Give Me Fever

“Give me a fever, and I can cure any disease.” Hippocrates

“When a treatment is ineffective, its risks — if not zero — always will exceed its benefits.”  Dr. Michael Shannon,  Children’s Hospital Boston pediatrician and Harvard Medical School professor.

I recently came across an article on a very popular health site and was struck by the opening paragraph: “Fevers, while not typically dangerous in their own right, can make children uncomfortable. If you have a child with a fever— whether it’s because of an illness or is a normal response to vaccination— you may wish to give antipyretic, or fever-reducing, medication.”  Giving any fever-reducing medicine, such as Children’s Tylenol, is the last thing you want to do for an ill child and can, in fact, both prolong the illness and actually cause more harm. The fact that there is little-to-no evidence that Tylenol/Advil therapy contributes to health has not stopped marketers, and sadly, most doctors from continuing to give patents this bad advice. According to the World Health Organization:

“Fever represents a universal, ancient, and usually beneficial response to infection, and its  suppression under most circumstances has few, if any, demonstrable benefits. On the other hand, some harmful effects have been shown to occur as a result of suppressing fever: in most individuals, these are slight, but when translated to millions of people, they may result in an increase in morbidity and perhaps the occurrence of occasional mortality. It is clear, therefore, that widespread use of antipyretics should not be encouraged either in developing countries or in industrial societies. Unfortunately though, just as fever represents an ancient biological response, an emotional effect is embedded deeply. Through the ages, parents have seen that when fever begins to diminish and disappears, the child feels better and recovers from the illness — whatever it was. Thus, the fever has become synonymous with the illness. This flaw in logic has persisted in parents’ and physicians’ minds, and they are seduced by the thought that if they “make the fever go away, the patient will be well.” No amount of scientific discourse will change this attitude . . .”

What exactly is a fever?

Simply put, fever is the body treating itself with heat. What happens during a fever? An infective agent (bacteria, virus etc.) is engulfed by a part of your immune system known as a macrophage. A series of chemical reactions take place that cause the thermostat (set-point) of your body to turn down. The body perceives its normal temperature to be too low and begins to generate more heat by shivering and conserving heat by constricting the blood vessels, which limits blood flow to the skin, and by shutting down the sweating mechanism. This is what causes chills.

The immune system also releases chemicals that provoke sleep to help preserve energy for fighting against the infecting germs. At the same time, chemicals are released that promote the breakdown in muscle tissue, which increases the body’s amino acid supply, which are the raw materials it uses for defense, repair, and energy. This is why muscle aches are common with fevers and chills. Excess amino acids also suppress the appetitive. This is important because the digestive system shuts down when the temperature goes above 99.5°F.  If food is eaten during a fever, it will strain the system by not being properly digested, and will add to the body’s toxic load, inhibiting its ability to deal with the fever’s cause. When body temperature is elevated, white blood cell production, motility, and killing ability are enhanced, and antibody production is increased up to 20 times. While the fever is cranking up the body’s defenses, it is also providing an inhospitable environment for the germs. At a temperature of around 104°F, most bacteria and viruses are killed. (Before the availability of antibiotics, syphilis was treated by infecting the patient with malaria, inducing a high fever and leading to a cure.)¹ The ideal temperature for a fever is between 102-103°F for fighting infectious disease. 104-107°F is considered the point where dehydration becomes a serious concern and a fever above 107°F is considered dangerous. Most harm associated with high fevers is usually due to dehydration rather than the fever. The concern should be more directed towards the cause of the fever rather than the fever itself. Serious conditions such as meningitis can cause a high fever, but the treatment should be directed towards the meningitis, not the fever.

What about the most common fear for parents— febrile seizures? All the medical research I have found has debunked the two most commonly held misconceptions about high fever in children: that it can result in dangerous seizures, and that fevers from infection must be controlled before they reach a certain point (usually I06°F), to prevent seizures and brain damage. Febrile seizures tend to occur early in the fever process, rather than after fevers have mounted, and a small percentage of children simply seem to be prone to them. Administering fever-reducing medicine does not stave off their recurrence. Most febrile seizures are the result of imbalanced electrolytes due to dehydration from diarrhea, vomiting, and increased perspiration.

Good fever management in the form of limiting food and maintaining fluids and electrolytes will prevent most fevers from progressing to more critical stages. And while it is true that fevers over I06°F are potentially damaging, such high temperatures are virtually always the result of heatstroke or brain injury, not infection, and so fears of a cold or flu causing a fever to rise to this level are groundless.  What happens when you give a fever reducer such as Tylenol? The entire metabolic process is stopped in its tracks, and now you still have an infection, but without any natural defenses. The potentially infectious person, instead of staying in bed because they feel sick, feels well enough to go to work or school, thereby exposing colleagues to the same illness. The maker of Tylenol (and those who manufacture other fever-reducing products) has successfully convinced the public that something absolutely must be done to bring down all fevers in young children. According to a recent article: 

Keeping in mind that bringing fever down by using medication possibly postpones recovery, increases the probability of a secondary infection, deprives one of clues as to the need for further examination or for changes in the therapeutic approach, and may provoke widespread side effects; physicians should treat feverish patients only when the expected benefits outweigh the possible risks.

Anti-fever medications have been marketed for use in children for decades, with drug companies spending $50 million a year on heart-tugging ads in parenting magazines and elsewhere. Still, it has long been acknowledged there is little or no data from studies in the very young to show the medicines are safe and work. Worse, some studies suggest the medicines are no better than dummy pills in treating cold and cough symptoms in young children.²

To sum up:

1.) Fever is the cure, not the sickness.

2.) Leave the fever alone unless it is threatening to go to dangerous levels.

3.) The febrile patient should fast and slowly resume feeding only when natural hunger returns, and the body’s temperature is back below 99.5°F.

4.) 102-103°F is considered optimal for infection fighting.

5.) Leave the sweating patient alone- sweating is the body’s own mechanism for lowering temperature, so don’t interfere with it.³

6.) Consult a Naturopathic Doctor in your area if you feel your fever is getting too high.

¹Wade Boyle,ND, Andre Saine, ND Naturopathic Hydrotherapy. Eclectic Medical Publications 1998; pp. 54.

²Axelrod PI, Lorber B: Antipyretic orders in a university hospital. Am J Med 1990; 88:31-35

³Wade Boyle, ND, Andre Saine, ND Naturopathic Hydrotherapy. Eclectic Medical Publications 1998; pp. 62.