Hi:  I came across this site after trying to find more answers for PPMS.  I was told I had it in Nov 2008.  I am 56 years old.  Ten years ago I had an MRI done, because something happened that resembled a stroke,  and there was nothing.  I've spent 10 years trying to get answers, and got extremely frustrated. I found you have to help yourself.... I don't have a lot of faith in the medical system. (I live in Canada).  I finally asked a doctor in the area I now live to refer me to another neuro.  He did and that's when I was told.  I got a 2nd opinion, and was told I "wasn't bad enough" to participate in a new trial that was for PPMS.  That just made me feel great !   And this was in an MS center, by the head guy, in a major city in Canada !   I've researched on my own and found a great book called "The MS Recovery Diet"  by Ann D. Sawyer and Judith E. Bachrach, they were both MS sufferers.  And the other book is by Dr. Barry Sears called "the Anti-Inflammation Zone".  This was recommended by the GP who referred me to the neuro. They are both worth reading.  This GP has done Omega 3 tests (you do pay for this) and these are sent to a lab in Guelph, Ontario ( the only one in North America) and they determine your inflammation level and that determines how much Omega 3's you require.  I am doing everything naturally, as they basically told me, you have PPMS, there's nothing we can do and there is no medication available.  Of which I'm glad, because that just band-aids the situation.   I have changed my lifstyle, (being retired helps regarding time) excluded all foods that can irritate inflammation, gluten, dairy, eggs, and my biggest culprit sugar.  I was told of someone that through naturopathic and homeopathic and food and lifestyles changes, went from 30 lesions in the brain to 2 (in 2 years)...Fatigue hits me in the evening, and I sound like I've been drinking...I had worked for a telecommunication giant for 15 years, during the last 5 years this started to surface.  I was an actress, dancer, and was beginning a voice over career, when this happened; so I retired early when a package was offered, reconnected with and married my high school sweetie in 2006, (after 30 years apart) and have begun a career doing genealogy...I don't have to talk...  I take B vitamins, B12, D, E, plus a very good multivitamin, mineral complex, and fish oil, because most people with MS are low in DHA's and EPA's (omega 3 essential fatty acids), and I walk daily......I'm not a sports person, I used to ride horses, but I haven't tried that yet.  I hope this helps and encourages others to fight for yourself, because no one knows your body better than you and that there are questions that need answering.  I am also very thankful that my husband is very loving, supportive and we're together "no matter what"..Here's to everyone :)   Shirley