Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder that affects many individuals globally, with a marked female predominance. MS is characterized by demyelination within the central nervous system (CNS), leading to impaired synaptic transmission and a wide range of neurological symptoms, including visual disturbances, motor dysfunction, cognitive decline, and vertigo. The pathophysiology of MS involves autoreactive white blood cells attacking the myelin sheath, resulting in lesion formation and progressive neuronal damage. Despite advancements in pharmacologic therapies, such as interferons, chemotherapeutic agents, and immunosuppressants like glatiramer acetate and Novantrone, current treatments primarily aim to mitigate symptoms or delay disease progression, often at the cost of severe side effects. These therapies do not address the root causes of the disease, and patient responses vary significantly. Recent research has explored novel approaches to MS management, including non-pharmacologic interventions. This paper proposes the use of prolonged intermittent fasting (IF) (>6 months) as a therapeutic strategy for MS. Emerging preclinical evidence, particularly in animal models, suggests that IF may reduce neuroinflammation, promote remyelination, and improve motor outcomes, thereby enhancing quality of life while minimizing reliance on medications with potentially life-threatening adverse effects. These findings come from the existing literature and are not derived from the present study, but they provide a rationale for further preclinical investigation. Although clinical data remains limited, this proposal highlights the need for further investigation into IF as a promising adjunct or alternative treatment modality for MS.
Keywords: daily caloric restriction; inflammation; intermittent fasting; multiple sclerosis; neurodegeneration; nutrition and metabolism; relapse-remitting; symptomatic management of multiple sclerosis.
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