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When does ms develop: Multiple sclerosis – Symptoms and causes

What Causes MS? | Multiple Sclerosis Society UK

No one knows for sure why people get MS. It’s likely to be due to a mix of genes, something in your environment and some lifestyle factors.

Is MS hereditary?

MS is not directly inherited from parent to child. There’s no single gene that causes it. Over 200 genes might affect your chances of getting MS. But genes are only part of the story.

MS can happen more than once in a family, but it’s much more likely this will not happen. There’s only about a 1.5% chance of a child developing MS when their mother or father has it (that means around one in 67 get it). There’s only around a 2.7% chance that you’ll get MS if your brother or sister has it (around one in 37 get it). In 2014 a very large study found that MS may be even less likely to be passed on than these figures suggest.

> Read more about genetics and MS

Environmental factors

MS is less common in tropical countries near the equator that get lots of sunshine. More people have MS in places further away from the equator like Britain, and that’s true no matter what your ethnic background is. Other countries where MS is more common include Canada, the US, Scandinavia, southern Australia and New Zealand.


There’s evidence that some viruses, and maybe bacteria, can help trigger MS.

A common virus called Epstein Barr virus (it causes glandular fever) has been linked to MS. Most people have had this virus but they never get MS. This shows that, like genes, infections might play a role but they aren’t the whole story.

Vitamin D

There’s more and more evidence that low levels of vitamin D, especially before you become an adult, could be a factor in why people get MS.

Our skin makes most of our vitamin D when we’re out in the summer sun. We also get some from food like oily fish, eggs, spreads and breakfast cereals with added vitamin D in them. You can also get extra vitamin D from supplements (but too much can be harmful).

A blood test can show if your levels of vitamin D are low.

> Read more about vitamin D and MS



Studies show you’re more likely to get MS if you smoke. It might be because the chemicals in cigarette smoke affect your immune system. If you have MS in your family, your risk of getting it too could go up if you’re exposed to passive smoking (breathing in other people’s smoke).

If you have relapsing MS and you stop smoking it can slow down how fast your MS might change to secondary progressive MS.


Studies show that getting MS could be linked to being very overweight (obese), especially when you were a child or young adult. This might be because obese people are often low in vitamin D. Obesity can also make your immune system overactive and cause inflammation in your body. There may be other reasons we don’t understand yet.

Of course, not all people who are very overweight get MS, and having MS doesn’t mean you are or were obese. But if your risk of getting MS is on your mind, perhaps because a close relative has it, then your weight is a risk factor you can change.

Tremors in MS | Multiple Sclerosis Society UK

Tremors can be a symptom of MS – a trembling or shaking movement you can’t control. This could appear as shaking hands, or tremors in other parts of the body. Some kinds of MS tremors can be called ‘ataxia’.

Like other MS symptoms tremors can come and go, or they could be longer lasting. Tremors in MS might be hardly noticeable to others, or they could be more severe. There are ways you can treat and manage MS tremors.

For some people with MS, tremors are so mild that no one else notices. For others, the tremor might be more pronounced. For example, it might cause a drink to spill when you lift a full cup. For a small percentage of people MS tremors are more severe, causing limbs to shake so that you need help with everyday tasks.

If your tremor is severe, it could have a significant impact on your independence. It can also directly affect your general wellbeing, work and social life. You might feel embarrassed about your tremor. You might avoid situations which make you feel self-conscious about it. Or it might make you feel anxious, and in turn that anxiety may make your tremor worse.

Whatever you feel – and it may be different at different times – you don’t have to cope alone. We can support you if you’ve got worries and questions. Our MS Helpline gives emotional support and information to anyone living with MS.

Tremor can be one of the more difficult symptoms of MS to manage, but there are things that can make a difference, including:

  • physiotherapy
  • occupational therapy
  • drug treatments
  • surgery

Read about treating and managing tremor

Gross tremor and fine tremor

Tremors in MS can be either big movements, called ‘gross tremor’, or small movements, called ‘fine tremor’.

Everyone has some amount of fine tremor – known as ‘essential tremor’. It’s when our hands shake a tiny bit, especially if we’ve drunk coffee or there’s a lot of adrenaline in our system after a shock or excitement.

Fine tremor in MS can be a more noticeable version of that. It might be a shaking in the hands, feet or other part of the body.

If you have the bigger movements of gross tremor, that might be in the arms or legs. This can make it harder to balance or perform certain active movements, like reaching for something.

How common are tremors in MS?

It’s not clear exactly how many people with MS are affected by tremor, but research suggests it’s between 25 and 60 per cent.

What kinds of tremors are most common in MS?

There are two kinds of tremors that are most common as a result of MS:

  • intention tremor
  • postural tremor

So as well as describing tremors as ‘fine’ or ‘gross’ (small or big), we can also use ‘intention’ and ‘postural’ to describe when tremors happen. 

Intention tremor

Intention tremor is the most common MS tremor. It comes on when you want to do something or reach for something. It often gets worse the closer you get to the object. If you have intention tremor because of your MS, you’ll probably find that while your muscles are completely relaxed – such as when you are lying down or asleep – your tremor goes away.

Postural tremor

Postural tremor is when you shake when you’re sitting or standing. It comes on while your muscles are trying to hold part of your body still against the forces of gravity. Like with intention tremor, postural tremor usually goes away if your muscles are completely supported or relaxed, for example if you’re lying down or sleeping.

Read more detail about different types of tremor from the National Tremor Foundation

Ataxia and tremor in MS

You might come across the word ‘ataxia’ used instead of, or as well as, tremor. Ataxia is when muscles aren’t coordinated. It can lead to different MS symptoms including problems with balance, coordination and sometimes tremor.

Some of the ways to treat and manage tremor can also help with ataxia’s effects on balance and coordination. For example, strengthening core muscles can help with posture.

Metabolic syndrome: symptoms, diagnosis, risk factors





  • Obesity
  • Diabetes


Modern medicine considers the metabolic syndrome as a set of associated factors that, together and individually, increase the risk of cardiovascular disease, stroke, and type 2 diabetes.

Pathological factors include high blood pressure, high blood sugar, accumulation of visceral fat, and abnormal blood cholesterol or triglyceride levels.

The presence of only one of these factors does not indicate a metabolic syndrome, but indicates a certain risk of its development and complications in the future. The more predisposing factors, the higher the risk of complications.

Mechanism of development of the metabolic syndrome

Most researchers believe that the primary etiopathogenetic mechanism for the development of the metabolic syndrome is primary insulin resistance. It is she who launches a chain of metabolic and hormonal disorders, contributes to the development of abdominal obesity.

Insulin resistance impairs the utilization of glucose by cells in peripheral tissues and the cells respond abnormally to insulin. Insulin is a hormone produced by the beta cells of the pancreas. The hormone helps sugar get inside the cell and be used as fuel.

In insulin insensitivity, glucose cannot easily enter the cells, resulting in increased workload on pancreatic beta cells and increased insulin production (hyperinsulinemia). For a while, this allows you to keep the level of sugar in the normal range, but then the glucose level rises, despite the fact that the body produces more and more insulin. On the one hand, hyperinsulinemia is a compensatory reaction, on the other hand, it is a pathological mechanism that contributes to the occurrence of other metabolic, hemodynamic and organ disorders.

The mechanisms by which insulin resistance develops are still being studied. But it is known that the development of insulin resistance is a consequence of genetic and environmental influences. There are several levels of breakdowns leading to the formation of an insulin resistance complex.

1. First level – Genetic mutations are described due to which insulin is initially abnormal.

2. The second level is the pathology of the insulin receptors themselves, which is manifested by insulin insensitivity, a reduced number or destruction of receptors under the action of antibodies synthesized by the immune system.

3. The third level – a violation of the signal transmission process, when insulin and receptors are working, but there is a violation of the signal inside the cell.

In many ways, certain behavioral responses contribute to the development of insulin resistance and metabolic syndrome:

  • Tendency to overeat or imbalance in nutrition Associated with an increase in the proportion of carbohydrates and fats in the diet, the use of fast carbohydrates, trans fats, a tendency to frequent snacks and food on the go.
  • Sedentary lifestyle.
  • Lack of skills to counteract emotional and other stresses.
  • Smoking, alcohol abuse.
  • Disturbance of normal nasal breathing (apnea), especially during sleep.
  • Long-term untreated or poorly treated arterial hypertension.

Metabolic syndrome is closely associated with being overweight or obese and inactive.

Risk Factors for Metabolic Syndrome

Metabolic syndrome is closely associated with overweight or obesity, lack of physical activity. Therefore, people with abdominal obesity, insulin resistance and inactive lifestyles have the highest risk of developing metabolic syndrome.

The following factors increase the chances of developing metabolic syndrome:

1. Age. The risk of metabolic syndrome increases with age.

2. Race and ethnicity. Hispanics are at the highest risk of developing metabolic syndrome.

3. Diabetes mellitus. A person with a personal (eg, gestational diabetes) and family history of type 2 diabetes is at risk of developing metabolic syndrome. It has been proven that the metabolic syndrome in 80% of cases is associated with type 2 diabetes mellitus.

4. Other diseases. The risk of metabolic syndrome is higher with associated conditions: non-alcoholic fatty liver disease, gallstone disease, atherogenic dyslipidemia, polycystic ovary syndrome, and gonadal dysfunction in men.

In some cases, the metabolic syndrome is associated with endothelial dysfunction, renal dysfunction (micro- and macroalbuminuria), inflammation (increased C-reactive protein (CRP), interleukins and other inflammatory mediators), hypercoagulation (increased fibrinogen and tissue plasminogen activator inhibitor-1 ), atherosclerosis.


Metabolic syndrome develops gradually and is not accompanied by any clinical symptoms for a long time. Most of the disorders associated with the metabolic syndrome have no obvious manifestations and can be detected incidentally through laboratory examination. The only noticeable sign indicating metabolic syndrome is a large waist circumference and a characteristic distribution of adipose tissue. With metabolic syndrome, fat deposition occurs in the abdomen and upper shoulder girdle.

Diagnostic criteria

Main criterion:

  • Central (abdominal) type of obesity – waist circumference over 80 cm in women and over 94 cm in men.

Additional criteria:

  • BP >130 and 85 mmHg, or treatment of hypertension with drugs.

Lipidogram :

  • Elevation of triglycerides ≥ 1.7 mmol/l.
  • An increase in the level of LDL cholesterol > 3. 0 mmol / l.
  • Reducing HDL-C < 1.0 mmol/l in men and HDL-C < 1.2 in women.

Early disorders of carbohydrate metabolism:

  • Impaired fasting glycemia (IFG) – elevated fasting plasma glucose ≥ 6.1 and < 7.0 mmol/L. Plasma glucose level 2 hours after loading 75 g glucose < 7.8 mmol/l.
  • Impaired glucose tolerance (IGT) – elevated plasma glucose level 2 hours after a load of 75 g of glucose ≥ 7.8 and < 11.1 mmol / l. Fasting plasma glucose is less than 7.0 mmol/L.
  • Combined UHN/IGT disorder – elevated fasting plasma glucose ≥ 6.1 and < 7.0 mmol/L in combination with an increase in plasma glucose 2 hours after exercise 75 g glucose ≥ 7.8 and < 11.1 mmol/L .

The basis for the diagnosis of metabolic syndrome is a combination of obesity and any two additional criteria.


A lifelong commitment to a healthy lifestyle helps prevent the development of metabolic syndrome.

A healthy lifestyle includes:

  • Getting at least 30 minutes of physical activity daily.
  • Eating plenty of vegetables, fruits, lean protein and whole grains and fiber.
  • Restriction of saturated fat and salt.
  • Weight control.
  • Smoking cessation.
  • Obesity
  • Diabetes


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Latynina Yulia Sergeevna


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  • Inflammation

How to prevent diabetes?

  • Obesity
  • Diabetes

Metabolic syndrome in children and adolescents – primary diagnosis (10-17 years old)

Metabolic syndrome (MS) is a complex of factors in the development of diseases of the cardiovascular system, diabetes mellitus and atherosclerosis.

MS is a symptom complex that combines obesity, hypertension, elevated blood sugar and cholesterol levels, which significantly increases the risk of developing cardiovascular disease, type 2 diabetes and a number of other diseases.

The development of MS is based on impaired functioning of adipose tissue and the development of insulin resistance.

Insulin is a hormone involved in all types of metabolism, produced by beta cells of the pancreas. Under the action of insulin, glucose enters the cells, where it is regarded as an energy source. Excess glucose can be stored in the liver as glycogen or used for fatty acid synthesis. Also, a high content of insulin reduces the activity of the breakdown of fats and proteins. If cells become resistant to insulin, then the body needs more of this hormone.

As a result, the level of insulin and glucose begins to rise in the blood, and the utilization of glucose by cells is disturbed. An excessive concentration of glucose contributes to damage to the walls of blood vessels and disrupts the functioning of organs, including the kidneys. Excess insulin leads to sodium retention by the kidneys and, as a result, to an increase in blood pressure.

In obesity, insulin begins to accumulate in fat cells, which contributes to the development of dysfunction of fat cells that are infiltrated by macrophages, this leads to the release of large amounts of leptin, cytokines (tumor necrosis factor), adiponectin, resistin, etc. interaction of insulin with receptors on the cell surface.

Insulin resistance contributes to an increase in very low density lipoprotein (VLDL), low density lipoprotein (LDL), triglycerides, resulting in a decrease in the concentration of high density lipoprotein (HDL). An excess of LDL (“bad cholesterol”) can lead to the formation of atherosclerotic plaques in the wall of blood vessels and to the pathology of the cardiovascular system.

Thus, MS is a complex of pathological conditions that are closely related.

Previously, it was believed that MS can only be observed in older people, but now the percentage of young people suffering from it has increased. This symptom complex is observed equally among both men and women of reproductive age – this may be due to pregnancy, the use of oral contraceptives, polycystic ovary syndrome. Recently, there has been an increase in the incidence among children and adolescents and have a clear upward trend.

It is alarming that among children with the same body mass index, insulin sensitivity is lower in the group of children with a large amount of visceral fat, the metabolic syndrome in children is asymptomatic for a long time, often begins to form in adolescence and adolescence, long before the clinical manifestations of diabetes. type 2 diabetes, arterial hypertension and atherosclerotic vascular lesions.

With timely diagnosis and treatment of the metabolic syndrome, the prognosis for the patient is favorable. Late detection of pathology and the lack of complex therapy cause serious complications. In the presence of concomitant endocrine diseases (hypothyroidism, diabetes mellitus, arterial hypertension), it is recommended to study the hormonal background and follow-up with a general practitioner and endocrinologist.