Dr. Gilbert chats with Dr. Okeanis Vaou about how climate may affect PD
Living with Parkinson’s disease (PD) often means learning to adapt to changes in movement, thinking, and overall health. What many people don’t realize is that the environment, particularly temperature, humidity, and altitude—can also have a significant effect on symptoms.
Recently, APDA’s Chief Mission Officer, Dr. Rebecca Gilbert hosted an insightful webinar on PD and climate, exploring how hot and cold weather, hydration, and environmental conditions influence daily life with PD. She spoke with Dr. Okeanis Vaou, a movement disorders specialist, about these topics and answered questions live from the audience. The presentation and discussion covered a wide range of questions that may help you or a loved one understand more about how these outside effects can play a role in PD symptoms, and what to do about it. For your convenience, we listed the topics and questions from the episode below with timestamps so you can skip to what interests you most.
Watch the full episode of Dr. Gilbert Hosts: Climate, Weather, & Parkinson’s Disease
30:37 Do some people with Parkinson’s feel chills in the hot weather and sweat in the cold weather?
32:13 People with Parkinson’s rely on their exercise to stay mobile. How can someone exercise when it is extremely hot outside?
34:41 Is it possible for your body to fool you so you do not feel thirsty even when you are dehydrated?
36:50 Can sweating problems (too much or too little) be a side effect of levodopa?
38:38 At what point should you stop your exercise if you are sweating excessively?
39:41 How do you balance the fact that in some studies, caffeine has been shown to help PD, but caffeinated drinks can also have diuretic effects?
41:29 What is the appropriate temperature to store your PD medications?
43:52 What is the best climate for someone with PD to live in?
45:33 You mentioned that gastrointestinal symptoms of PD may vary with temperature. Should you consider adding a medication for constipation only when temperatures increase?
46:43 Are there available medications that help with the temperature dysregulation of PD?
Additional Audience Questions Related to Parkinson’s and Climate
In this article we will address some of the additional and important audience questions that we did not have time to get to during the broadcast.
Q: Does altitude make a difference in PD symptoms?
A: Yes. High altitude means lower oxygen levels, which can worsen fatigue, dizziness, or cognitive changes in people with PD. If you travel or move to higher elevations, give your body time to adjust and check with your doctor about managing any new or worsening symptoms.
Q: How does humidity affect someone with PD?
A: Humidity makes it harder for the body to cool itself, which can intensify overheating, fatigue, and dehydration in PD. High humidity can also worsen swelling and stiffness. Staying in air-conditioned spaces and using dehumidifiers can help manage symptoms.
Q: Does barometric pressure affect PD symptoms?
A: Some people with PD report that changes in barometric pressure (such as before storms) worsen pain, stiffness, or fatigue. While research is limited, it’s possible that pressure shifts influence symptoms indirectly, much like they do in arthritis.
Q: What are healthy sources of electrolytes that aren’t sugary?
A: Electrolytes like sodium, potassium, and magnesium are essential for hydration. Options that avoid excess sugar include:
- Coconut water (unsweetened)
- Diluted electrolyte tablets or powders (look for low-sugar formulas)
- Foods like bananas, oranges, leafy greens, nuts, and yogurt
Q: Can heat cause hallucinations in PD?
A: Yes. Extreme heat can lead to dehydration, electrolyte imbalance, or even delirium, which can worsen or trigger hallucinations—especially in people taking PD medications. If hallucinations appear suddenly during hot weather, seek medical advice promptly.
Q: Is water just as good as electrolyte drinks?
A: For most people, water is enough for hydration. Electrolyte drinks may help if you’re sweating heavily or exercising in heat, but they’re not always necessary. Because many commercial options are sugary, water remains the safest, cheapest, and healthiest baseline.
Q: Do coffee and tea count toward hydration?
A: Caffeinated coffee and tea can act as mild diuretics, increasing urine production. For most people, drinking 1-2 cups a day may not have any significant implications. However, for those with PD who might also have increased sweating or drops in blood pressure, the negative effects of coffee and tea on hydration can be more impactful. If you enjoy coffee and tea, consider drinking decaffeinated varieties. In addition, limit the amount you drink, favoring water throughout the day.
Q: How can I prevent excessive nighttime urination while still staying hydrated?
A: Nighttime urination (nocturia) is common in PD. Strategies include:
- Front-loading hydration earlier in the day
- Limiting fluids 2–3 hours before bedtime
- Avoiding caffeine and alcohol in the evening
- Discussing medication timing with your doctor
This allows you to stay hydrated while improving sleep quality.
Q: How can I check whether I have drops in blood pressure from PD or dehydration?
A: Drops in blood pressure when standing (orthostatic hypotension) are common in PD. You can check at home with an automated blood pressure cuff. It is best to measure blood pressure while lying down. Then, stand up and remeasure after 1 and 3 minutes. A drop of 20 points systolic or 10 points diastolic suggests orthostatic hypotension. Dizziness and lightheadedness are also abnormal results to look for as well. Report results to your doctor, who can guide treatment options.
Tips & Takeaways
- PD can affect how the body handles heat, cold, and hydration.
- Both dehydration and overheating are serious risks, so proactive hydration and climate control are essential.
- Exercise remains critical for PD management; just be sure to adapt it for safety in extreme weather.
- Coffee and tea can act as mild diuretics. Decaffeinated coffees and teas are better for hydration and make sure to balance them with water.
- Monitoring blood pressure, hydration, and symptoms can help manage day-to-day challenges.
- You can catch up on any past episodes of Dr. Gilbert Hosts you may have missed, rewatch the ones that interest you the most, and share them with friends and family.
This blog was written by Clark Jones, PhD, and was reviewed, edited, and approved by Dr. Rebecca Gilbert.