has not seen a benefit from simply adding MCT oil to increase ketone production. If you have MS you may want to explore both options.

If you have done the Wahls protocol and it hasn’t quite worked well for you, I want you to know there is research specific to the ketogenic diet being helpful, in case you would like to try that out.

The bottom line regarding Ketogenic Diets and the Treatment of Multiple Sclerosis

I don’t care if you do a #ketogenic diet for your MS. I just sincerely want you to know there is an evidence-base using diet to treat this disorder. I want you to know that a ketogenic diet is a multiple sclerosis treatment. I want you to know all the ways you can feel better! #MS #autoimmune #neurology #ketogenic

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If your brain fog comes from Multiple Sclerosis and you would like to work with me on learning how to use the ketogenic diet and other powerful nutritional supports as a treatment, you can learn more about my online program. Lots of 1:1 interaction, support, and personalization to help you learn all the ways you can feel better!

Brain Fog Recovery Program