'Bad Cholesterol' and MS

It turns out that high cholesterol could be at least partially to blame for more than just heart disease and stroke. In a recent study, researchers in Australia discovered that “bad fats” can hasten disease progression in people with multiple sclerosis (MS).

For their experiment, scientists at Menzies Research Institute Tasmania identified 141 patients who were diagnosed with MS and followed their progress from 2002 to 2005. Their blood was evaluated at the start of the study, and then again every six months. The Expanded Disability Status Scale (EDSS) test was used to determine each patient's level of disability. The EDSS measures everything from reflexes to bowel and bladder function to the ability to walk.

The researchers found that patients with higher levels of certain lipids known as “bad fats” also scored higher on the EDSS, meaning that they were more disabled. Over the course of several years, they noted that these same patients progressed faster in their disease. 

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The research team studied two things. First, they “examined whether lipid levels were associated with actual disability,” said lead researcher Dr. Ingrid van der Mei in an interview with Healthline. They found that some lipid levels, including total cholesterol, were associated with greater disability.

“These associations were seen even after we took other factors into account,” said van der Mei, “including how much physical activity people did, smoking, peoples age, and gender.”

Van der Mei's team also examined whether lipid levels caused faster disease progression. “We found that the ratio of total cholesterol levels relative to High Density Lipoproteins (HDL) was associated with a higher change in disability.”

But could the disease progression actually be causing an increase in "bad fat" levels? “We could not find evidence that this was the result of reverse causality,” said van der Mei, “—that those who progress faster have less physical activity, increase their weight and as a result have higher lipid levels, but we can not rule this out.”

More research is needed, but for now, "that means if we are reducing those lipid levels by people improving their physical activity or improving their weight or having a better diet,” van der Mei explained in an interview with Australia's ABC, “that might actually influence how their disability progresses."

Progression vs. Relapse

Based on the same study, Dr. van der Mei’s team published a separate paper describing their observations about the connection between MS relapses and cholesterol levels. According to the study’s highlights, while bad fats may be associated with disease progression, body mass index (BMI) and cholesterol measures didn’t impact relapse rates in their study patients.

So, a person who has a high BMI or high cholesterol level might not necessarily experience more MS relapses. Relapses are considered to be the result of an inflammatory process. Progression in MS is characterized by the degeneration of neurons in the brain. 

The fact that certain lipids have no effect on relapse rates, yet markedly impact MS progression, could tell us more about the role that these bad fats play in the body.

While relapses are most often accompanied by an increase in physical symptoms, often a patient’s progression is not so readily apparent.

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From Your Lips to Your Lipids

Patients concerned about the accumulation of damage caused by MS that may not be visible to the naked eye should talk to their neurologists. Likewise, neurologists should be monitoring their patients' cholesterol levels.

"Neurologists should check lipid levels and treat them when they are too high," van der Mei told Healthline. "They could say that reducing lipid levels may possibly also have an influence on their progression in disability."

A simple blood test to check lipid levels might reveal that using a cholesterol-lowering drug like Zocor could be helpful. In a study published earlier this year, researchers at the National Hospital for Neurology and Neurosurgery in London found that high, daily doses of the drug reduced brain atrophy in people with progressive MS.

As we learn more about the disease, evidence is emerging about the important role that diet plays. Heeding the researchers’ advice for patients to exercise, lose weight, or improve their diet might be the most empowering thing someone with MS can do to impact the course of his or her disease.

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