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Nausea With MS: Causes and Tips for Managing

Posted on May 06, 2022
Medically reviewed by
Joseph V. Campellone, M.D.
Article written by
Sarah Winfrey

As many as 10 percent of people diagnosed with multiple sclerosis (MS) experience nausea or an upset stomach. This symptom can be accompanied by feelings of dizziness, hot flashes, vomiting, and more.

If you are experiencing nausea and wondering if it’s related to MS, talk to your doctor. Once you understand the cause of your nausea, you can work with your neurologist or health care team to find a treatment that will help you feel better, improve your quality of life, and maintain your overall sense of well-being.

How Do People Experience Nausea With MS?

Many MyMSTeam members have reported experiencing nausea alongside MS.

“I was just recently diagnosed, but I have experienced getting extremely hot, where I almost look like I have a sunburn, start sweating like crazy, and eventually throw up,” one member said. “Afterward, I feel so drained and almost like I have the flu.”

Some people experience nausea every once in a while, like one member who shared, “About four years after being diagnosed, I was feeling this way. I left work, drove about 30 miles, and by the time I got home was vomiting. I couldn’t sit up, or I would vomit.”

Other people experience nausea regularly. One member wrote, “I have had MS for 25 years. My nausea started in the last year. I also get bad vertigo at the same time. I haven’t vomited but have felt I was going to.”

For a few people, nausea and hot flashes are associated with MS flares (relapses). One member made this connection, saying, “When having a bad flare, I sometimes feel nauseous, then hot.”

What Causes Nausea in MS?

There are many potential causes of nausea in MS. Other common symptoms of MS, like dizziness and vertigo, may cause feelings of nausea. You may also experience nausea as a side effect of MS medications.

Dizziness

People with MS often experience dizziness and vertigo. This is due to demyelination, or damage to the myelin sheath protecting nerves in the central nervous system (the brain and spinal cord).

MS is an autoimmune disease. It occurs when the immune system mistakenly attacks the body’s healthy cells — in the case of MS, the nerve cells. Demyelination causes lesions, or areas of damaged tissue, to form on the nerve cells. These lesions affect the nerve cells’ ability to relay information to the brain. Lesions where the brainstem connects to the inner ear or in the part of the brain that coordinates visual and spatial information can cause a person to feel dizzy.

Even if not caused by MS, dizziness and vertigo can cause you to experience nausea.

Vision Problems

MS can cause many vision problems, including nystagmus (rapid eye movement) and diplopia (double vision). Vision problems may lead to nausea in some people, particularly if the vision problems affect how someone perceives their body’s position or location in their surroundings.

Stomach Problems

MS can also cause a wide variety of stomach and bowel problems. Dyspepsia (indigestion), in particular, can cause nausea and vomiting. Dyspepsia is caused by problems in the way the digestive tract functions. Researchers believe that dyspepsia can result from either MS itself or medications used to treat MS. You may also experience indigestion for reasons unrelated to MS.

Aside from nausea, dyspepsia may also cause gastrointestinal pain, bloating, burping, heartburn, and the inability to finish meals.

MS Medications

Many medications for MS have side effects that include nausea. These include dantrolene, modafinil (Provigil), dimethyl fumarate (Tecfidera), teriflunomide (Aubagio), amantadine (Symmetrel), and ocrelizumab (Ocrevus). Some medications prescribed for depression in MS may also cause nausea, including paroxetine (Paxil), sertraline (Zoloft), and fluoxetine (Prozac).

One member also mentioned experiencing nausea while taking multiple medications: “I have been going through severe nausea since this December. My doc said it could just be the mix of meds I am taking.”

Other Possible Causes of Nausea

Many things not related to MS can cause nausea. These other causes include (but are not limited to):

  • Pregnancy
  • Perimenopause or menopause
  • Motion sickness
  • Viruses and bacteria
  • Gastroparesis (paralysis of part of the stomach)
  • Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis

Your doctor will help you determine whether your nausea is related to MS, MS medications, or something else entirely. That way, they will be able to help you find the best treatment for your nausea.

Managing Nausea With MS

You can manage your nausea, whether caused by MS or something else, in many ways.

MS Medication Changes

If you and your neurology team believe that your MS treatment is causing your nausea, they may recommend that you change treatments. You will need to weigh the pros and cons with your medical team to decide if it’s better to treat the nausea or change medications. Many MS treatments are available, and you may be able to find one that works for you without causing or worsening side effects like nausea. Your doctor can also prescribe you anti-nausea medications like ondansetron.

Motion Sickness Medications

Sometimes, medications for motion sickness can help improve nausea. These are available over the counter and include meclizine and dimenhydrinate. They may not help everyone, and they can cause significant tiredness and lethargy. You will need to decide if they are the right choice for you. As always, consult a health care professional before trying new medications to manage MS symptoms, even if they are available over the counter.

Vestibular Rehabilitation

Some physical therapists are trained to help people who feel chronically dizzy or nauseated. They will give you a series of exercises — usually involving slow head or body rotations — that may help alleviate some of your vertigo and nausea. Talk to your doctor about whether this might be a good option for you.

Home Remedies

Many home remedies may help alleviate nausea. You can try these alongside the strategies above or while you are waiting to see if other treatments work.

Home remedies for nausea include:

  • Eating or drinking ginger — You can try ginger tea, ginger gummies, ginger supplements, or including ginger as a spice in food.
  • Trying peppermint — Some people find that sucking on peppermint candies or drinking peppermint tea helps alleviate feelings of nausea.
  • Drinking plenty of water — Dehydration can make nausea worse.
  • Wearing acupressure bands around your wrists — These bands feature a nub that puts pressure on an acupressure point on the inner wrist. Some people find that wearing them regularly helps improve their feelings of nausea and vertigo.
  • Trying breathing exercises — Taking deep breaths low into the stomach (into the diaphragm) may help alleviate nausea for some people.

Find Your MS Team Today

If you are living with MS, consider joining MyMSTeam today. Here, you can ask questions, share your story, and connect with nearly 185,000 people from around the world who understand life with multiple sclerosis. You’ll find a team of people from around the world who will help you live well, no matter what MS might throw at you.

Are you dealing with nausea related to MS? How do you manage it? Share your story in the comments below or by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Joseph V. Campellone, M.D. is board-certified in neurology, neuromuscular disease, and electrodiagnostic medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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