Aaron Boster

And what we see clinically is that MS is really, really quiet typically during the second and third trimesters.

And if you take it a step further, anytime a woman has a change in hormone levels, like even during the monthly menstrual cycle, you can see an uptick of disease activity.

Well, most women enter perimenopause around age 45 and estrogen levels start to fall at 40.

And so when the protective estrogen levels are now falling down, the rates that women in their 50s progress is the same as with men.

Oh.

And so that's freaky deaky.

What I find is hormone replacement therapy tends to help with a lot of symptoms.

And it looks like it might help slow some things down in MS.

And so I think this topic in particular is underappreciated even amongst MS neurologists and needs to be looked at a lot more.

I love this question.

And it's an area that I'm particularly interested in.

So just to level set real quick,

There's a bunch of microbes that live inside of us.

We probably have as many microbial cells in us as we do like human eukaryote cells.

And the vast majority of those bacteria live in our gut, particularly in the colon.

It's populated with these colonies of bacteria.

And that's referred to as the microbiome.

Now, interestingly, for reasons that we don't understand, many people with autoimmune diseases, including people with MS, have something called dysbiosis, which is a doctor term for you got jacked up microbes.

You know, your gut bacteria is goofy and you don't have the right kind of gut bacteria.

And there's a growing understanding that the microbiome interacts with your immune system for real.