Medication Side Effects

Conventional disease modifying therapies (DMT) for MS include several categories of medications intended to slow the course of the disease, treat or prevent relapses, or help manage disease symptoms.

However, DMTs themselves are often associated with their own sets of side effects that risk not only comfort and other aspects of health, but also abandonment of what may otherwise be a beneficial therapy.

The following are the most common side effects, along with natural means of coping recommended by patients and practitioners:

Food Safety in Immunosuppression

Food Safety Meat cleaned
Image Credit: Yousaf Usman

     Preventing intake of pathogenic (unhealthy) bacteria or fungi in food is particularly important during and after treatments that suppress or weaken the immune system, as these can make you more susceptible to foodborne illnesses.

     Not uncommon with immunosuppressive treatments is neutropenia, a condition in which you have lower-than-normal levels of a type of protective white blood cell called neutrophils. If you have neutropenia, your doctor may suggest for you to follow special food safety guidelines.

       If you have had a stem cell transplant, your diet may be stricter than that of a patient who had drug or biologic therapy and no transplant.

     Dietary guidelines published by institutions or doctors about food safely may also recommend avoiding foods that are more often associated with illness.

Basic Guidelines to Follow

  • Avoid raw or rare meat, poultry, and fish and uncooked or undercooked (e.g., soft-boiled or sunny-side up) eggs.

    • Cook meat, poultry, and fish until they are well-done (no pink matter).

    • Thoroughly cook eggs, being sure not to leave the yolks “runny.” Avoid foods containing raw eggs such as raw cookie dough or homemade mayonnaise.

  • Refrigerate all meat, poultry, seafood, dairy, eggs, and legume-based foods (including soy products) until the moment of preparation or consumption. Freeze meat, poultry, and seafood if they are to be stored for more than three days.

  • Avoid unpasteurized beverages, such as raw dairy products and pre-packaged raw fruit juices.

    • Consume only pasteurized dairy products and fruit juices or homemade fruit juices prepared just prior to consumption.

  • Avoid soft mold-ripened and blue-veined cheeses such as Brie, Camembert, Roquefort, Stilton, Gorgonzola and Bleu or other soft, unpasteurized cheeses.

  • Avoid raw sprouts, such as alfalfa.

  • Avoid salad bars and buffets.

  • Thoroughly wash hands before and after handling food.

  • Sanitize your work area with bleach, alcohol, or similar material before and after preparing food, especially when handling high-protein items such as meat, poultry, and seafood.

  • Avoid well water unless it has been tested, filtered, or boiled for one minute before drinking. At home, it is considered acceptable to drink most tap water, unless particularly contaminated. Bottled water is considered best.

  • Wash fresh fruits and vegetables before peeling. For extra safety, use a produce wash – these are available readymade, or can be made with simple staples.

Produce Wash Recipes by Kittencalrecipezazz

INGREDIENTS

SPRAY

1 Tbsp / 15 ml lemon juice (fresh is best)

1 Tbsp / 15 ml baking soda

1 cup water

or

SOAK

¼ cup / 60 ml vinegar

2 Tbsp / 30 ml salt

DIRECTIONS

For spray: put all ingredients into a spray bottle (note that it will foam), shake gently to mix, then spray on produce and allow to sit for about 2-5 minutes; rinse under cold water before using.

or

For soak: fill a clean sink or a large basin with cold water; add in vinegar and salt and mix; place the produce in and allow to sit for 25-30 minutes (the vinegar cleans and the salt draws out insects, worms, and dirt, as well as wax); rinse under cold water before using.

Notes on the “neutropenic diet”: In a review of studies, this diet was never proven to decrease exposure to harmful bacteria in foods or benefit immunosuppressed individuals in any way. Safe preparation and handling of foods is more important than restricting intake of specific food groups, as balanced nutrition is important for coping with treatments1.


Reference

1. Pedretti L, Leardini D, Muratore E, et al. Managing the Risk of Foodborne Infections in Pediatric Patients with Cancer: Is the Neutropenic Diet Still an Option? Nutrients. Mar 27 2024;16(7)doi:10.3390/nu16070966

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