Most of us have learned that when we are sick with a fever, that we should do something to get the fever down. That something usually is medication, which usually works. But is that the best approach? Should you really treat a fever if you have a cold or influenza?
Maybe surprisingly, studies over the last 20 years overwhelming show that it is usually better not to treat your fever. Note that our recommendations concern fevers in adults. Fevers in children are more complex, with different treatment guidelines.
What causes a fever
Fever itself is not an illness. It is a sign that your body is fighting an illness, and your immune system is working. When your body is significantly invaded by a virus or bacteria, your amazing immune system goes into action to kill off the invader. Part of that action is our white blood cells increase in number and release various chemical substances that kill the invading organism. These chemicals are “pyrogenic cytokines”, consisting mostly of interleukins and tumor necrosis factor. These substances travel to the hypothalamus of our brain, and reset our body “thermostat” located there. To get to an increased temperature, we start to shiver, our blood is shunted from our skin to our core organs, and we may want to get under the covers to keep warm.
Usually better not to treat fever with medication
Since the mid 1970s, experiments done first on lizards, and then on mice, showed that animals with serious infections who had an elevated temperature had a much better survival rate than the animals who did not have a fever. This led to research on humans, and multiple studies have shown that an elevated temperature in most cases is a good sign, helping your immune system fight the infection better. People with pneumonia, influenza, the common cold, and even a serious bloodstream infection (sepsis), have shorter illnesses and survive better (in the case of sepsis), if they have a fever.
A fever helps fight the infection
Many biochemical processes work faster at higher temperatures, and your immune system processes do as well. At a higher temperature, white blood cells kill bacteria faster, and B and T cells make more antibody and kill viruses more efficiently.
How to treat without medications
So the growing consensus among infectious disease specialists is that most infections will resolve faster without fever-lowering medication such as aspirin and acetaminophen. One irritating but beneficial thing about an elevated temperature is that it tends to keep you more at home and resting, and rest helps you recover faster. Also important is plenty of fluids, because if you are warm, you lose more fluids. Drink plenty of water, soup (especially chicken soup), tea, or electrolyte juices such as Gatorade to keep you well-hydrated during a fever.
But how should you treat?
If you can’t tolerate how you are feeling—for example if the elevated temperature and body aches are keeping you from sleeping, then take medication. If your fever is high, 40 degrees or more; if it doesn’t lower with medications; or persists more than 3 days, you should see a doctor. These are general guidelines, and if you have any questions while you are ill, the safest approach is to seek medical care.
Next time you have a common cold or flu infection, keep this in mind. You don’t have to fear a fever; it is a good thing really, and helps your immune system work better. Don’t rush to lower it unless you really need to.
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