How Alcohol Affects Multiple Sclerosis

Note: While research on alcohol is evolving, the Centers for Disease Control and Prevention says drinking less or not at all is better for your health.

Multiple sclerosis (MS) is a disease of the central nervous system that can lead to physical and cognitive symptoms throughout the body. Since alcohol affects the central nervous system, it’s important to know how alcohol can impact the symptoms and progression of MS.

Read on to understand the immediate and long-term effects of alcohol on multiple sclerosis, plus whether it’s safe for you to drink when you live with MS.

Alcohol can temporarily worsen the nerve signaling problems already caused by MS, says Carrie Hersh, DO, staff neurologist at the Mellen Program for MS at Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas.

This can lead to increased symptoms, like:

• Balance issues
• Fatigue
• Brain fog and slowed thinking
• Dizziness
• Slurred speech
• Blurred vision
• Tremors

This overlap of symptoms can increase the risk of falls, confusion, or feeling unsteady.

“Alcohol may make these symptoms more noticeable,” says Hersh. “These effects usually wear off, but they can interfere with safety and daily functioning while they’re present.”

However, alcohol’s effect on people with MS may vary widely from person to person, depending on their symptom pattern and disease stage.

“Because MS affects multiple areas of the nervous system, alcohol’s effects can be unpredictable and vary from day to day,” says Hersh. “Even small amounts may have a bigger impact than in people without MS.”

“Most current studies show no clear evidence that alcohol speeds up MS progression or disability, but they also don’t prove that it is helpful,” says Hersh. She notes that many studies find a “neutral” effect, meaning light or moderate drinking doesn’t seem to change the overall course of MS for most people.

Additionally, differing drinking patterns aren’t always reflected in the research. “Research findings can vary depending on whether studies look at light, moderate, or heavy drinkers, because these groups often have very different health behaviors,” Hersh adds.

Because research results vary, experts like Hersh still recommend caution.

“They typically recommend sticking to general guidelines, such as no more than one drink per day for women and two for men, and avoiding heavy or binge drinking,” Hersh adds. She notes that experts also emphasize being aware that even small amounts of alcohol can temporarily worsen MS symptoms like balance or fatigue.

“We still don’t know whether different types of alcohol (wine vs. beer vs. spirits) have different effects on MS,” Hersh adds. “It’s also unclear how alcohol interacts with modern MS medications or how it affects people at different stages of disease.”

Tips for Safe Drinking

When it comes to drinking safely with MS, there’s no 100 percent risk-free scenario. However, Hersh notes that understanding how alcohol affects your specific symptoms can help you make safer choices and avoid unnecessary risks.

She suggests you:

• Drink slowly and with food
• Stay hydrated
• Avoid drinking when your symptoms are already flaring
• Avoid drinking and driving
• Check with your doctor about medication interactions
• Be aware of your environment and potential fall risks (like dim lights, uneven surfaces, and crowded spaces)

“Start by noticing how alcohol affects your symptoms, such as balance, vision, mood, or sleep, and let those responses guide your limits,” adds Hersh. “Most importantly, talk with your provider about your medications and personal risk factors so you can set safe, realistic boundaries.”

An alternative to drinking with MS is experimenting with nonalcoholic beverages.

“Many people find that choosing alcohol-free versions of their favorite drinks allows them to participate socially without triggering symptoms,” Hersh points out.

When to Avoid Alcohol Altogether

Hersh notes that there may be some cases when it’s best to avoid alcohol altogether. These include factors like:

• Balance problems
• Severe fatigue
• Liver disease
• High risk of falls
• Taking medications that affect the liver or cause drowsiness

“In these cases, avoiding alcohol helps maintain safety, energy, and mobility,” says Hersh.

If you do decide to drink with MS, talk to your care team about how to best approach it.

“Providers can help by giving personalized guidance based on your symptoms, lifestyle, and medications, rather than offering ‘one-size-fits-all’ rules,” Hersh adds.

• Alcohol and MS both affect the central nervous system, so even small amounts of alcohol can temporarily worsen MS symptoms like balance issues, fatigue, brain fog, and vision changes.
• The short-term effects of alcohol can appear quickly, even with light drinking, and can vary based on an individual’s disease and symptom patterns.
• Research on drinking and MS progression is inconsistent. Light, infrequent drinking may be neutral for disease progression, while heavy drinking can negatively impact overall health and indirectly impact MS progression.
• Some people with MS can drink moderately if they monitor their triggers, follow guidelines, and confirm medication interactions with their doctor, but others with more severe MS symptoms may be advised to avoid alcohol.