You're at a restaurant with friends and the question comes up before you've even had a chance to look over the menu: drinks, anyone? If you have multiple sclerosis, you may want to think it through before you say, "yes." If you ask experts whether alcohol and MS mix, the answer is, "it's complicated." Like a lot of things in life, there are some pros and cons to the issue.
Why It May Be OK
"There is some data that MS patients are a little more likely to have cardiovascular disease than the general population," says Anthony Reder, MD, professor of neurology at the University of Chicago Medicine, "so it might be beneficial for MS patients to drink in moderation."
How much is moderate? The government's "Dietary Guidelines for Americans" says it's one drink a day if you're a woman and up to two drinks a day if you're a man.
Why You Should Think Twice
There are a few things you should know before you open up that bottle of beer.
"Alcohol affects the central nervous system, meaning it can impact judgment, balance, and coordination," says Barbara Giesser, MD, professor of clinical neurology at UCLA's David Geffen School of Medicine.
"And since MS can also lead to problems with balance and coordination, adding alcohol on top of that may make those issues even worse."
Another reason to be cautious is that alcohol can make you feel like you need to pee in a hurry. It's a problem that you could already be dealing with because of your MS.
Alcohol can affect how well you sleep. That can also be an issue with MS, so you may not want to add to your troubles by drinking.
Not everyone reacts to alcohol the same way. "Some people may become more sensitive than others to how much drinking alcohol impacts their MS symptoms," Giesser says. "So while drinking in moderation may not impact some people at all, even one drink might be too much for someone else. The best thing is to use common sense when deciding how much to drink."
Medicines and Alcohol Aren't a Good Fit
Some of the drugs you take may not mix well with alcohol. "Many MS medications have the potential for irritating or damaging the liver," Giesser says. So does drinking a lot of alcohol. If you drink heavily, you could wind up overtaxing your liver and increasing your risk for liver damage.
On top of that, specific meds you use to control your MS symptoms can interact with alcohol and change the way you feel.
"Some of the Valium-family of drugs MS patients take to deal with anxiety and stiffness could mix with the alcohol and make you feel more floppy than usual," Reder says. Plus, opiates that help control your pain can make you sleepy -- something that can also get worse when you add alcohol.
What About Your Friends Who Don't Have MS?
Some people may wonder if there's a chance that drinking can raise your risk of getting MS. There's no evidence that it does.
Some research suggests the opposite. A study by the Institute of Environmental Medicine in Sweden shows drinking could lower your risk of multiple sclerosis. The reason? Alcohol reduces inflammation in the body and MS is an "inflammatory" disease.