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Staying Cool With Multiple Sclerosis
The fact that heat makes multiple sclerosis (MS) symptoms feel worse isn’t news — it was first noted in the late 1800s. But recent research has confirmed another unpleasant truth, one that many people living with MS might already know: Thinking and memory are worse on hot days. The “cure,” however, could be as simple as an iced coffee and a cool bath.
Back in the 19th century, doctors noticed that hot baths and exercise both seemed to lead to worsening multiple sclerosis symptoms. This heat intolerance is referred to as Uhthoff’s phenomena, named after German ophthalmologist Wilhelm Uhthoff, who first described it.
Doctors today know that this reaction can be caused by summer weather, cooking at home, taking a hot bath, physical exertion (including working too hard to move your wheelchair), or even fevers from infections like a wintertime flu.
Published in the journalNeurology,researchers looked at the cognitive performance of 40 people with MS and 40 people without it over the course of a year. They found that those with multiple sclerosis performed worse on tests of thinking and memory when the outdoor temperature was hot than when it was cool. Because the study participants were tested in both summer and winter, the researchers were also able to compare any given individual’s performance from one season to the next. “Within the same person, there was a fluctuation in their cognitive performance,” says study researcher Victoria Leavitt, PhD, a neuropsychologist at the Kessler Foundation in West Orange, N.J., and an instructor at the New Jersey Medical School in Newark.
The Facts on Multiple Sclerosis and Heat
The phenomenon is more challenging to understand because the changes caused by heat aren’t permanent — a good thing for someone with multiple sclerosis, but not helpful to drawing conclusions if you’re a researcher. Once the temperature cools or the person with MS is able to cool down, the heat-related exacerbation appears to dissipate.
In addition, image testing conducted by Harvard University researchers showed that during warmer months, people with multiple sclerosis have more active T2 lesions in their brain. These imaging results are typically a sign of an exacerbation, but don’t necessarily signal a progression of the disease.
Why heat (both internal and external) has this effect is still not fully understood. ”It’s a complicated situation,” Dr. Leavitt says. For example, she says that with her study subjects, poorer cognitive performance occurred on warm days regardless of whether the participants had spent time in an air-conditioned car or cooled down briefly in the lab before testing. Also, she says, researchers believe that high humidity can play a role along with high temperatures, but this has yet to be fully explored.
How to Cope With Heat Intolerance
To compensate for heat levels that can worsen your multiple sclerosis symptoms, try these tips:
- Drink cool drinks.Iced coffee, cold water, and slushies are all options for helping to cool down. They're also good alternatives to hot drinks that could be aggravating your symptoms.
- Pick cool over hot.In any situation, go for the cooler option. Choose swimming over walking in the heat, for example, or a cool or tepid bath instead of a long hot soak.
- Plan around hot weather.“If you have a choice between taking a test in the winter or the summer, knowing heat affects cognition could guide the decision,” Leavitt says. Try to organize other major events, such as wedding planning, around the weather as well. Likewise, stay in a cool environment during the hottest parts of the day, especially during summer months.
- Invest in a cooling vest.These are specially designed to keep your body cool. People living in particularly hot and humid areas of the country might find them especially helpful.
- Keep rooms cool.Air conditioning is helpful if you have it, but you can also use a fan to move air around and keep yourself cooler.
- Dress to be cool.Wear layers so you can cool down more easily. Pick breathable fabrics and loose styles that allow air to move.
- Spritz yourself.Use a spray bottle to mist yourself if you’re out in the heat. You can also use cool packs and apply them to your neck, forehead, or wrists to cool down.
Like many aspects of living with MS, learning more about your condition and the factors that make symptoms worse — like heat — can help you gain greater control over your life.
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