Keeping Your Cool: MS and Heat Intolerance
By Connie Brichford
Reviewed by Pat F. Bass, III, MD, MPH
Sensitivity to heat can disrupt the quality of life for people living with MS. Here’s how to keep your cool.
Heat intolerance is a common issue for people living with multiple sclerosis (MS). Not only are they in general more sensitive to heat, but heat can also make their MS symptoms considerably worse.
MS-related heat intolerance occurs because the myelin protective covering around the nerves in the brain is damaged and doesn’t function properly when the body is overheated, says Jack Burks, MD, chief medical officer of the Multiple Sclerosis Association of America.
“The nerve impulses cannot travel efficiently, and fatigue sets in,” Dr. Burks explains. “The dangers of heat intolerance might include a temporary decrease in balance, strength, feeling, or vision, which could lead to falls and other problems,” he says.
The best way to avoid a temporary increase in MS symptoms related to heat intolerance is to avoid overheating in the first place. But if you do feel overheated, it’s important to take steps to cool yourself down.
Try the following strategies to see what works for you:
Ice Can Be Nice
Lisa Emrich, 46, a musician and music instructor from northern Virginia, uses ice to cool down. She says that when she becomes overheated, she has trouble thinking and speaking clearly, and sometimes has difficulty walking.
“There have been times my husband and I are outside working in the yard and everything is fine, until suddenly I get overheated and have to ask him to help me inside because my legs have difficulty moving,” she says.
“Ice is one of my favorite ways to cool down — it can be used in so many ways. On the inside of the wrist is nice, or on the back of the neck, your forehead, or the middle of the chest. If it’s a large ice pack, I like to hold it on the front of my body and try to cool off quickly.”
Take Care During Exercise
Exercise can offer both physical and emotional rewards to people living with MS, but it’s important to choose activities that work for you rather than against you.
Swimming or water aerobics in a pool with a low water temperature are two options that work well for people prone to heat intolerance.
Avoiding outdoor exercise during the hottest parts of the day, taking frequent breaks, and taking advantage of air-conditioned gyms are also smart ideas that can help you stay fit in a safe way.
Emrich says she likes to place a fan in front of her exercise bike to help her stay cool. She also wears lightweight, breathable clothing.
Avoid Hot Situations
“Most people do not appear visibly different” when heat intolerance strikes, says Dr. Burks, but “they may feel tired, weak, or have a recurrence of old MS symptoms when exposed to high temperatures or conditions such as a hot tub or vigorous activities.”
To avoid problems, limit time in hot tubs if you use them, keep hot showers and baths short (or take lukewarm showers and baths), and steer clear of steam rooms and saunas.
Travel With Care
Whether you’re traveling by plane, train, or automobile, take steps to reduce your risk for overheating. Wear layers so you can deal with varying temps, whether they’re too hot or too cold, Emrich says. She recalls a time when she was on a plane waiting for the remaining passengers to board, the air-conditioning wasn’t on, and she felt herself start to overheat.
“I remember asking the flight attendant to please bring me a cup of ice,” she says. “I basically used that all over my forehead and body, and I got wet, but at least I cooled down quickly!”
Another time in a train station, she says she started to get too hot as she waited for her train, so she went into a shop and asked if they would fill a bag with ice.
When traveling by car, choose your seat carefully. “I think about what side of the car I want to sit on so that I’m not baking in the sun,” she says.
If your vacation plans include other people, be open with them about your need to avoid becoming overheated.
“If I travel home to Oklahoma to visit family in the summer, I plan ahead and let my family members know I won’t be participating in too many outdoor activities,” Emrich says. “I’ll probably spend more time inside. And I plan what time of day to be outside — not in the middle of the day. In the morning is good, in the evening is good, but avoid the period when the temps are at their peak. Wait until the sun goes down.”
Pay Attention to Your Body
Whether you’re exercising or simply doing chores around the house, it’s important to pay close attention to the signs your body gives you when you have MS. If you’re getting uncomfortably warm orfeeling dizzy, faint, or excessively sweaty, take a break and give yourself some time to cool down before you start again.
If you become overheated and can’t get to a cool place on your own, ask for help, especially if you know that your temporary symptoms affect your mobility.
“If you know that you become a danger to yourself because you’re having trouble walking, it’s really important to watch out for your safety and get someplace where you can cool off,” Emrich says. “If you need help, ask for assistance.”
Ask Others What They Do
Talk to other people living with MS to find out what helps them avoid heat intolerance. The National Multiple Sclerosis Society says that eating Popsicles and drinking icy drinks are good ways to beat the heat. You can also try cooling vests, neck wraps, and bandanas soaked in cold water.
If you’re newly diagnosed with MS and have not yet met other people living with it, a support group can be an invaluable resource for information and advice on coping with heat intolerance and other symptoms of MS.
Additional reporting by Mikel Theobald.
Last Updated: 4/28/2016