Multiple Sclerosis and Gut Health: What to Know

Can Gut Health Affect Multiple Sclerosis?

Can Gut Health Affect Multiple Sclerosis?
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Updated on May 27, 2025
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Trillions of bacteria, fungi, and other organisms live in your digestive system. Collectively known as your gut microbiome, these microbes normally coexist peacefully, working to support digestion, immunity, and overall health. However, in some cases, a dramatic change to a person’s diet can throw off the balance of their gut microbiome and affect their health, putting them at risk of developing certain diseases — among them, multiple sclerosis (MS).

One research review notes that studies have consistently found that people with MS have markedly different gut microbiomes than those who don’t have the disease. The review’s authors believe that altering the gut microbiome has the potential to help people with MS.

The Link Between Gut Health and MS

The relationship between the gut and MS is complex, according to J. William Lindsey, MD, director of the division of multiple sclerosis and neuroimmunology at the University of Texas Health Science Center at Houston. “It involves interactions between diet, nutritional status, the bacteria in the gut, and the activity of the immune system,” he explains.

So, how are these things connected?

For starters, “diet affects nutritional status, and it also changes the composition and activity of the bacteria in the gut microbiome,” says Dr. Lindsey.

This disruption in the gut bacteria can set off a chain reaction. “The microbiome can affect the activity of the white blood cells in the intestine, and these white blood cells can migrate to other parts of the body, including the brain,” says Lindsey. “The microbiome also produces metabolites such as short-chain fatty acids and altered bile acids that get into the blood and affect immune system activity.”

Because MS is an autoimmune disease of the central nervous system, these disruptions, which lead to an increase in pro-inflammatory bacteria in the gut, are thought to impact the condition.

Can Modifying Bacteria in the Gut Change the Course of MS?

Maintaining a consistently healthy diet can positively impact the gut microbiome. And findings from various small studies done in people and in mice suggest that a healthy diet can reduce MS disease activity, especially in combination with other healthy lifestyle habits.

However, these aren’t definitive studies, and no research suggests that diet can completely replace medication therapy for MS. More research consisting of larger studies is needed to help formulate specific recommendations for modifying the gut microbiome to help manage MS.

MS-Friendly Diet Tips to Promote Gut Health

Regardless of what we know — and still don’t know — about the link between the gut microbiome and MS, research has shown that taking steps to eat a healthy diet is an important part of an overall MS management plan.

 “A healthy diet can lead to a healthier microbiome,” says Lindsey.
That said, studies on microbiome composition in response to diet have been conducted mostly on mice with an MS-like disease, rather than on humans with MS. More research is needed to identify specific recommendations.

While there are no dietary guidelines specific to MS, the same eating plans that are known to support cardiovascular health and promote healthy aging — such as the DASH diet and Mediterranean diet — are also good for MS, says Lindsey.

That means eating a diet focused on:

  • Fruits
  • Vegetables
  • Whole grains
  • Legumes
  • Nuts
  • Seeds
  • Healthy fats

And limiting:

  • Processed foods
  • Red meat
  • Added sugars
  • Refined grains

Why Do People With MS Need to be Careful About Getting a Flu Shot?

People with multiple sclerosis have good reason to get the flu shot every year, because the disease and certain MS treatments can leave them vulnerable to complications, says Purvi S. Parikh, MD, of NYU Langone Health.
Why Do People With MS Need to be Careful About Getting a Flu Shot?

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Can Probiotics Help?

The terms “gut health” and “probiotics” often go hand in hand. That’s because increasing your intake of probiotics, or “good” bacteria, can help reduce inflammation in your gut.

 The overactive immune response in MS is associated with both gut inflammation and its microbiome imbalance.

Studies involving animals suggest that consuming probiotics may help reduce the severity of MS, delay its progression, improve certain symptoms, and even prevent MS from ever developing. However, more comprehensive research is needed to see if probiotics may have the same effect in humans.

 Because this research has not been proven in humans, you should continue using MS treatments that have strong evidence of efficacy, such as the medication and nonpharmaceutical therapies your doctor may recommend as part of your regimen.

Probiotics can be found in fermented foods such as:

Probiotics also come in the form of supplements — ideal for people who don’t care for the signature sour, yeasty flavor of these food sources. That said, only certain strains, including Lactobacillus paracasei and Bifidobacterium animalis, have shown promising results for MS, and most of the research has been conducted on animals rather than humans.

Probiotic supplements aren’t regulated by the U.S. Food and Drug Administration, so before you stock up, check with your doctor. Since the link between the gut microbiome and MS isn’t yet fully understood, it’s best to err on the side of caution.

The Takeaway

  • People with multiple sclerosis, an autoimmune disease that affects the central nervous system (CNS), are known to have imbalances in their gut microbiome — the collection of bacteria, fungi, and other organisms that play a role in digestion, immunity, CNS communication, and overall health.
  • The disruption in the gut microbiome can affect immune function and lead to inflammation, causing various symptoms and ultimately, damage to the CNS.
  • Research indicates that positively altering the gut microbiome can influence the disease by preventing inflammation, but most of the research is preliminary and focused on animals, so additional human trials are needed to develop treatment recommendations.
  • Experts recommend following a healthy diet designed to support a robust, varied gut microbiome, as research recommending specific dietary treatments is not yet available.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Altieri C et al. Gut-Microbiota, and Multiple Sclerosis: Background, Evidence, and Perspectives. Nutrients. February 14, 2023.
  2. Stoiloudis P et al. The Role of Diet and Interventions on Multiple Sclerosis: A Review. Nutrients. March 9, 2022.
  3. Hoffman K et al. Gut Microbiome-Modulated Dietary Strategies in EAE and Multiple Sclerosis. Frontiers in Nutrition. March 28, 2023.
  4. Probiotics. Cleveland Clinic. October 30, 2023.
  5. Kumar Yadav S et al. Interaction of the Gut Microbiome and Immunity in Multiple Sclerosis: Impact of Diet and Immune Therapy. International Journal of Molecular Sciences. September 29, 2023.
  6. Jiang J et al. Efficacy of Probiotics in Multiple Sclerosis: A Systematic Review of Preclinical Trials and Meta-Analysis of Randomized Controlled Trials. Food & Function. March 21, 2021.
  7. Blais LL et al. Probiotic and Commensal Gut Microbial Therapies in Multiple Sclerosis and Its Animal Models: A Comprehensive Review. Gut Microbes. June 15, 2021.
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Jessica Baity, MD

Medical Reviewer
Castle Connolly Top Doctor

Jessica Baity, MD, is a board-certified neurologist practicing in southern Louisiana. She cares for a variety of patients in all fields of neurology, including epilepsy, headache, dementia, movement disorders, multiple sclerosis, and stroke.

She received a bachelor's degree in international studies and history from the University of Miami and a master's in international relations from American University. She graduated from the Louisiana State University School of Medicine, where she also did her internship in internal medicine and her residency in neurology.

Prior to practicing medicine, she worked in international relations and owned a foreign language instruction and translation company. 

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Kerry Weiss

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Kerry Weiss is a New York–based freelance writer, editor, and content strategist specializing in health and wellness. She has contributed to a variety of online publications, including Healthline, WebMD, Sharecare, Twill Care, and What to Expect.
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