quest turned into tragedy is not the kind of freedom that we want. coded move where you become a gateway to islamist terror. exclusive report from a destroyed city. village in the sights of our guests starts october 24th on d w. this week on in good shape we'll be looking at the micro biome how your gut influences your brain. and multiple sclerosis a diagnosis that can change your life. and here comes your host dr constantly. hello and welcome to in good shape this is a highly automated bus it works with our driver and it brings people everywhere

because mobility is important to us but not everyone is as mobile as i am and if mobility is not there we've got a problem. hello and welcome marc on i'm meeting and she suffers from multiple sclerosis so why don't you have and we did check and have of will i like to go with the world at him valen but it's his way of poor this is what we're going to talk about with paul 1st look at how most he's the head of the neurology apartment here at the britain charity and is very well known. and we will continue our talk in just a moment but 1st i will show you a young man who loves nothing more than to jump of high cliffs so it's pretty normal life but he suffers from multiple sclerosis and he's got

a you tube channel and he talks about this to his fans. but also. to be out in nature to jump off a cliff into the sea from a height of 20 or 25 meters that's a feeling of independence and freedom various kinds of fun finds. patrick island just loves that feeling and he loves sports he's superfit the 2 years ago his body gave him a nasty surprise. i had attending feeling in my left arm and leg like ants running up and down. at the beginning flare ups were sometimes so intense i couldn't control my movements properly so i had to stop cliff diving. at least the diagnosis. as multiple sclerosis patrick was 28 at the time the thought that he might end up in

a wheelchair was terrifying. as totally knocked me off my feet because if you've never been diagnosed with an illness like that it's hard to understand how lousy you feel when they tell you it's patrick has been spared frequent flare ups but when they occur they interfere with every day life and especially sports business just monitors his condition what he does feel all the time however is the tingling in his left arm and leg. it's the result of inflammation in the brain. multiple sclerosis is a disease of the brain and spinal cord which causes inflammation in certain areas there has to be and that causes flare ups. these flare ups are the symptoms that the patients experience. they vary depending on the area of the brain where the inflammation occurs. neurological tests show that patrick

ottman just still in pretty good shape his reflexes and coordination are barely compromised. by hand and this is the good news is that mr argent is not suffering from any serious enduring problems that manifest in everyday life then it's often the case that in the early stages of m.s. issues that arise with flare ups subside again. still patrick does sometimes have difficult moments. i was on the board and about to jump but i just couldn't quite my body was telling me no not today that was a blow to my self image i fuck terrible that triggered a downward spiral of i dunno where you go on. medication prevents or at least delays flare ups but never knowing how the disease will proceed it is a considerable emotional and psychological burden.

if you get into a depressive phase it's hard to get out of it again without the right help and the right people around you but also. patrick has sought help and seen a therapist he's created a you tube channel called eye of patrick about enjoying life to the max what ever adversity you face he also addresses issues related to his disease. i want to talk about disability what does it mean you don't have to be in a wheelchair to be disabled it's enough to have rheumatism diabetes or like me and mess. with my you tube channel i want to encourage others with m.s. and tell the world that even with the disease you can still have fun. for patrick fun means high diving including cliff diving and he's going to carry on diving as long as his condition permits. serious flare ups could mean difficulty moving or even for hours. when it's so bad if you were to develop persistent coordination

problems i think it would be difficult for him to continue with the sport such as high diving. though in general sport is good for m.-s. patients it keeps them fit i would support his carrying on although he should always ask himself whether he's really up to it. but if. it can help with m.s. patients train coordination balance and core strength. but the quality of life is also important not withdrawing into one's shell. doesn't begin to climb lift it off a little things that help you cope having the right friends doing support you form i come here almost every day here i am life goes on like this and that isn't going to get you down and i'm not going to hide myself away it's. fine once i learn to accept things bifocal very much better just talk to you if you smear might

be looking for if you feel better. so how are you today i'm fine today i like my day it's perfect so if you think back for the 1st signs you had from the small to this to rose's what was it like what were the 1st signs oh i didn't know what happened it's a long time ago it's in and i think i think high for the 1st time and i started to weep blind and here i'm betting that met some folks they don't know what if. this puzzling up forward as i didn't know and so forth and. then by. into all the spinal to have yet running that examine the spinal fluid and see her in the cells and that said i don't want that i'm sorry about it i wanted to i wanted to wait until my body felt tell you what happened so you believed in your

body and the body would give you all the answers soon as i had lots of stress and a chop in the live and it's charted in 2005 again and then 20 years yes my 3 years and i have lost my husband and in paris and i went up there over the fruit and the traffic late light came from. red to green and i couldn't go and this was a proper member came back to berlin and somebody had some days later and here it was clear so finally you got your spinal tap and then you got the diagnosis he had to destroy everything motley's everything changed then didn't it change that i changed my job i want there by the year later again and i said ok it's fine but i will try and my life other changes so it's in the very hard to get a diagnosis which will definitely change your life i think it's a very very good everybody used to his normal life and then there's complete change

from one moment with the other i but as for me it was great but i think that lots of people and there are lots of. i think it's better so what were your greatest fears sitting in a wheelchair for instance and the 1st time yes but later on i have the feeling feel true it's not the perp and. the problem are i think it's not a field trip so now you're living with multiple sclerosis there are certain kinds of attacks the disease worsen sort of what i think. the attacks are very hard i can't move lyrics i can't move the arms i can't. car larry march a country to i can count moves that i have and and they're fast but normally it goes away and then i started to to live what for so sharply but.

i wanted to then last thing writing i made and then mashing says how can you keep your good spirit oh i think my mother 1st said i'm a fan when. character. if you will give her a push here and save or make it so in the feeling that everything will be your bank she was right i don't know much and i have this idea the 1000 from multiple always on the bright side of life it's very good so let's 1st take a look at what research is saying about multiple sclerosis so i will have a good talk to her for soledad's. look times is a neurologist who researches multiple sclerosis at berlin shall he hospital he's also a medical advisory board member for the german m.s.i.e. he and his team are trying to find out what causes multiple sclerosis by

discovering more about the triggers they hope to develop better treatment options. if this multiple sclerosis doesn't mean you will end up. in the dr house full of things today and why you see him is called the disease of the fouls and faces that's because symptoms of multiple so this is very different very good the regime use militarization so we have for instance the new laws we have numbness and tingling you have perrie's this force. also later on we have dysfunction of urine blood and later. often fatigue is a big problem for patients so if you take a look well divide you will find that there are approximately 2500000 cases of m.s. world wide and the number of patients increasing so why so we cannot compare

the situation 40 years ago and today because a change so many things for instance. because a month's imaging was not available 40 years ago today is the standard. diagnosis not stick to will. we can make those much all years and in former years you have new. year for diagnosis. and so also the many opportunities of treatment also increase our values for the disease so we have much more diagnosis but that does not mean that we have really more ill patients is there any explanation that m.s.m. occurs mainly in young people especially in when multiple throws a very complex disease mediated. disturbance lead to

destroy of tissue of the brain and spinal cord and that means. as an auto immune diseases that you have overreaction of the immune system and of course in young people's as a more potential of active immune system and the disease different here or in europe or on a global scale world wide in different countries yes it's a very interesting question and trusting fixed all the data already showed us that there is a difference to the pending from the region of patients are living that means depending from the let it you would. the greater distance from the. the. incidence of the disease so do we really know what causes multiple sclerosis. based on the mentioned global differences different processes have been

established that means for instance a series of. exposure to sunlight and vitamin d. plays a role in the disease development we have the hygiene hypothesis. which means that the development of the immune system in the child needs some challenges which we don't have. amount in developed countries but if there are so many different causes and the perhaps don't know them all how can we treat m.s. . we don't treat the causes of we try to. stop. just. over activity and so we have to do. about 16 different drugs approved during the last 25 years and they are very different from the from the side effects from the

application of you have injectables you have oral drugs infusions and so we can try for every individual patients the best. treatment. our aim is to reach the so-called. that means no evidence of disease activity so if we speak about the immune system really have to take a look at our gut flora of the big to really get in our intestines because they play an important role for immune system even in a mess patients. happy cut may be the key to health in particular the health of the brain new research shows that the brain gut axis plays a significant role in diseases like parkinson's alzheimer's and multiple sclerosis . into order for your brain to function normally an intact

gastrointestinal system with healthy intestinal flora is crucial the intestines feed the brain the new discoveries are coming so fast that i'm certain will no longer be able to ignore the gut when it comes to therapies for diseases. recent studies show that the bacteria in our intestines are of more importance than previously believed billions of microorganisms live in our gut around 2 kilograms worth and they affect our brain 2. studies on mice have shown that eliminating intestinal flora can damage brain activity. we've found that when mice have a flawed gastrointestinal system with no gut bacteria the immune system in the brain is dramatically affected. researchers at the university of medical center took a close look at immune cells the protect the brain against disease they discovered that the cells only function if intestinal bacteria can produce certain substances

that they need. usually. called micro glucose cells are very active in the brain they have small appendages which monitor the nerve cells of the central nervous system if bacterial metabolites short chain fatty acids disappear then visa immune cells are hampered they wither away like plants in a garden that are not watered. the brain's immune system atrophies when it doesn't get certain materials from the gut. intestinal bacteria are responsible for turning the food we eat into valuable substances among them short chain fatty acids. slike probiotic acid. scientists wanted to know if these fatty acids could in turn cure a disease brain they tested this by adding probiotic acid to the drinking water of a sick mind the result the immune system recovered.

that's fine for you it was a completely surprising finding we didn't expect it at all. would it also be the same case in humans would it be possible to heal the brain via the gut doctors that sunk use of hospital in bookham think so. they've seen that the brain as well as the intestines are affected in patients with multiple sclerosis. is in an affair and the competence and we've observed a change in the composition of the intestinal micro biome that means all of the bacterial strains that exist within the intestines and what we're seeing is in effect an impoverished with a decline and diversities of bacterial species in the gut. among the hundreds of bacterial species found in our guts about $160.00 appeared to be common to the healthy human intestine people with m.s. some of those are missing for reasons that aren't entirely clear and that leads to a deficit of short chain fatty acids such as probiotic acid. then you go back to it

because there are fewer bacteria present less probiotic acid is developed in the intestine and that's reflected in the patient's blood that's in you know. that also proved true for an orator who has m.s. she had unusually low levels of probiotic acid in her blood. the doctor decided to add appropriate supplement to her other medication and it appears to help. me i coughed i have more strength it's easier for me to complete my daily activities. i also feel more focused in mice but in most m.s. patients say that after a short period of time they already noticed an improvement they feel more fit they have more strength experience less fatigue. and they're less susceptible to infections venier in fact unfairly but the main change could be measured in their

blood the doctors found that immune cells increased by 30 percent and the number of certain white blood cells implicated in inflammation drops by up to 50 percent arianna szpilman must also given probiotic acid and not only did the symptoms of m.s. improve another condition did as well. to tap and i was waiting for my hay fever symptoms to appear but they didn't and then i realized that it could have to do with the probiotic acid that i took. the hypothesis is that part of the immune system is located in the intestinal walls in cells as well as bacteria and their metabolic products are all found there and the fatty acids that the bacteria produce could be what strengthening the immune system. neurologist gold is convinced that that's the case he's a multiple sclerosis specialist he says he hasn't found any negative side effects

from propane on a gasket and quantities we don't know of any risks and the european food safety authority has cleared an amount that is actually $200.00 times higher than the concentration endos that we consider useful. when patients ask me i say try it out and see if it works for you i have to emphasize again and again that we don't have data from clinical trials and kind of. therapies are still being researched but one thing is for sure healthy balanced diet benefits your intestinal flora will make your gut feel good and maybe help your brain as well. what's your take on probably on i guess it. well we ask larry often from our patients if they should take probably on i guess it but is it probably only as it is a short chain fatty acids produced by special bacteria in the gut and we know that it's probably going to get as it is influencing special immune cells from the

animal studies we know that it has an effect and so we hope it's also effective in patients in the treatment of as patients as additional treatment but there's a lack of. studies still that there are no major side effects so you could just try it. if patients want to say ok i take it because it has no side effects and what about vitamin d. i mean there are several studies suggesting that this might be helpful in the miss patients. yes. we know that from other studies too and also in our patients we look for it to be delivered as a blood and the most of the patients really have a very low vitamin d. level so we. give them a supplement of vitamin d. and the most neurologists are doing that but you don't know except if it really

influence the course of the disease so what else can patient to say nutrition wise response and exercise ready. first of all as a physician to comment that there should be a. prescribed medication but they can do a lot of talk about that so we recommend that they show to perform insurance sports that means walking jogging swimming or cycling. as they can and should not smoke because smoke this lead to a progression of multiple sclerosis so if a patient today would get the diagnosis multiple sclerosis what are his chances to stay out of a wheelchair in the past is evidence that. shorter life span a little bit but you have known you are data. concerning modern treatment and. hope for the modern treatment. enabled the patient

to lead a normal life or a good life. even visit out. thank you so much for this talk today and i know this is a very very interesting show and you don't want to leave your t.v. screen but you have to if you want to write us an e-mail. in good shape issue weekly health show on d w covering many aspects of health care we look at what's new in medical treatment nutrition fitness and beauty. we discuss these topics in depth with specialists and offer you opportunities to pose your own questions. on an upcoming show we'll be talking about antibiotics they're being prescribed more often than ever but resistance is also on the rise what are the consequences and are there alternatives to send your questions to in good shape at d w dot com just write the word antibiotics in the subject line we look forward to

hearing from you. so how do you see a future i think a pure truth computer open and i like it and i like to mesh everything was coming up and he wishes now lots of. i want hope for everybody i want that people are respecting everybody and i think that's a very important choice head for courage and to let charities very important issues let's hope that they get true. so see you again next week and until then let's all try to stay in good shape.

i know nothing at the gym but just sometimes i am but i stand up and whip it up and pretend to have an think deep into the german culture of looking at the stereotype of the quacks that is think is most of the country that i now live. via need to see the thickness gram a day out to you it's all about a block now by my show join me for meet the jetman bundy w. . post the

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play play play play. play. play this is news live from berlin is this ceasefire in northeastern syria already crumbling kurdish led forces accused of violating the troops but ancora says there were no more clashes in the area also coming out of thousands take part in a mass rally in catalonia in northern spain to protest against the jailing of separatist leaders bringing parts of the region to stansted. charlie you are strong armed boris johnson begins his campaign to persuade the british parliament to back his new threats to deal.