I am 34, female. How can I manage relapsing-remitting MS?

Question

Hello doctor, I am 34, diagnosed with relapsing-remitting MS 13 months ago after sudden vision loss in the left eye, severe leg numbness, and frightening balance problems, causing multiple falls. The neurologist started weekly Interferon beta injections, but I have terrible, debilitating flu-like symptoms after every single shot, lasting two to three days, making work absolutely impossible. I also developed significant depression and severe anxiety, which I had never experienced before.

I do not know if it is directly from medication or the psychological stress of this frightening diagnosis. Balance and coordination have gotten progressively worse despite treatment, and I have fallen numerous times at work, which is particularly embarrassing. The overwhelming crushing fatigue is unlike anything I have ever experienced, and I barely complete 10-hour working shifts anymore.

My husband and I were actively trying to conceive, but now I am absolutely terrified about how pregnancy might affect MS progression and medication safety. Some days I feel relatively normal, but others I can barely walk or think clearly, making it incredibly difficult for people to truly understand this unpredictable disease.

Are there newer disease-modifying treatments with significantly fewer debilitating side effects? I desperately need something to prevent relapses while allowing me to work and hopefully have children someday.

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I am very sorry you are going through this.

Relapsing-remitting multiple sclerosis (MS) can feel unpredictable and frightening, especially when symptoms affect your vision, balance, job, and future plans. The fatigue, depression, and anxiety you describe are unfortunately very common in MS, and the side effects from interferon injections can make everything feel even heavier. Many patients struggle just as you are, and it is not a sign of weakness. It is the nature of MS combined with a medication that is often difficult to tolerate.

The good news is that there are many newer disease-modifying treatments that can reduce relapses and disability progression with far fewer flu-like side effects. Examples include oral medications such as Dimethyl fumarate, Teriflunomide, and Fingolimod. These are taken daily or every other day and do not cause the post-injection flu symptoms that Interferon causes.

Some people also do extremely well on infusion therapies such as Ocrelizumab or Natalizumab. These medications are given every few weeks or months and are often more effective than Interferon at preventing relapses and new MRI (magnetic resonance imaging) lesions. Many patients on these medicines feel more stable, have better energy, and can continue working full-time.

Depression and anxiety can be medication-related, but they are also part of how MS affects the brain and immune system. You should never feel embarrassed to tell your neurologist. Mood changes are treatable. Antidepressants, counseling, and even switching MS medications often help.

Regarding pregnancy, many women with MS have healthy pregnancies. Pregnancy itself often reduces relapse activity due to natural immune changes. The main question is which medication is safe to continue while trying to conceive. Some disease-modifying therapies must be stopped months before pregnancy, while others, such as Glatiramer acetate, are considered safer options if a woman wants to conceive.

Your neurologist can choose a medication plan that balances disease control with pregnancy safety. Many women with MS have children and continue to live active lives. Physical therapy can also help with balance and leg strength, reducing fall risk. If fatigue is severe, medications such as amantadine or modafinil can be helpful.

You are falling at work, the fatigue, and the unpredictability of symptoms are not things you just have to tolerate. You deserve a treatment that controls MS without taking away your quality of life. A switch from Interferon to an oral agent or an infusion therapy is a very reasonable next step, especially since the current medication is limiting your ability to function.

I hope this helps you.

Thank you.