EPISODE 29: Weather and Its Effect on Autoimmune Disease

STACY: Hey everyone, welcome back to Autoimmune Adventures. Today we're going to talk about how different weather conditions, hot weather, cold weather, and the ever changing patterns that exist can affect people living with autoimmune disease. We're also going to share some tips on how to manage those effects, so let's go ahead and jump in.

In today's Good Bit Minute, we explore the uplifting connection between nature and our health. Engaging with the natural world offers profound benefits, especially for those managing autoimmune disease. Research indicates that spending time in nature can significantly enhance our immune system. A study that was highlighted in Time magazine says that individuals who take long walks in a forest over consecutive days can actually increase their natural killer cells or their NK cells by 50 percent when activity levels remain 23 percent higher than usual for a month following the walk. So you can go out and hang out in nature for a while, and it will continue to benefit your body for over a month, which I think is amazing.

NK cells play a crucial role in combating infection and regulating the immune response, which is particularly beneficial for individuals who have autoimmune disease. And beyond immunological benefits, nature exposure also positively impacts mental health. The American Psychological Association reports that spending time in natural settings is associated with improved attention, lower stress, better mood, and a reduced risk of psychiatric disorders, and these mental health improvements can be especially valuable for those coping with autoimmunity.

Moreover, a study from Stanford found that walking in nature yields measurable mental benefits and may reduce the risk of depression. The finding underscores the therapeutic potential of nature walks as simple, accessible means to enhance our well being. And incorporating regular nature exposure into our routine, be it through forest walks, gardening, just spending time out in a park, taking your dogs out to the dog park, can serve as a natural cost effective strategy to support physical and mental health.

And as we continue to understand the intricate relationship between our environment and our well being, it helps us to heal. And nature offers a hopeful and empowering approach to manage health challenges. Now, because I had a lot of research in there, we will include links for the Stanford report in Time in our transcript so that you can read further if you're interested in learning more.

BECKY: As we're talking about today's subject, where we're talking about the weather, keep in mind that with those of us that have autoimmune disease, sometimes how we interact with nature is going to change depending on the circumstances. The perfect example of that is if we start here with hot weather, during the summer months or in really warm climates, a lot of people with autoimmune diseases can experience more flare ups or symptoms that make everyday activities harder.

That is especially true for those of us with lupus. I know that I have limited time I can spend in the sun. We were raised in a desert. I used to love to be out in the sun all the time, but I kind of love my cloudy days now, because I can actually spend more time outside. Remember, it's not just about being uncomfortable in the heat, because definitely there's that. It can cause flare ups, but the heat can actually throw off your body's balance.

If you've got lupus and you've got that heat and sun intolerance, it actually feels like your skin's on fire. My husband asked me about it once, and I tried to explain to him that it's not like a sunburn because goodness knows I'm a redhead with pale skin. I have had my share of sunburns in my life, even with sunscreen. It's not the same thing. Even after having a really severe sunburn, it doesn't feel like the same. The point being is that you have to recognize sunscreen is a given. You have to limit your time in the sun. And so be aware of those kind of things.

We love the sun. It's wonderful. We love our vitamin D. But for those of us with certain kinds of autoimmune diseases, you have to limit your exposure.

ALYSIA: Absolutely. A couple other of those autoimmune diseases that are most affected by heat are going to be MS, multiple sclerosis. When people with MS are exposed to high temperatures, it can actually make their symptoms worse.

And there's something called Uthoff's phenomenon, and with that, heat makes the nerve function deteriorate temporarily, and it leads to things like blurry vision and weakness and numbness, and I think oftentimes that could be also associated with heat stroke or heat exhaustion. You really have to be careful.

I don't have any specific diseases that really are affected by heat myself; however, I have found that if I spend long periods of time in the heat and direct sunlight, I don't feel well just generally afterward. You know, I don't know what the explanation is for that.

STACY: What happens when you have an autoimmune disease is that your body has problems regulating your temperature. It is so otherwise occupied by the other things that it is trying to take and put in task that temperature regulation is what's called an autonomic response. It's something that your body does automatically, but if your body is on high alert, I want you to think about if you find yourself in a place where you're really, really cold, what does your body do? It goes into a state of pumping adrenaline and cortisol to keep your body doing what it needs to do.

Well, if your body's already doing that, It doesn't know how to regulate when you're in a situation like walking outside in the sun. That's what makes it worse for MS. That's what makes it worse for lupus. That's what affects the skin and the internal organs and the heat will worsen the inflammation, and it makes everything really, really uncomfortable.

ALYSIA: You know, that actually makes sense. I definitely have temperature regulation problems in my body, whether it is heat or cold, it is a year round problem for me. It's frustrating, but add perimenopause to that, and it's just like, you're just screwed.

We've got to talk for a second about how heat can affect people with rheumatoid arthritis or other autoimmune diseases that impact your joints when it's hot. Your body is working harder to stay cool, like Stacy was saying, which can exacerbate the fatigue that comes with autoimmune diseases. So somebody with RA might feel even more drained than usual when the temperature is high, which seems a little counterproductive. You think arthritis, you think it's the cold that's going to bother them. It does, but heat can be just as troublesome.

BECKY: It's more than feeling warm. The body, like we mentioned, goes into overdrive when it's trying to cool itself down. When it's really hot, Some people with autoimmune diseases actually can have trouble sweating, which sounds unusual, but that is actually a thing that can happen with certain autoimmune diseases. And if you can't sweat, you have more trouble cooling yourself off.

I know I have the opposite problem. I did not used to be a sweater. I actually feel like I excessively sweat. When I'm having trouble regulating my body, even when my body's trying to cool me down again, like everything, it's just going into overdrive.

The sweat system doesn't always work as well with those of us that have autoimmune diseases. It means that we're not cooling down maybe as effectively as other people, or again, it's going into overdrive. It's just not working the way it's meant to work, and that can lead to overheating.

STACY: I know that with me, with my lupus. I can spend a long time outside when it's cool and it doesn't bother me. I have to be careful of the sun, but it doesn't bother me at all. I can be out in the cold because I don't have Raynaud's. I don't have something that causes blood flow issues, so I can be out in the cold and be quite comfortable.

But on a sunny day, I can be outside for five minutes trying to walk my dogs and I come in and I'm literally running a fever. My body cannot compensate for the heat. Outside here in Texas, I overheat and I sit on my couch with a cold, wet wash rag on my head.

ALYSIA: It's worth investing in a few things to help keep you cool, I think, during the summer months, because it really is helpful for those of us with autoimmune disease.

Obviously, you want to stay hydrated. You want to drink lots of water. Consider electrolytes in your water during those really hot months. Or if you are doing hard work, staying inside during the peak heat hours of the day, if you've got to be out and about, try planning it for earlier or later in the day, instead of during those hot, hot hours and then using cooling accessories like little fans, cooling towels that Stacy mentioned, those can be very helpful to have them in your car, have them in your house. I think it's helpful to have them in your office, have them and keep them at the ready, because if you're like me, I never know when my body is going to have an issue, or whether I'm going to be totally fine and it's not going to be a thing. They're not expensive things to have on hand, but they can make a big difference in how you deal with the heat.

STACY: Keep water with you all the time. I cannot emphasize enough the importance of having a good water bottle. And keeping it with you. I have a third arm and it's my water bottle. It has to go with me everywhere. I don't shop without it. I don't get in the car without it. I do not walk around without it. It is with me all the time, and it's because I know that if I get overheated, I'm gonna get violently ill, so I keep ice water on me pretty much all the time. Do what you know works for you to protect yourself from the heat when it's a concern that you might have.

ALYSIA: Find yourself a good water bottle and make it your best friend.

BECKY: And a great hat. Anytime I go out in the sun at all, I have a wide brimmed hat. Sometimes I will wear a baseball cap, but usually I have to have a wide brim - like what you'd wear when you are out gardening. I wear it when I'm out in public. And I wear sunglasses and things and people probably think that I look hilarious, or like some little safari person, but I don't even care anymore, because I know even if I go on a longer car ride, when the sun is out, I have to be wearing a hat or I have some of those problems.

So now we're going to kind of switch gears. I think it's kind of maybe more applicable for where we're at for this time of year. We're going to talk about the cold weather. You might think the cold weather would be easier to handle for people with autoimmune diseases. It, of course, comes with its own set of challenges.

Definitely, again, things like rheumatoid arthritis, lupus, fibromyalgia, anything where you can have joint pain and stiffness, that can easily get worse with dropping temperatures. When the temperature drops, the body tries to conserve heat, which can cause blood vessels to constrict, leading to reduced blood flow to the joints.

For those of us that have Raynaud's, we can get cold sometimes, even in the middle of summer, especially our fingers and toes. But during the winter and the cold temperatures, we have to be especially careful. Hand warmers are great. If you're somewhere where you can take a warm shower after you've been out in the cold, or if you need to stand there a little bit longer washing your hands until the water goes from cold to warm, whatever you need to do to keep the blood flowing, as it will, because that's, that's definitely a problem for people in the cold.

ALYSIA: Yeah, my husband gave me the best Christmas present this year of an electric jacket, and I have a little battery charger for the battery that sits in it. I haven't had an occasion to use it just yet, but I am certain it will get some good use as I live in Minnesota. Yeah, I have electric hand warmers and I now have an electric jacket.

I always keep blankets in the car. The little popping hand warmers are great. There are all kinds of, of little things, but when you do have that restricted blood flow, that's going to mean less oxygen and nutrients that are getting to those joints. So that's what makes them feel stiffer, more painful, more swollen. And it's especially difficult for those that are suffering with RA. Their joints are already inflamed and the cold weather just makes it worse. And I think we have all experienced how tough it can be to move in the cold. But for those of us with autoimmune conditions, it's like the cold makes everything feel more stiff and heavy.

Sometimes it's hard to even get out of bed in the morning. I have a heated mattress pad. And it has been a godsend. I wish I'd bought it years ago. I don't know why I didn't know about it sooner. Some of these things that will assist us in regulating our temperature, it really makes a difference in our comfort levels.

STACY: I think that we sometimes forget that this is part of the self care we need to have for ourselves. Is making sure that we have the things we need so it isn't just about feeling cold because there is a very real physical reaction that happens in the body that can be quite dangerous if you have Raynaud's like Becky does, you can actually have blood flow problems. That's why protecting those extremities is really important - keeping your fingers and your toes safe is important.

When I was living in Northern Michigan for grad school, I had battery operated socks that I wore inside my boots. They went all the way up to my knee, and they were the greatest thing that had ever been created, because if I hadn't had them - by the time I would walk the mile into the university (because no one was driving on that snow) - I wouldn't have had toes left. I would have had frostbite.

You have to remind yourself when it's really cold that even when it doesn't feel really, really cold, you have to protect your fingers and your toes. So you need to wear gloves. You need to think about thick socks and warm, waterproof shoes. You need to think about how to keep the blood flowing in your fingers and your toes and keep your extremities warm.

It's important for anyone, honestly, but it's really important for people with autoimmunity, because keeping our body temperature regulated is extremely important, and in the cold, if we don't layer up, we can't do that.

ALYSIA: I don't have Raynaud's, but I do have Hashimoto's and I know that that can be an issue. Cold intolerance can be an issue for those of us fighting with Hashimoto's. So I've lived in Minnesota for almost, almost a decade now. And one of the first things I learned, Minnesota is a, is a, is a different breed and when I moved here, our first winter, I didn't have any kind of clothing for myself. I bought all the boots and all of the gear, everything I needed for my kids, cause they had to go at the bus stop, and they had to, you know, they wanted to be outside. I'm like, it's fine. I'll just stay inside for the rest of my life during the winter. You know, I'll just never leave my house during winter.

One of the things I learned here, they have a saying in Minnesota that there is no such thing as bad weather, only bad clothes. And that is extremely accurate. I have since invested. I have all the things I need probably to live through a polar vortex outside if I really needed to, which I'm so glad I don't. If you live somewhere that has harsh winters, please invest in the products that you need to invest in to protect yourself. It will make a difference. I promise.

BECKY: As we're talking about as our joints get cold and how hard it can be to get up in the mornings on cold days. Fatigue is also a real thing that can often get worse in cold weather. The body expends extra energy trying to keep itself warm and it can leave you feeling more drained than usual.

And I will tell you, I love kind of cloudy weather and stuff, because I can spend a little more time outside, but I live on a small farm. I go out and do my farm chores in the morning, and on those days where it is really cold, I do feel that. I feel that extra fatigue. Stuff that is not a big deal - and normally, you know, I'm used to feeding the animals. I come in, I just sit and take a break before I have breakfast or whatever. It's one thing - but on those cold days, you sometimes come in, and I'm like, ready to go back to bed again. Be aware that the fatigue in the cold is a real thing, too.

ALYSIA: As we're talking about winter and cloudy days and fatigue, it reminded me that we should probably mention that those of us that suffer with autoimmune disease are often more inclined to suffer from Seasonal Affective Disorder.

That's something to be aware of. We need to be getting enough light. I have a happy light. I sit in front of every single morning as I get ready for work. I use it religiously. So be aware that you might be a little more susceptible to seasonal affective disorder. You're going to want to make sure that you get enough sunlight or artificial light as well. Um. through a happy light, you're going to want to make sure you're getting vitamin D supplemented. If you are not having your levels be high enough and it really does good to get out and about, whether it is indoors or outdoors, like just don't stay in your house. You're going to feel better if you move around.

Talking about changing weather - we talked about hot, we talked about cold, let's just talk about general changing weather. Because I think we all, you know, everybody nowadays is like, "Oh, the weather's been crazy!" It happens all the time. I think that's just the way life is now. Climate change is a real thing. The weather can be volatile sometimes, and that changing weather it really can make an impact on our symptoms, especially when the weather changes rapidly, when the temperature is shifting, when it goes from sunny to stormy, it can really throw off your whole body.

I thought that. In the first several years of being sick with autoimmune issues, I thought I might be crazy because I really did get aches and pains in my joints when the weather would change. And I thought, Oh my gosh, have I aged? Like, I feel like an 80 year old woman when my joints start hurting, because the weather changed so rapidly. It's a real thing.

BECKY: It is, and the main culprit is obviously the barometric pressure, which is the pressure in the air around us, and it changes when storms are coming. We are experiencing this in Texas right now. Even though it's the middle of winter, we had a couple of lovely days where it was like 60, 65 degrees.

It was just fabulous, but we're going down to below freezing for the next few days, and we might even get a little bit of snow. So recognize when there's those major weather shifts. which can often happen this time of year, where it's a big change from warm to cold. For those of us with autoimmune diseases, especially fibromyalgia, any kind of arthritis, lupus, again, RA, anybody that has an autoimmune disease that affects their joints, you're gonna fill those drops in barometric pressure, and it can definitely trigger pain, and sometimes it can even trigger a full-on flare.

STACY: You know, it's really true. I know that my lupus and my arthritis in my ankles become unbearable more so than when it's cold outside, when we're doing this yo-yo barometric up and down thing, that pressure change hurts a lot more for me, at least.

ALYSIA: I was talking to a physician's assistant friend of mine and he was explaining that when the weather is rapidly changing, they get more and more people coming in with illness. Not necessarily autoimmune illness. We're talking colds, fevers, flus, pneumonias, when the weather is yo-yoing. I don't know why that is, but we are already susceptible to illness, and so I think when the weather changes, it's probably even a little more dangerous for us.

STACY: Anyone who has chronic pain issues is going to notice these changes.

ALYSIA: It's a great point. I really think that it is important to keep your eye on the weather once you have autoimmune disease. I was never somebody who wanted to talk about the weather. It's something, I have a weather app on my phone and there's actually fun weather apps.

I suggest one called "What's the Forecast." That one's really fun. There's another one called "Funny Weather," and they pop up just kind of funny little things like, "It's going to be farting snowflakes today," or, you know, just silly, silliness when the weather is going to be crazy. It does give me a little smile, but it also gives me a heads up to prepare, so I check my weather app every day. I generally have a pretty good idea of what's coming my way.

And so that I can prepare whether that be, you know, making sure I have good anti inflammatory foods that are going to be ready for me to eat, comfort foods, because I already am going to have inflammation. I know that. Whether it be canceling something so that I can be home and resting more, because I know I'm going to be hurting, using tools, getting heating pads or electric blankets to ease that discomfort, sometimes you do need to change your plans, and that's okay. I think it's okay. And it's good to prepare, get a weather app, know what's coming. Be ready.

BECKY: Yeah. And that is one of many ways that we can help manage how the weather is going to impact our autoimmune diseases. Kind of to sum it all up, I guess, some of the challenges and the best ways to manage things to consider, especially if we're talking about HOT WEATHER, just revisiting:

• Staying hydrated is probably your number one thing.

• Sunscreen, obviously.

• Shade.

• Finding places, if you're somebody with lupus or one of the other ones where you can't spend a lot of time in the sun, spend more time indoors.

• Even if you can spend more time in the sun, make sure that you're staying inside during the peak heat when it's really bad.

• Use fans. Be a little nerd and wear that cute one around your neck that blows up in your face to help cool you off.

• Wear breathable clothing. There's so many things that you can do. And we're not saying go out and spend a ton of money all at once to get every little thing. Find what works for you and just build it up a little bit at a time.

Talk to friends, talk to family, see what has been effective for them. There's so many little gimmicky things. Some of them are maybe not as effective as others, but there's a lot of ways that you can help manage your time in the heat.

STACY: And then when it's COLD, remember,

• Layering's your friend, wear a lot of layers.

• Keep your thick socks and gloves on, keep those fingers and toes warm.

• Keep your joints protected.

• Use some heat like heating pads or hot water bottles when you're at home.

Just remember that you're going to be more sensitive to those pressure changes, so be careful with them. Try to track the weather forecast, keep an eye on it. We kind of have to remind ourselves often that we have symptoms we have to manage, and because we have to manage those symptoms, we need to be advocating for ourselves by paying attention to what's going on with the weather so we can be prepared for it.

BECKY: One of the ones that I had forgot to mention that I think is very useful that I know I use as somebody with lupus, and I don't just use it in the heat either. I use it during the winter, anytime I'm out in the sun. There are clothes that are actually UV protected. Like, I buy long sleeve shirts that actually have UV protection, the hats that I wear have UV protection, and that's just one of those other little extra things you can do for any time of year.

ALYSIA: Yeah, and don't forget to protect your eyes as well. I think it's important to have really good sun protection for your eyes. I was going to say prevention is the best medicine for this problem. You know what is going to happen if you get too cold or too hot. So do what you need to do to prepare for that.

I know for me personally, that if I get chilled to the bone, which happens, it is a very uncomfortable road back to getting to a place where my body can regulate its temperature again. The cold that I feel is not the, Oh, I'm chilly. Oh, burr, I'm shivering. It's a bone deep cold that you cannot just simply put another layer on and make it go away. I do what I can to prevent getting in that state. Prevention is the best medicine here. So listen to your body. You will learn. Forgive yourself if you mess up, and you don't know. You'll learn.

If you start to feel off due to the weather, take some breaks. Try not to push yourself too hard. Cold plunges are very big right now. I know saunas are very big, infrared saunas specifically. I know have health benefits. I don't have the science to discuss that right now, but I do want to say if that's something that you have heard about, and you are interested in, consult with your doctor, but I know that there can be real benefits to cold exposure and to heat exposure if they are done safely and correctly. So we don't want to discount cold and heat as being potentially good for us, because they can be. We just have to know how to use them properly for ourselves and our bodies, right?

STACY: I think we have to remember that it needs to be controlled. We can't control the sun, we can't control a blizzard, but we can control how long we expose ourselves to cold or how long we expose ourselves to an infrared sauna. And both of those are things that I know, that I've heard from doctors are very beneficial, but they're also controlled environments. Before you go and just get yourself a sauna, make sure that you actually talk to someone about it.

And when I say someone, I don't mean your best friend; I'm talking about go and get medical advice on whether that is what is best for your body. Because if your doctor approves it, it can be greatly beneficial. I have had a lot of really good experiences with red light therapy, but I've also checked in with my doctor about whether or not that was okay for me. You need to, as always, consult a medical professional, but there are some really promising things in both of those arenas.

BECKY: I know a lot of people who have had good experience with cold therapy as well, the polar plunges or things like that. But again, that is definitely something you want to consult with a doctor on if you have any heart problems or anything like that.

Definitely things that are possibilities, but you would want to consult with a medical professional before you tried.

Thanks for joining us today while we discuss the pros and the cons, and I love the idea of there is no bad weather. Weather is weather. We just need to learn to cope with it the best way that we can.

Please let us know if there's other episodes you'd like to see from us in the future. We hope you will like and subscribe, and you can find us at autoimmuneadventures. com.

Remember you are worthy of joy. Your disease does not define your life. You do.

HELPFUL LINKS:

Articles/Studies related to the benefits of spending time in nature:

Time

American Psychological Association

Stanford Report