Many people who have MS experience a temporary exacerbation of their symptoms when the weather is very hot or humid, notes the National Multiple Sclerosis Society (NMSS). This is a feature of Uhthoff’s phenomenon, a temporary worsening of symptoms that can occur in people with MS due to an increase in core body temperature, according to a July 2021 article published in StatPearls. Uhthoff’s phenomenon can be triggered by exposure to hot weather, among other factors. Meanwhile, some people who have MS notice that certain symptoms, spasticity in particular, get worse when the weather is cold, per the NMSS. People who have MS who are sensitive to temperature are typically advised to avoid extreme temperatures, both hot and cold, adds the NMSS. Could changing where you live affect how well you feel? If you are considering a move for this reason, you may want to test it out to see if the new climate improves your symptoms before you relocate, recommends the NMSS. Here are a few other factors that people who have MS should consider before making a move: RELATED: How to Spot the Signs of an MS Flare
Look Up the Average Monthly Temperatures
Before you move, especially if you’re considering the southern United States, research the average monthly temperatures for the areas that interest you. Between 60 and 80 percent of people with MS experience Uhthoff’s phenomenon with exposure to heat, notes the article in StatPearls. People who have MS should be warned against exposure to the sun when the outside temperature is greater than 86 degrees F. They should also be mindful of other factors that can increase core body temperature, such as saunas, hot tubs, hot showers, and exercise during midday, when the weather is hotter. However, while heat and humidity can temporarily worsen MS symptoms, they do not cause more actual nerve damage, notes Barbara Giesser, MD, a multiple sclerosis specialist with Pacific Neuroscience Institute and professor emeritus of clinical neurology at the David Geffen UCLA School of Medicine.
Research the Average Annual Snowfall
Not only can colder temps worsen symptoms for some people who have MS, snow and ice on the sidewalks and streets can make getting around difficult or even impossible, especially if you have trouble walking or use a wheelchair. “Ice and snow can make for potential hazards for persons who already have impaired mobility. Some persons with MS may have worse symptoms with cold or cold and wet weather as well,” says Dr. Giesser. Before making a permanent move, look up the average annual snowfall for the places that interest you. If you happen to like cold weather, you can make walking in slippery conditions a bit safer by putting removable traction devices on your winter boots and an ice tip attachment on your cane. Trekking poles may be another option. If you have a manual wheelchair, consider swapping your tires for wider tires with knobby treads and softer rubber, or pneumatic tires, notes University of Utah Health. RELATED: What to Do When Cold Weather Worsens MS Symptoms
Consider How Much Vitamin D You Will Get
Studies are currently under way to determine whether vitamin D levels have an effect on MS disease activity, according to the NMSS. Prior research published in Annals of Neurology found that low vitamin D levels are associated with more MS disease activity, or the formation of new lesions in the brain. Recent research also suggests that vitamin D may play a role in neuroprotection and myelin repair, notes the NMSS. And since the skin uses ultraviolet B from the sun to make vitamin D, living in a sunnier climate may make a difference. The skin makes little if any vitamin D during the fall, winter, and spring months at latitudes above 37 degrees north of the equator, and people who live in these areas have a relatively greater risk of vitamin D deficiency, according to Harvard Health. A 2015 study published in BMC Neurology found that an increase of latitude by 1 degree (further from the equator) predicted increased odds of moderate disability or high disability among people who have MS. An increase in latitude of 1 degree was also associated with increased odds of having more relapses over the previous year, with study authors suggesting that vitamin D is likely to play a key role in these associations. Moreover, multiple sclerosis is more common in northern climates (above 40 degrees latitude), notes the Cleveland Clinic. According to a recent study published in July 2021 in Brain, prevalence of MS increases by up to 10-fold between the equator and 60 degrees north and south, which is thought to be due at least in part to vitamin D production. The study also found for the first time that this latitudinal gradient of prevalence of MS is established very early in life, as soon as in utero or at birth, especially in females. “Vitamin D appears to be involved in the risk of developing MS, and there are some data that suggest that higher vitamin D levels may protect somewhat against relapses,” says Giesser. However, the benefits of sun exposure must be balanced against the risks of overheating, as well as the deleterious effects of the sun such as skin cancer, she warns. “Vitamin D supplementation can also be accomplished with vitamin D–containing foods and/or vitamin supplementation. It’s important to remember that too much vitamin D can be toxic, so levels should be monitored.” A review published in Nutrients in March 2020 notes that there are risks and benefits to vitamin D supplementation in MS, specifically at higher doses, and the research is still inconclusive, so it’s best to talk to your neurologist before taking supplements.
Make Sure You Have Access to Medical Care
Your healthcare team may go beyond your neurologist to include a physical therapist, occupational therapist, speech-language pathologist, psychologist, social worker, and other specialists. To find a city where you’ll have access to all of these healthcare providers, go to the NMSS’s Partners in MS Care page and enter the ZIP code of your desired location. The list includes centers for doctors, specialists, and other resources within 5 to 250 miles of the ZIP code you entered. However, if you do move and want to continue to see a certain doctor or healthcare provider, the recently expanded availability of telemedicine may give you more options.
Get to Know Your Transportation Options
If you use a wheelchair or scooter to get around, be sure to consider your transportation options. Some cities may have public transportation that’s handicapped accessible, while other areas may offer paratransit, where you call in advance to reserve a ride in a van or minibus. Ride-hailing apps may offer another transportation option in some areas. How do you find out what’s available in a given location? Try searching online for city or county transportation information, which should list public transit options and indicate whether they are wheelchair accessible. You might also search for a municipality’s office (or agency) on aging and disabilities for information on additional transportation services for people who cannot use public buses, subways, or trains.
Keep Your Personal Preferences in Mind
The best place to live — with or without multiple sclerosis — depends in part on your lifestyle. Would you prefer to be in a city? Suburb? Rural community? Do you need to be in a certain area for your work? And, of course, you have to consider your budget and what you can or cannot afford. In addition, consider your answers to questions such as: How close are you to activities that are important to you? How easy is it to access them? What’s your proximity to family and friends? If you have to rely on them to get places, where they live can affect where you live.
Take Care Not to Increase Stress Levels
Negative stress is associated with new or enlarging brain lesions, according to research published in the journal Psychological Medicine. Potential sources of stress related to where you live include:
A long daily commuteLack of community servicesNo strong social connections to people in your areaExcess noise in your living environmentHigh level of air pollution (from living near a busy road, for example)
Any of these can be an argument for changing your location or for staying put, if a move would introduce new sources of stress into your life.
Make an Educated Decision About Where to Live
The best locations are those that meet your specific needs, so be sure to identify what your requirements and preferences are before you choose a new place to live. RELATED: 10 Best Exercises to Boost Wellness When You Have MS
