Introduction
Many people with MS ask whether it is safe to drink alcohol. It is a reasonable question, as alcohol affects the nervous system, and MS already affects functions such as balance and coordination.
The research on alcohol and MS is mixed, and the picture is not simple. This article explains what the studies show, how alcohol can affect MS symptoms, and practical points to consider when making your own choices.
Key Takeaways
- What research shows about alcohol and MS outcomes
- How alcohol can affect MS symptoms
- How alcohol may interact with MS medications
- What the Australian alcohol guidelines recommend
- How to make informed choices about drinking
What the Research Shows
Research on alcohol and MS has produced mixed results. Some large studies have found that low to moderate alcohol intake is not associated with worse outcomes, and in some cases is associated with slightly better outcomes. A large Swedish study of more than 9000 people with MS found that low to moderate drinking was associated with a lower risk of disability worsening, compared with not drinking, mainly in relapsing-remitting MS. High alcohol intake showed no clear benefit.
Other research points in a different direction. Some studies have found that moderate or high alcohol intake is associated with more lesions on MRI scans. Reviews of the overall evidence describe the results as inconsistent.
Researchers note that alcohol has well-established health risks, and that associations seen in observational studies do not prove cause and effect. It is also possible that some people reduce their drinking as their MS progresses, which can affect study results.
How Alcohol Affects MS Symptoms
Separate from long-term outcomes, alcohol can have immediate effects. It acts on the parts of the nervous system involved in balance, coordination, and speech, which MS may already affect. For some people, even small amounts of alcohol can temporarily worsen unsteadiness, slurred speech, or fatigue.
Alcohol can also affect sleep, mood, and bladder function, all of which are relevant in MS. Paying attention to how alcohol affects you personally is a useful guide.
Alcohol and MS Medications
Most disease-modifying therapies do not have specific rules about alcohol, but some medications used in MS can interact with it. For example, medications for pain, spasticity, sleep, or low mood can increase drowsiness when combined with alcohol. Some medications can also affect the liver, and alcohol adds to this.
It is worth checking with your GP or pharmacist about your specific medications before drinking, rather than assuming alcohol is safe to combine with them.
Australian Guidelines and Making Choices
The Australian guidelines for the general population recommend no more than 10 standard drinks a week, and no more than 4 standard drinks on any one day, to reduce health risks. These apply to adults generally and are a useful reference point for people with MS.
Some practical points may help:
- Keep within the national guidelines or below
- Drink with food and water, and pace yourself
- Notice how alcohol affects your symptoms, and adjust accordingly
- Avoid alcohol if it worsens your balance or interacts with your medications
- Speak with your GP if you are concerned about your drinking
Summary
The research on alcohol and MS is mixed. Some studies link low to moderate intake with no clear harm, while heavy drinking and some MRI findings point the other way. Alcohol is not a treatment for MS, and it carries general health risks.
Alcohol can temporarily worsen MS symptoms such as balance and fatigue, and can interact with some medications. Keeping within national guidelines, noticing your own response, and checking with your GP or pharmacist can help you make informed choices.
FAQs
Do I have to give up alcohol if I have MS? Not necessarily. Research does not clearly show that low to moderate drinking worsens MS, but alcohol has general health risks and can affect symptoms.
Can alcohol cause an MS relapse? There is no strong evidence that alcohol causes relapses. It can, however, temporarily worsen symptoms such as balance and coordination.
Is red wine good for MS? Some studies have linked moderate red wine intake with lower disability scores, while others have linked alcohol with more MRI lesions. The evidence is not consistent, and alcohol is not recommended as a treatment.
Can I drink while taking my MS medication? It depends on the medication. Some can interact with alcohol, so it is best to check with your GP or pharmacist.
How much alcohol is considered low risk? Australian guidelines recommend no more than 10 standard drinks a week and no more than 4 on any one day for adults.
References
- Wu, J., et al. (2024). Association between alcohol consumption and disability accumulation in multiple sclerosis. Neurology: Neuroimmunology & Neuroinflammation, 11(5), e200289. https://doi.org/10.1212/NXI.0000000000200289
- Hedström, A. K., Hillert, J., Olsson, T., & Alfredsson, L. (2014). Alcohol as a modifiable lifestyle factor affecting multiple sclerosis risk. JAMA Neurology, 71(3), 300–305. https://doi.org/10.1001/jamaneurol.2013.5858
- Diaz-Cruz, C., Chua, A. S., Healy, B. C., et al. (2017). The effect of alcohol and red wine consumption on clinical and MRI outcomes in multiple sclerosis. Multiple Sclerosis and Related Disorders, 17, 47–53. https://doi.org/10.1016/j.msard.2017.06.015
- Foster, M., Zivadinov, R., Weinstock-Guttman, B., et al. (2012). Associations of moderate alcohol consumption with clinical and MRI measures in multiple sclerosis. Journal of Neuroimmunology, 243(1–2), 61–68. https://doi.org/10.1016/j.jneuroim.2011.12.007
- Olsson, T., Barcellos, L. F., & Alfredsson, L. (2017). Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nature Reviews Neurology, 13(1), 25–36. https://doi.org/10.1038/nrneurol.2016.187
- National Health and Medical Research Council. (2020). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC. https://www.nhmrc.gov.au/health-advice/alcohol
