Treatment Options: Oral Medications


MSMonday: Treatment Options: Oral Medications 

Last week we discussed inject-able medications. This week let’s discuss the oral medication options that are available. Oral medications didn’t hit the market until just recently. Before then, people with MS were stuck with injection only options, which was clearly not ideal. As patients, we would hear about oral medications being an option someday in the future, but we didn’t know when it would actually happen. Until it eventually did in 2010 when Gilenya was approved by the FDA. Currently there are only three oral medications on the market approved for relapsing remitting MS. Let’s take a closer look at each of these medications.

Gilenya

Gilenya is in a new class of medication called sphingosine 1-phosphate receptor modulator (that’s a mouthful). Scientist think that it works by keeping certain white blood cells in the lymph nodes, thereby making it impossible for them to cross the blood brain barrier and get into the central nervous system. Making it so the cells cannot get into the central nervous system, reduces inflammation and damage to nerve cells. In several studies done, Gilenya was shown to be effective. Gilenya cut relapses by 52% when compared to Avonex in a one year study. It also prevented relapses by 54% when compared to placebo over a two year period. The FDA approved the use of Gilenya in 2010 for relapsing remitting MS.
There are several side effects associated with Gilenya. Headache, slowed heart beat, weakness, fatigue, infection, elevated liver enzyme’s and diarrhea were noted. An uncommon side effect is macular edema, which is the swelling of an area of the retina which is responsible for central vision. Gilenya is also known to slow the heart rate significantly, especially in the first month of treatment. An individual also might feel really tired, have heart palpitations or chest pain or feel dizzy. Usually if someone experiences the symptoms, they will disappear within the first day or two of treatment.
In 2012 the FDA updated the regulations around a patient’s first dose of Gilenya. It is now required that an individual have an ECG before receiving the first dose and again six hours after the first dose. Is also recommended that the first dose be taken under medical observation. This is due to a patient unfortunately passing away in late 2011 after taking their first dose of Gilenya. As far as I know, the has not been definitively linked to Gilenya.

Tecfidera

Tecfidera, also known as dimethyl fumarate, is an oral medication taken twice a day that was specifically developed for people with relapsing remitting MS. A similar chemical compound called Fumaderm, has been used in Germany for many years to treat flares of psoriasis. The specific way Tecfidera works is still unknown, but scientist think that it activates certain pathways in the body that help to protect nerve cells from damage and inflammation. In one study, in a two year period 27% of people who are taking Tecfidera experience a relapse compared to 46% of people in the placebo group. Tecfidera was approved by the FDA in 2014 for the use in relapsing remitting MS.
Common side effects of Tecfidera  include flushing, stomach pain, nausea and diarrhea. Side effects seem to be present more so at the beginning of treatment, and then will dissipate as treatment progresses. There have been cases of PML reported in patients who are taking Tecfidera, 4 of them actually. PML is a rare and deadly brain disease that can happen when individual is taking an immuno-suppressant medication. In order to develop PML, individual must be positive for the JC virus first. Routine blood test to monitor JC virus status is recommended when taking most MS meds.

Aubagio

Aubagio, also known as teriflunomide, is a pyrimidine synthesis inhibitor. It works by reducing the number of white blood cells in the central nervous system, decreasing inflammation overall and protecting nerves in people with MS. In several studies, Aubagio was proven to be effective over placebo, reducing relapses by 31%, reducing disability progression by 30% and showing an 80% decrease in brain lesions. Aubagio was approved in 2012 by the FDA for use in relapsing remitting MS.
Common side effects of Aubagio include headache, nausea, hair loss, diarrhea, elevated liver tests, like symptoms and numbness or tingling in in the hands or feet. Less common but more serious side effects include elevated blood pressure, increased risk for infections and liver damage. While taking Aubagio  you will need to have regular blood test to monitor liver function and blood cell counts. Aubagio is also associated with severe birth defects, and neither women nor man should be taking Aubagio if pregnancy as planned. Aubagio can remain in your body for up to two years after discontinuing the medication, so a special treatment may be needed to remove the drug from your system if you’re planning on becoming pregnant. Usually when taking the medication, it is required that an individual be on an effective birth control method.
I took Aubagio for about a year. Unfortunately I went into the treatment already in a “active disease state “, and had two relapses while taking the medication. I liked how I could just take a pill instead of the daily injections of my previous Copaxone, but I soon experienced side effects of (a lot of) hair loss and irregular blood cell counts. Due to the relapses, I eventually changed medications. 
The arrival of oral medications has been a welcome relief for many MS patients. They represent the constant advancement of research and development. Hopefully the future will bring many more options to the table.

I’M ALISSA!

I help women who have also been diagnosed with Multiple Sclerosis make specific and personalized diet, lifestyle & subconscious changes so that they can begin to heal their body, reduce disease symptoms, and return to a life they love.hey there,

follow along on Instagram:

My reality has changed a whole bunch over the years.

I started out with only a few symptoms. But I could get through the day.

Until all of a sudden I couldn’t.

All within a few years I went from “fine” to:
Having horrible symptoms, had 3 relapses and found myself with “aggressive MS”

This was not ok with me.

Eventually, I took my life into my own hands and rethought how I did most things.
I realized I had to make some changes, or else idk what else was gonna happen to me.

So I did.

I changed my diet.
I changed how I worked out.
I changed my job in the name of stress management.

This is just the tip of the iceberg.

If you want this transformation for you too (I know it’s possible) I’m launching my signature course: Holistically Healing MS in a few weeks. 

This is the course you need to get started on this path for yourself.

Only the waitlist is gonna get the pre sale price… 
Comment WAITLIST below and I’ll add you to it!!

My reality has changed a whole bunch over the years.

I started out with only a few symptoms. But I could get through the day.

Until all of a sudden I couldn’t.

All within a few years I went from “fine” to:
Having horrible symptoms, had 3 relapses and found myself with “aggressive MS”

This was not ok with me.

Eventually, I took my life into my own hands and rethought how I did most things.
I realized I had to make some changes, or else idk what else was gonna happen to me.

So I did.

I changed my diet.
I changed how I worked out.
I changed my job in the name of stress management.

This is just the tip of the iceberg.

If you want this transformation for you too (I know it’s possible) I’m launching my signature course: Holistically Healing MS in a few weeks.

This is the course you need to get started on this path for yourself.

Only the waitlist is gonna get the pre sale price…
Comment WAITLIST below and I’ll add you to it!!
...

43 8
This is the reality I lived, I want you to experience it too.

No, this is not a quick fix.
No, these results wont happen overnight.
No, this won’t cure you.

BUT-

Yes, you can have your life back.
Yes, you can feel better than you do right now.
Yes, your current reality doesn’t have to be a forever reality.

My success years ago was all thanks to the diet changes and the work I put in to know exactly how to eat to support MY body and MS at the same time. 

Yes it took a few months, but what it gave me back was my life- and that’s priceless. 

I’m spilling all the beans on what this process looks like and how to do it in my upcoming Masterclass:
5 Secrets To Creating Your Own MS Diet. 

Comment CLASS below and I’ll send you the link to sign up!!

This is the reality I lived, I want you to experience it too.

No, this is not a quick fix.
No, these results wont happen overnight.
No, this won’t cure you.

BUT-

Yes, you can have your life back.
Yes, you can feel better than you do right now.
Yes, your current reality doesn’t have to be a forever reality.

My success years ago was all thanks to the diet changes and the work I put in to know exactly how to eat to support MY body and MS at the same time.

Yes it took a few months, but what it gave me back was my life- and that’s priceless.

I’m spilling all the beans on what this process looks like and how to do it in my upcoming Masterclass:
5 Secrets To Creating Your Own MS Diet.

Comment CLASS below and I’ll send you the link to sign up!!
...

13 5
This is my vision for the masterclass I’m hosting next Monday.

I want this to be an interactive experience where you learn how to best take care of yourself and MS symptoms through the food you’re eating.

Instead of:
- feeling hesitation and confusion around what foods are best for MS
- not making changes because you’re afraid you’ll do it wrong 
- saying no again to going out to eat with friends 

Find the freedom and confidence you’ve been looking for.

Comment CLASS below and I’ll send you the link to sign up!!

This is my vision for the masterclass I’m hosting next Monday.

I want this to be an interactive experience where you learn how to best take care of yourself and MS symptoms through the food you’re eating.

Instead of:
- feeling hesitation and confusion around what foods are best for MS
- not making changes because you’re afraid you’ll do it wrong
- saying no again to going out to eat with friends

Find the freedom and confidence you’ve been looking for.

Comment CLASS below and I’ll send you the link to sign up!!
...

11 3
Do any of those hit home? 
 If yes… comment MASTERCLASS below.. I got you

Do any of those hit home?
If yes… comment MASTERCLASS below.. I got you
...

14 3
I get asked this question about different foods at least once a week.

Are potatoes with olive oil ok?
Are tomatoes ok even though Tom Brady doesn’t eat them?
What about grains?

It’s all gonna get the same answer from me….

Sure there are foods with nutrient profiles that match the needs of MS, ✨BUT✨if you don’t tolerate them or feel good eating them, they’re not for you.

I’m hosting a Masterclass next week all about this.

⭐️5 Steps to Creating Your Own MS Diet⭐️

You’ll walk away with:

✨Confidence you’re moving in the right direction regarding changing your diet. You’ll know where to start, how to troubleshoot when you “fall off the wagon” and how to find what works for you. 

No more feeling like:
- you have to start AGAIN on Monday..
- you can’t go out to eat with your friends..
- you’re at the mercy of the few foods you tolerate..

Come join me to learn the balanced way out of all or nothing food land.

Comment MASTERCLASS below and I’ll send you the link to sign up!!

I get asked this question about different foods at least once a week.

Are potatoes with olive oil ok?
Are tomatoes ok even though Tom Brady doesn’t eat them?
What about grains?

It’s all gonna get the same answer from me….

Sure there are foods with nutrient profiles that match the needs of MS, ✨BUT✨if you don’t tolerate them or feel good eating them, they’re not for you.

I’m hosting a Masterclass next week all about this.

⭐️5 Steps to Creating Your Own MS Diet⭐️

You’ll walk away with:

✨Confidence you’re moving in the right direction regarding changing your diet. You’ll know where to start, how to troubleshoot when you “fall off the wagon” and how to find what works for you.

No more feeling like:
- you have to start AGAIN on Monday..
- you can’t go out to eat with your friends..
- you’re at the mercy of the few foods you tolerate..

Come join me to learn the balanced way out of all or nothing food land.

Comment MASTERCLASS below and I’ll send you the link to sign up!!
...

14 2
My mom will confirm, this was me HARD as a kid.

I used to hate all forms of vegetables, just cause they were vegetables. Whether or not I had tried them was irrelevant, I hated them all the same.

Now, I’m not saying this to blame myself for anything, I’m more saying this as a message of solidarity and that it’s never too late to change.

But I also understand that process is hard!! 
Sometimes getting support can help you move forward.

If you:
- are wanting to change your diet to help MS symptoms but aren’t sure where and how to start
- feel frustrated when you do make changes because you can’t stick to them
- have already been eating super strict and can’t seem to add more foods back to your diet

My Masterclass the 5 Secrets to Creating your Own MS Diet is for you!!

Comment MASTERCLASS below and I’ll send you the link to sign up!!

My mom will confirm, this was me HARD as a kid.

I used to hate all forms of vegetables, just cause they were vegetables. Whether or not I had tried them was irrelevant, I hated them all the same.

Now, I’m not saying this to blame myself for anything, I’m more saying this as a message of solidarity and that it’s never too late to change.

But I also understand that process is hard!!
Sometimes getting support can help you move forward.

If you:
- are wanting to change your diet to help MS symptoms but aren’t sure where and how to start
- feel frustrated when you do make changes because you can’t stick to them
- have already been eating super strict and can’t seem to add more foods back to your diet

My Masterclass the 5 Secrets to Creating your Own MS Diet is for you!!

Comment MASTERCLASS below and I’ll send you the link to sign up!!
...

15 1
It’s been a week for me… maybe you too?

Use this short video for a moment of peace and regulation.

What do you notice in your body and about your emotions when you exhale and drop your shoulders?

Or when you hear bird songs?

Notice what makes you feel more calm, relaxed and at peace. 
Do more of that..

It’s been a week for me… maybe you too?

Use this short video for a moment of peace and regulation.

What do you notice in your body and about your emotions when you exhale and drop your shoulders?

Or when you hear bird songs?

Notice what makes you feel more calm, relaxed and at peace.
Do more of that..
...

12 4
I get it… I was once in paralysis by analysis for years!!

I’m creating a Masterclass/Workshop experience in August to cover this exact topic: what and how to eat for MS. 

BUT!! I need your help to narrow down what we’ll be talking about.

Which of these options sounds most helpful?
Comment the number below!!

Workshop ideas: 

1. Simple Nutrition for MS: what you need to know about eating for healing 

2. Create Your Own MS Diet: How to know what is best for YOU, while also helping MS symptoms

3. Education into Action: How to put the knowledge you have into action steps that make progress

4. Blend of it All: Education, steps to finding your own MS diet and how to get started

Want something else?? Tell me 👇🏼👇🏼

I get it… I was once in paralysis by analysis for years!!

I’m creating a Masterclass/Workshop experience in August to cover this exact topic: what and how to eat for MS.

BUT!! I need your help to narrow down what we’ll be talking about.

Which of these options sounds most helpful?
Comment the number below!!

Workshop ideas:

1. Simple Nutrition for MS: what you need to know about eating for healing

2. Create Your Own MS Diet: How to know what is best for YOU, while also helping MS symptoms

3. Education into Action: How to put the knowledge you have into action steps that make progress

4. Blend of it All: Education, steps to finding your own MS diet and how to get started

Want something else?? Tell me 👇🏼👇🏼
...

7 3
FYI- This process took several YEARS for me . So please stop beating yourself up if you’re not here yet.

Tbh- I needed to go through the scared, intimidated, rebellious no way before I got to the heck yes.

It took me being at rock bottom, symptoms out of control and knowing I needed something else.

So I didn’t really “do anything” to be ready. 
I just was when I was.

If you’re feeling ready to make diet changes to help your MS symptoms, I created an Eating for MS guide just for you! 

Your guide includes:
- The best foods to be eating when you have MS
- Several ways to get started
- Fast and easy meal ideas
- And so much more!!

Comment GUIDE below and I’ll send you the link to download!

FYI- This process took several YEARS for me . So please stop beating yourself up if you’re not here yet.

Tbh- I needed to go through the scared, intimidated, rebellious no way before I got to the heck yes.

It took me being at rock bottom, symptoms out of control and knowing I needed something else.

So I didn’t really “do anything” to be ready.
I just was when I was.

If you’re feeling ready to make diet changes to help your MS symptoms, I created an Eating for MS guide just for you!

Your guide includes:
- The best foods to be eating when you have MS
- Several ways to get started
- Fast and easy meal ideas
- And so much more!!

Comment GUIDE below and I’ll send you the link to download!
...

15 7
I get it- it’s really easy to shame yourself into changing something, especially your diet/the foods you eat. And especially when we feel there are other things we “should be doing” because we know “it’s better for us”.

But that is NOT my wish for you.

Hi 👋🏼 my name is Alissa and we do things differently around here.

My goal is to empower you with the knowledge and tools necessary to make informed decisions about your dietary choices, tailored to your unique MS needs and preferences.

This is why I wrote my Eating for MS Guide the way I did.
I did not give you foods to fear or messages of ONLY EAT THIS FOOD FOREVER OR ELSE.

I’m giving you the tools to be confident in the choices you’re making, because you know it works for YOU. Not because you “should” do it this or that way.

If you’ve been wanting: 
- to eat in a way that supports your body with MS, but are confused about all the different messages online
- to feel empowered about your choices, not shamed
- to do it all in a gentle, slow way, not a crash diet..

My guide is for you!!
Comment GUIDE below and I’ll send you the link to download!!

I get it- it’s really easy to shame yourself into changing something, especially your diet/the foods you eat. And especially when we feel there are other things we “should be doing” because we know “it’s better for us”.

But that is NOT my wish for you.

Hi 👋🏼 my name is Alissa and we do things differently around here.

My goal is to empower you with the knowledge and tools necessary to make informed decisions about your dietary choices, tailored to your unique MS needs and preferences.

This is why I wrote my Eating for MS Guide the way I did.
I did not give you foods to fear or messages of ONLY EAT THIS FOOD FOREVER OR ELSE.

I’m giving you the tools to be confident in the choices you’re making, because you know it works for YOU. Not because you “should” do it this or that way.

If you’ve been wanting:
- to eat in a way that supports your body with MS, but are confused about all the different messages online
- to feel empowered about your choices, not shamed
- to do it all in a gentle, slow way, not a crash diet..

My guide is for you!!
Comment GUIDE below and I’ll send you the link to download!!
...

7 2
Or for when you’re trying to talk yourself out of being sick.. 🙋🏻‍♀️🙋🏻‍♀️😂😂

Even if you feel fine, try saying a few of these out loud. Feel what happens to your body when you do.

Do you feel an expansion or lightness in your chest?
Does breathing get a little easier?
Just notice the shifts in your body.

I’m not saying we can talk ourselves out of it (illness, flares etc) … but… our body and cells respond to our thoughts.

So how we think about ourselves is definitely in the conversation of how we can take care of ourselves overall. 
🧡🧡🧡

Or for when you’re trying to talk yourself out of being sick.. 🙋🏻‍♀️🙋🏻‍♀️😂😂

Even if you feel fine, try saying a few of these out loud. Feel what happens to your body when you do.

Do you feel an expansion or lightness in your chest?
Does breathing get a little easier?
Just notice the shifts in your body.

I’m not saying we can talk ourselves out of it (illness, flares etc) … but… our body and cells respond to our thoughts.

So how we think about ourselves is definitely in the conversation of how we can take care of ourselves overall.
🧡🧡🧡
...

39 4

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