IMPORTANT: Before purchasing any cooling vest or cooling technology, ActiveMSers recommends reading the below guide and our detailed review of 17 cooling vests, which features an exhaustive battery of tests and analysis. These tests have been instrumental in us forming our recommendations.
Gear Guide: Cooling Vests & Apparel Updated March 23, 2017
With summer rearing its ugly head annually, us folks with multiple sclerosis cringe with anticipation. Like breakfast cereal and gravy, warm days and MS just do not mix. We need to stay cool to prevent our bodies from getting angry and plunging us into a seemingly endless malaise along with a list of symptoms that could rival an eight-year-old’s list of wanted presents from Santa.
Why does this happen? The most common hypothesis: the more heat, the more your body’s nerve impulses can escape due to demyelination. Current is moving too fast and the signals become muddied, meaning a rise in MS symptoms. Cooling increases conductivity, prolonging the current available, meaning more current can flow through your nerves and signals are more reliable.
To avoid the heat of summer, one option is to stay indoors and bask in the chilly pleasures of air conditioning. But we are ActiveMSers, desperately seeking pleasure without walls. Now ideally we’d have a portable 2-ounce air-conditioning unit attached to our belt (let’s call it the Apple iCool). Alas, such things do not exist. That said, we do have cooling vests--as well as innovative cooling systems--at our disposal. Why do they work and why does it matter? CJ Skok, a neurosciences student from Indiana University, wrote a technical white paper on the effects of cooling on multiple sclerosis that we have exclusively republished here on ActiveMSers with permission. Its detailed and insightful, in particular its discussion of common triggers (exercise exertion, hot bath/shower, warm weather) and why colder is not necessarily better in a cooling vest due to the science of thermoregulation.
Ranging in price from just a few sawbucks to thousands of dollars, cooling vests/systems can help those with multiple sclerosis maintain cooler core temperatures and lessen the severity of symptoms often caused by heat. Personally my eyes go wacky, leg weakness and spasticity becomes an issue, but for others, fatigue, cognitive issues, and a host of other symptoms can be backbreaking.
The vest from Coolture, developed by a former DKNY designer diagnosed with MS, proves that cooling vests can be both functional and attractive.
INSURANCE COVERAGE. Most health insurers shrug their shoulders when patients ask if cooling vests are a covered expense. Don't give up. Cooling is essential for multiple sclerosis patients, and should qualify under Durable Medical Equipment (insurance code E-1399). Still getting denied? The National MS Society has these recommendations for filing an appeal.
Picking the Right Cooling Vest So how do you pick the right vest? What’s the best vest for the dollar? Will the dang thing even work? Good questions, all. Every MSer will have different needs, and not everyone will gain the same benefit. There are no guarantees. Indeed one vest may have limited effect while another could be a godsend. We at ActiveMSers want to help you make the best, most educated decision possible.
Cooling technology first needs to be broken down into two types: active and passive. Active cooling vests and cooling systems require some form of power (electricity or battery) to operate. They continually provide maximum cooling--many lower the body’s core temperature--and are usually used in the home although they are portable and can be used in the car, the office, etc. These tend to be more expensive systems and generally start around $150 and can run into the four figures.
Passive vests have no working components and are easily portable. Use them basically anywhere your body can go, whether it be on a jog, to the zoo, or to a ballgame. But their cooling power is short-term (30 minutes to 4 hours). While they have limited effectiveness in lowering the core body temperature, passive vests do provide a degree of heat relief helping to abate symptoms brought on by MS. These are the most affordable types of vests, and range in price from $30-$500).
It’s important to note the differences of these types of active and passive cooling vests and systems, as the type of cooling--and the construction of the vest--will drastically affect performance. Additionally, outdoor humidity, ambient temperature, exposure to direct sunlight, and even body temperature of the wearer can influence cooling power. In fact, cooling "power" may not even be much of a benefit, as cooling too much can end up constricting your superficial blood vessels near the skin as your body's natural defense mechanism to warm up kicks in. So your body starts giving out less heat (preserving it, as it thinks its getting colder) and you start warming up. Quite the conundrum!
And lastly, realize that the pricier the vest doesn’t always mean the best choice for your particular situation. Likewise, going with the cheap fix might result in nothing more than wasted cash and one extra piece of clothing hanging on that exercise bike you should use more often. You need to weigh what's most important to you, from convenience to concealability to construction. That said, let’s dive in.
TIP: You can recharge gel/ice packs on the go very fast using this little trick. Fill your cooler with ice. When you want to recharge your packs, add water and a teaspoon or so of salt. Mix it up, and the slurry will super cool those packs faster than even your freezer. The secret is in the salt, which lowers the temp of your slurry to the mid 20s. Please note: you may want to contact your vestís manufacturer to make sure salt will not damage the gel/ice packs.
The Cool Shirt active cooling suit.
TIP: To get the maximum cooling effect from a vest, it should fit snuggly around your body. If it hangs loose, some of the cooling power will be lost as youíll only be chilling air and not your body. Zip up vests must be sized properly to hug your chest. Poncho-style vests, which you wear by putting your head through the center hole and drape over you chest and back, are typically made snug with side straps (usually velcro).
COST-FREE VESTS. Please don’t assume willy nilly that you can’t afford a cooling vest--insurance may cover it if you have a prescription from your doctor (and the VA typically covers vest purchases, active or passive). Better yet, the Multiple Sclerosis Association of America (www.myMSAA.org) provides free vests for those with limited incomes (see if you qualify) as does the Multiple Sclerosis Foundation (www.msfocus.org).
Passive Phase Change Cooling Vests ($100-$400) Unlike ice packs, which chill to below freezing, phase change packs maintain much higher temperatures. These phase-change packs often contain liquids (typically nontoxic oils and fats) that solidify (like wax) typically between 55 to 65 degrees and in our tests reliably provide cooling power for as long as 4 hours, the best we've tested. Some vests, like those from First Technology International, rely solely on absorbing heat and require no refrigeration. Although these vests don't "feel" as cold as ice or gel vests, they are working. Due to the higher temps, these vests are comfortable worn directly against the skin. Phase change packs can be recharged in the refrigerator, freezer, in ice water, or even at room temperature. Typical weight: 3-5 lbs. Examples: Glacier Tek (www.glaciertek.com), First Line Technology (www.firstlinetech.com), Thermapparel (www.thermapparel.net), TechNiche International (www.techniche-intl.com), Polar Products (www.polarproducts.com). + Recharges quickly, in as little as 5 minutes + Good for those with cold sensitivity + No condensation on packs + Long-lasting cooling capacity - Can be heavy - Might not "feel" cold
The Flex Vest from Glacier Tek.
Passive Gel Pack Cooling Vests ($150-$300) These vests use cooling sheets that activate when soaked in water and plump when agitated. The user then freezes these sheets, which are dropped into the garmet prior to wearing. These vests provide reliable cooling are tend to be lighter in weight than ice or phase change vests. The gel also does not freeze as coldly as ice, so safety is not a concern. Some of these vests can be worn under clothing and may be somewhat concealable. Expect about three hours of cooling per charge. Examples: Stacool Vest (www.stacoolvest.com), Coolture (www.coolture.net) + Comfortable, consistant cooling power, not too cold + Thinner profile means vests could be worn under clothing + Replacement gel packs are inexpensive - Gel packs feel a bit slimy in the first few freeze cycles - Condensation is common - Must have access to a freezer to fully recharge
The vest from Stacool.
Passive Embedded Gel Cooling Vests ($75-$200) These vests are lined with hydrogel crystals that activate when soaked in water. After the gel ribs plump fully, the vests are towel dried (or put in the spin cycle of your washer) to remove excess water. They are then folded, placed in a plastic bag, and frozen. When removing the vest from the freezer, vests tend to be icy and likely will need some coaxing to fully open. They are among the lightest cooling vests available (second only to evaporative) but have less endurance than phase change, gel inserts, and ice, lasting between 30 minutes to a couple of hours in optimum conditions. Also note that these vests need to be stored cool (in the freezer or fridge) in order for the gel ribs to remain plump or else the user will have to repeat the initial activation process detailed above. Examples: IZI BodyCooling (www.izibodycooling.com), Arctic Heat (www.icevests.com), Polar Products (www.polarproducts.com). + Can be extremely lightweight + Packs down smally when uncharged + Typically best suited for athletics - Limited cooling capacity, no more than 2 hours when frozen - Entire vest must be chilled; takes up room in freezer - Vest can be damp, less practical for day-to-day use
The IZI BodyCooler functions is a true hybrid vest, with both hydogel and evaporative cooling.
Passive Ice Pack Cooling Vests ($100-$300) These vests are among the most popular and basic in design and tend to provide the most theoretical cooling power among passive vests (which scientific research suggests is not always a positive), with cooling that can reliably last for several hours. The user pre-freezes the ice packs, which are then dropped into pockets on the garment prior to wearing. But our tests have shown that many of these vests can have too much cooling if properly frozen--on par with therapeutic icing for injuries, which should be done for no more than 20 minutes--and in theory could cause frostbite if worn with a single T-shirt. If you find a vest too cold, ActiveMSers recommends these vests be worn with extra layers of clothing for safety, especially if you are already numb in the chest area. Examples: SteeleVest (www.steelevest.com), Polar Products (www.polarproducts.com) + Affordable + Maintains cooling charge longer than many vests + Popular with complimentary vest programs for MSers - Cooling packs often too cold - Typically heavier than other passive vests - Must have access to a freezer to fully recharge
The popular Kool Max vest from Polar.
Passive Evaporative Cooling Vests ($30-$80) Just soak the vest in cool water, then towel or wring dry, and you are ready to go. You’ll likely get a little damp, but that’s to be expected as these vests are essentially portable evaporative coolers that chill the human body. To be effective, the vest should only be worn in low humidity (arid/desert) environments. These are the most affordable passive vests but also typically the least effective. Note: if your home/gym is cooled by an evaporative cooler (swamp cooler), using the vest while the cooler is running will result in little benefit. Examples: TechNiche International (www.techniche-intl.com), Silver Eagle Outfitters (www.silvereagleoutfitters.com), Polar Products (www.polarproducts.com) + Most affordable style of passive vests + Quite lightweight, good for sports + Easy to recharge (just add water) - Not effective in humid environments - Limited cooling capacity - Vest is damp, could breed bacteria if stored incorrectly
The women's vest from Silver Eagle Outfitters.
Active Cooling Vests ($350-$2,000) Most active vests work by recirculating chilled fluid through the vest being worn by the MSer. The vest, which may include a cap, requires a separate cooling unit--a pump to recirculate the fluid and a cooler to hold the ice that chills the fluid--and a power source. Typically these vests run off either A/C or battery power (say D cells or a car battery). By reducing the body’s core temperature and providing a constant level of cooling, these vests have been shown in studies to be therapeutic and to reduce MS symptoms in many (but not all) patients. Usually MSers with heat sensitivity will wear this type of cooling garment several times over the course of a day. The vests themselves range greatly in weight, from as little as 2 lbs to 10 lbs and heavier. While the vests can be worn during exercise--for instance putting the pump/cooler equipment next to the stationary exercise bike--wearing the vest outdoors is impractical. However, the benefits of the cooling vest may continue to last for a period of time (manufacturers say up to an hour or two) after the vest is removed. There is one vest that touts portability (about $500 with accessories), although at 12 lbs you better be fit with good balance if you plan to strap on the water/battery backpack. Examples: Cool Shirt Systems (www.coolshirt.net), Veskimo Hydration Backpacks (www.veskimo.com). + Maximum cooling benefit + Best of any vest type at dropping core body temperature + Effectiveness proven in studies - Due to power/fluid needs, vests are not very portable - Vest complexity ups price significantly - Not practical for most outdoor activity
The active portable vest from Veskimo with backpack.
Active Cooling Systems ($995+) Relatively new to the market, active cooling systems like those made by CoreControl are not vests at all. Unlike cooling vests, which cool the body from the outside, cooling systems work to extract heat from the blood as it moves through the body. This technology is pricey (typically $1,000 or more) and is most often used by those who can afford the price tag: professional sports teams, big-time college sports programs, private hospitals, and the military. But it has found an audience with MSers for its potential effectiveness and convenience. Simply insert your hand into the system, a light vacuum seal is created around the wrist (to keep blood vessels from constricting with the cold) and lightly grip the cooling handle for a period of time. That’s it. A pump, power, and fluid are still required. According to CoreControl, their system works by using the “specialized blood vessels [that] exist in the palms of your hand for heat dissipation purposes. These structures--your body’s radiator--allow large amounts of blood to flow directly beneath the skin when the body needs to dissipate excess heat. CoreControl enhances the blood flow to those surfaces through a combined application of temperature and a slight vacuum.” It’s important to note that the system works best to cool someone who is experiencing heat stress (blood vessels wide open), and only has limited effectiveness at cooling the MSer who is relaxing at home or has done only mild activity (blood vessels already relatively constricted). Examples: CoreControl (www.avacore.com) + Newest cooling technology on market + Convenient to use, relatively lightweight + Extremely effective after heavy exercise - Pricey ($995) - Limited effectiveness after light/no activity - Hard to use during activity, limited portability
The innovative Core Control system.
Members of ActiveMSers can save up to 20% on select cooling vests with reserved coupon codes. To get your discount, join today by signing upfor our newsletter. NOTE: ActiveMSers has negotiated these discounts and has no other affiliation with these companies and receives no compensation or commission of any kind. Some vests were donated for testing purposes.
ActiveMSers Recommendations After testing a combination of ice vests, ice torso wraps, phase change vests, and gel vests, ActiveMSers has prepared some general vest recommendations. (Please note, active vests have not been tested.)
There is no one single best cooling vest. Indeed what works brilliantly for one body type might fall woefully short for another. They all have their pluses and minuses--in an ideal world you’d have more than one type. You’ll need to decide what is most important to you in a vest, a certain vests fit certain body types better. If one doesn’t work for you, try another. NOTE: There are many more vests than those listed here. If you have a favorite vest and would like it to be considered, write me at firstname.lastname@example.org. Best all-purpose: Repeated testing has cemented phase change vests as the preferred technology by ActiveMSers. They are the most versatile, since they can be charged in virtually any environment--in the fridge, freezer, ice water, or even in just an air conditioned home. First Line Technology's vests (www.firstlinetechnology.com), which impressed in our testing despite being the least "cool" of all vests, can be worn under clothing somewhat stealthily. We also highly recommend the vests from Glacier Tek (www.glaciertek.com), especially their new versatile Flex Vest.The hybrid phase change/evaporative TechKewl cooling vest from TechNiche International (www.techniche-intl.com) is extremely versatile as well. The attractive vests from Coolture (www.coolture.net), a gel pack vest, are well-made and fashion forward, while the gel pack vest from StaCool (www.stacoolvest.com) earns kudos across the board. A new favorite is the ultra lightweight and totally concealable UnderCool vest from Thermapparel (www.thermapparel.net). Best for maximum therapeutic effect: Choose an active vest, like those from Cool Shirt (www.coolshirt.net), very popular with motorsport professionals, and the vest from Veskimo (www.veskimo.com), which is relatively portable with the backpack system. The innovative cooling system by CoreControl (www.avacore.com) has potential, especially for quick cool down if you are overheated. None of these are terribly portable and convenient to use, however.
Best for athletics: There are several that stand out: the ultra lightweight cooling shirts and vests from IZI Body Cooling (www.izibodycooling.com) and the snug, light vest by Arctic Heat (www.icevests.com). Also consider the athletic phase-change Standard or Mesh vest from First Line Technology (www.firstlinetechnology.com), the Flex Vest from Glacier Tek (http://www.coolvest.com/) and the elite hybrid sport vest from TechNiche (www.techniche-intl.com). Because of its light weight and snug fit, the vest from Thermapparel works well (www.thermapparel.net). Although not terribly portable, the gee-whiz cooling system by CoreControl (www.avacore.com) is geared to cool after a workout. Best to wear under clothes: Sometimes you don't want to advertise you are wearing a cooling vest. The hands-down winner in this category is the UnderCool vest from Thermapparel (www.thermapparel.com), virtually invisible and weighing on 1 lb, 11 oz. Weighing 3 lbs 12 oz with thin heat absorbing packs, the standard mesh cooling vest from First Line Technology (www.firstlinetech.com) is a good choice here along with the Flex Vest from Glacier Tek (http://www.coolvest.com/). StaCool (www.stacoolvest.com) and TechNiche International (www.techniche-intl.com) both make vests that work underneath clothing moderately well. No other vests tested earn high marks for concealability.
Best for travel: Phase change vests are the easy choice in this category, as they can recharge in the hotel mini fridge or ice bucket. In fact, packed closely together in their charged state, they can stay charged for days even outside of a cooler. Better still: the First Line Technology (www.firstlinetech.com) cooling vests can recharge at room temperatures or in under 10 minutes with ice water.
Best for plus sizes: A constricting, chest hugging vest is not terribly flattering for some body types. Again, the UnderCool from Thermapparel leads the way (www.thermapparel.net). We like the Polar Products (www.polarproducts.com) Kool Max Fashion vest in this department, as its loose fit and clean design make it appear like anything but a cooling vest. And since it doesn't fit as tightly, the max cooling of ice packs is not a detriment. Another stylish alternative is the vest from Coolture (www.coolture.net) as the patent-pending buckled waist band accommodates many sizes, while the cold packs conform better to the body than others. First Line Technology's XPC (http://www.firstlinetech.com/product/xpc-cooling-vest/) vest works well with larger chests.
Best for those on a budget: TechNiche International (www.techniche-intl.com) sells sporty evaporative vests for under $50. Polar Products (www.polarproducts.com) also offers an inexpensive evaportive vest. Maranda Enterprises (www.marandaenterprises.com) pitches an affordable ice vest through Amazon that often runs under $70. Of course, a zip lock bag and ice cubes can work in a pinch.
The concealable, easily rechargeable First Line Technology Standard Mesh Cooling Vest is a versatile, all-purpose vest.
Thermapparel's vest is the lightest and most concealable on the market.
The elite hybrid TechKewl vest from TechNiche, with phase change and evaporative cooling, is among our favorites.