the many benefits of fever

WHY “HOT” IS GOOD
WHEN YOU ARE SICK

Fever

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“Despite this evidence, treatment of fever is common in the ICU setting and likely related to standard dogma rather than evidence-based practice. Despite its long history of study, the exact mechanism of fever and its potentially protective effect is not fully delineated. One could hypothesize that treatment of fever compromises immune competence and renders patients more susceptible to infection. Take, for example, the classic experiment by Kluger in 1981. Here, Kluger infected cold-blooded iguanas with bacteria. He gave them the opportunity to seek heat via sunlamps and all but one sought the warmth to raise their temperature. The one who did not was the only one who died. Next, he injected the iguanas with bacteria and gave them antipyretics. The iguanas that were able to mount a fever despite the antipyretic were the only ones that survived. This simplistic experiment, in addition to the biologic plausibility for the beneficial effects of fever, now supported by several key randomized controlled trials, suggests maybe the pendulum is due to swing back to a more permissive approach to fever.”  Cherry -picked from the December, 2015 issue of The Journal of Thoracic Disease (Fever: Suppress or Let it Ride?)

There is a book that every parent (and grandparent) should have on their shelves.  World renowned pediatrician Robert Mendelsohn’s HOW TO RAISE A HEALTHY CHILD IN SPITE OF YOUR DOCTOR is like having a doctor on call when your child is sick — especially important for new parents!

Although most parents tend to panic when fever strikes their child, remember that fever is the number one way that your body fights off infections.  As the father of four children, I certainly realize that fever can be scary.  But in general, children older than two or three who do not appear to be in distress; fever is positive evidence of an active immune system that is being revved up to help a whole array of immunological processes work more effectively. Some of the numerous benefits of fever include things like…..

  • FEVER KILLS INFECTIONS:  Fever has the ability to kill invading organisms via heat.
  • FEVER IS A NATURAL ANTIBIOTIC:  Fever stimulates antibody production specific to the infection.  In all but the worst of the worst infections, this is far better than ANTIBIOTICS.
  • FEVER BOOSTS IMMUNE SYSTEM FUNCTION:   Fever causes more interferon to be produced to block the spread of viruses to healthy cells.  The body also makes more chemical mediators to specifically fight invaders.  Collectively these are known as INFLAMMATION, and in the correct amounts, are vital for your health.
  • FEVER INCREASES LEUKOCYTE PRODUCTION:  Fever stimulates production white blood cells which mobilize and attack invaders.
  • FEVER INCREASES MACROPHAGE PRODUCTION:  Macrophages are cells that go to combat when intruders are present in the body. These cells actually “eat-up” the invading organism — kind of a Pac Man meets ‘The Blob’ sort of thing.
  • FEVER DRAMATICALLY BOOSTS CHEMOTAXIS:  Each degree of fever doubles the speed that your White Blood Cells (Immune System cells) can get from point A to point B.  Four degrees of fever means that your WBC’s are moving 16 times faster than normal (2x2x2x2).

Unfortunately, what have we been trained to do in the face of fever?  Most parents freak out!  I routinely have parents call me on the phone and say something like,  “Oh my goodness Dr. Schierling.  Little Johnny has a temperature of 102.  Should I give him an ice bath.  Do I need to go to the ER?  I have been giving them Children’s Tylenol; should I give them more?”  Instead of letting the body embrace the fever to fight and kill the invading infection like God created it to do in the first place, too many people want to use anti-fever drugs —- drugs like ACETAMINOPHEN, IBUPROFEN, and ASPIRIN by themselves or in combination, which can be dangerous, or even deadly.

It’s very important to think of a fever as an integral part of your healing process.  And like Dr. Mendelssohn likes to remind parents, “The most difficult thing to do when your child is sick, is to do nothing“.  To be certain, he is not advocating doing “nothing“.  Rather, he is telling parents that they need not run to the doctor because of a fever, except in rare cases.  Instead of trying to lower a fever through medication, try to work through it and allow it to run its course.  Consume copious amounts of liquids such as broths and water until the fever breaks. Because a fever slows down the movement of food in THE GUT (peristalsis), avoid solid foods.  And do not forget to rest.  Fever dramatically increased metabolism and energy use.  Activity uses the body’s essential energy needed to fight invading organisms, and hinders immune system function.

I often recommend actually taking a very hot shower or bath, putting on sweat pants, a sweat shirt, and a stocking cap; then climbing into bed and using lots of covers.  Often times, artificially inducing a fever — or increasing a low grade fever, is actually helps kick your illness quicker.  This is fairly simple to understand once you understand the many benefits of fever.

DR SCHMITT’S WORK
In 1980, Dr. Barton D. Schmitt, a professor of pediatrics at the University of Colorado School of Medicine, published the now classic article about what he termed Fever Phobia.   He believed that many parents were basically terrified by almost any fever — even low grade fevers, believing that their child was neurologically in danger.  A group at Johns Hopkins University looked back and re-evaluated Dr. Schmitt’s work in 2001, publishing a paper in the journal Pediatrics, called Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?.  Their conclusion was that the fears and misconceptions about fever have not changed.

As many as 5 percent of children are at risk for seizures with fever. These seizures can be terrifying to watch but generally are not harmful and do not cause epilepsy. Still, a child who has a first-time febrile seizure should be checked by a physician. (These seizures tend to run in families, and children who have had one may well have another.)   Children between the ages of 6 months and 3 years seem to be the group most prone to these kinds of seizures. If your child does have a fever-induced seizure, there is a chance that the seizure may occur again.  But most of the time, children simply outgrow them.

Dr. Michael Crocetti, lead author of the 2001 study and associate professor at Johns Hopkins University had this to say, “Parents are telling us that they’re worried that fever can cause brain damage or even death in their childrenI’ve been doing this for a long time, and it seems to me that even though I do a tremendous amount of education about fever, its role in illness, its benefit in illness, it doesn’t seem to be something they keep hold of from visit to visit.  Dr. Schmitt believes the fear comes from, “doctors and nurses who weren’t taught about fever and all the wondrous things fever does in the animal kingdom.    Doctors are part of the problem.

Dr. Janet Serwint, another of the study’s authors who is both a colleague of Schmitt and a professor of pediatrics at Johns Hopkins, echoed his sentiments, I personally think there should be much more education about this……. the helpfulness of fever — how fever actually is a well-orchestrated healthy response of our body.

OFFICIAL” FEVER GUIDELINES:
According to the American Academy of Pediatrics, if your child is younger than two months of age and has a rectal temperature of 100.4 degrees Fahrenheit or higher, you should call your pediatrician immediately. Children older than 2 months of age with a fever of 102 degrees or higher that does not respond to fever-reducing medication should be seen by a doctor.  Just remember, although these medications might help with some of the associated discomfort, treating your child’s fever will not help the body get rid of the infection any quicker.  In fact, it might prolong the illness (HERE).

When a child’s temperature reaches 105 degrees, this is considered a medical emergency and the child needs immediate medical attention, according to the American Academy of Pediatrics.

After asking my brother (he and his wife are both ER Physicians) what they do for children with high (105 range) fevers, I was almost amazed by his answer.  Most of the time, they give these kids Tylenol and send them home with instructions to return if things don’t improve in a timely fashion.

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