WHEN TO TREAT A FEVER (reprise) and WHY THEY OCCUR AT ALL?
I posted this a while back and given the cold, flu and Coronavirus season being upon us (Coronavirus season has never left! We are the only country in the world still in the first wave of the pandemic), I thought it worth amending and re-posting. Many of the points are still valid, and some have changed.
Viral infections thrive in the winter because most of them thrive in cooler, dryer conditions, whether outside or in your body. They also like close contact, SARS Cov-2 in particular because it is airborne, which is why it didn’t go away this summer. A fever is part of our immune response to fight viruses.
Fevers are a common sign of illness, but they also play a key role in fighting infections. Technically, a fever means you have a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher in adults. For kids, a fever is when their temperature is higher than 100.4°F (measured rectally); 99.5°F (measured orally); or 99°F (measured under the arm).
I hear patients tell me all the time that they have a “low-grade fever”. Personally, I feel that you either have a fever or you don’t. The whole “low grade” thing to me, is like being “a little bit pregnant”. In addition people who tell me that they don’t get fevers are wrong, have an extremely mild infection, they are REALLY, REALLY sick or may have some kind of underlying immune problem, and most don’t. In the vast majority of cases, if you don’t have a fever, you don’t have an infection, or at least not one which needs to be treated, whether viral or bacterial. Don’t let someone give you an antibiotic, unless it is clear you have a bacterial (not a viral) infection. No “just in case”. You are harming yourself. “Covering all the bases” is not medicine, it’s voodoo.
A fever is a symptom of your immune system trying to fight the infection. The higher temperature does make it more difficult for some microbes, including viruses, to survive.
Fever and the coronavirus
Fever, along with cough and shortness of breath, is among the “classic” symptoms of COVID-19. We know that there are a myriad of symptoms which Covid causes and can present with, including loss of smell, GI issues…If you have symptoms and think you have been exposed to COVID-19, call your healthcare provider. The CDC’s Self-Checker tool can help you make decisions about seeking medical care. Mayo Clinic also offers a tool that helps you decide on seeking medical care and whether you need a COVID-19 test.
For significant fever, aches and pains, take acetaminophen (Tylenol). If you are taking any combination of cold or flu medicine, keep track of all the ingredients and doses, and make sure not to exceed a total of 3,000 milligrams of acetaminophen per day. It is better to avoid Motrin (ibuprofen) or other non-steroidal anti-inflammatories like Aleve. There is some evidence that NSAIDs can increase the chances of covid-19 taking hold. The mechanisms are not clear. Some think it has to do with their impact on the immune system, decreasing its efficacy or possibly promoting viral binding to cell walls. Regardless of the cause, stick with acetaminophen.
However, keep in mind that a fever is also our body’s response to infection and helps combat it. We are all too soft and comfortable in modern society and can’t deal with the least bit of discomfort. If your temperature is below 102 and you are not too terribly uncomfortable, ride it out. Drink PLENTY of water since fevers may simply be a result of dehydration. As a general rule of thumb, if you are peeing at least 4 times a day, you are probably hitting the minimum amount of hydration.
If your fever is above 102, or you are really not feeling well, take acetaminophen. Too high a fever is actually a sign that your immune system may become overwhelmed and you should seek medical attention. Too much response from your immune system may also be a problem, resulting in tissue (lung) damage.
Stay safe and Be well.
AC 😎✌️🌱❤🐖🏃🏻🧘🏻♂️🌎
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html