Testing and Biomarker Monitoring
Follow the data, not the dogma
I've leaned the hard way that just because I feel good or think I am taking good care of my health, it doesn't mean things are workng well under the hood. This is where medical testing can provide critical insight.
With my MS, three types of tests have been particularly relevant over time; MRI, the specialized Octave MSDA, and general health biomarkers.
MRI
MRIs are a cornerstone of MS monitoring for good reason — they can identify lesions, track structural changes, and serve as an important early warning system if new damage appears. I've had more MRIs than I can count. They are critical tools, with a few limitations I keep in context.
MRIs can only find lesion damage in areas they scan. With MS, this might be the brain or different cervical, thorasic or lumbar sections of the spinal cord. Also, some MRI machines also offer more focus and better zoom capabilities than others.
More fundamentally, MRIs report lesion damage after the fact. Like an x-ray of a broken bone, the result is clearer than the cause. MRIs don't say much about whether MS biology is improving or degrading at a cellular or inflammatory level.
In my experience, MRIs haven't always correlated to my disease experience. MRI equipment availability, insurance coverage, and time limitations have sometimes meant partial scans on lower power machines were the only thing available. For someone like me with primarily spinal lesions, a brain-only or lower res spinal scan often returns results that don't fully match my symptoms or mobility. Still valuable, just not a complete, actionable picture.
As an example, my neurologist noted my 2018 MRIs showed a "freaking horrible", battered spinal cord that would typically be correlated with wheelchair use. They also noted that I walked into the office and add more sensory response than expected. A follow up MRI in 2025 showed no evidence of (new) disease activity, and the same spinal cord damage, even as my EDSS disability score dropped from a 6.5-7.0 to a 4.5.
My takeaway is MRI was very helpful in context with the rapid progression of my first 15 years with MS. It has been less useful or actionable as my immune and inflammatory activity calmed down over the last eight years. While an MRI showing new lesion development would be an critical warning sign for me, for now MRIs are not giving me much actionable information to assess my MS healing process.
The Octave MSDA Test
Biomarker testing helps fill thie information gap for me, and I'm grateful my neuro uses them as an additional diagnositc tool. I've been using the Octave MSDA test as an ongoing disease activity monitor — essentially an MS instrument panel between MRIs.
I also appreciate that Octave is treatment-agnostic, which makes it a practical tool for evaluating whether a non-pharmacologic approach is holding up in real life, or whether it's time to reconsider.
At my neurologist's recommendation, I first took the Octave test in summer 2025. It showed a medium-high risk for disease progression. After careful management of diet and stress factors, a follow-up text six months later showed a meaningful drop in my on-going disease risk. I am now taking the test on a quarterly basis. My intent is to maintain objective feedback and context for my MS status and trajectory.
General Health Biomarker Testing
I also use Function Health for broader biomarker monitoring — vitamin D levels, inflammatory markers, cholesterol, magnesium, and other factors that matter for general health alongside MS. The AI tools built into the platform allow for some useful interpretation, though working through results with a doctor remains the optimal approach.
MS deserves focused attention, but it doesn't exist in isolation and won't be the thing that eventually kills me. Monitoring overall health is part of the same job. Currently, my bloodwork biology says I am about 10 years younger than the date my driver's license. For me, the impact of my 4Ms regimen on my general health is as important as its MS value. Enough so that even if there was a magic pill that fixed MS, I would still keep drinking the green shake and such for the overall benefit.
Nothing here is a medical recommendation. This is how I use these tools — your path should involve your own medical team.