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:

Or, comment WAITLIST to be notified when it’s ready!!

I’ve been talking to many of you about your questions regarding eating for MS.

There’s lots of confusion about what is “right” and “wrong”. 

Lemme tell you, I’ll answer this in the guide for sure- and it prob won’t be the answer you’re expecting?

Drop any other questions below and I’ll answer them!!

Or, comment WAITLIST to be notified when it’s ready!!

I’ve been talking to many of you about your questions regarding eating for MS.

There’s lots of confusion about what is “right” and “wrong”.

Lemme tell you, I’ll answer this in the guide for sure- and it prob won’t be the answer you’re expecting?

Drop any other questions below and I’ll answer them!!
...

17 5
:: first, comment WAITLIST below to be notified when my new Eating for MS Guide is available!::

When I was first diagnosed with MS I didn’t even think to ask if anything else besides medication would help me.

It didn’t even occur to me that changing my diet or managing stress would also play a part in my disease.

It took a few years, several relapses and failed medications for my BOYFRIEND (now hubby) to ask my neurologist if any diet would help.

And even then, my neuros answer was 🤷🏻‍♂️.

If you also haven’t considered it, let me be the first to tell you:

✨IT’S ABSOLUTELY POSSIBLE✨ 
to decrease your symptoms and influence your long term prognosis by implementing lifestyle changes.

What we eat
How we move
How we manage stress
Our toxin burden
Our hydration status
Etc etc etc
all go a long way in helping us MSers live better with MS.

I lived this transformation; from totally exhausted and unable to get off the couch to hiking mountains or playing golf,
I KNOW it’s possible for you, too.

I’m in the final stages of putting together a comprehensive resource on Eating for MS, comment WAITLIST and I’ll let you know when it’s ready!!

:: first, comment WAITLIST below to be notified when my new Eating for MS Guide is available!::

When I was first diagnosed with MS I didn’t even think to ask if anything else besides medication would help me.

It didn’t even occur to me that changing my diet or managing stress would also play a part in my disease.

It took a few years, several relapses and failed medications for my BOYFRIEND (now hubby) to ask my neurologist if any diet would help.

And even then, my neuros answer was 🤷🏻‍♂️.

If you also haven’t considered it, let me be the first to tell you:

✨IT’S ABSOLUTELY POSSIBLE✨ 
to decrease your symptoms and influence your long term prognosis by implementing lifestyle changes.

What we eat
How we move
How we manage stress
Our toxin burden
Our hydration status
Etc etc etc
all go a long way in helping us MSers live better with MS.

I lived this transformation; from totally exhausted and unable to get off the couch to hiking mountains or playing golf,
I KNOW it’s possible for you, too.

I’m in the final stages of putting together a comprehensive resource on Eating for MS, comment WAITLIST and I’ll let you know when it’s ready!!
...

27 22
I’ve seen this trend with women under 35 and over 35.. so let’s see if we can adapt this for others living with MS!

Those of you who are living with MS for just a few years ask a question and those of us who have been living with it for many years will answer!

Who knows, this may bomb, but the idea is fun!!

Ask away!

I’ve seen this trend with women under 35 and over 35.. so let’s see if we can adapt this for others living with MS!

Those of you who are living with MS for just a few years ask a question and those of us who have been living with it for many years will answer!

Who knows, this may bomb, but the idea is fun!!

Ask away!
...

40 41
Last week I wanted 0 to do with working out. 

I love working out,
I love being able to lift heavy things and feel strong.
But last week?
Nah, I was all set. 

However.. I have some goals and abilities I want to maintain.

Strength training is one way of the consistent ways I help myself to feel good despite living with MS. 

So I made sure that there wasn’t a reason I didn’t want to workout besides my inner toddler, and lo and behold- there wasn’t.
So off I went. 

I gave myself permission to go lighter and slower, which helped me be successful in doing it at all. 

I often find that when I stop strength training for a while, everything starts to hurt, so that’s obviously not what I’m going for. 

I also have a goal of gaining muscle. Muscle decline happens anyway with age, I don’t need to help it along with not moving. 

✨Following through with my daily habits is a form of self care.✨

If you’re done with thinking: 
“I know what to do, I just can’t seem to do it” 
DM me ACTION and we’ll chat

Last week I wanted 0 to do with working out.

I love working out,
I love being able to lift heavy things and feel strong.
But last week?
Nah, I was all set.

However.. I have some goals and abilities I want to maintain.

Strength training is one way of the consistent ways I help myself to feel good despite living with MS.

So I made sure that there wasn’t a reason I didn’t want to workout besides my inner toddler, and lo and behold- there wasn’t.
So off I went.

I gave myself permission to go lighter and slower, which helped me be successful in doing it at all.

I often find that when I stop strength training for a while, everything starts to hurt, so that’s obviously not what I’m going for.

I also have a goal of gaining muscle. Muscle decline happens anyway with age, I don’t need to help it along with not moving.

✨Following through with my daily habits is a form of self care.✨

If you’re done with thinking:
“I know what to do, I just can’t seem to do it”
DM me ACTION and we’ll chat
...

17 4
Instead of being a lump on the couch, now I can go hiking up a mountain with my husband 
Or walk 8 miles around NYC with my sister 
Or do a workout at the gym
Or shower, go shopping and cook dinner all in the same day 

This is possible because: 
✨Yes, the medication I’m on helps for sure 

But truthfully my life has improved so much because of:

✨My daily habits and lifestyle (my morning routine, my diet, my sleep habits, my workouts..)

✨ But what REALLY moved the needle is actively working to have a mindset that allows me to be flexible with myself, to give myself grace when I “mess up” (aka- when I don’t follow through on a habit)

✨This is a mindset that doesn’t require perfection✨

This allows me to be consistent with the habits- like diet changes or movement programs or whatever else I want to do, which then allows me to see progress (aka: my body feeling better)

Which THEN gives me the motivation and desire to keep doing what I’m doing.

✨This is the secret to “success”- right here.✨
Consistent action + giving yourself grace + noticing progress = motivation to keep going. 

It’s not quick or sexy, its actually rather boring.
But boring is actually way better!! 

If you want a life where you:
Feel good in your body, 
Have energy to spend on your friends and family, 
Don’t think about what the MS symptom of the day will be..

I help you create that life for yourself in my signature program, Holistically Healing MS. 

Today is the last day it’s on FLASH SALE… 
Comment MOUNTAIN below and I’ll send you the details!!

Instead of being a lump on the couch, now I can go hiking up a mountain with my husband
Or walk 8 miles around NYC with my sister
Or do a workout at the gym
Or shower, go shopping and cook dinner all in the same day

This is possible because:
✨Yes, the medication I’m on helps for sure

But truthfully my life has improved so much because of:

✨My daily habits and lifestyle (my morning routine, my diet, my sleep habits, my workouts..)

✨ But what REALLY moved the needle is actively working to have a mindset that allows me to be flexible with myself, to give myself grace when I “mess up” (aka- when I don’t follow through on a habit)

✨This is a mindset that doesn’t require perfection✨

This allows me to be consistent with the habits- like diet changes or movement programs or whatever else I want to do, which then allows me to see progress (aka: my body feeling better)

Which THEN gives me the motivation and desire to keep doing what I’m doing.

✨This is the secret to “success”- right here.✨
Consistent action + giving yourself grace + noticing progress = motivation to keep going.

It’s not quick or sexy, its actually rather boring.
But boring is actually way better!!

If you want a life where you:
Feel good in your body,
Have energy to spend on your friends and family,
Don’t think about what the MS symptom of the day will be..

I help you create that life for yourself in my signature program, Holistically Healing MS.

Today is the last day it’s on FLASH SALE…
Comment MOUNTAIN below and I’ll send you the details!!
...

39 2
If you’ve been a client, I’m sure you’ve heard me rant about how society’s expectations for women have set us up for autoimmunity and illness. 

We were praised for being quiet, not rocking the boat, keeping the peace, helping others before ourselves, not talking back, etc etc. 

But where did this get US? The women behind the behaviors? 
Sick, anxious and depressed- that’s where. 

Healing MS or any autoimmune disease can’t happen until you put yourself first. 

That doesn’t mean all of a sudden become a b*tch and ignore the world.

It means considering yourself as much as you consider others. 

One of my clients this week was talking about the boundaries she set in her life and how proud she was of herself. 

She was able to manage the uneasiness (aka: terror) of:
potentially letting others down,
being abandoned and 
discarded for voicing her needs. 

No wonder we’re all sick when even saying our needs outloud is scary!
What allowed her to do that after all these years of staying silent? 

Well many things, but one of them is “nervous system regulation” aka: utilizing small exercises that allow your body to “respond appropriately” aka: not entering an anxiety freak out spiral- to daily stressors. 

This is the “stress management” you’ve been looking for and what will change your life. 

My program Embodied Resilience is your road map to how. 

Drop a 🌀🌀 in the comments and I’ll send you details

If you’ve been a client, I’m sure you’ve heard me rant about how society’s expectations for women have set us up for autoimmunity and illness.

We were praised for being quiet, not rocking the boat, keeping the peace, helping others before ourselves, not talking back, etc etc.

But where did this get US? The women behind the behaviors?
Sick, anxious and depressed- that’s where.

Healing MS or any autoimmune disease can’t happen until you put yourself first.

That doesn’t mean all of a sudden become a b*tch and ignore the world.

It means considering yourself as much as you consider others.

One of my clients this week was talking about the boundaries she set in her life and how proud she was of herself.

She was able to manage the uneasiness (aka: terror) of:
potentially letting others down,
being abandoned and
discarded for voicing her needs.

No wonder we’re all sick when even saying our needs outloud is scary!
What allowed her to do that after all these years of staying silent?

Well many things, but one of them is “nervous system regulation” aka: utilizing small exercises that allow your body to “respond appropriately” aka: not entering an anxiety freak out spiral- to daily stressors.

This is the “stress management” you’ve been looking for and what will change your life.

My program Embodied Resilience is your road map to how.

Drop a 🌀🌀 in the comments and I’ll send you details
...

52 10
It’s ok if it takes time from learning about something to implementing it into your lifestyle.

There is a lot that needs to happen in our mind and body for us to be ready to change something about our day to day life. 

And it’s ok if that process takes longer than you “think it should” or want it too. 

You know what *won’t* help you when this happens? 
Being mean and judgemental to yourself. 

You’re not lazy and nothing is wrong with you, so stop saying that to yourself. 

You know what *will* help you when this happens?
Taking action. 
Action is the antidote to the fear and overwhelm you’re feeling. 

But- in a whole different way than you have been trying.

The key is slow and steady, not sexy or flashy- but this means it’s something better- sustainable. 

Sustainable means “able to be maintained or held”- which is the goal for habits right? 

Being “perfect” for 2 weeks then “messing up” (missing a day) then feeling like a “failure” for that one day, then being “off the wagon” for 3 months isn’t doing you any good (said with muchhhh ♥️♥️♥️)

We want a Supportive Sustainable Lifestyle aka being able to keep up with your habits and progress overtime (ideally for the rest of your life right? It’s about the journey not the destination)

If you want to create a lifestyle that is supportive to reducing your MS symptoms, so you don’t need to be thinking about being on or off “the wagon” again, my signature program Holistically Healing MS is for you.

And good news, it’s on flash sale this week- and the lowest price it will be ever again. 
Comment MSSUCKS below and I’ll send you details
🧡🧡🧡

It’s ok if it takes time from learning about something to implementing it into your lifestyle.

There is a lot that needs to happen in our mind and body for us to be ready to change something about our day to day life.

And it’s ok if that process takes longer than you “think it should” or want it too.

You know what *won’t* help you when this happens?
Being mean and judgemental to yourself.

You’re not lazy and nothing is wrong with you, so stop saying that to yourself.

You know what *will* help you when this happens?
Taking action.
Action is the antidote to the fear and overwhelm you’re feeling.

But- in a whole different way than you have been trying.

The key is slow and steady, not sexy or flashy- but this means it’s something better- sustainable.

Sustainable means “able to be maintained or held”- which is the goal for habits right?

Being “perfect” for 2 weeks then “messing up” (missing a day) then feeling like a “failure” for that one day, then being “off the wagon” for 3 months isn’t doing you any good (said with muchhhh ♥️♥️♥️)

We want a Supportive Sustainable Lifestyle aka being able to keep up with your habits and progress overtime (ideally for the rest of your life right? It’s about the journey not the destination)

If you want to create a lifestyle that is supportive to reducing your MS symptoms, so you don’t need to be thinking about being on or off “the wagon” again, my signature program Holistically Healing MS is for you.

And good news, it’s on flash sale this week- and the lowest price it will be ever again.
Comment MSSUCKS below and I’ll send you details
🧡🧡🧡
...

12 0
One of the criticisms I see about using lifestyle medicine to help improve MS symptoms is that it means “I think my disease is in my control, totally up to me and therefore my fault”.

The things in our control, are only a piece of the puzzle in how we feel, our MS symptoms and disease progression. 

Many more things also go into our health equation:
- Genetics
- Age
- Socioeconomic Status 
- Education 
- Health care access
- Your community 
- Economic stability 

I’m not saying that lifestyle medicine doesn’t matter, it does a lot. I’m just saying it’s not the *only* thing that matters. 

What are your thoughts on this? I know it’s a highly charged topic for some!

One of the criticisms I see about using lifestyle medicine to help improve MS symptoms is that it means “I think my disease is in my control, totally up to me and therefore my fault”.

The things in our control, are only a piece of the puzzle in how we feel, our MS symptoms and disease progression.

Many more things also go into our health equation:
- Genetics
- Age
- Socioeconomic Status
- Education
- Health care access
- Your community
- Economic stability

I’m not saying that lifestyle medicine doesn’t matter, it does a lot. I’m just saying it’s not the *only* thing that matters.

What are your thoughts on this? I know it’s a highly charged topic for some!
...

35 5
Living with MS is hard.
Some days are harder, some easier.

If you’re in a season where it feels hard, I see you.

I believe in you.
🧡🧡🧡

Living with MS is hard.
Some days are harder, some easier.

If you’re in a season where it feels hard, I see you.

I believe in you.
🧡🧡🧡
...

21 2
The food we eat can have a powerful impact on our MS symptoms and how we feel.

It’s not a magic bullet- because nothing is.

But, there is incredible potential for healing and improvement.

If you’re not quite ready to follow a “diet template”, like The Wahls Protocol or Autoimmune Protocol, that’s ok. 

Focus on getting some of these foods on your next trip to the store:

🥗Brightly Colored Fruits & Veggies 
🥬Deep Leafy Greens 
🍤Seafood & Shellfish 
🥜Healthy Fats
🥩Organ Meat

Each of these different types of foods contain antioxidants, vitamins and minerals that help support cellular functions, immune health and even help with myelin formation.

Not eating any of it? That’s ok!
Start with adding a serving or two here and there.
Ideas: 
✨Have a salad with dinner
✨Toss some veggies in your breakfast egg scramble
✨Have some olives or nuts as a snack instead of chips

It doesn’t have to be hard or complicated.

There is SO MUCH we can be doing to help improve our MS symptoms & progression with diet & lifestyle interventions.

Each thing you’re doing matters.

It may seem like it’s not worth it sometimes, but I’m here to tell you it is.

Keep going!
🧡🧡

The food we eat can have a powerful impact on our MS symptoms and how we feel.

It’s not a magic bullet- because nothing is.

But, there is incredible potential for healing and improvement.

If you’re not quite ready to follow a “diet template”, like The Wahls Protocol or Autoimmune Protocol, that’s ok.

Focus on getting some of these foods on your next trip to the store:

🥗Brightly Colored Fruits & Veggies
🥬Deep Leafy Greens
🍤Seafood & Shellfish
🥜Healthy Fats
🥩Organ Meat

Each of these different types of foods contain antioxidants, vitamins and minerals that help support cellular functions, immune health and even help with myelin formation.

Not eating any of it? That’s ok!
Start with adding a serving or two here and there.
Ideas:
✨Have a salad with dinner
✨Toss some veggies in your breakfast egg scramble
✨Have some olives or nuts as a snack instead of chips

It doesn’t have to be hard or complicated.

There is SO MUCH we can be doing to help improve our MS symptoms & progression with diet & lifestyle interventions.

Each thing you’re doing matters.

It may seem like it’s not worth it sometimes, but I’m here to tell you it is.

Keep going!
🧡🧡
...

19 6
In case you needed to hear that today.

You’re not a failure.
You didn’t “fail” at healing.
Having MS is hard- do what’s best for you.

In case you needed to hear that today.

You’re not a failure.
You didn’t “fail” at healing.
Having MS is hard- do what’s best for you.
...

62 9

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