Is it safe for Multiple Sclerosis patients to fast?

Ramadan fasting predispose multiple sclerosis (MS) patients to a great challenge. Clinicians should have practical knowledge about the effects of fasting on MS. A mini-symposium was held in 2013 to answer the common questions about fasting in MS patients. In current review we present a summary of the mentioned mini-symposium.Generally, fasting is possible for most stable MS patients. Thorough monitoring of symptoms, proper adjustment of drug regimens, as well as, providing patients with evidences on MS and fasting are inevitable parts of management. Data from experimental studies proposed that calorie restriction prior to disease induction ameliorated disease severity by reducing inflammation and demyelination. According to the results of the mini-symposium, fasting doesn’t have adverse effects on disease course in patients with mild disability (Expanded Disability Status Scale (EDSS) score ≤3). There was a general consensus that during fasting (especially in summer), some MS symptoms (such as dizziness, fatigue, fatigue perception, cognitive problems, spasticity, vision, weakness, gait, and balance) may exacerbate. However, they return to normal levels during feasting period. A majority of experts did not recommend fasting to patients: with EDSS score of 7 or more, during attacks, with active disease or coagulopathy; on high doses of anti-spastics, corticosteroids, and anti-convulsants.