Multiple sclerosis (MS) is a disease where the body’s immune system attacks the brain and spinal cord, causing inflammation and damage. While current medicines help reduce flare-ups, they don’t always help with brain fog and tiredness. Scientists are exploring whether a ketogenic diet—a way of eating that’s high in fat and very low in carbs—might help MS patients feel better. Early research suggests this diet could reduce inflammation, boost energy in brain cells, and improve thinking and energy levels. However, the diet is hard to stick with and may cause side effects, so more research is needed before doctors recommend it widely.

The Quick Take

  • What they studied: Whether eating a high-fat, low-carb diet (called the ketogenic diet) could help people with multiple sclerosis feel better and have fewer symptoms
  • Who participated: This was a review of existing research, so it didn’t involve new patients. Instead, scientists looked at studies that had already been done on MS patients trying the ketogenic diet
  • Key finding: Early studies suggest the ketogenic diet may help reduce brain inflammation, decrease tiredness, improve thinking clearly, and help the body repair nerve damage in MS patients
  • What it means for you: If you have MS, this diet might be worth discussing with your doctor as something to try alongside your regular MS medicines. However, it’s not a replacement for your current treatment, and it’s hard to follow long-term, so talk to your healthcare team before starting

The Research Details

This was a review article, which means scientists read through many different studies that had already been published about the ketogenic diet and MS. They looked at what researchers had found about how this diet affects the body and brain in people with MS. The review examined the science behind why the diet might work—looking at things like inflammation, how brain cells use energy, and damage to nerve coverings. The scientists also looked at what problems people faced when trying to follow this diet, like difficulty sticking with it and possible side effects.

A review article is important because it pulls together all the information from many smaller studies to give us a bigger picture. Instead of relying on one small study, we can see patterns across multiple research projects. This helps doctors and patients understand what the current evidence actually shows and what questions still need answers.

This review looked at recent research and tried to be thorough, but there are some important limits to know about: Most studies on this topic have been small and short-term (not lasting very long). The studies used different versions of the ketogenic diet, making it hard to compare results. There weren’t many diverse groups of people studied—we need research on more different types of MS patients. The review points out that we need bigger, longer studies before doctors can confidently recommend this diet to all MS patients

What the Results Show

Research suggests the ketogenic diet may help MS patients in several ways. First, it appears to calm down the inflammation in the brain and spinal cord that causes MS damage. Second, it may give brain cells more energy and help them work better, which could improve thinking and memory problems that MS patients often experience. Third, early evidence suggests it might reduce extreme tiredness, which is one of the most bothersome symptoms for many MS patients. Fourth, the diet may help the body repair the protective coating around nerves that MS damages.

These benefits seem to happen because of special molecules called ketones that the body makes when eating very few carbohydrates. These ketones appear to reduce harmful inflammation and help brain cells produce energy more efficiently. Some research also suggests the diet might improve how the body handles blood sugar and change the bacteria in the gut in helpful ways.

Additional findings from the research include improvements in overall quality of life and mood in some MS patients who tried the diet. Some studies showed improvements in markers that doctors use to measure nerve damage. The diet may also help with weight management, which can be beneficial for MS patients. However, these secondary findings are based on fewer studies and need more research to confirm.

Current MS medicines (called disease-modifying therapies) are good at reducing the number of disease flare-ups, but they don’t always help with thinking problems, tiredness, and overall quality of life. The ketogenic diet appears to target these areas that medicines don’t address as well. This is why scientists think it could work alongside regular MS treatment, not instead of it. However, unlike MS medicines that have been tested in large, long-term studies, the ketogenic diet research is still in earlier stages.

The review identified several important limitations: Most studies were short-term, so we don’t know if benefits last over years. Different studies used different versions of the diet, making it hard to know which approach works best. The studies included relatively few people and didn’t have much diversity in terms of age, gender, and MS type. We don’t have enough information about long-term safety, especially regarding heart health and nutrient deficiencies. Some people find the diet very difficult to follow, and we need better ways to help people stick with it. Finally, many studies lacked proper control groups, which makes it harder to know if improvements came from the diet or other factors

The Bottom Line

Based on current evidence, the ketogenic diet may be worth discussing with your MS care team as a possible addition to your regular treatment (moderate confidence level). It should never replace your prescribed MS medicines. If you’re interested in trying it, work with a dietitian who understands both MS and the ketogenic diet to make sure you’re doing it safely and getting proper nutrition. Start slowly and monitor how you feel. This recommendation is strongest for people who have tried standard treatments and still struggle with tiredness or thinking problems.

This research is most relevant for people with MS who experience significant tiredness, brain fog, or other symptoms not fully controlled by their current medicines. It may be particularly interesting for those who have tried multiple MS medications without complete relief. People with heart disease, kidney problems, or certain nutrient deficiencies should be cautious and discuss this with their doctor first. This is NOT appropriate for people who are pregnant, breastfeeding, or have a history of eating disorders without medical supervision.

If you try the ketogenic diet, expect to give it at least 2-3 months before deciding if it’s helping, though some people notice improvements in energy within 4-6 weeks. Changes in thinking and brain fog may take longer—up to 3 months or more. Remember that results vary greatly between individuals, and some people may not notice benefits at all

Want to Apply This Research?

  • Track daily energy levels (1-10 scale), mental clarity/brain fog (1-10 scale), and mood daily. Also note any MS symptoms like numbness or weakness. This creates a clear picture of whether the diet is actually helping you personally
  • Start by replacing high-carb foods (bread, pasta, sugar, rice) with healthy fats (nuts, avocados, olive oil) and proteins (fish, eggs, chicken) while keeping carbs under 50 grams per day. Use the app to log meals and carb counts, and set reminders to drink enough water and take any supplements your doctor recommends
  • Check in weekly with your energy and brain fog scores to spot trends. Every month, review your food log to see if you’re staying consistent with the diet. Share monthly summaries with your doctor or dietitian to make sure the diet is working for you and not causing problems. If you’re not seeing improvements after 3 months, discuss with your healthcare team whether to adjust the diet or try something different

This review discusses emerging research on the ketogenic diet for multiple sclerosis, but it is not a substitute for professional medical advice. The ketogenic diet should never replace your prescribed MS medications or disease-modifying therapies. Before starting any new diet, especially if you have MS, consult with your neurologist and a registered dietitian. Some people may experience side effects or nutrient deficiencies on this diet. This information is based on current research, which is still limited and evolving. Individual results vary greatly, and what works for one person may not work for another. If you have other health conditions, take medications, or have concerns about your health, discuss this diet with your healthcare provider before beginning.