Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses (2015)
Findings Overall, 44 unique meta-analyses including 416 primary studies of different risk factors and multiple sclerosis were examined, covering a wide range of risk factors: vaccinations, comorbid diseases, surgeries, traumatic events and accidents
, exposure to environmental agents, and biochemical, infectious, and musculoskeletal biomarkers. ... Only three of the 11 significant meta-analyses (p<0·001) included more than 1000 cases, had 95% prediction intervals excluding the null value, and were not suggestive of large heterogeneity (I²<50%), small-study effects (p for Egger’s test >0·10), or excess significance (p>0·05). ..."
- [aside because i'm particularly interested in it...]
"The meta-analyses with very large heterogeneity examined asthma, dental amalgam, bone mineral density in femoral neck and hip, Chlamydia pneumoniae DNA in CSF, chronic cerebrospinal venous insufficiency, immunoglobulins for C pneumoniae in serum, immunoglobulins for C pneu moniae in CSF, organic solvents, serum homcysteine, serum vitamin D, and serum uric acid.
"Vitamin D and sun exposure have also received attention as risk factors for multiple sclerosis in an
attempt to explain the geographical trends and latitude of multiple sclerosis incidence.7,8 Here, we show that, despite the signifi cant association of higher serum 25(OH)D (a biomarker of vitamin D in serum) with
lower multiple sclerosis incidence, the estimated prediction interval of the eff ect size included the null,
which suggests that in some settings the effect of vitamin D on multiple sclerosis might be absent.
Additionally, the evidence for vitamin D had very large heterogeneity and the presence of small-study effects, further suggesting that the evidence supporting low serum vitamin D concentrations as a risk for multiple sclerosis is weak and requires assessment in prospective studies and clinical trials."
Many studies on environmental factors associated with multiple sclerosis have caveats casting doubts on their validity. Data from more and better-designed studies are needed to establish robust evidence. A biomarker of Epstein-Barr virus (anti-EBNA IgG seropositivity), infectious mononucleosis, and smoking showed the strongest consistent evidence of an association."
of course i'm now reviewing the known nutrient interactions between each of these. smoking is a clear negative influence on nutrient status but i'm not sure science has been looking hard at interactions btw nutrient status and elevated immunoglobulins in infection. limited results so far:
Elevated IgE level in relationship to nutritional status and immune parameters in early human immunodeficiency virus–1 disease (1995)
i had head/neck sports trauma that basically triggered my diagnosis shortly thereafter (couple weeks max) but i think at best it was just the last straw among many.