Caffeine tablets may help MS patients’ balance, mobility

Taking caffeine tablets — the equivalent to about two cups of coffee a day — may help people with multiple sclerosis (MS) keep their balance and move more easily, which could aid their quality of life, a small study suggests.

While the tablets may be a low-cost option for easing movement problems caused by MS, more research is needed to know if there are side effects from taking caffeine too long or at higher doses.

The study, “Potential efficacy of caffeine ingestion on balance and mobility in patients with multiple sclerosis: Preliminary evidence from a single-arm pilot clinical trial,” was published in PLOS One.

MS occurs when the immune system mistakes the myelin sheath that protects nerve cells as foreign and attacks it, causing inflammation. As a result, people with MS see a range of symptoms, including difficulty walking, and problems with balance and coordination.

While the exact mechanism is unclear, people who drink coffee or other beverages with caffeine, such as black and green tea, have a lower risk of getting MS. How and whether caffeine eases symptoms of MS is unclear.

Caffeine, which is also found in small amounts in cocoa, increases brain activity and helps people feel more alert, focused, and energetic. It may also affect breathing patterns and how fast the heart beats. In people without MS, it’s been seen to help with posture and balance.

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Caffeine and movement 

Here, researchers in Iran investigated the effects of 200 milligrams (mg) of caffeine, taken as tablets every day for 12 weeks, on movement problems caused by MS in 30 adults (23 women, seven men; mean age, 38.9) with a diagnosis of MS.

Most (76.7%) had relapsing-remitting MS, where new or worsening symptoms are followed by periods of recovery when symptoms ease. Four (13.3%) had secondary progressive MS, a stage that follows relapsing-remitting MS, and three (10%) had primary progressive MS, where symptoms steadily worsen over time.

Before starting caffeine tablets, the patients entered a two-week run-in period with a placebo. Baseline measurements were taken after the run-in and compared with those taken after 12 weeks on the tablets.

Taking caffeine tablets significantly improved the ability to safely balance on a static or dynamic platform, as seen by a significant increase in the mean Berg Balance Scale (BBS) score from 37.6 points at baseline to 48.6 points after 12 weeks.

It also helped patients complete a Timed Up-and-Go (TUG) test a mean 12 seconds faster. In the TUG test, patients are asked to stand up from a chair, walk along a 3-meter (10-feet) line, turn, walk back, and sit down again. Completing it faster indicates better mobility.

Moreover, as early as two weeks after starting caffeine, patients saw improved quality of life, as seen by a significant decrease in the mean Multiple Sclerosis Impact Scale (MSIS-29) score from 84.4 points at baseline to 74.2 points at two weeks.

While men reported a sharper decrease in their ability to walk over time, problems with balance became worse for older people as time progressed, suggesting sex and age should be considered when evaluating response to treatment.

“Although preliminary, our findings showed that daily consumption of 200 mg caffeine resulted in early and sustained improvement in functional mobility, static balance, and dynamic balance,” wrote the researchers, who said further studies with “larger sample sizes and longer follow-ups” could confirm their findings.