Multiple sclerosis (MS) tends to be viewed as an abrupt disease—vision loss, numbness, tiredness, and other neurological interruptions. But based on a revolutionary new study at the University of British Columbia (UBC), the body could begin to send warning signals as much as 15 years before a diagnosis is officially made.This study, which appeared in JAMA Network Open, contradicts decades of premises on when MS really gets started. It proposes that the disease can enter an extended and insidious prodromal phase, with such nonspecific symptoms as fatigue, dizziness, headache, depression, and anxiety—often ignored or misdiagnosed. These could all be early whispers of MS in the making.Led by Dr. Marta Ruiz-Algueró, a postdoctoral fellow at UBC, the study analyzed the medical histories of 2,038 Canadians with MS and compared them to more than 10,000 people without the condition. Using detailed administrative and clinical records that spanned 25 years, researchers tracked how often patients visited healthcare providers before their first classical MS symptoms.15 years before diagnosis, people who later developed MS were already visiting general practitioners more frequently. Their complaints often centered on fatigue, pain, dizziness, headaches, and mental health concerns like anxiety and depression.12 years before: Psychiatrist visits began to rise.8 to 9 years before: Visits to neurologists and ophthalmologists increased, often due to vision issues or unexplained nerve-related symptoms.3 to 5 years before: More visits to emergency medicine and radiology departments.1 year before diagnosis: Healthcare use spiked across multiple specialties, especially neurology and emergency medicine.“These patterns suggest that MS has a long and complex prodromal phase where something is happening beneath the surface but hasn’t yet declared itself as MS,” said Dr. Ruiz-Algueró.Is Mental Health One of the First Clues?One of the most striking revelations was the presence of mental health conditions, particularly anxiety and depression, in the earliest stages of the disease's progression. These symptoms were found to be significantly more common in people who eventually developed MS—often more than a decade before diagnosis.“We’re only now starting to understand what these early warning signs are, with mental health-related issues appearing to be among the earliest indicators,” added Ruiz-Algueró.However, the researchers are clear: not everyone with depression or fatigue has MS, and most people with such symptoms will never develop the condition. But in combination with other red flags and patterns, these findings could help doctors detect MS earlier.Why These Findings Could Change How MS is Diagnosed?Traditionally, MS diagnosis hinges on a demyelinating event, such as vision loss or difficulty walking. But this study shifts the focus further upstream, suggesting that the disease process starts silently, even while symptoms seem unrelated or mild.Dr. Helen Tremlett, senior author of the study, emphasized that early detection is key:“By identifying these earlier red flags, we may eventually be able to intervene sooner—whether that’s through monitoring, support, or preventive strategies.”The implication is profound: if clinicians know what to look for, they could start identifying people at risk much earlier and possibly even slow the progression before major damage occurs.How MS Works?Multiple sclerosis is an autoimmune condition where the immune system mistakenly attacks the protective covering of nerves—the myelin sheath. Over time, this leads to inflammation, scarring, and disruption in the brain’s ability to communicate with the rest of the body. Common symptoms include:Chronic fatigueNumbness or tinglingLoss of coordination or balanceVision problemsMuscle weaknessMemory and cognitive changesDespite decades of research, the exact cause of MS remains unknown. Genetics, viral infections, environmental factors, and immune system dysfunction are all believed to play roles. Previous studies have also identified MS-specific antibodies in blood up to five years before symptoms, suggesting the immune system may go rogue much earlier than expected.This extended prodromal phase isn't unique to MS. Parkinson’s disease, for instance, has long been known to begin with subtle mood changes, constipation, and sleep disturbances years before motor symptoms appear.Tremlett and her team say MS is now showing similar patterns, and it’s time to recognize that the disease doesn’t start with the first lesion—it starts long before that.“This is the most comprehensive picture to date of how patients engage with a range of healthcare providers in the years leading up to a diagnosis,” said Tremlett. “Our findings dramatically shift the timeline for when these early warning signs are thought to begin.”While there's still no cure for MS, early detection could pave the way for better disease management, fewer relapses, and slower progression. If you're experiencing chronic fatigue, unexplained pain, dizziness, or persistent mental health concerns—and you’re not getting answers—it’s worth advocating for yourself. While these symptoms are common and non-specific, studies like this show they may sometimes be the earliest signs of something more serious, like MS.