Should You Drink Coffee if You Have MS?

Coffee has some benefits and some drawbacks for everyone, but for people living with multiple sclerosis (MS), the pros and cons may be more important to consider.

Coffee, and other caffeinated drinks, may help some symptoms of MS and worsen others — and this may depend on your particular symptoms and when and how much coffee you consume.

“The effects of caffeine can vary widely,” says Lisa Doggett, MD, MPH, family and lifestyle medicine physician at the Multiple Sclerosis and Neuroimmunology Center of University of Texas Health in Austin.

“Everyone is different, but many people experience negative side effects from caffeine, like increased bladder urgency, anxiety, or sleep disruption — symptoms that are already more common in MS, says Dr. Doggett, who also lives with MS.

But is this a good strategy for dealing with MS fatigue?

But it’s important to pay attention to how caffeine affects you and make appropriate adjustments.

MS is known to cause bladder symptoms, including frequency, urgency, and incontinence. The lesions caused by MS — areas of damage to the myelin sheath that protects nerve fibers — can affect how the bladder functions. The bladder can be either overactive or underactive.

Caffeine can worsen an overactive bladder. It can stimulate bladder muscles and can act as a mild diuretic. This can lead to increased urinary frequency, urgency, and potentially, incontinence, says Sarah Anderson, PharmD, senior director of clinical resources and programming at the National MS Society.

“Caffeine is considered a bladder irritant and should typically be avoided in people with urinary dysfunction,” Dr. Anderson says.

Bowel issues are also common in MS — both bowel incontinence and constipation. Your bowels depend on signaling through your central nervous system, but when these pathways are damaged, the signaling is dysfunctional. People may not feel an urge to go until suddenly they do — causing incontinence. And because they may not feel the need to go on a regular basis, it can lead to constipation.

Coffee is known to stimulate the bowels, so it can help for constipation but also worsen incontinence symptoms by suddenly overstimulating the bowels.

“Listen to your body and note how your body reacts to caffeine and coffee,” says Anderson. Discuss your coffee consumption with your healthcare provider to determine whether coffee should be avoided if you have these issues.

“Caffeine stimulates the central nervous system and can trigger the body's fight-or-flight response, which can mimic or exacerbate anxiety symptoms like increased heart rate, restlessness, and even feelings of fear or panic,” says Doggett.

It’s also important to be aware of other sources of caffeine you may be consuming, like tea, some sodas, energy drinks, and chocolate.

People with MS may take disease-modifying medications to reduce relapses and slow progression, and these medications do not typically interact with caffeine. But other medications that people with MS may take to help with symptoms may interact with caffeine, says Anderson. These include:

• Antidepressants
• Antipsychotics
• Thyroid medications
• Anticoagulants
• Osteoporosis medications

Talk to your healthcare provider about your medication list and coffee consumption to determine if you need to avoid coffee or alter when you drink it based on your medication schedule.

• For most people with MS, having a cup of coffee or two in the morning shouldn’t be a problem and may even help some symptoms like fatigue and cognitive function.
• If you have bowel or urinary symptoms, it’s important to consume caffeine judiciously and try to figure out how much and when it helps you, and when it may be exacerbating your symptoms.
• Caffeine may interact with some medications taken for MS symptoms. Check with your doctor if you’re concerned about your caffeine intake.