Powered By
Researchers and doctors once thought neuromyelitis optica spectrum disorder (NMOSD) was a form of multiple sclerosis (MS), but they now recognize it as a separate condition. Still, NMOSD can sometimes be mistaken for MS because the two conditions’ symptoms can look alike. NMOSD may also occur alongside other health conditions.
Sign up to view the results!
Continue with Facebook
Sign up with your email
NMOSD is an autoimmune disorder, and it’s common for people with one autoimmune condition to have others too. About 1 in 4 people with one autoimmune disease may develop another. Many conditions related to NMOSD — called comorbidities — also fall into this category.
The eight conditions discussed below are some of the most commonly seen with NMOSD.
Migraine is a common condition, so it’s not surprising that many people with NMOSD also experience migraine headaches. Migraine is a neurological disease that can severely affect quality of life, causing intense head pain, nausea, and sensitivity to light or sound.
Although NMOSD and migraine both involve the nervous system, they’re separate conditions that can occur in the same person. In one study, more than 63 percent of participants with NMOSD reported having migraine headaches. Researchers linked these headaches to structural changes in the central nervous system (CNS) that show up on magnetic resonance imaging (MRI) scans. Migraine in people with NMOSD may also be a side effect of certain medications, such as rituximab, an injection often used to manage autoimmune diseases.
Some research suggests that between 2 percent and 5 percent of people with NMOSD also have systemic lupus erythematosus (SLE), also referred to as lupus. Because both conditions can affect the nervous system, it can sometimes be hard to tell which one is causing certain symptoms. Lupus can cause a wide range of symptoms throughout the body, such as:
Like NMOSD, SLE is an autoimmune disorder, and it’s one of the most common autoimmune conditions linked to NMOSD. Having both conditions may require different treatment approaches, so doctors may need to tailor care based on which symptoms are caused by which disease. More research is needed to fully understand how the two conditions interact.
Sjögren’s disease (formerly called Sjögren’s syndrome) is another common autoimmune disease that can occur alongside NMOSD. In Sjögren’s, the immune system attacks the glands that produce moisture. This leads to dryness in the areas like the mouth, eyes, nose, and vaginal area and can also affect the digestive system. Common symptoms include:
Up to 65 percent of people with Sjögren’s disease also develop problems that affect other organs and systems, including the nervous system. Researchers aren’t sure how Sjögren’s affects the CNS, but they’ve observed that neurological disorders like NMOSD tend to be particularly severe in people with both diseases.
Myasthenia gravis, another autoimmune condition that might overlap with NMOSD, also affects the nervous system. However, instead of originating in the CNS, myasthenia gravis interferes with how nerves and muscles communicate. This can lead to muscle weakness, especially in the eyes and face. Early symptoms often include droopy eyelids and double vision. Other symptoms include:
A study published in 2025 found that almost 4 percent of people with NMOSD also had myasthenia gravis. That may seem like a small number, but because both conditions are rare, this overlap likely isn’t random.
The researchers reported that all participants who had both conditions were women. None had any other autoimmune diseases. They also were diagnosed with myasthenia gravis before NMOSD, and most had a later onset than usual — NMOSD typically appears between ages 30 and 40.
Celiac disease is another autoimmune condition that can occur in people with NMOSD, though it’s less common than some of the others discussed here. Still, celiac disease can affect the nervous system and may contribute to neurological symptoms.
In people with celiac disease, the immune system overreacts to gluten, a protein found in wheat, barley, and rye. This reaction causes inflammation in the small intestine, which over time can damage the lining and make it harder to absorb nutrients from food.
Gluten is found in many common foods, including bread, pasta, cereal, and even products like canned soups and sauces. For people with celiac disease, it’s important to follow a gluten-free diet. Researchers have found that in people with both NMOSD and celiac disease, switching to a gluten-free diet may be beneficial for both conditions.
Anxiety disorders are among the most common conditions seen in people with NMOSD. Some research suggests that up to 45 percent of people with NMOSD experience anxiety.
There are different types of anxiety disorders, and it’s possible to have more than one at a time. Symptoms can affect both the body and the mind, including:
Studies show that anxiety, depression, and sleep disorders can all significantly affect quality of life for people with NMOSD. Poor sleep can worsen anxiety symptoms, and anxiety can also cause sleep problems.
Up to 40 percent of people living with NMOSD also experience depression or major depressive disorder, one of the most common comorbidities in neurologic diseases. Depression can have a major impact on quality of life, and sleep disturbances — also common in NMOSD — can make depression symptoms worse.
Depression looks different for everyone, but common symptoms include:
Without the right treatment, depression in people with NMOSD can increase symptoms like pain and fatigue. Pain may result from inflammation or pressure on the spinal cord or specific nerves like the optic nerve. Fatigue and pain in NMOSD can also worsen depression symptoms.
NMOSD can occur alongside hematological (blood cell) disorders, including different types of anemia. One study found that iron-deficiency anemia affects almost 15 percent of people with NMOSD.
Iron-deficiency anemia happens when the body doesn’t have enough iron to make red blood cells, which carry oxygen. Without enough oxygen-rich blood, you may experience:
Researchers aren’t sure if NMOSD and iron-deficiency anemia are directly related. However, both conditions are more common in females, particularly those of reproductive age. Cleveland Clinic notes that 80 percent to 90 percent of people living with NMOSD are female, and Yale Medicine reports that up to a third of women of reproductive age in the U.S. have iron-deficiency anemia. This overlap may help explain why the two conditions are seen together.
Be sure to tell your doctor about any conditions or symptoms you experience along with neuromyelitis optica spectrum disorder. Your healthcare team can work with you to create a treatment plan for NMOSD and any other conditions you may have — while helping you avoid possible treatment interactions.
Sometimes, NMOSD and other autoimmune disorders can be managed with similar treatments, such as immunosuppressive therapy. Your doctor may also recommend regular follow-up appointments to track your progress and adjust your care as needed.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
Do you have any conditions related to neuromyelitis optica spectrum disorder? Let others know in the comments below.
Get updates directly to your inbox.
Continue with Facebook
Sign up with your email
Become a member to get even more
Join
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.