Reducing Fever

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  • #609578
    simcha613
    Participant

    I don’t understand the logic in using different types of medications to reduce fever. Isn’t fever part of the body’s natural defense system to fight disease? Why are we trying to turn off the system that G-d created?

    I don’t think this is similar to those who are against using vaccines or medications in any case. Vaccinations and medications are used to fight disease and I think it makes sense that we have to do our hishtadlus to fight the disease that is trying to damage our bodies. But fever isn’t a disease. Fever is natural. Fever is how the body fights disease. Fever is what G-d gave our bodies to fight disease. Why are we trying to stop it? Is fever not a good thing? If it’s not a good thing, why it our body’s natural response to disease?

    #958214

    Disease is just as natural as fever. If it wasn’t for disease and the death that it causes, humans would not have been able to survive as long as they have.

    Luckily, in the dark ages when Europe was plagued by the plague, the Jewish people built up some sort of resistance to the infection and was able to overcome its detrimental effects.

    #958215
    verapoi yerapei
    Participant

    I am in med school and your are absolutley right to an extent. The body raises its tempature because it sows and kills the microbe that is harming you in the first place. However, at a certain point the fever reaction can get too strong, the extreme of which would be temps like 104-105 but even less than that is already strong. I don’t give my kids fever -reducers till they hit almost 101 or if they are very uncomfortable. but as long as long as you are feeling fine and temps are below that the best thing to do is leave the fever

    #958216
    popa_bar_abba
    Participant

    Luckily, in the dark ages when Europe was plagued by the plague, the Jewish people built up some sort of resistance to the infection and was able to overcome its detrimental effects.

    lol

    Is that your rationalist explanation?

    #958217
    Health
    Participant

    simcha613 -“I don’t understand the logic in using different types of medications to reduce fever. Isn’t fever part of the body’s natural defense system to fight disease? Why are we trying to turn off the system that G-d created?”

    You make a good point.

    From the Merck Manual (not the whole article) (which btw I own a copy):

    “Treatment of fever:

    Specific causes are treated with anti-infective therapy; empiric anti-infective therapy is required when suspicion of serious infection is high.

    Whether fever due to infection should be treated with antipyretics is controversial. Experimental evidence, but not clinical studies, suggests that fever enhances host defenses.

    Fever should probably be treated in certain patients at particular risk, including adults with cardiac or pulmonary insufficiency or with dementia. Drugs that inhibit brain cyclooxygenase effectively reduce fever:”

    Tylenol, Aspirin, Ibuprofen, Aleve, etc.

    So basically only in some people or if it goes too high will the fever in itself be dangerouus & should be treated. The main reason people grab the pill bottle is because fever usually accompanies fatigue, chills, sweats, etc. and popping a pill makes people feel better – creature comfort. I’m just like e/o else -the pill makes me feel better so I pop ’em.

    #958218
    Torah613Torah
    Participant

    Fever can also make some people too weak to eat or drink, which can be dangerous.

    #958219

    Agree with verapei. I’m a 2nd year med student. Ii is quite fascinating. endotoxins during an infection causes your body to produce cytokines (il-1, il-6 etc.). They cross into the brain where they cause a release of arachidonic acid (through PLA2 which NSAIDS stop etc.)which ultimately are synthesized to PGE2. Now, he anterior portion of your hypothalamus is what stops your body from overheating. The PGE2 when created within the anterior hypothalamus , creates a higher thermoregulatory set-point. This helps your body fight the infection. However if it gets over 42 Celsius (about 107.6 F), that is hyperpyrexia that can cause coma and irreversibly damage your brain (cerebellar purkinje cell particularly susceptible). Over 43 Celsius, you can’t survive. (Should not be confused with Hyperthermia, which is when your body overheats, without a higher set-point. Really fascinating stuff. I’m waiting for Health’s to chime in with his/her’s expertise

    #958220
    Health
    Participant

    MediumThinker -“to chime in with his/her’s expertise”

    Smells like sarcasm, but anyway it’s a him.

    “Ii is quite fascinating. endotoxins during an infection causes your body to produce cytokines (il-1, il-6 etc.)”

    I guess the “etc.” includes TNF-alpha, but this is not important for the general public. What is important is that there are two types of pyrogens -exogenous & endogenous. Cytokines are from the endogenous (comes from inside the body) and infections are from the exogenous (comes from outside the body). Both can cause fever.

    The main thing with s/o who is sick is Not their temp., but how they look and act. If they look sick -then they are until proven otherwise.

    Also, any fever over 103.6 degrees (39.8 Celcius) should probably take fever-reducing pills and seek medical care, not necessarily in a ER, but by your PCP, unless it’s obvious that the person has something like a cold. Also, if they have serious S & S (eg. not alert/responding, diff. breathing, dehydrated, chest pain, etc.) then they should go to an ER or call 911.

    #958221

    “Cytokines are from the endogenous (comes from inside the body) and infections are from the exogenous (comes from outside the body).”

    I think you did not completely understand what you wrote. it is not cytokines versus infections. The cytokines (TNF-alpha plays a minor role in this process) are usually released in response to an infection of some kind. I think you did not understand that this exogenous refers to exogenous substances that directly trigger release of cytokines (i.e. lps as a major role in gram -sepsis) as opposed to the other more regulated immunological response, which some term endogenous. I guess Wikipedia was unclear. Am I right in presuming that you are not a doctor?

    #958222
    Health
    Participant

    MediumThinker -“I guess Wikipedia was unclear. Am I right in presuming that you are not a doctor?”

    Let me explain you something those guys with a lot of Chutzpa and Gaava don’t end up to be good practioners. (Though almost e/o gets the degree.) Even a medium thinker can get into med school -it doesn’t take a good thinker to be able to reguritate your textbook.

    I hope you can comprehend the following:

    “J Endotoxin Res. 2004;10(4):201-22.

    Infection, fever, and exogenous and endogenous pyrogens: some concepts have changed.

    Abstract

    For many years, it was thought that bacterial products caused fever via the intermediate production of a host-derived, fever-producing molecule, called endogenous pyrogen (EP). Bacterial products and other fever-producing substances were termed exogenous pyrogens. It was considered highly unlikely that exogenous pyrogens caused fever by acting directly on the hypothalamic thermoregulatory center since there were countless fever-producing microbial products, mostly large molecules, with no common physical structure. In vivo and in vitro, lipopolysaccharides (LPSs) and other microbial products induced EP, subsequently shown to be interleukin-1 (IL-1). The concept of the ‘endogenous pyrogen’ cause of fever gained considerable support when pure, recombinant IL-1 produced fever in humans and in animals at subnanomolar concentrations. Subsequently, recombinant tumor necrosis factor-alpha (TNF-alpha), IL-6 and other cytokines were also shown to cause fever and EPs are now termed pyrogenic cytokines. However, the concept was challenged when specific blockade of either IL-1 or TNF activity did not diminish the febrile response to LPS, to other microbial products or to natural infections in animals and in humans. During infection, fever could occur independently of IL-1 or TNF activity. The cytokine-like property of Toll-like receptor (TLR) signal transduction provides an explanation by which any microbial product can cause fever by engaging its specific TLR on the vascular network supplying the thermoregulatory center in the anterior hypothalamus. Since fever induced by IL-1, TNF-alpha, IL-6 or TLR ligands requires cyclooxygenase-2, production of prostaglandin E2 (PGE2) and activation of hypothalamic PGE2 receptors provides a unifying mechanism for fever by endogenous and exogenous pyrogens. Thus, fever is the result of either cytokine receptor or TLR triggering; in autoimmune diseases, fever is mostly cytokine mediated whereas both cytokine and TLR account for fever during infection.”

    #958223
    Health
    Participant

    MediumThinker -“Agree with verapei. I’m a 2nd year med student.”

    If you or your friend “verapei” get into the third year and your handler tells you to go see a pt. – before you do it and come back to your handler and make a fool of yourself, ask the resident, intern, PA, NP or nurse for some pointers in general and what’s going on with your pt. You’ll still make a fool of yourself, but not such a big one. Also, before each rotation buy a student book on the rotation like Blueprints, Recall, etc. Read it before, during and afterwards.

    #958225
    twisted
    Participant

    I remember being swabbed down with alcohol to bring dowm the high fevers of my childhood. I can still recall choking on the vapors. In my recent bout with the flu, a retired doc told me to just stick my feet in cold water if the fevers go too high. Didn’t need to, but I tried it once, and it works.

    #958226
    Health
    Participant

    twisted -“In my recent bout with the flu, a retired doc told me to just stick my feet in cold water if the fevers go too high. Didn’t need to, but I tried it once, and it works.”

    There are a lot more modern ways to lower temp. besides taking pills.

    From the Mayo clinic:

    “You can try a number of things to make yourself or your child more comfortable during a fever:

    Drink plenty of fluids.

    Fever can cause fluid loss and dehydration, so drink water, juices or broth. For a child under age 1, use an oral rehydration solution such as Pedialyte. These solutions contain water and salts proportioned to replenish fluids and electrolytes. Pedialyte ice pops also are available.

    Rest.

    It’s necessary for recovery, and activity can raise your body temperature.

    Stay cool.

    Dress in light clothing, keep the room temperature cool and sleep with only a sheet or light blanket.

    Soak in lukewarm water.

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