How spring affects people with multiple sclerosis — and which season is actually best

May 20, 2026

Spring brings more light, vitamin D and movement — but also sudden temperature swings, pollen, allergies, infections and fatigue. A guide to how each season (spring, summer, autumn, winter) affects MS, which time of year is most tolerable, and how to prepare for weather changes.

Why seasons matter at all in multiple sclerosis

I am writing this from a personal angle too: I have lived with MS for years, and I know how much a calm explanation matters. Multiple sclerosis (MS) is a disease in which temperature, light, humidity, allergens, infections and mood directly shape how we feel from day to day. Demyelinated nerves are highly sensitive to changes in body temperature (Uhthoff phenomenon), while the immune system reacts to seasonal infections, allergens and vitamin D levels. That is why almost every person with MS notices that symptoms "ride the waves" of the seasons — and that some parts of the year are far easier to live with than others. More on the basics: [Uhthoff phenomenon and heat in MS](/blog/uhthoff-fenomen-ms-toplota), [hypersensitivity in MS](/blog/preosetljivost-multipla-skleroza-senzorna-hipersenzitivnost) and [MS fatigue](/blog/umor-multipla-skleroza-fatigue-terapija).

Spring — a season of renewal, but also of triggers

For most people spring is a season of optimism — more sun, longer days, the end of winter. In MS, however, spring is a double-edged sword. On one side: vitamin D rises, we move more, mood lifts, seasonal depression eases. On the other: there are sudden temperature swings (cold morning, warm noon), pollen and allergies, viral respiratory infections that often spill over from winter, and the first warm days that can already trigger the Uhthoff phenomenon in sensitive people.

What typically helps in spring with MS. Skin synthesis of vitamin D rises (15–20 min of forearms and face several times a week, without burning) — which directly supports immune modulation and lowers relapse risk ([vitamin D in MS — the science](/blog/vitamin-d-ms-nauka)). Longer days and more light regulate the circadian rhythm and improve sleep and mood. It is easier to be active outdoors — walking, [yoga](/blog/joga-multipla-skleroza-edss-nivoi), light [exercises for MS](/vezbe) — reducing fatigue and spasticity.

What spring typically makes worse. Allergies and pollen (birch, ash, grasses) — do not worsen MS directly, but exhaust the immune system, disrupt sleep and create fatigue that overlaps with MS fatigue. Seasonal respiratory infections can trigger pseudorelapses or true relapses. Sudden weather changes (heat waves in early May) bring back the Uhthoff phenomenon after winter. Spring fatigue is real — the body is adapting to a new day length, hormonal balance and temperature.

Practical recommendations for spring. Check 25-OH vitamin D at the end of winter / start of spring and dose to the target range of 40–60 ng/mL. Talk to an allergist about second-generation (non-sedating) antihistamines if you have significant pollen allergy. Wear layered "onion-style" clothing for sudden temperature shifts. Start using cooling gear (vest, scarf, towel) at the first warm days. Get your flu and COVID vaccinations on time and wash hands often — spring is an infection season. Keep a [symptom and relapse diary](/blog/kako-prepoznati-relaps-ms-checklist-dnevnik) so you can tell pseudorelapse (allergy, infection, heat) from a true relapse.

Summer — the hardest season for most people with MS

Many studies and registries (Christogianni 2018, Leavitt 2014, MS Society UK 2020) plus self-reported data show that summer is the worst tolerated season for most people with MS. Heat waves (above 30 °C), humidity, strong sun and dehydration trigger the Uhthoff phenomenon — increased fatigue, blurred vision, weakness, "brain fog", and a higher risk of pseudorelapse. MS hospitalisations rise in summer months in warm climates. More: [Uhthoff phenomenon](/blog/uhthoff-fenomen-ms-toplota).

What helps in summer. Cooling vests and scarves (KewlFit, Polar Products, ColdAvenger), an air-conditioned bedroom (18–22 °C), outdoor activity early morning or late evening, a wide-brim hat and 100% UV sunglasses, drinking cold water through the day (2–2.5 L), avoiding sauna, hot sun and physical exertion at noon. Swimming in cool water is excellent — cooling and exercise at the same time. For travel — pick mountains or seaside with night breeze; avoid deep continental interiors and tropical destinations at the peak of summer.

Autumn — often the most tolerable season

Autumn is, for a large share of people with MS, the most pleasant season: temperatures drop into the ideal range (15–22 °C), humidity is moderate, the day is still long enough, vitamin D from summer is still in the blood, and there are fewer allergens than in spring. Energy rises, spasticity eases, Uhthoff stops being a problem. It is the ideal time for rehabilitation, regular exercise, walking, hiking, cycling and setting up habits for winter. Watch out: late autumn brings the first wave of respiratory infections (flu, RSV, COVID) — vaccinations and hand hygiene are crucial. Already in October/November, check vitamin D and start winter supplementation.

Winter — short days, vitamin D, infections and cold

Winter has its pros and cons. Pros: no overheating, Uhthoff is almost absent, indoor exercise is easier, sleep is often better. Cons: short day and lack of sun → falling vitamin D, seasonal depression (SAD), fatigue; viral infections (flu, COVID, RSV, common cold) that can trigger relapse; extreme cold in some patients worsens [spasticity](/blog/spasticitet-multipla-skleroza-terapija), pain and tremor; ice and snow increase the risk of falls in people with balance problems ([balance and ataxia](/blog/ravnoteza-ataksija-ms)).

Practical recommendations for winter. Vitamin D supplementation 2000–4000 IU daily (with level checks every 2–3 months). A 10,000-lux light therapy lamp (20–30 min in the morning) if you have seasonal depression. Vaccines on time (flu, COVID, pneumococcal where indicated). Warm gloves, hats, layered clothing; warm safe footwear with non-slip soles; cane or crutches for snow and ice. Indoor exercise (stationary bike, treadmill, yoga, [exercises by EDSS level](/vezbe)). Mediterranean diet with warm cooked food — [more](/blog/ms-dijeta-mediteranski-rezim).

Which season is best for people with MS — the short answer

For most people with MS the most tolerable seasons are early spring and autumn (March–May and September–October), when temperatures are between 15 and 22 °C, humidity is moderate, the day is long enough for vitamin D and mood, and infections and allergies are fewer than in late spring or winter. The hardest season is summer (peaking in July–August), because of heat and the Uhthoff phenomenon. Winter sits in the middle — comfortable on temperature, but challenging because of infections, lack of light and falling vitamin D. Of course, this is the average picture — a smaller share of patients tolerate summer better than winter (e.g. those whose spasticity worsens in the cold), so individual tracking is always rule number one.

Which climate or country is most comfortable to live with MS

The ideal climate is temperate, with small seasonal swings, mild summers (up to 26 °C) and mild winters (above 0 °C), moderate humidity and enough sunny days. Examples: northern Italy, southern France (outside the summer peak), Slovenia, northern Spain (Galicia), the Pacific coast of North America (Vancouver, Portland, San Francisco), New Zealand, parts of Australia (Tasmania), southern England. Less favourable: tropical and subtropical zones (Florida, Thailand, Singapore), desert regions, continental interiors with extreme summers and winters. In Serbia the spring and autumn months in the continental part and the entire mountain region (Zlatibor, Kopaonik, Tara) during summer are most tolerable, while the Montenegrin and Croatian coast in summer is tough due to high humidity and temperatures.

Practical habits that help across all seasons

Keep a symptom and trigger diary (temperature, humidity, daily activity, sleep, diet, mood) — the best way to recognise your own patterns and to tell pseudorelapse from true relapse. Keep vitamin D in the target range all year. Vaccinations on time (flu in autumn, COVID per guidance, pneumococcal by age). Mediterranean diet, hydration, regular 7–9 hours of sleep, stress control ([stress management](/blog/upravljanje-stresom-ms)), regular EDSS-tailored exercise, neurologist visits at least once a year (and per DMT protocol). Have a heat kit (cooling vest, scarf, cold water bottle) and a winter kit (warm gloves, non-slip footwear, light therapy lamp) — prepared and within reach.

Seasons in multiple sclerosis are not just "atmosphere" — they are biological triggers that shift body temperature, immunity, vitamin D, sleep and mood. Spring is a season of renewal, but also of allergies, infections and the first warm days. Summer is the hardest for most — Uhthoff phenomenon and overheating. Autumn is often the most pleasant — perfect temperature, vitamin D stores, fewer allergens. Winter demands attention to vitamin D, vaccines and mood. The best approach is not to change the climate, but to know your triggers, prepare for every season and discuss seasonal adjustments to therapy and habits with your neurologist.

Sources

Christogianni A, Bibb R, Davis SL, et al. "Temperature sensitivity in multiple sclerosis: an overview." Mult Scler Relat Disord. 2018: https://pubmed.ncbi.nlm.nih.gov/30053717/. Leavitt VM, Sumowski JF, Chiaravalloti N, DeLuca J. "Warmer outdoor temperature is associated with worse cognitive status in MS." Neurology. 2012: https://pubmed.ncbi.nlm.nih.gov/22675080/. Smolders J, Torkildsen Ø, Camu W, Holmøy T. "An update on vitamin D and disease activity in multiple sclerosis." CNS Drugs. 2019: https://pubmed.ncbi.nlm.nih.gov/31487005/. Tao C, Simpson S Jr, van der Mei I, et al. "Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis." J Neurol Neurosurg Psychiatry. 2016: https://pubmed.ncbi.nlm.nih.gov/27559182/. Spelman T, Gray O, Trojano M, et al. "Seasonal variation of relapse rate in multiple sclerosis." Ann Neurol. 2014: https://pubmed.ncbi.nlm.nih.gov/24757001/. National MS Society — "Heat & Temperature Sensitivity": https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Heat-Temperature-Sensitivity. MS Trust — "Temperature sensitivity": https://mstrust.org.uk/a-z/temperature-sensitivity. MS Society UK — "Heat sensitivity": https://www.mssociety.org.uk/about-ms/signs-and-symptoms/heat-sensitivity-and-ms. This article is informational and does not replace consultation with your neurologist.