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November 7, 2013

Cold Weather’s Impact on Autoimmune Disease Flares + Tips For Being Outside in Fall and Winter

Changes in or extreme climates can often have an effect on disease conditions.  In some cases, there are certain types of weather that can be helpful in controlling or improving a condition; other times, climate can impact disorders negatively in terms of symptoms and disease progression.  Here we consider the effects of cold weather and temperatures on autoimmune disease.

Why does cold air (dry or wet) affect pain and flares in autoimmune disease?

The first thing to mention here is that autoimmune conditions come in all shapes and sizes, and as such are affected by many factors.  Some conditions, such as rheumatoid arthritis, are greatly impacted by the weather (especially cold and/or rainy), while others are minimally affected, if at all.  In contrast, other disorders show an improvement in symptoms with cooler weather and may flare on warmer days.  There is no hard and fast rule as to how weather will affect individual patients.  Having said this, the short answer is we’re not entirely sure why autoimmune flares tend to worsen in cold weather, but we do know a few things regarding this phenomenon.

In general, weather extremes of any kind will place additional stress upon the body, which is usually not helpful for those suffering from a host of conditions, autoimmune and otherwise.  Thus, generalized stress can increase the incidence and severity of autoimmune conditions in a non-specific way, simply by adding to the heightened physiological demands of the body during such periods.  For instance, in very cold weather, bodily heat escapes quickly, leaving less energy and fewer resources available to deal with basic and enhanced requirements.  Other conditions such as cold agglutinin disease, which is a variant of autoimmune hemolytic anemia, only occur during periods of lowered body temperature.  This emotional and/or physical stress can leave an autoimmune sufferer more susceptible to flares, which might be better controlled in more temperate weather (though sometimes the opposite is true; it is a very individualized presentation).

More specifically, it seems that one likely cause of cold-induced pain in many cases is the fact that smaller blood vessels tend to spasm in low temperatures, which leads to a restriction of blood flow to the associated areas.  This is known as Raynaud’s phenomenon when it is secondary to an established autoimmune disease (or Raynaud’s disease when it appears on its own) and it is something that many autoimmune patients know all too well, as it often occurs in conjunction with various autoimmune conditions.  The spasms can cause extreme pain, swelling, numbness and discoloration, and they occur most prominently in the fingers, toes, ears and nose (because these are all areas with very small vessels and therefore less blood flow and adaptive ability).  It is possible, though not certain, that similar problems in larger joints (and therefore vessels) are related in terms of pathology.

Another potential but controversial explanation for joint inflammation during certain types of weather involves the postulation that lower barometric pressure leads to increased swelling in the joint spaces.

Are there any studies done on brief breaks from cold weather, e.g., beach vacation in winter, and helping to reduce joint pain and other symptoms from the cold?

Unfortunately, the literature is fairly sparse in this area, and it appears that there hasn’t been a great deal of research or investigation into the causes of or remedies for such flares.  There is one unofficial site, written by a doctor, that does a decent job of collecting most of the available research on the topic and providing brief summaries.   Another brief response from a different physician (not a study, just clinical advice) advises that in most cases the best weather for autoimmune patients is warm and dry, such as in the Southwest.  But again, this will vary from patient to patient, and what works for one may be detrimental to another.  Otherwise, not much else was found upon literature review.

What is the best way to combat cold weather effects on pain and inflammation?

There is unfortunately no secret weapon used to combat such effects in those diagnosed with autoimmune disease.  That is, there is really nothing special one can do in cases of autoimmune conditions, other than the normal measures anyone would take in extreme cold to prevent complications.  Still, there are several effective ways to prevent or at least mitigate the negative impact cold weather has on some autoimmune sufferers.

Just as is the case in people without autoimmune conditions, extreme cold requires some contemplation and preparation.  On particularly cold days, one should dress in layers, being sure to wear gloves and a hat; this serves the dual purposes of keeping joints warm and more flexible, and reducing overall cold stress.  If it is absolutely necessary to remain outside for long periods, it is crucial that one plans to take breaks and go inside occasionally, preferably before symptoms can begin to flare.

And while patients should consider exercising indoors during these temperature extremes, it is important, when doing so outdoors, to remain active for the duration, in order to keep joints and muscles warm and more flexible, making them less prone to pain and inflammation.  Finally, in extreme autoimmune cases, some people have found that changing climates (by moving) is quite helpful, though clinicians and researchers are divided on the issue, and it is, once again, very personalized as to the benefits.

Questions for your doctor:

  • What is the best climate, if there is one, for my condition(s)?  Is it worth considering moving?
  • What are the recommended protective/preventive measures I should take when out in extreme cold temperatures?
  • Can you provide me with any resources or information regarding the effects of cold weather on autoimmune disease, or disease in general?
  • What is your opinion of the barometric pressure theory of joint pain and swelling?
  • Are there other causes of cold weather complications in autoimmune disease, besides vessel spasms and those mentioned above?


About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians.  After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time.  He may be reached at [email protected].

This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on Oct 25, 2013.

This post contains the opinions of the author. AARDA is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. AARDA does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.


  1. Shahida Iqbal says:

    Im a known case of SLE and have worsen condition during extrem weather. Dont know how to manage.i dont look sick by face and can comfortably talk while having sever stiffness.it makes people surprised that apperentaly absolutely normal looking person cant move or getup from bed. This is very painful attimes to make people believe.dont know how to coop.

  2. Vicki says:

    My husband and daughter both have Graves Disease. Over the past week I’ve heard the same things coming from both of them. Let me explain the weather here first. The temp here has been in the high 90s with the humidity at almost 100%. They are both complaining with muscle weakness, joint problems. Although that is one of the symptoms of this disease, it has been extreme this week. Has anyone else suffered these, almost debilitating, symptoms?? Please email with comments. Thanks.

  3. Mustafa says:

    Hi, I agree 100%
    I have U colitis and I live in toronto, canada. Yes my flares only come in the cold weather. Everytime i visit a hot climate during the cold season my symptoms subside and i get remission.I visited the middle east in april 2016 Once i came back to toronto after 8 months last december my symptoms returned in 3 days. Its frustrating as I feel I have to leave canada seeking a warmer climate.

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