The Basics
Why do we need to worry about fevers? Do we indeed need to worry? Do fevers cause seizures? Why do we have them in the first place?
It’s not only cold and flu season, but it is also the season, sadly, for COVID-19. Fevers are a pretty common symptom in both viral and bacterial infections. Like anything when it comes to the body, fevers have a purpose.
Mounting a fever is a normal physiologic response to an infection trigger, also called a pyrogen. Both virus and bacteria can be pyrogens. When a bacteria or virus enters our body, this exposure causes white blood cells to produce hormones such as cytokines which induce fever.
These hormones circulate and reach the temperature regulation center in the brain located in the hypothalamus. The center elevates the body’s set-point and a new, higher “normal” body temperature occurs.
Fever is a Symptom, Not an Illness
It is important to remember that fever is a symptom of illness, not an illness itself, and fever aids in a healthy immune response during infection or other causes of inflammation. Not only does increased body temperature have direct antimicrobial activity, but it also aids in improved immune function. During a fever, there is increased activity of the lymphocytes and antibody production, as well as increased bactericidal activity of neutrophils and macrophages (which are the body’s pac man and eat up virus and bacteria).
It is normal to see variation in body temperature at different points throughout the day; typically having lower body temperature in the morning than compared to in the evening. While there remains some variability in the numbers that constitute normal body temperature and fever, the following parameters are commonly agreed upon:
- Normal Temperature: 97 – 99°F
- Low-Grade Fever: 99 – 100.9°F
- Common Fever: 101 – 103.5°F
- High Fever: > 103.6°F
Are Fevers Dangerous?
They certainly can be if they go above and beyond where it is considered safe. But fevers DO NOT cause seizures. Seizures related to fever are due to the extremely rapid rise in body temperature and not the temperature itself. Some children are more prone to a rapid rise in temperature in response to common illnesses.
Fevers also DO NOT cause brain damage unless the temperature is greater than 107 degrees. This high of a temperature usually occurs due to injury of some kind. Fevers from infections rarely exceed 106 degrees, which is still a high number and feels scary!
Fevers feel scary mostly because of the myths of seizures and brain damage. Also, when children have high fevers, they don’t feel well and no parent wants that!
Should We Treat Fevers? If so, when?
And so, the question at hand is: should we treat fevers, and if so, when? In general, it is okay and safe to let a low-grade fever run its course, as it is likely to be benign and short-lived. The therapeutic goal when making the decision to treat a low-grade fever should not be treating the fever itself, but instead treating discomfort. Consider adding on a fever reducer with higher fevers that disturb ability to properly hydrate, eat, and sleep.
Fever is conventionally treated with a general category of drugs called antipyretics, most commonly either NSAIDs or acetaminophen. Of these, acetaminophen is generally the preferred choice as NSAIDs can cause unwanted side effects on the gastrointestinal tract. Not only will antipyretics reduce fever, but they can also be helpful in relieving other symptoms, such as headache and muscle/joint pain, that often accompany febrile illness.
Naturopathically, we can support the body during any illness with adequate rest, hydration, and nutrition. Hydrotherapy can be a natural alternative to antipyretics to decrease fevers; consider either sitting in a cool/tepid bath, or applying cool towels to the body.
When to Get Medical Help
In some cases, fever requires prompt medical attention. Below are some general guidelines on when you should contact a doctor or other medical health professional.
Pediatrics:
- 0 – 6 weeks old: fever of ≥ 101ºF
- 7 weeks – 3 months: fever of > 101ºF that is unresponsive to antipyretic medications
Any Age:
- Fever > 104ºF unresponsive to antipyretic
- Fever that lasts several days or keeps returning
- A chronic underlying health condition, such as: diabetes, heart disease, cancer
- Fever plus 1 or more of the following symptoms: difficulty breathing, neck pain/stiffness, unusual rash, severe headache, seizure or confusion, severe vomiting or diarrhea, abdominal pain
In the end, it is important to remember that FEVER IS OUR FRIEND!
