Question in pregnant period

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Question in pregnant period

Postby Rita » Tue Apr 26, 2005 9:34 am

I have a question in mind from long time ago, how is possible to a pregnant woman recover (during this period) most of her problems caused by MS if these problems are derived by a destruction in the myelin sheet? It has no big sense; if there is a hole, there is and how could it disappear? Is the sheet remielyneted during a short period and returned to the old status in few days?

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Postby Shayk » Tue Apr 26, 2005 8:33 pm

Hi Rita

I think you’re probably asking a lot of questions here.

There is some information about 3 specific hormones that rise during pregnancy and drop fairly significantly in the post partum period. These are two forms of estrogen: estradiol and estriol; progesterone and Vitamin D 3.

Estriol

An article in 2002 entitled Treatment of Multiple Sclerosis with the Pregnancy Hormone Estriol, abstract here, describes a very small Phase I study in women with RRMS and SPMS. With respect to women with RRMS given a “pregnancy dose” of estriol, 8 mg/day, the study states:

Although this is a small trial on a very limited number of RR patients, it is noteworthy that the degree of improvement in enhancing lesions in this study was within the realm of what has been observed previously for the four approved treatments in much larger trials.

Paced auditory serial addition (PASAT) cognitive testing was also measured in the study.

PASAT cognitive testing scores were significantly improved in the RR group (p = 0.04), but not in the SP group.

Subsequent data analysis from this study also suggested estriol may be neuroprotective.

Progesterone

There is some mice research that suggests progesterone (also elevated in pregnancy) is neuroprotective and “promyelinating”. A couple of quotes from an abstract entitled ]Local synthesis and dual actions of progesterone in the nervous system: neuroprotection and myelination
Although there are only a few studies addressing the biological significance of PROG synthesis in the brain, the autocine/paracrine actions of locally synthesized PROG are likely to play an important role in the viability of neurons and in the formation of myelin sheaths……..PROG may exert its neuroprotective effects by regulating expression of specific genes in neurons and glial cells, which may become hormone sensitive after injury…..Local synthesis of PROG in the brain and the neuroprotective and promyelinating effects of this neurosteroid offer interesting therapeutic possibilities for the prevention and treatment of neurodegenerative diseases, for accelerating regenerative processes and for preserving cognitive functions during aging.


Another interesting abstract which highlights progesterone is entitled Steroid synthesis and metabolism in the nervous system: Trophic and protective effects

Europeans are in the process of initiating a study of progestin in women with RRMS.

Guys, I know you probably feel left out, but there is at least a study (not MS related at all) that concludes: Progesterone may be a more important steroid hormone in men than previously believed.

Vitamin D 3

I’ll leave information about this to people who have studied this much more than I have. I have read that Vitamin D 3 is also elevated during pregnancy and drops in the post partum period.

This is all to say that 3 hormones that are elevated in pregnancy and drop after delivery: estriol, progesterone, and Vitamin D 3, may be beneficial in the management of MS. Progesterone may be particular helpful in the formation of myelin sheaths.

I hope this helps.

Sharon (who had no progesterone at the age of 57 8O )
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Postby treez » Wed Apr 27, 2005 7:40 am

I can relate to all the questions you are asking. I too have questioned how people can lose there symptoms during specific "events". I don't know that there is a positive answer to this.

The conclusion I have drawn is this, in laymans terms..... With the exception of "black holes", nerve conduction is not permanently lost in many cases. The nerve insulation(myelin) can be repaired, possibly not to it's original state, but the evidence of repair is there. This all comes back to losing myelin or losing axons( the actual nerve conductor).

From our point of view, this is an excellent outlook. I see it as the possibility of repair and regaining lost function. Although pregnancy isn't a possibility for me :? , a statement I've made many times is, "women have a cure available to them, they just have to make sure they stay pregnant" :wink:

Us guys aren't so lucky.

I don't think I've really answered any questions, just presented some opinions. Isn't alot of this MS thing just based on opinions and circumstantial evidence?

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Postby Arron » Wed Apr 27, 2005 9:34 am

if you look at how Aimspro is described to work, it is similar-- it seems to boost nerve conduction in the short term (accounting for "I can see again!" revelations) while being an immunomodulator in the long term.

Fampridine-SR is another one that seems to boost nerve conduction.
Disclaimer: Any information you find on this site should not be considered medical advice. All decisions should be made with the consent of your doctor, otherwise you are at your own risk.
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Re: Question in pregnant period

Postby NHE » Thu Apr 28, 2005 1:41 am

Rita wrote:I have a question in mind from long time ago, how is possible to a pregnant woman recover (during this period) most of her problems caused by MS if these problems are derived by a destruction in the myelin sheet? It has no big sense; if there is a hole, there is and how could it disappear? Is the sheet remielyneted during a short period and returned to the old status in few days?

I believe during pregnancy that there's a large shift in the immune system towards tolerance. A developing child is essentially a foreign body. A normal immune system would attack and destroy it. In an autoimmune disease such as MS, it could be that chronic inflammation in the CNS never gives the remyelinating repair processes a chance to recover from the damage that's been caused. Then, once the immune system shifts towards tolerance during pregnancy, the repair processes can begin to recover from the prior damage somewhat. The hormones that were mentioned above may play a role in the immune system's shift. However, I have yet to look extensively into the scientific literature in this area so I will leave the finer points of the discussion to others with more information.

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Pregnancy

Postby treez » Thu Apr 28, 2005 6:36 am

I know I have recently run across a study about pregnancy and MS. Although not the exact article, here is a link to National MS Society article posted recently. Just some reading, no real answers. Isn't that the NMSS anyhow?

http://www.nationalmssociety.org/Highlights-Pregnancy.asp

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Postby Rita » Thu Apr 28, 2005 9:05 am

Very interesting all the points of view exposed here, and this makes me think that the remielinyzacion must be possible and not so difficult to obtain.

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