AuthorProf G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

Biohacking comes of age

Barts-MS rose-tinted-odometer  ★★ You know something is happening when it gets its own review article in the New England Journal of Medicine. The review article in last weeks issue covers the science and medicine around intermittent fasting (IF) and its effects on health, ageing and disease. The article even includes a few lines on IF and its potential impact on MS.  In my ‘2020 Vision’ post...

2020 vision

Happy New Year. We hope you all had a good festive break. The following are some of what we at Barts-MS want to achieve and work towards in the next decade.  #PreventMSWe have little doubt that MS is a preventable disease and by tackling many of the environmental risk factors we may be able to turn around the MS epidemic and see a fall, or at least a levelling off, in the incidence of MS. This...

Zero stars

Barts-MS rose-tinted-odometer – zero stars Some of our readers are not satisfied with the Swedish Gothenburg 50-year follow-up data on MS outcomes, I presented yesterday; they make the comment that the data is out of date. However, there are very few databases that have 50+ year follow-up data; one of them is the Swedish National MS Register. The following is the latest Swedish registry...

Glass-half-full

Barts-MS rose-tinted-odometer  ★★★★★ I was attacked yesterday for painting a too bleak picture of MS outcomes and for not focusing on the fact that some pwMS actually age well and do well in the long-term. I apologise for being so negative, hence this post to address the data gap.  The best data we have on the longterm follow-up of pwMS in a ‘community-setting’ is the Gothenburg study. In...

What is advanced MS?

Barts-MS rose-tinted-odometer – zero stars Someone recently asked what is advanced MS? I suspect they have been getting frustrated with our use of this adjective without a clearer understanding of what it really means. To find out if you have advanced MS you need to put yourself through a battery of stress tests to find-out much reserve you have left to deal with MS and life in the future...

Is siponimod the first cul-de-sac DMT?

Barts-MS rose-tinted-odometer  ★ A big worry for neurologists and pwMS is the sequencing of DMTs. What DMTs can be used before and after each other and does the sequencing of DMTs change the risk profile of the individual DMTs concerned? These have been dealt with many times on this blog and I am in the final stages of completing phase 1 of my app that will address the specific issues around each...

Flu, it’s not too late to be vaccinated

Barts-MS rose-tinted-odometer  ★★★ Not walking my talk. Having not taken up the NHS offer of the seasonal flu vaccine and having just spent the last 3 days bed-bound with severe flu I found the following research paper very timely.  Using the Norwegian registries these investigators show that pwMS are much more susceptible to the complications of influenza, i.e. pwMS are much more likely to...

Slip-sliding away – do I have secondary progressive MS?

Barts-MS rose-tinted-odometer – zero stars We have been running a campaign that #MS_is_1_not_2_or_3_diseases for sometime. This is based on the biology of MS and not what we see clinically. The pathology that underpins so-called progressive MS is the loss of axons, loss of neurons and loss of synapses, which are the chemical connections between neurons. All three of these processes begin...

How much do you weigh?

Barts-MS rose-tinted-odometer  ★ When last have you weighed yourself and calculated your BMI (body mass index)?  BMI = body mass (kg) / the square of the body height (m) [kg/m2]; to save you time and effort you can simply use the NHS BMI calculator, which takes imperial measurements as well.  I am not sure if you are aware that childhood and adolescent obesity is an important risk...

Do you have high blood pressure?

Barts-MS rose-tinted-odometer  ★ ★ ★ ★ ★ Who knows their current blood pressure? If you have MS you should know your blood pressure, your BMI (body mass index), your lipid status and whether or not you have impaired glucose tolerance or diabetes. In other words, all pwMS should have an annual health check outside of their MS clinic appointment to be screened for comorbidities. We know that pwMS...

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