Can Aspirin Reduce Heat Sensitivity in MS?

I saw a headline that suggested it might. But I quickly learned that the headlines often don’t tell the whole story.

I’ve been living with multiple sclerosis (MS) for almost 30 years now, so I’m always on the lookout for new research about the disease. Discoveries give me hope. They show me that scientists are continuing to advance their understanding of MS and find new ways to try to prevent, treat, and — maybe one day — cure it.

And with so much research taking place every day in labs across the country, it’s rarely difficult to find stories that offer such hope.

Even experts are amazed at how quickly the field is changing.

But sometimes, the media headlines about breakthroughs are more about clickbait than correctness. Recently I came across one with a headline that teased that aspirin might be a simple and effective treatment for heat sensitivity for people living with relapsing-remitting MS.

As someone with MS who is greatly affected by the heat, I opened this article with particularly eager eyes. If I could swallow an over-the-counter pill to reduce the heat’s effect on my body, my life would change in a big way.

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Details matter

Upon delving into the article, I quickly determined two things about the study.

• The good: The phase 3 trial was randomized, placebo-controlled, and double-blind — all qualities that make for an effective study.
• The not-so-good: The study was made up of only 60 participants.

Yeah, just 60. That’s not a lot. With so few people, we can’t really draw any solid conclusions. As a reference point, the Food and Drug Administration requires 300 to 3,000 participants for clinical trials seeking approval of new drugs.

When I searched online to find out more about the trial, I discovered that the full study was only available to those with a subscription to the Journal of Neurology, the medical journal where the research was published. Only the abstract — essentially a summary of the study — was available to the general public. This makes it difficult for us to find out what could be essential details.

Digging deeper

So I did the best I could. I used the abstract to glean as much information as possible. Here’s what I learned:

Participants were given 650 milligrams (mg) of either aspirin, acetaminophen (Tylenol), or placebo at each of three study visits over 3 weeks (separated by at least 1 week).

Results showed that both medications were effective in reducing overheating during exercise for people with MS:

• Those who took aspirin prior to exercise experienced only a 0.006°F average increase in temperature.

• Those who took a placebo experienced an average 0.68°F increase. While 0.68 doesn’t sound like a lot, it’s enough to make those of us with MS miserable. In Uhthoff’s phenomenon, it takes less than 1° of increase in body heat to exacerbate symptoms.

• People who took acetaminophen experienced about half the temperature increase (an average of 0.31°F) as those who took placebo.

So those in the aspirin and acetaminophen groups both showed significantly smaller temperature increases than those on placebo.

However, taking aspirin or acetaminophen did not change how long people with MS could exercise before they reached exhaustion.

But again: There were just 60 people in the study. So while the headline sounded exciting, it didn’t really tell the whole story. But the authors’ conclusions suggested that further studies with more people could be valuable.

Worth a shot

Like some 60% to 80% of individuals with MS, I too experience Uhthoff’s phenomenon, sometimes simply called heat sensitivity. And so while I know there are huge benefits of exercise for people with MS, I also shy away from it sometimes. Uhtoff’s phenomenon is most definitely no fun.

Many of us with heat sensitivity turn to wearable air conditioners, cooling wraps, ice vests, or portable fans to ward off the worst of our symptoms when we exercise. But aspirin is far less cumbersome. And far less expensive.

Even if the study was small, I figured, it couldn’t hurt to try it myself. After all, humans have safely turned to this nonprescription pills to reduce fever, aches and pains, and inflammation for more than a century, I reasoned.

It seemed like it was worth a shot.

My experience

As a point of reference, I’m someone who revels in the sub-freezing temperatures of winter, someone who sits in the basement for the comfort of its frigidity. So when I walk my dog in the warmer months or use my stationary recumbent bike, I always take precautions (usually an ice pack or fan) and still notice a bump in my symptoms.

But I wanted to try the aspirin route for myself. So I took two 325-mg tablets of aspirin, 1 hour prior to exercising, in place of my proven strategies.

But alas, the aspirin was of no consequence. The pills were no match against one warm-day walk and two 30-minute recumbent bike workouts.

With pain, dizziness, and numbness striking me in full force, I knew I had to go back to my plan A.

Ice packs and fans it would be.

Regardless of my own experience, I remain encouraged by the results of this study. I imagine researchers will use the learnings of this study to design new, larger trials that address MS-related heat sensitivity. I imagine this is yet another step in the ever-evolving study of MS.

In the meantime, I’ll keep on walking my dog and riding my bike despite the slight uptick in symptoms that break through, knowing that the worsening symptoms are not permanent; and when the pools are open, I’ll continue to swim laps, an activity that does not cause my body temperature to rise.

Talk with your doctor

We’ve all read it before, so it probably goes without saying, but your doctor is absolutely your best source for determining the best ways to control your MS symptoms.

In retrospect, I should have consulted mine before attempting this experiment. It’s important to be really careful when trying a medication off-label — even if it’s over the counter. Aspirin can cause side effects, including bleeding and bruising. It could also potentially interact with other medications, especially for those of us with MS who are on several meds.

And the fact that I couldn’t access the full study for any additional details made it even riskier.

Learn from my mistake and talk with your healthcare professional before beginning a new treatment protocol, even if it’s seemingly benign.

Further, your doctor can help you make sense of MS research headlines. Doctors can give you a more nuanced take on the study results before you book that biking trip in Florida.

Chill out

With summer upon us, now is the time to pay careful attention to keeping your body temperature down. Whether it’s air conditioning, an ice vest, or something else, make sure you’re turning to your Plan A and staying as cool as possible during these warm months.

As for me, I’ll be chilling in the pool — and the basement — waiting for winter.