Managing any chronic disease can be challenging — and multiple sclerosis is no different. While certain lifestyle changes can help ease symptoms, patients typically depend on medications to lower the relapse rate and slow the disease’s progression. Tysabri is one such medication. But how does alcohol interact with it, and is it safe to drink while taking it? 

In this post, we’ll explore what Tysabri is, how it helps treat multiple sclerosis (MS), and how it interacts with alcohol. We’ll also offer some tips for managing MS. Let’s dive in!

What Is Tysabri Used for?

Tysabri is a prescription medication that is used to treat relapsing forms of multiple sclerosis (MS). It’s considered a highly effective disease modifying drug, as it has been shown to reduce the number of relapses of MS and reduce the severity of any relapses that occur. In fact, in clinical trials, people taking Tysabri had about 70% fewer relapses of MS than people taking a placebo. Similarly, MRI scans showed that people taking Tysabri had fewer, smaller, or no new areas of active MS. 

Tysabri contains the active drug natalizumab, a “biologic” drug (one that’s made in a lab from living cells). It works by preventing potentially damaging immune cells in the bloodstream from entering the brain and spinal cord. Tysabri, typically taken intravenously once every month by patients with relapsing MS, is prescribed to people who haven’t responded well to other treatment options.

The side effects of Tysabri vary, but some of the most common include headache, fatigue, joint pain, urinary tract infection (UTI), and lung infection. In some instances, Tysabri can lead to herpes infections, liver damage, and allergic reactions. Tysabri can also increase the risk of progressive multifocal leukoencephalopathy (PML), a rare brain infection that usually leads to severe disability or death.

Understanding Multiple Sclerosis

So what is MS, and why is treatment necessary? MS is a chronic disease of the central nervous system that disrupts communication within the brain and spinal cord. It’s believed to be an autoimmune disorder, a condition in which the body attacks itself. But environmental factors, infectious agents (such as viruses), and genetics can also play a role in the development of MS. 

In MS, myelin — the fatty tissue surrounding and protecting nerve fibers — is destroyed in many areas of the brain and spinal cord. The loss of myelin forms scar tissue called “sclerosis.” When the nerves are damaged in this way, they can’t conduct electrical impulses to and from the brain. Interrupting communication signals causes unpredictable symptoms, including numbness, tingling, mood changes, vision loss, slurred speech, memory problems, lack of coordination, and fatigue. 

Signs and symptoms of MS vary widely between patients and depend on the location and severity of nerve fiber damage. Some people have only mild, short-term symptoms, while others experience paralysis and lose their ability to see clearly, write, speak, or walk. 

MS and Alcohol: How Does Alcohol Affect Multiple Sclerosis?

When it comes to the relationship between MS and alcohol, there’s some conflicting evidence. Some studies show that alcohol can temporarily worsen symptoms of the condition, while others suggest it can calm an overactive immune system.

Because MS is a chronic inflammatory condition, scientists believe that it’s caused by an overactive immune system. Because of this, MS therapies often aim to suppress the immune response. Some studies discovered regular alcohol intake suppressed one aspect of immunity. However, there’s a lack of conclusive evidence, so scientists agree that more research needs to be done to determine whether alcohol can benefit people with MS. 

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What we know for sure, though, is that there are some potential negative consequences of drinking alcohol with MS. Here are some of them: 

• Worsened MS symptoms. People with MS often struggle with coordination, balance, and slurred speech. Even just one alcoholic beverage can cause them to become a bit more wobbly and slow their reaction time. As a central nervous system depressant, alcohol slows the reactions in our brain and spinal cord. This can lead to slow thinking, slow responses, and greater physical weakness in people with MS.
  
  Additionally, some people with MS report an overactive bladder and a greater need to urinate. Alcohol may only make things worse, since it’s a diuretic and causes us to pee more frequently. Furthermore, long-term alcohol consumption can impair the immune system and increase the inflammatory response characteristic of MS. 
• ‍Altered mood. Mood disorders like anxiety, depression, and suicidal ideation are common in people with MS — and often more severe compared to those without the condition. Alcohol on its own can lead to symptoms of depression and anxiety. Even though it provides a temporary mood boost through the release of dopamine (that “feel good” chemical), it disrupts the balance of neurotransmitters and can leave us feeling more depressed in the long run. 
  
  One study found that MS patients with histories of problematic drinking showed an increased risk of anxiety throughout their lifetime. Researchers also noted a link between suicidal thoughts and excess drinking in people with MS. 
• ‍Harmful interactions with medications. Common medications for treating certain symptoms of MS include muscle relaxants, antidepressants, anti-inflammatory agents, such as NSAIDs (nonsteroidal anti-inflammatories), non-narcotic pain drugs, and opioids. Combining these with alcohol can be harmful. For instance, alcohol’s sedative effect can increase the impact of muscle relaxants and opioids. It can also increase the risk of stomach and intestinal bleeding resulting from NSAID use. Similarly, consuming alcohol while taking antidepressants may increase feelings of depression and hopelessness.
  
  It’s also worth noting that consuming alcohol can have a negative effect on important vitamins and minerals. For instance, it can lower levels of zinc — a chemical important for cell growth and repair.  

Does Drinking Alcohol Cause MS? 

So, does alcohol itself increase our risk of developing MS? Here again, there’s a bit of conflicting evidence whether alcohol consumption is an environmental risk factor for MS. One study from 2006 showed that people who drank hard liquor daily had a 6.7-fold increased risk of MS. However, a larger 2014 study showed that people who reported moderate alcohol consumption had half the odds of developing MS compared to those who did not drink alcohol. 

More recently, two studies found no significant association between drinking alcohol and developing MS. To date, there’s not enough conclusive evidence to say whether alcohol leads to an increased risk of developing the condition. However, there is conclusive evidence that regularly consuming alcohol can be detrimental to our overall health and well-being, affecting nearly every bodily system.

Alcohol and Tysabri Side Effects

What about drinking alcohol while on Tysabri — is it safe? While there are no harmful interactions between alcohol and Tysabri, drinking alcohol while on this medication may increase the risk of side effects. For instance, Tysabri can cause headaches, nausea, infections, and altered mood. Adding alcohol can increase these side effects because alcohol is a central nervous system depressant that causes similar side effects to Tysabri. 

For instance, alcohol causes dehydration, which can lead to headaches and nausea. Alcohol also weakens our immune system, increasing our risk of infections. It can also have a depressive effect on our mood by upsetting the delicate balance of neurotransmitters in our brain.

But it’s not just that alcohol can increase Tysabri’s side effects. As we learned above, alcohol can exacerbate MS symptoms in general. According to the National Multiple Sclerosis Society, people with MS have experienced temporary worsening of balance and coordination after even just one drink. 

In general, it’s best to consult a medical professional to determine whether it’s ok for us to drink alcohol while taking Tysabri.

How To Manage Drinking With Tysabri

If we do choose to drink alcohol while being treated with Tysabri, here are 5 tips to help manage symptoms:

1. Limit consumption. Since alcohol can worsen both Tysabri’s side effects and symptoms of MS, it’s best to limit our consumption. Drinking moderate amounts means limiting ourselves to one drink a day for women and two drinks a day for men. However, we’ll be better off if we cut back to just one or two drinks a week.

2. Don’t drink right before bed. Since both alcohol and MS can lead to frequent urination, it’s best not to consume alcohol right before bed. Doing so may cause us to wake up in the middle of the night, disrupting our sleep. Keep in mind that alcohol also disrupts REM sleep — the most important stage for physical and mental restoration.

3. Drink water. Whenever you drink alcohol, make sure you’re also drinking water. Staying hydrated is vital for many bodily functions, and it offers various benefits for people with MS, such as reducing bladder and bowel symptoms, decreasing the side effects of Tysabri, and preventing fatigue and mental decline.

4. Choose drinks with lower alcohol content. Avoid taking shots and drinking hard liquor or drinks with a higher alcohol content, as these can rapidly increase blood alcohol content (BAC) levels and make us more intoxicated. Opt instead for drinks with a lower alcohol content, such as beer or wine.
   
   
5. Don’t drink on an empty stomach. Eating before drinking slows alcohol absorption, giving our body more time to process it. Eating a nutritious meal high in protein or healthy fats can be particularly beneficial. You might also consider snacking while drinking: this helps us drink more slowly and limit our consumption.

If you notice that alcohol worsens Tysabri’s side effects or MS symptoms, it’s best to avoid drinking entirely. And keep in mind that regularly consuming alcohol can be detrimental not just to our physical health, but our mental health as well.

Tips for Managing Multiple Sclerosis

In addition to the above, we can take certain steps to help manage MS symptoms. Here are 5 tips: 

1. Eat nutritious food. There’s no special MS diet, but a healthy eating plan can give you more energy and help stave off chronic conditions such as heart disease and type 2 diabetes. Experts recommend plenty of fruits and vegetables, lean protein, and omega-3 fatty acids. It’s also wise to consume enough fiber to prevent constipation, a common problem for people with MS. Many fruits, vegetables, whole grains, beans, and lentils are good sources of fiber. 

2. Keep your body moving. Exercise is important for people with MS both for fitness and for function. Regular exercise promotes flexibility and balance, and it can also help with other MS symptoms, such as constipation, fatigue, and cognitive issues. Many people with MS benefit from working with a physical therapist, who can help identify exercises to strengthen body areas that are particularly weak. 

3. Exercise your brain. It’s important to exercise your brain. Because of the condition, MS patients often have to use more of their brain to do a specific task than other individuals. Doing crosswords, playing word games, taking classes, reading, or engaging in other mentally challenging activities can help keep your brain sharp and engaged.

4. Practice stress management techniques. Many people with MS experience heightened levels of stress because of difficulties living with the condition. Meditation, mindfulness, deep breathing exercises, and other stress-reduction practices have been shown to improve quality of life and possibly slow disease progression. Spending time with friends and loved ones or finding a club to join can also help us cope with stress.

5. Protect your mental health. As we’ve learned, many people with MS can struggle with depression. It’s important to prioritize your mental health and seek treatment if necessary. Both psychotherapy and antidepressant medication have been found effective for depression in people with MS. Additionally, joining an MS support group can help us feel less alone. 

The Bottom Line

Tysabri is a prescription medication that can be used to help treat relapsing forms of multiple sclerosis — a chronic disease of the central nervous system that disrupts communication within the brain and spinal cord. While there’s no harmful interaction between Tysabri and alcohol, drinking may increase the risk of side effects, such as headaches, nausea, infections and mood changes. Drinking alcohol can also worsen MS symptoms in general. If we choose to drink alcohol while being treated with Tysabri, it’s best to limit our consumption.

If you’re struggling to control your alcohol intake, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people cut back on their alcohol consumption and become healthier, stronger, and happier in the process.