Multiple Sclerosis Symptoms and Winter Weather

 Most of us with multiple sclerosis are heat intolerant to the point of being unable to function outside during peak summer temperatures. When I asked people with MS on my blog what their MS temperature “limits” were, I was surprised that many people came back with answers lower than I would have expected – most said that 80 degrees was pretty much their cutoff for comfort and that 55- to 70-degree weather was really ideal.However, it got even more interesting when several people said that while hot temperatures were not good, the cold wasn't so great for them, either.
Many people wrote in to complain of increased spasticity in the cold weather. Readers mentioned that their limbs "felt like wood" or that their joints ached during lower temperatures. A couple of people also mentioned that the MS “hug” could be intolerable in the cold. (The MS hug is the gripping feeling around the torso that is caused by a lesion in the spinal cord that results in spasms in the tiny muscles between the ribs.)
I also know that some people living with MS tend to feel more fatigued in winter months. This could be an indirect result of coping with some of the symptoms mentioned above. It could also be that the shorter days and limited sunlight are exacerbating depression, which can be a symptom of MS.
New data is emerging all the time on the role of vitamin Din MS. Experts are fairly confident that low vitamin D has a role in developing MS, but now it is really looking like vitamin D levels have an impact on relapses and disease progression. It has been well-established that vitamin D levels in people are lower in winter months due to less exposure to sunlight (which is necessary for the body to produce vitamin D). Perhaps we feel our symptoms more acutely when our vitamin D reserves are at their winter lows, although this hasn’t been confirmed yet by scientific studies.
However, the effects of cold on MS symptoms have not been studied extensively. I was able to find one study that compared people with MS in the same four-week inpatient therapy program held in two different locations: Spain (warm) and Norway (cold). After therapy, the average walking distance had increased more in Spain (70 meters, as opposed to 49 meters in Norway) and participants also reported less exertion after walking in Spain than they did in Norway.*
I've put together a few tips below to help you enjoy the colder months if you find that you are bothered by frigid temperatures. Please add your own stories and tips in the comments section.
  • Soak up the sunshine. As much as you can stand to be outside during the warmest part of a sunny winter day, do it (within reason). Help your body produce vitamin D. Even better, get a little exercise outside while you are at it. 
  • Don't overdo the heat inside. I tend to get a little dramatic when I get too cold and, as a result I take really hot baths or showers. Recently, I got dangerously dizzy from my hot shower. Remember, extreme heat is not our friend, either. 
  • Warm yourself from the inside. Try drinking a hot beverage to take the chill off and warm your core faster.

Like many other situations that we must navigate through with MS, a little strategic planning about winter activities can help you have a little control over symptoms. Really put some thought into what you enjoy doing in the winter, take a couple more precautions and get the most out of the cold months.
*It should be noted that the people in this study were not heat-intolerant.
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Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.

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  • Rodger Ashton-Smith   Dec 28, 2018 2:16 PM
    I don't get too bad with a winter time but in summer my fatigue gets bad for me and stops me doing much. The cooler weather treats me well.
  • Kathy Stein Simeral   Dec 30, 2018 5:35 PM
    I have had a couple significant relapses over the years, as well as many exacerbations. All of these episodes have been in the Winter.
    I seem to be less tolerant of the cold than heat. I do, however, also feel heat intolerant during extreme temperatures in the 90’s+. I like planting beds of flowers and maintaining them during the late Spring and Summer months. If I use a soft ice pack and put it at my waist, this seems to provide me with a prophylactic response to heat tolerance. My core body heat seems to respond to the cooling effect of the soft ice pack, and I don’t feel too overwhelmed.
    In your blog, you noted that the MS hug was more intolerable to some during the Winter months. I found that to be very interesting, as I too had one such incident about 4 years back. In fact, I went to the ER at a major medical center here in St. Louis, MO that is affiliated with Washington University (BJC Health), and was having severe hug symptoms. The ER physician and the hospitalist were not familiar with the MS hug, and they actually made it seem as though I were crazy when I told them what I thought I was having.......and I can honestly say it was the most horrific experience of my life living with MS. I actually thought I was having a heart attack with a crushing feeling across my chest. I was in horrible pain and crying, etc. Since my heart monitor and blood pressure did not reflect a MI, they really thought I was having psychiatric problems. Even though I had never presented with any psychiatric or psychotic episodes in the past. I was labeled as such...
    My internist who has known me for many many years and who knew my prior work history as an Office Manager of a Private Orthopedic Practice, as well as being prior employed by Washington University as an Administration Asst of the Orthopedic Department, knew me to be of sound mind and a good historian. Since that episode, I now have panic attacks, which has become less and less this past couple of years thankfully. That just goes to show how you can be made out to be crazy if they do not know you personally.
    I appreciate your article. Thank you.