Today I am writing my first D-mine^® Care Blog article, and it is very fitting for this moment:
finally it’s summertime – at least on the Northern Hemisphere 😊. Generally, summer, sunshine, and warm temperatures invite us to spend more time outdoors. I live in Northern Germany, where a cool breeze from the coast is usually part of everyday life. However, the hot and sometimes sweltering temperatures of over 30°C that we are currently experiencing – and that are becoming increasingly common due to climate change – can be exhausting for everyone, but especially for people living with Parkinson’s disease. While many people enjoy the sunshine and warmth, extreme heat can present particular challenges for individuals with Parkinson’s, as it may affect the body’s ability to regulate temperature and increase the risk of dehydration and worsening symptoms. For this reason, it is important to take extra precautions during the summer months and pay close attention to your body’s signals to stay safe, comfortable, and well hydrated.

People with Parkinson’s may be especially vulnerable to heat because the disease can impair the autonomic nervous system, which is responsible for regulating involuntary functions such as body temperature, sweating, and blood pressure. As a result, the body may be less effective at cooling itself, causing core temperature to rise more quickly during hot weather. In addition, certain Parkinson’s medications, particularly anticholinergics, can reduce perspiration, further limiting the body’s natural ability to dissipate heat.

Heat can also worsen Parkinson’s symptoms in several ways. High temperatures and dehydration may affect the absorption of levodopa, potentially leading to increased “off” periods, greater motor fluctuations, and a higher risk of dizziness or orthostatic hypotension – a sudden drop in blood pressure when standing up. Furthermore, many people with Parkinson’s experience a reduced sense of thirst, making it easier to become dehydrated without noticing the warning signs.

Hydration Strategies for Summer Safety

To prevent overheating and minimize symptom exacerbation, it is essential to regulate body temperature and stay well hydrated. Enough fluids, wearing lightweight, breathable clothing, seeking shade or air-conditioned environments whenever possible, and avoiding strenuous physical activity during the hottest hours of the day, is helpful! By planning ahead and taking these precautions, people with Parkinson’s can enjoy the summer season more safely while reducing the risk of heat-related complications.

Ensure adequate fluid intake

At high temperatures, in the summer heat, the body loses a lot of water through sweating. So, it is especially important to drink enough and regularly throughout the day, even if you do not feel thirsty, as the body loses a lot of fluid and electrolytes (salts). Preferably you should drink water, unsweetened teas, or diluted fruit juices. Water can be infused water with e.g. mint, cucumber, or lemon. Light broths helps with electrolyte balance and in case of dysphagia, thickened fluids can be useful. Fluids to Limit are alcohol, which accelerates dehydration; sodas with high sugar content, which provide poor hydration; and excessive amounts of coffee or strong tea, which act as diuretics. The appropriate amount of fluid to drink depends on age, activity, and individual factors. The following recommendations serve as a general guide for adults:

🌞 At least 2.5 to 3 liters of water per day

🌞 In extreme heat, physical exertion, or exercise: up to 4–5 liters

When you sweat a lot (e.g. during exercise or working in the sun), to compensate for the loss of electrolytes, you can resort to mineral water with a high sodium content Light isotonic drinks or homemade drinks (e.g., water with a little salt and juice).
Avoid alcoholic, caffeinated and extremely sweet beverages, as they can stimulate metabolism and lead to heat generation. Also try to avoid Ice-cold drinks in large gulps, as they can irritate the stomach.

My hint, if you find it difficult to drink large amounts of water, an ice cube or a popsicle might be a good alternative.

Adapting Nutrition and Madeication Time

Hot weather often leads to a reduced appetite, which can make medication management more challenging for people with Parkinson’s disease. Since dietary proteins may interfere with the absorption of levodopa in the small intestine, the timing of meals and medication is particularly important. To optimize effectiveness, levodopa is often recommended 30 minutes before a meal or about two hours afterward. During periods of extreme heat, it may also be beneficial to consume protein-rich foods such as meat, fish, or eggs later in the day, when temperatures are cooler. In addition, replacing large meals with several smaller: The larger the portion, the more energy your body needs to expend for digestion, and as a result, your body temperature increases. Balanced meals throughout the day can help reduce digestive strain and support more stable energy levels.

Be sure to eat a balanced diet with plenty of fruits and vegetables, which are rich in vitamins and minerals. Eat cold foods like salads or cold soups to cool the body. I further recommend easily digestible carbohydrates (e.g., whole-grain rice, potatoes). Conversely, foods high in salt, such as chips, instant soups, sausages, or convenience foods, which often contain a lot of salt, should be avoided. Why? Parkinson’s medications (e.g., levodopa) and heat can lower blood pressure. However, too much salt can increase blood pressure and place additional strain on the circulatory system.

Protect yourself from the sun

Direct sunlight can strain the circulatory system. Wear a hat, sunglasses, and lightweight, breathable clothing made from natural fibers like cotton or linen that covers the skin. Dark colors should be avoided because they retain more heat. Sunscreen with a high sun protection factor protects the skin from sunburn. Even an umbrella can be a great help in strong sunlight.

Schedule activities during the cooler hours and avoid strenuous activities

As temperatures rise, so does the strain on our bodies. Things we can do without problems on cooler days can quickly become dangerous in extreme heat.

Why is physical rest important? In hot weather, our cardiovascular system works at full speed to regulate body temperature. Physical exertion such as exercise, gardening, or heavy lifting can place additional strain on the body – especially in older people or those with underlying health conditions. Therefore, avoid strenuous activities between 11 a.m. and 5 p.m., when it’s hottest. Temperatures are often more pleasant in the early morning and evening. Use these times for walks, light exercises, or other outdoor activities. At midday, when the sun is strongest, you should stay in shaded or air-conditioned areas. Plan breaks and regularly seek shade or cool rooms. Parkinson’s patients are sometimes more sensitive to heat. Listen to your body and watch signs of overheating: Headaches, dizziness, nausea, extreme fatigue, confusion, or weakness are warning signs. If you notice signs of overheating, you should immediately go into the shade, cool off, and drink enough.

Cool down your surroundings and yourself

Use fans, air conditioners, or wet cloths to lower the ambient temperature. Cool your wrists, neck, or forehead with damp cloths to regulate your body temperature. Special cooling towels or cloths such as hoodies, stockings or pants are available that provide instant cooling. For those without air conditioning at home, cooling bedding could be a good alternative. The cooling effect automatically regulates itself based on body temperature. Many contain high-quality silver, which has odorinhibiting and antibacterial properties.

Adjust your medications

Heat can affect the effectiveness of your Parkinson’s medication. Talk to your doctor about whether an adjustment is necessary and follow the recommended intake times. Also note how your medication must be stored. At a prescribed room temperature for medication, find a cool place in your apartment, e.g. on the floor near interior walls. You can also use a cool box. But please keep an eye on the temperature, because you should make sure it’s not too cold. And do not store your medication in a refrigerator.
My personal note: Keep the outdoor temperature in mind, when you pick up your medication from the pharmacy. If you store it in the trunk of your car while you enjoy a cool ice cream at the café, your medication may overheat in the trunk and then might be unusable. If you are using an apomorphine pen in hot weather, there are special self-cooling bags that are also used by diabetics, for example.

Environmental Modifications

Maintaining a cool and comfortable home environment can play an important role in preventing heat-related problems. During the hottest hours of the day, keeping shutters, curtains, or blinds closed can help reduce indoor temperatures, while opening windows during the cooler evening and early morning hours allows fresh air to circulate. Fans may also provide relief, although additional cooling strategies – such as using a spray bottle with cool water or placing damp cloths on the neck, wrists, or forehead – can be particularly effective in helping the body stay cool.

Stay in touch

Also pay attention to social security. If you live alone, you should regularly inform family, friends, or neighbors about your well-being. Arrange regular, short check-ins – a phone call, a text, or a brief meeting during the day is often enough. This way, others will quickly notice if something is wrong.

Heatstroke, circulatory collapse, or sudden weakness can occur more quickly than expected in the summer. In an emergency, every minute counts. If you know you’re alone and are looking after yourself, you can react quickly if anything unusual happens. So share your daily routine or any special risks with a trusted person, keep important phone numbers handy, and use emergency watches or apps that provide quick assistance in an emergency. Stay connected not only physically but also socially – this will make you safer in the summer. If you are interested in how to best travel with Parkinson’s medication, such as an infusion pump, you are welcome to read our blog post about “Traveling with an Apomorphine Pump”.

Warning Signs and Clinical Red Flags

Caregivers and family members should be particularly vigilant during periods of extreme heat, as heat-related complications can develop quickly in people with Parkinson’s disease. Certain symptoms may indicate a medical emergency and should prompt immediate medical attention.

Warning Signs include:

⚠️ Sudden confusion, unusual disorientation, or changes in mental status

⚠️Signs of severe dehydration, such as a very dry mouth, retracted tongue, or dark-colored urine

⚠️ Rapid, unexplained weight loss over a short period

⚠️ Frequent dizziness, falls, or lightheadedness especially when getting up

⚠️ Prolonged “off” periods or motor blockages that do not improve with the usual medication

⚠️ A body temperature above 38.5 °C (101.3 °F)

If any of these symptoms occur, medical advice should be sought promptly to prevent serious heat-related complications

My conclusion:

Summer can be a lovely time for Parkinson’s patients if they take a few precautions. With enough fluids, sun protection, and smart activities, you can safely enjoy the hot days. Listen to your body and don’t hesitate to seek medical help if you feel unwell.

I welcome feedback about your experience with the heat and the sun. How are you and your Parkinson’s patients doing? What’s it like in the region where it’s often hot? Maybe I can learn from you who to overcome the heat in Northern Germany 😊

Sunny greetings from Anna