Too Hot? Too Cold? Your Guide to Temp Control With MS

by Emily Shiffer Health Writer

The ability to self-regulate your temp is a bodily function that many of us take for granted. But according to a study in the journal Temperature, 60% to 80% of people with multiple sclerosis struggle with temperature sensitivity, leading to worsening symptoms. “Overheating may aggravate a variety of neurological functions, including walking and mental processing speed,” says Brian Weinshenker, M.D., neurologist at the Mayo Clinic. The good news: Temperature sensitivity can be managed—even reversed in some cases. We asked neurologists for tips to help people with MS find some relief.

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Why Can’t I Control My Body Temperature With MS?

“The parts of the brain that regulate temperature and blood flow start deep in the center of the brain, and their connections or functioning can change due to MS,” says Mary R. Rensel, M.D., a neurologist at Cleveland Clinic in Cleveland, OH. Nerves help control the amount of blood pressure and blood flow to certain parts of the body, and with MS, there can be scarring/thinning of their protective wrap called myelin, or a loss of nerves themselves, that leads to temperature regulation issues. But, keep reading—there are some things that can help.

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Stay Hydrated

Drinking water isn’t only good for quenching thirst. “It helps to regulate blood pressure; and you’ll be less lightheaded or fatigued due to low blood pressure or slow regulation of blood pressure,” says Dr. Rensel. What does blood pressure have to do with body temp? As environmental temperatures change, your blood vessels narrow or widen to keep you warm or cool. This can increase or decrease blood pressure that is needed to keep your blood moving through veins and arteries, according to the Mayo Clinic.

You don’t have to carry around a car-size container of H20 though. Just “take small sips of cool/cold drinks frequently to avoid dehydration,” says Dr. Weinshenker.

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Eat Regular, Healthy Meals

“Healthy foods give the nerves more energy to work well and last longer,” says Dr. Rensel. While there is no specific "MS Diet," many MS specialists recommend a low-fat, high-fiber diet. A low-fat diet has been linked to reduce risk of obesity, which may lead to progression of MS, while fiber helps lower and regulate blood pressure, critical for temperature regulation. Not sure where to start? Stock up on these snacks: low-fat yogurt, raspberries, kimchi, and cashews.

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Avoid Exposure to Extreme Cold

Spasticity (muscle stiffness and tightness) is often a side effect in MS patients exposed to super cold weather. “A much less common problem occurs in patients with advanced MS, who may have a hard time regulating body temperature and may become prone to hypothermia (low body temperatures, often even lower than 94 degrees Fahrenheit),” says Dr. Weinshenker. In these cases, a person with MS may develop impairment of autonomic control and could experience significant slowing of their thinking (even coma-like). "Patients with advanced MS who repeatedly become drowsy or unresponsive should be investigated for this problem,” says Dr. Weinshenker.

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Keep Moving

“When someone is conditioned and active, their blood pressure is controlled and their heart is stronger, helping the person have more strength and energy,” says Dr. Rensel. These benefits also help temperature regulation. But since your body temperature rises during exercise, it’s important to consult your physician before beginning an exercise routine.“ A few ways to stay cool while working out: Exercise indoors with AC or swim in a pool that is less than 85 degrees. If you do exercise outside, choose cooler times of day, like early morning or evening, and avoid sunlight exposure which can also raise your body temperature.

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Properly Cool Down Before and After Your Workout

If you do plan to do a workout that will elevate your temperature, you should cool yourself both before and after. A 2018 study found that pre-cooling therapies prevented worsening symptoms caused by increased temperature while exercising. Cooling garments such as a cooling vest with gel or ice pack inserts, pre-moistened towels, cooling hats, or clothing made of sweat-wicking, breathable fabrics like cotton, nylon, polyester, linen, silk or merino wool can help. Worked up a good—and hot—sweat during your workout? Cool off fast by sitting in a tub of cool water (or under a streaming cool water shower) for 20-30 minutes to reduce your core body temperature, according to the National MS Society.

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Keep Showers and Baths Lukewarm, Not Hot

One of the most common triggers for overheating in MS patients can happen in baths and showers that are too hot, says Dr. Weinshenker. Instead, you should keep your bath and shower water lukewarm. Making some adjustments within your bath or shower can also help you feel more comfortable and confident when it’s time to bathe. Installing grab bars, handrails, a shower chair or transfer bench can be helpful tools. You may also consider a lever faucet handle or handheld showerhead for more control.

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Set Up a Cool Home Office

With many of us working from home these days, you can also create a cool, temperature-regulated workspace. Fun fact: Stress itself can lead to higher body temperatures, so if work is stressful, your core temp may rise, even if all you're doing is sitting at your desk. Products like desk fans and portable air conditioning units can help keep you cool and reduce humidity.

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Plan for Busy or Active Days

Making sure you are prepared if you plan to be away from home or on your feet all day, so your temperature doesn’t get out of control. “Try to prevent or manage temperature sensitivity so that the nerves don’t get overheated leading to more MS symptoms,” says Dr. Rensel. She suggests doing this by getting plenty of rest the night before, packing plenty of water and healthy snacks, hats, and cooling products. Remember, while your MS makes you more sensitive to the temperature, you can still control your reaction to it.

  • MS and Temperature Sensitivity: Temperature. (2018). “Temperature sensitivity in multiple sclerosis: An overview of its impact on sensory and cognitive symptoms.” ncbi.nlm.nih.gov/pmc/articles/PMC6205043/
  • Fatigue and Hydration: Multiple Sclerosis. (2016). “Fatigue and fluid hydration status in multiple sclerosis: A hypothesis.” ncbi.nlm.nih.gov/pmc/articles/PMC5156578/
  • Pre-cooling Therapy: Multiple Sclerosis Related Disorders. (2019). “Impact of pre-cooling therapy on the physical performance and functional capacity of multiple sclerosis patients: A systematic review.” pubmed.ncbi.nlm.nih.gov/30544086/
Emily Shiffer
Meet Our Writer
Emily Shiffer

Emily Shiffer is a former digital web producer for Men’s Health and Prevention, and is currently a freelancer writer specializing in health, wellness, weight loss, and fitness. She is currently based in Pennsylvania and loves all things antiques, cilantro, and American history.