Women - get out of Canada

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Re: Women Should Get Out of the US too

Postby Lyon » Tue Oct 24, 2006 7:56 pm

oo
Last edited by Lyon on Sat May 07, 2011 5:15 pm, edited 1 time in total.
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Postby bromley » Wed Oct 25, 2006 8:42 am

Sharon,

Many thanks for your post and your link to the US research. It's striking how similar the findings and conclusions are:


[Canada]
"The substantial increase in the female to male sex ratio in Canada seems to result from a disproportional increase in incidence of multiple sclerosis in women. This rapid change must have environmental origins even if it is associated with a gene-environment interaction, and implies that a large proportion of multiple sclerosis cases may be preventable in situ".


When I sat next to Professor Ebers (one of the authors) in May he tried to explain this gene-environment to me. I got lost in the technicl stuff. But I had thought that you needed genetic susceptibility and then a trigger e.g. a virus kicked off the disease process. I think his view was that the environmental factor had an effect on the genes. But don't quote me - I didn't pass basic biology at school.

[US]
"Such marked changes in geography, sex, and race in such a short interval strongly imply a primary environmental factor in the cause or precipitation of this disease".


When I attended the MS / EBV seminar in May, a researcher from Denmark said the incidence of MS was increasing, but only among women.

Earlier this year there was another piece of research from Canada which showed that immigrants without a northern European ancestry were also being diagnosed with MS - which sort of shot down the Viking ancestry theory. So it may be that the genetic susceptility is more common than originally thought (and more widespread than just those with northern European ancestry).

If strikes me that the researchers need to focus on the increasing incidence of MS in women if they are to identify the environmental factor. I tried to identify social changes over the last 30 years which have impacted upon women (sort of contrasting the position with my mother who married in the early 1960s) - more having careers & family, more experiencing divorces / break-ups, drinking more alcohol, smoking more, more sexual partners, less time outside (due to work / home), more using the contraceptive pill, more going to University - this is all very generalised, but there have been substantial changes compared with the 1950s / 1960s. Unfortunately, whichever change I pick e.g. the pill, I could come up with a woman with MS where this did not fit e.g. my nun with MS example.

But standing back, I looked at what Sharon said about stress. All these changes have resulted, on the whole, in additional stress (I guess increases in mental health illnesses e.g. depression might show an increase as well). So maybe, this is the common factor - perhaps stress leads to chemical changes in the brain which then disrupts the normal functioning of the immune system. For example, viruses are present in the CNS but are kept under control by immune system surveillance. Once disrupted, the cascade of events which are seen in MS might follow. Or the chemical changes cause damage to the CNS which then results in the immune system mopping up the debris. Unless the researchers come up with something better, I'd say that stress could be the common denominator. Not sure how we deal with it.

Ian

PS I see that Jimmylegs is having boyfriend problems. I'll put a word in for you if you want Dignan. But you know I'm not one to meddle in the private lives of users of this website. Failing that, Scoobyjude might be a backup if Jimmylegs isn't interested.
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Postby Muu » Wed Oct 25, 2006 12:51 pm

Ian
can you send us all a vial of what you're on right now. You seem to be in a mischevious mood with this one!
My contribution for what it's worth is that a persons susceptability to ms increases with the number of boxes he or she ticks- sex, stress, genetics, diet, climate, vitamin d deficiency, viral exposure, hormonal levels and so on. More ticks a greater liklihood of getting it. Canada is more temperate than Florida so perhaps that may be a factor.
Muu

ps My Aunt Stella lives in Forida and has lots of widowed ladies available if any of you guys are interested in meeting a "mature"woman, often an unatural shade of orange and v partial to Early Bird suppers and Ma Jong!
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Postby bromley » Wed Oct 25, 2006 1:31 pm

My contribution for what it's worth is that a persons susceptability to ms increases with the number of boxes he or she ticks - sex, stress, genetics, diet, climate, vitamin d deficiency, viral exposure, hormonal levels and so on. More ticks a greater liklihood of getting it. Canada is more temperate than Florida so perhaps that may be a factor.


I think what you suggest is sensible - which may mean that a single trigger / cause will never be identified. But there must be something else going on to account for the increase in women getting MS. And Canada seems to have a particular problem - I noticed that earlier this year the Canadian MS Society upped its estimate of people with MS. I'm still attracted by a virus as a trigger because some of the so called outbreaks and clusters. I once started a thread about EBV (Glandular Fever or Mono) and was surprised by the number of posting from people at University who recalled an outbreak of mono, and how several years later some had been diagnosed with MS (one mentioned a college of 300, where there was an outbreak of mono and three women had subsequently been diagnosed with MS). So an infection may be part of it, but I'm not sure why MS is increasing among women. Perhaps other factors are having an impact on a woman's hormone levels which makes them even more susceptible (diet coke!) if they come in contact with the infection e.g. a virus.

The other issue is MS in children which is now being recognised - as young as 2 years old. I'm not sure what light this sheds on the gender difference i.e. whether there is a similar ratio as in adults. I do know that data shows that children diagnosed with MS have a much higher level of EBV infection than children who do not have MS. Vit D must have some role - probably a lack of it reduces your defence against MS. And children tend to spend much more time on computers / video games than out on their bikes etc.

I recall reading an article on Professor Ebers who said that as a young doctor (20 years ago) he thought he could work this disease out over a weekend. But it is complex and multi-faceted - a bit like giving a blind man a Rubics cube.

Ian

PS Dignan said he might be interested in your Aunt Stella - perhaps you could forward him a photo. Arron the moderator is always on the lookout for a ladyfriend so would be grateful to be put in touch with your aunt's friends.
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Postby Chris55 » Thu Oct 26, 2006 1:11 pm

Or.....these people in Canada have something other than MS. (I know, I know...stop playing Devil's Advocate!)
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"MS"

Postby jimmylegs » Thu Oct 26, 2006 3:31 pm

i agree that there are probably a bunch of factors. at the moment i am banking on the idea that one or two of those factors can be corrected and then the whole situation goes away. i STILL think "MS" is a pretty vague thing to say. is anyone researching more detailed diagnostic tools i wonder...

at the same time i think i've been mis'diagnose'd and i just have a bit of a malnutrition systems fail so... who knows...

of course i totally agree with the vitamin D thing. mothers (and expectant mothers) are dutifully protecting their own and their children's skin from the harmful rays of the sun...
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Postby Chris55 » Thu Oct 26, 2006 4:20 pm

Melody--there are 240 autoimmune diseases--so far. Kind of reminds one of the "miscellaneous file".
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Postby Lyon » Thu Oct 26, 2006 4:20 pm

oo
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Postby LisaBee » Thu Oct 26, 2006 5:36 pm

Lyon,

I agree with you - some of the increase of MS seen in women may be attributable to diagnostic bias, but it might also be on the physician side, not on the gender-specific tendencies on seeking a diagnosis. I suspect, since MS has always been thought to be more common in women than men, when presented with some suggestive initial symptoms a physician may be more inclined to a diagnosis of MS in a woman than a man, whereas the male patient may get more of a "wait and see". In the case of mild MS, there will be more women diagnosed if this diagnostic bias is true. I have also read, and don't know if this has really been determined, that men, in general, tend to have a more severe progression than women. This observation may also be do to diagnostic bias, that is, if men with mild MS are underdiagnosed and therefore under-represented in study groups, it would weight the proportion of men with more severe MS relative to women and make it seem that men, once diagnosed, tend to have a worse prognosis on average when really they don't if the diagnoses were equally applied to the presenting symptoms. It is all speculation though. I don't know of any way to examine for or control for this kind of bias, if it indeed exists.

It may be that women really are more susceptible to developing MS. It is impossible to compare all factors between men and women if some are unique to each gender. Other factors are not purely gender-specific but gender related, due to metabolic differences. If uric acid levels are higher in men, and gout is more prevalent in men, and gout is inversely related to MS, there may be something there. If vitamin D deficiency is a susceptibility factor for MS, and if vitamin D deficiency is more common in women than men, then perhaps that is also a clue. Perhaps women even need more vitamin D than men. I haven't looked into that. I've often wondered about it, given the high prevalence of female osteoporosis. I've never been totally satisfied with the explanation that women just have thinner bones to start with, and that is why more wind up with osteoporosis (although, contrary to drug ads, osteoporosis is not exclusively a female disease, just as gout is not exclusively a male disease). I read an article examining vitamin D levels in women with other autoimmune diseases, such as lupus - one PubMed abstract indicated that in newly diagnosed female lupus patients in one of the Carolina states (can't remember which), vitamin D deficiency was prevalent.

Just some random thoughts......
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total agreement

Postby jimmylegs » Thu Oct 26, 2006 5:46 pm

lisa i am right in your random thought camp! to add to what i said before about iron -> nitric oxide -> low uric acid -> bbb permeability i would say it's also pretty obvious that women have lower iron status than men, you can only lose iron by bleeding! so we have more oxidative stress and less uric acid to help deal with it.
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iron

Postby jimmylegs » Fri Oct 27, 2006 1:38 am

strangely though i found a study from 1989 that says ms patients typically have higher serum ferritin than controls. i don't fit that profile i was deficient when i started having all my problems...
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Postby bromley » Fri Oct 27, 2006 3:05 am

Thanks for all the contributions to this thread - it was something to get our teeth into. It's interesting that the researchers conclude that:

[we] hypothesize that this is due to environmental factors, which if identified, could be addressed


If only they could identify the factors!

Ian
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Postby bromley » Mon Oct 30, 2006 5:58 am

Here's the Acclerated Cure Project's take on the Canadian women MS research. Jimmy, make sure youy clean your nicotine stained teeth for your first kiss with Dignan.

"The 2:1 female to male ratio in MS is a commonly-quoted prevalence statistic, and refers to the number of women and men currently alive who have been diagnosed with MS. However, like anything else, that ratio is subject to change, and learning whether/how it is changing can lead to many important areas of investigation. A team of Canadian researchers took advantage of a massive MS database to see how gender ratios have changed in their country over the past several decades. The database recorded the birth years and genders of people diagnosed with MS who had been seen at one of the participating MS clinics. Analyzing this data in five-year blocks starting with birth year 1931 and ending with 1980 revealed a dramatic and steady increase in the F:M ratio. For subjects born between 1931-1935, the gender ratio was 1.9 (female to male). For those born between 1976 and 1980, it was 3.21. Further analysis indicated that this increase was very likely due to an increase in MS among women rather than a decrease in MS among men.

This interesting result raises the question of why MS seems to be increasing among women. The authors propose a number of factors such as smoking, working outside the home, and dietary changes. Oral contraceptives aren't a strong candidate because other studies have failed to implicate them as a risk factor for MS, and because the increase in the gender ratio started decades before their widespread use. Perhaps investigating environmental factors in countries where the gender ratio is quite different would help highlight those factors that may be involved in MS."
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Postby Melody » Mon Oct 30, 2006 4:26 pm

bromley wrote:
This interesting result raises the question of why MS seems to be increasing among women. The authors propose a number of factors such as smoking, working outside the home, and dietary changes. Oral contraceptives aren't a strong candidate because other studies have failed to implicate them as a risk factor for MS, and because the increase in the gender ratio started decades before their widespread use. Perhaps investigating environmental factors in countries where the gender ratio is quite different would help highlight those factors that may be involved in MS."


About the same conclusions we came to here. I take it we are authors. :wink:
John was diagnosed Jan 2005. On lipitor 20mg .On Copaxone since July 4,2005. Vitamin D3 2000iu-4000iu (depending on sunshine months)June 10 2005(RX::Dr. O'Connor) Omega 3 as well Turmeric since April 2005. Q10 60mg. 1500mg liquid Glucosamine Nov 2005.
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Postby bromley » Tue Oct 31, 2006 11:26 am

Here's more coverage about this research - can't work out if I got this because of bad genes, kissing a girl at 15 who gave me EBV (Glandular Fever), being born in March? But my twin sister hasn't got MS (or no signs of it), has smoked 40 a day since her mid teens, does no exercise and isn't an outdoors type like myself. But then she won £130,000 two years ago - so perhaps you're just lucky or not!

MS diagnosis rate soaring for Canadian women

A new study has pinpointed an alarming trend that suggests women with multiple sclerosis now outnumber men in Canada by a ratio of more than three to one.

The researchers, led by Dr. George Ebers of Oxford University, examined Canadian data on multiple sclerosis patients. They also found that this gender ratio has been rising for at least 50 years.

More than 1,000 new cases of the disease will be diagnosed this year in Canada, and an estimated 55,000 to 75,000 people are currently living with the disease.

The Canadian research shows:

In 1931, for every one man diagnosed with MS, 1.8 women received the diagnosis.

Around 1940, the picture starts to change. The rate of MS cases in men stays relatively the same, but in women, it rises.

And by 1980, for every one man diagnosed, more than three women develop MS. The team that conducted the research into the Canadian multiple sclerosis data is speculating that an unknown contributing factor has emerged in the last half century to make MS a female-dominated disease. The findings will appear in the November edition of the Lancet's neurology journal.

"Since there is no indication that multiple sclerosis in men has decreased, it seems that the sex ratio change is determined by a preferential increase in affected women," the study says.

Canada has among the highest rates in the world, as do many nations in northern Europe, prompting speculation genetics and geography may increase the risk for people who live in countries far from the equator.

There is growing acceptance of the theory that a vitamin D deficiency due to low sun exposure may be a contributing factor in the development of the often-disabling disease.

If there is a link between vitamin and multiple sclerosis, this could suggest it is a result of less time spent outdoors.

Other possible factors that could be contributing to the trend include the changing role of women in the work force, dietary habits, increase in smoking among women, use of oral contraceptives, and changes in the timing of childbearing years.

Given that the trend in the sex ratio of immigrant patients was similar to that of Canadian-born patients, the researchers believe that this trend is mirrored worldwide.

Previous research found that having an older brother or sister with MS does not protect younger siblings from developing the disease, suggesting that a genetic predisposition and other factors are likely behind the onset of multiple sclerosis.

This findings cast into doubt the theory that children whose immune systems are exposed to infections introduced by older siblings are less likely to develop the potentially debilitating disease.

The study found that babies concieved during the summers, when their mothers have higher levels of vitamin D in their blood are less likely to develop MS later in life.

"Some of the risk appears to be gestational, and very early in life," Dr. Ebers said.

This suggests MS may be preventable, if scientists can figure out what's going on, and if it's as simple as a woman having adequate levels of Vitamin D before or during pregnancy or early childhood.

Multiple sclerosis is an unpredictable disease caused by inflammation and patchy destruction of the protective myelin covering the central nervous system. Those with the progressive disease tend to go through sporadic periods of attack followed by recovery.

The cause of MS is not known, but most researchers believe it is an autoimmune disease, according to the Multiple Sclerosis Society of Canada. Age of onset among patients is usually between 20 and 40, but MS has also been diagnosed in children.

Multiple sclerosis initially may cause numbness and tingling in the extremities and temporary loss of vision in one eye. As the disease develops, patients may experience a range of symptoms, including extreme fatigue, balance and co-ordination problems, muscle stiffness and weakness, and speech and cognitive difficulties.

Source: CTV.ca © 2006 CTV Inc. All Rights Reserved.
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