Living with MS/Work, School, and Leisure

Does Alcohol Cause MS Flare-Ups? What To Know

Written and medically reviewed by Ari Magill, M.D.

Posted on June 15, 2026

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Key Takeaways

For people living with multiple sclerosis, questions about whether alcohol can trigger a flare-up are completely valid, and the relationship between the two is more complex than a simple yes or no.

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You’re out for dinner when someone pours wine. You pause. You wonder: Will this make my MS worse? Could a drink tonight actually trigger a flare-up?

If you live with multiple sclerosis (MS), these are valid questions. The relationship between alcohol and multiple sclerosis is more nuanced than most people realize, and it comes down to understanding what a flare-up actually is, how alcohol affects your nervous system, and what the research really shows.

Can Alcohol Trigger an MS Flare-Up?

First, it helps to know what a true MS relapse actually is. A relapse is when new MS symptoms appear, or old symptoms come back, and last for at least 24 hours, without an infection or a change in body temperature causing them.

During a true relapse, inflammation driven by the immune system occurs along the nerves and myelin — the protective coating around nerve fibers — causing actual damage to the nervous system.

There’s no clear evidence that one drink directly triggers the immune inflammation that causes a true MS relapse. So, strictly speaking, a glass of wine at dinner won’t trigger a relapse.

What alcohol can do is temporarily worsen symptoms you already have. Doctors call this a pseudoexacerbation — a short-term symptom flare that isn’t driven by new nerve damage, but by outside triggers like alcohol, heat, or exhaustion. The effects feel real because they are real, but they fade once the alcohol clears your system. It’s still worth taking seriously, even if it isn’t a true relapse.

When it comes to longer-term effects, the research gets complicated. A study of more than 409,000 people — including more than 2,100 people with MS — didn’t find a clear link between drinking alcohol and the risk of developing MS.

Some studies from Sweden and Denmark found that people who drank alcohol had a lower chance of developing MS. However, this doesn’t mean alcohol prevents MS. These results may be different because the studies looked at different groups of people, different drinking habits, or other factors.

One study found that people with relapsing-remitting MS who drank low or moderate amounts of alcohol had less disability than people who didn’t drink. Relapsing-remitting MS is the most common type of MS. It causes flare-ups followed by times when symptoms get better or go away. Heavy drinking didn’t show the same link.

The bottom line: Research on alcohol and MS is mixed. Some studies suggest possible benefits from low or moderate drinking, while others show risks from heavy or long-term drinking. Right now, health experts do not have clear guidelines on how much alcohol is safe for people with MS.

How Alcohol Can Worsen MS Symptoms

Even if alcohol doesn’t trigger a true relapse, it can still make day-to-day life with MS harder. Alcohol is a central nervous system (CNS) depressant, which means it slows activity in the brain and nerves. MS also affects the central nervous system. Because alcohol and MS affect the same parts of the body, their effects can overlap and make symptoms worse.

Temporarily, alcohol can make the nerve signaling problems caused by MS worse. Both MS and alcohol affect the cerebellum — the area at the back of the brain that controls balance, coordination, and eye movements. When these effects overlap, the risk of falls, confusion, and feeling unsteady increases.

Here are some of the specific ways alcohol can make MS symptoms worse:

Balance and coordination — MS already disrupts the signals your brain sends to your muscles, making balance and coordination harder. Alcohol amplifies that disruption — a sensation one MyMSTeam member described as feeling like they’ve had 10 drinks after just one.
Fatigue — Alcohol can disrupt sleep and make fatigue worse. Since fatigue is one of the most common MS symptoms, drinking may leave you feeling more tired than usual for days.
Cognitive difficulties — MS can affect memory, focus, and how quickly you process information. A study showed that people with MS who drank alcohol for longer periods had higher disability levels and more brain lesions — areas of scarring — on MRI scans.
Bladder dysfunction — Alcohol is a diuretic — meaning it makes your kidneys produce more urine. That can worsen urgency and leakage, problems that are already very common in MS.
Mood and depression — Depression is common in MS and tends to be more severe than in the general population. Because it is a CNS depressant, alcohol may worsen mood symptoms and emotional functioning, particularly with heavy or frequent use.
Dizziness — Dizzy spells are another symptom that alcohol can intensify, especially for people who already experience vertigo or balance issues related to MS.

Alcohol and MS Medications

If you’re taking a disease-modifying therapy (DMT) — a medication designed to slow MS activity and reduce relapses — there’s another layer to consider: how alcohol interacts with your treatment.

None of the DMTs currently available for MS are entirely free of risk to the liver. That matters because alcohol is also broken down by the liver. When the two combine, they add cumulative stress to an organ that’s already working hard.

Several disease-modifying therapies for MS can affect liver function and require regular liver blood tests, including several commonly prescribed options, such as teriflunomide (Aubagio) and fingolimod (Gilenya). In such cases, clinicians may recommend limiting alcohol use during treatment.

Alcohol also interacts with many of the other medications people with MS take for symptom management. Drugs prescribed for spasticity (muscle stiffness and spasms), pain, insomnia, and depression are often brain-slowing drugs themselves — things like the muscle relaxant baclofen, opioid pain relievers, and certain sleep aids. Combining these with alcohol can cause dangerous over-sedation and significantly raise the risk of serious side effects.

Alcohol can also make it harder to follow your MS treatment plan. In one study, people with MS who had alcohol dependence were more than twice as likely to miss doses of their DMT. Because DMTs work best when taken as prescribed, heavy drinking may make it harder to keep MS under control.

Reducing Risk: Alcohol, Comorbidities, and MS

Living well with MS means looking at the whole picture of your health. Alcohol doesn’t just affect MS symptoms and medications directly — it also raises the risk of other conditions that can make MS harder to manage.

Alcohol use disorder in people with MS has been linked to higher rates of high blood pressure, diabetes, obesity, stroke, and depression. These conditions are called comorbidities, meaning they happen along with MS. Comorbidities are already more common in people with MS than in the general population. Alcohol can raise the risk of some of these conditions, which may make MS symptoms and disability worse over time.

That’s not meant to be discouraging — it’s meant to be empowering. Many of these risks are within your control. Focusing on what you can change, like your alcohol intake, is one of the most direct ways to take charge of your MS outcomes. These healthy eating and lifestyle choices support your overall MS management.

What responsible drinking looks like can vary from person to person. Some people with MS find they can tolerate an occasional drink without noticeable effects.

Others — especially those with more advanced symptoms affecting balance, cognition, or bladder control — may find that even small amounts of alcohol cause significant problems.

People with MS who have significant balance or cognitive impairment may be advised to limit or avoid alcohol, especially considering that other serious medical conditions can be worsened by alcohol.

Talk with your neurologist about whether alcohol is safe for you. This is especially important if you take a DMT or medications to manage MS symptoms. Your neurologist can help you understand your personal risks and decide whether you should limit or avoid alcohol.