12 MS Triggers and How to Avoid Them

Medically reviewed by Heidi Moawad, M.D. — Written by Kimberly Holland — 

Triggers of MS symptoms, such as vitamin deficiencies and stress, may contribute to worsening symptoms and vary from person to person. Identifying and avoiding your MS triggers may help prevent relapses.

Multiple sclerosis (MS) triggers include anything that worsens your symptoms or causes a relapse. You can often avoid your MS triggers once you know what they are.

In addition to working to avoid your triggers, other strategies can help reduce your relapse risk, including regular exercise and a balanced diet.

You might be more sensitive to some of the more common triggers than others. You may have some triggers in common with others who have MS, as well as some that are unique to you.

Over time, you may be able to identify triggers that make your symptoms worse. Keeping a journal of your symptoms, when they occur, and what you were doing beforehand can help you identify potential triggers.

Here are some of the most common triggers you may experience with MS and tips to avoid them.

1. Stress

Having a chronic disease like MS can be a source of stress. But stress can also stem from other sources, including work, personal relationships, or financial worries. High stress levels may worsen MS symptoms, including fatigue.

How to avoid

Find a relaxing, stress-reducing activity that you enjoy. Yoga, meditation, and breathing exercises are all practices that may help reduce stress and reduce the risk of making symptoms worse.

Talking with a mental health professional may also help you learn to reduce and manage stress. For example, cognitive behavior therapy (CBT) can teach you new strategies to both think about and handle situations that cause stress.

2. Heat

The heat from indoor heating systems, the sun, and artificially heated saunas and hot tubs may be too intense for some people with MS. They can often lead to a period of exacerbated symptoms.

How to avoid

If heat is a trigger for you, skip high-heat environments like saunas, hot yoga studios, and hot tubs. Keep your home cool and run extra fans if necessary.

On hot days, avoid direct sunlight, wear loose, light-colored clothes, and stay in the shade as much as possible. Personal fans, clothes with cooling fabrics, and staying hydrated may also provide some relief from heat.

3. Childbirth

Pregnant people with MS may experience a relapse after delivering their baby. The chance of relapse is elevated in the first 3 monthsTrusted Source after delivery.

How to avoid

You may not be able to prevent a flare after childbirth, but you can take steps to reduce its severity and impact. In the immediate days after giving birth, try to rest and care for yourself as much as possible. This can help your body recover more efficiently. It may also be helpful to reach out to family and friends for support as you recover.

According to some researchTrusted Source, exclusive breastfeeding may have a potential protective effect against postpartum flare-ups.

However, if you’re taking disease-modifying medication, nursing may potentially be harmful to your baby. Talk with an OB-GYN and neurologist about your post-birth options. Some people may choose to stop some medications or use other therapies during pregnancy and nursing.

4. Getting sick

Infections can cause MS flare-ups, and MS is also more likelyTrusted Source to raise your risk of certain types of infection.

For example, people with impaired bladder function are more likely to develop urinary tract infections. This infection may exacerbate other MS symptoms.

Infections like the flu or common cold can also worsen MS symptoms.

Some medications may also affect your body’s immune function.

How to avoid

Protecting yourself from illness and practicing behaviors that reduce your risk of infections is an important part of treatment for MS.

You can do this by washing your hands during cold and flu season and avoiding people who are ill, especially when you’re experiencing a flare. You can also take other precautions, such as wearing a mask in public spaces and following food safety guidelinesTrusted Source to prevent foodborne illnesses.

Talk with a doctor if you think you’re getting sick.

5. Certain vaccines

Vaccines are generally safe — and recommended — for people with MS. Certain vaccines that contain live pathogens can potentially lead to an infection for people who have a weak immune system.

If you’re taking certain medications, a doctor may also recommend you postpone vaccination.

How to avoid

Talk with a neurologist about any vaccine you’re considering. Some vaccines, like the flu vaccine and COVID-19 vaccine, may help you prevent a future flare infection. A doctor can help you determine which vaccinations are safest for you.

6. Vitamin D deficiency

One review of researchTrusted Source notes that lower vitamin D levels are associated with a higher risk of flare-ups than adequate vitamin D levels and that adequate vitamin D levels may be protective against developing MS.

But a newer studyTrusted Source points out that more research is needed to determine whether low vitamin D levels cause flare-ups or occur with them for another reason, such as lack of sun exposure during relapses or other factors.

How to avoid

A doctor may monitor your vitamin D levels regularly as part of routine lab work. If you have a vitamin D deficiency, they may recommend getting more vitamin D from food and safe sun exposure.

They may also recommend vitamin D supplements. Be sure to talk with a doctor about the safest supplement options before trying any. Doctors typically recommend opting for a supplement brand that is subject to third-party testing, as supplements are not regulated by the Food and Drug Administration (FDA) the way medications are.

7. Lack of sleep

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