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Temperature Regulation

Some studies show that up to 64 percent of people with Parkinson's disease report trouble with temperature regulation. This included heat and cold intolerance as well as excessive sweating. This can influence one's willingness to exercise, participate in social activities, and impact their safety in extreme weather conditions.



Why does this happen?

There are two main parts of the nervous system that control our temperature: the hypothalamus and the autonomic nervous system. Unfortunately, both can be impacted by Parkinson's. The hypothalamus helps with our heart rate, hunger, thirst, sex drive, blood pressure, sleep, and temperature. The hypothalamus works to control temperature by triggering the body to physically respond to changes in temperature via the autonomic nervous system. The autonomic nervous system can be broken into two parts, parasympathetic and sympathetic nervous system. The parasympathetic nervous system is your rest and digest part of your nervous system and the sympathetic nervous system is the fight or flight part of your nervous system. Both work to change how your body physically in response to what environment you are in. For example, if you are cold or exposed to cold, your blood vessels in the skin will constrict and you will shiver in attempts to increase your body temperature. If you are too hot or exposed to heat, you will start to sweat and your blood vessels will dilate.



Heat intolerance

Common symptoms include:

  1. feeling very hot in temperatures that are only moderately warm

  2. exhaustion and fatigue during warm weather

  3. nausea, vomiting, or dizziness when hot

  4. excessive sweating

  5. mood changes when too hot

Some people may report that their clothes and bed sheets are soaked during the night due to excessive sweating. Some people may experience excessive sweating during their OFF time or during periods of increased dyskinesias. Too little sweat is not often thought of when it comes to heat intolerance, but it can actually be more dangerous. Without sweating, our body does not cool. Overheating can occur in situations when we cannot sweat but are too warm. This can lead to a heat stroke or other heat-related illnesses, like heat exhaustion.



Cold Intolerance

common symptoms include:

  1. feeling overly cold

  2. uncontrolled shivering

  3. increased tremors due to shivering




Lifestyle modifications to improve temperature regulation


For those who are too hot:
  1. stay hydrated. You should aim to drink half your body weight in ounces. If you are dehydrated, your body will have a hard time constricting or dilating blood vessels.

  2. take cool or lukewarm showers to avoid excessive temperatures.

  3. avoid sweat triggers such as spicy food, caffeine, and alcohol.

  4. use moisture-wicking and cooling sheets and clothes. They help absorb the sweat and dry faster.

  5. consult your doctor before using saunas or steam rooms, especially if you get too hot but do not sweat.


For those who are too cold:
  1. dress in layers. Your base layer should always fit snug. Make sure your base layer is made of a moisture-wicking material.

  2. try to limit time spent outdoors when in colder temperatures.

  3. use hand warmers and feet warmers.

  4. drink hot beverages.

  5. Cover your hands, feet, and head when you are sleeping to help maintain body heat.



Medication considerations

Anti-cholinergic medications tend to be helpful for those with excessive sweating, but should be avoided by people who have impaired sweating.

If excessive sweating occurs during occurs during your OFF time, talk with your neurologist about medication changes to reduce your OFF time.

Topical glycopyrrolate is a gel that can be used on the skin in areas that are typically sweaty for you over-sweaters.

Botox injections are sometimes used to help control excessive sweating in specific areas, like the underarms, hairline, or palms.

Prescription-strength anti-perspirants can also be used to help control excessive sweating in the underarms and in the soles of the feet.




As always, talk with your neurologist if you are experiencing any of these symptoms and see what options are the best for you!





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