Temperature "good" and "bad". Why is fever dangerous and when should it be dealt with?

36.6 is not a constant body temperature of a healthy person; if you monitor it throughout the day, this value will fluctuate slightly. The lowest result, about 36 degrees, will be at the time of morning sleep. If a person is hot after physical activity, the temperature may rise slightly

Body temperature is affected by heat, humidity, and too warm clothing. Women experience a slight jump in temperature (by half a degree) on certain days of the menstrual cycle. But this will be a one-time increase. A cause for concern may be an increase in temperature from 37.2 to 37.9 over a period of more than a month - this is a low-grade fever.

If a low-grade fever lasts more than two weeks, and is accompanied by symptoms such as fatigue, poor sleep, shortness of breath, then you should not delay seeing a therapist. Often, a low-grade fever signals a problem in the body when other symptoms have not yet appeared.

Causes of low body temperature

Exhaustion of the body

A slight decrease in temperature is observed with long-term dieting, when the body experiences a deficiency of energy compounds and important microelements.
All metabolic processes slow down, the activity of tissue respiration decreases, and contractile thermogenesis in the muscles becomes insufficiently effective. I am worried about constant weakness for no apparent reason, there are headaches and dizziness. Even with moderate physical activity, you quickly feel overworked. The skin is pale and cold to the touch. Temperature values ​​are in the range of 34-35° C. Low temperature is a sign of exhaustion caused by grueling sports training or hard physical work. A person experiences weakness in the body, drowsiness, apathy.

Similar manifestations are characteristic of nervous exhaustion. With chronic stress, metabolic processes are disrupted and the body is unable to adapt to changing living conditions. Emotional disorders come to the fore; temperatures almost never fall below 34 degrees. You should see a doctor to rule out a more serious cause of hypothermia.

Hypothermia

Hypothermia occurs when wearing clothes that are too light during the cold season, staying in the cold for a long time, getting wet in the rain or falling into cold water. If body temperature is below 35° C, but above 32° C, mild hypothermia develops. During this period, there is a slight trembling throughout the body, the person tries to move his arms and legs to warm up. Due to active contractions of the masticatory muscles, the teeth begin to “chatter.”

The skin quickly acquires a bluish tint, which is most pronounced on the fingertips and face. At low temperatures within 28-32 degrees, the nervous system and metabolic processes are gradually suppressed. Due to the formation of a neuromuscular and vascular vicious circle, the body no longer maintains the temperature at the level necessary for life.

As the temperature drops, severe weakness, drowsiness, general lethargy increases, and hallucinations often begin. With severe hypothermia (less than 28 degrees), there is a high probability of respiratory and circulatory arrest. Failure to provide medical assistance at any stage of hypothermia is fraught with serious complications, including death.

Vegetative-vascular dystonia

Reduced body temperature during VSD is caused by impaired autonomic regulation and microcirculation disorders. Periods of hypothermia are characterized by weakness, trembling in the legs, and darkening of the eyes. If the patient is not helped in time, he may faint. Attacks develop periodically and are provoked by staying in a stuffy room, physical exertion, and prolonged stress. Symptoms occur more often in young, emotionally labile people.

Post-viral asthenia

During the recovery period after an infectious disease, a person’s body temperature drops below 36 degrees, which is associated with depletion of the body’s energy reserves and low activity of the immune system. Signs of hypothermia, increased drowsiness and symptoms of general malaise (weakness, fatigue, weakness) with post-viral asthenia persist for several weeks.

When walking fast or doing physical activity, you feel shortness of breath and your vision becomes dark. The duration of the period of low temperature depends on the severity of the infection and the body's reserve capabilities. Due to the lack of adaptive mechanisms in children, illness often lasts longer than in adults. Usually the condition improves gradually until the state of health and temperature are completely normalized.

Hypoglycemia

When blood sugar levels are less than 3 mmol/l, energy starvation of the brain and all tissues occurs, metabolism slows down, which causes a decrease in body temperature. At first, hypothermia is insignificant, weakness and dizziness are a concern, and profuse sweat appears on the skin. If the causes of hypoglycemia are not eliminated, the condition worsens and the temperature continues to decrease. With severe glucose deficiency, deep fainting occurs with a drop in the thermometer to 34° C.

Anemia

A decrease in body temperature is part of the anemic syndrome caused by low levels of hemoglobin and red blood cells in the blood. Temperatures are in the range of 34-35.5 degrees. Manifestations of hypothermia include increased fatigue, headaches, and “fly spots” flashing before the eyes. The appearance of hair deteriorates, nails crumble and break, and taste preferences change. The main causes of anemic syndrome:

• Deficiency anemia
  : iron deficiency, B12 and folate deficiency.
• Hereditary anemias
  : sickle cell, thalassemia, Minkowski-Choffard microspherocytosis.
• Posthemorrhagic anemia
  : with profuse external bleeding, internal bleeding, hemorrhage in the body cavity.
• Aplastic anemia
  .
• Hyperpolymenorrhea in women
  .

Hypothyroidism

Insufficient production of thyroid hormones slows down metabolism and inhibits the effects of the brain's thermoregulation center. These reasons cause the appearance of a constant low temperature, independent of external factors. The skin with hypothyroidism becomes very pale, waxy, and hair falls out due to microcirculation disorders. Hypothermia is accompanied by lethargy, weakness, drowsiness during the day, and even after a long sleep a loss of strength is felt.

Addison's disease

Corticosteroids produced by the adrenal cortex increase metabolic processes and help maintain normal body temperature. When their production is insufficient, the first symptoms are chronic fatigue and drowsiness, which gradually intensify as adrenal insufficiency progresses and precede the appearance of other disorders.

Low body temperature develops against the background of systemic disorders caused by the pathological functioning of various organs and systems - a drop in blood pressure, tachycardia, muscle weakness. The combination of temperature readings less than 32-33 ° C, a sharp decrease in blood pressure, lethargy or loss of consciousness means the onset of Addisonian crisis - a serious condition requiring immediate medical attention.

Depression

In depression, changes in associative connections between the hemispheres and hyperactivity of the limbic system disrupt the functioning of the thermoregulation center. As a result, the body cannot maintain normal temperature. Temperature values ​​rarely drop below 34.5° C, but hypothermia is prolonged. The skin, especially on the extremities, becomes cold, a marbled pattern appears due to capillary dysfunction, and pathological drowsiness is often a concern.

Pathology of the hypothalamus

With diffuse inflammation or hemorrhages in the hypothalamic region, a persistent drop in temperature below 32 ° C is typical, poorly controlled by warming. When the posterior hypothalamus is damaged, poikilothermia occurs - temperature fluctuations of more than 1 ° C associated with changes in the temperature characteristics of the environment. If a person with poikilothermia is exposed to a cold climate, they may experience a hypothermic coma with permanent brain damage.

Intoxication of the body

The accumulation of toxic compounds in the blood and their penetration into the brain disrupts the transmission of nerve impulses and the functional activity of brain tissue. Under the influence of toxins, body temperature decreases by 2-3°, the general condition quickly deteriorates - loss of consciousness and suppression of reflexes are typical. There is a waxy pallor and coldness of the skin, beads of sweat appear on the forehead. Such symptoms require emergency help to eliminate the cause of intoxication.

Emergency conditions

Temperature indicators rapidly decrease during shock conditions, when pathological expansion of superficial vessels occurs, and heat transfer increases several times. The general condition of the patients is extremely serious, body temperature drops 3-4 degrees below normal. Severe hypothermia combined with low blood pressure and chest pain indicates myocardial infarction.

The cause of low temperature can be ischemic stroke. When cerebral circulation is impaired, low temperature is accompanied by paresis of the limbs, sensitivity and speech disorders. Stunning, drowsiness, and short-term loss of consciousness are possible. A decrease in temperature and focal neurological symptoms usually increase gradually. In newborns, hypothermia is a consequence of asphyxia.

Complications of pharmacotherapy

Often, a low temperature is caused by taking psychotropic drugs that depress the central nervous system: barbiturates, benzodiazepines, clonidine. The side effect is associated with the suppression of muscle tremors and a decrease in heat production; due to the expansion of skin capillaries, the body quickly loses heat. Medicinal causes cause hypothermia only when dosages are not observed or when maximum doses are deliberately taken. An overdose of tablets leads to stupor or first degree coma.

Rare causes

• End-stage liver failure
  .
• Sepsis and septicopyemia
  .
• Comatose states
  : diabetic ketoacidosis, uremia, lactic acidosis.
• Iatrogenic factors
  : failure to maintain thermal balance during operations, low temperature in intensive care wards.
• Spinal cord injuries
  : spinal cord injury, tumors, syringomyelia.

What should you do if you notice a symptom?

If the patient is either cold or hot, what to do with the temperature? When he gets chills, he should cover himself with a blanket, and when it gets hot, put on dry, light clothes. You can cover yourself with a sheet. The patient's main regimen is bed. If the child does not want to lie down, make sure that he does not engage in too active games, preventing the body from overheating.

It is necessary to ensure that the air in the room is periodically renewed. While airing, the patient can go to another room. You need to constantly replenish fluid reserves in the body by gradually drinking green tea, diluted juices, fruit drinks, and compotes. Water procedures cannot be taken; only wiping adults with a solution of water and vinegar 9% in a 1:1 ratio is allowed. Rubbing yourself with alcohol or cool water can make your fever worse.

Urgently call an ambulance for chills

If the temperature becomes high, it is recommended to call an ambulance in the following cases:

• headache and temperature above 38.5°C, drowsiness, lethargy;
• stomach pain and fever, especially if there is also vomiting and diarrhea;
• rash;
• convulsions, other severe conditions;
• lack of effect from taking antipyretics;
• overcoming the mark of 39.5 °C.

The ambulance service of JSC "Medicine" (clinic of Academician Roitberg) in the Central District of Moscow provides medical assistance around the clock in case of emergency. An urgent call to the team can be made by calling +7 (495) 229-00-03.

When should you go to the doctor?

If fever and blood pressure, cough, and aches appear simultaneously, you should not self-medicate. It is recommended to make an appointment with a doctor. JSC "Medicine" (academician Roitberg's clinic) in the center of Moscow invites you to use the services of experienced therapists who will diagnose the disease and prescribe the correct treatment. You don’t want to put your health at risk, so make an appointment immediately to prevent complications from developing! The clinic has a modern diagnostic department, laboratories for testing, and a hospital. If the need arises, a full range of medical services can be obtained without leaving the clinic.

Diagnostics

A patient with thermoregulation disorders is examined by a general practitioner or emergency physician (in case of critical hypothermia). The scope of diagnostic measures depends on the patient’s condition and the degree of temperature decrease. At values ​​above 32°C, advanced laboratory and instrumental studies can be performed to identify the cause of hypothermia; at lower values, they are limited to basic methods. The most informative:

• Physical examination
  . First of all, to detect the cause of a person’s low body temperature, thermometry is performed. Temperature is most often measured in the rectum; an esophageal probe is used to obtain accurate information about the internal temperature. To assess consciousness, the integrity of the pupillary and pain reflexes is checked.
• Blood tests
  . The basic checklist includes measuring glucose, red blood cells and hemoglobin levels. A biochemical blood test can reveal high levels of nitrogen and urea, laboratory symptoms of liver disease. To diagnose anemia, the amount of free iron, ferritin and transferrin is determined.
• Hormonal profile
  . To exclude pathologies of the thyroid gland, the content of thyroxine and free T3, thyroid-stimulating hormones of the pituitary gland are taken into account. You also need to examine the amount of adrenal hormones and catecholamines. To confirm Addison's disease, an ACTH stimulation test and information about the levels of essential electrolytes are required.
• Electrographic methods
  . An ECG is recommended for all patients, which allows detecting pathognomonic signs - Osborne wave, prolongation of the PQ and QT intervals. To assess the functional activity of the brain, an EEG is prescribed. In a hospital setting, electromyography and electroneurography of peripheral nerve trunks are sometimes performed.
• X-ray imaging
  . A CT scan of the brain is the first thing to do to rule out central causes of low body temperature. The images may reveal mass formations or possible swelling of the hypothalamic region. Scintigraphy of the thyroid gland with iodine isotopes helps to study the structure of the organ in more detail.

When does a temperature of 37.5 to 38°C occur without symptoms?

Temperature without symptoms in the range between 37.5-38°C is observed:

• for problems with the thyroid gland;
• tuberculosis;
• allergies;
• neurological diseases;
• oncology;
• pneumonia;
• gastroenterocolitis;
• viral hepatitis A.

Do not forget about such serious diseases that occur with an increase in temperature, such as:

• systemic lupus erythematosus, rheumatism, other autoimmune processes;
• endocarditis, myocarditis;
• syphilis, gonorrhea, genitourinary infections;
• rubella, measles, other viral infections.

Treatment

Help before diagnosis

If the body temperature is more than 32°, you can get by with passive warming. The person is wrapped in heated blankets or placed in a bath with warm water and given hot tea. With prolonged hypothermia and satisfactory condition during the convalescence period, specific treatment is not required - sleep 8-10 hours a day, increased calorie intake, and adequate rest are recommended. If the reasons for the detected low temperature are unclear, consult a doctor.

First aid for hypothermia

Conservative therapy

At critically low temperatures, active warming is effective: heat fans and heating pads, inhalation of warm humidified oxygen and intravenous infusion of heated solutions. In emergency situations, warm lavage and extracorporeal blood purification methods are used. For etiotropic and pathogenetic treatment of diseases accompanied by a drop in human body temperature below 36 degrees, the following are prescribed:

• Vitamins
  . With general exhaustion of the body, B vitamins are indicated, which enhance neuromuscular transmission and improve the trophism of nervous tissue. Alpha tocopherol is used as a powerful antioxidant. For severe weakness, glucose solutions with vitamin C are administered.
• Hormones
  . Replacement therapy with levothyroxine allows you to accelerate the processes of metabolism and thermogenesis, and restore normal body temperature. In case of Addison's disease, cortisol preparations are necessary; in case of a lack of mineralocorticoids, aldosterone is additionally administered.
• Cardiotropic drugs
  . Medicines stimulate cardiac activity in shock and other critical conditions, normalize cardiac output and increase blood pressure. The drugs of choice for emergency care are solutions of adrenaline or dobutamine; in hospital therapy is supplemented with glycosides.
• Antidepressants
  . The medications are serotonin receptor agonists and improve neural connections between different parts of the brain. Temperature normalization occurs due to stimulation of the hypothalamic center and increased contractile thermogenesis.
• Antibiotics
  . Hypothermia often masks the manifestations of a severe bacterial infection, so broad-spectrum antibiotics are indicated for very low body temperatures. Medicines are administered intravenously until temperature values ​​normalize and general condition improves.
• Antidotes
  . For acute signs of intoxication, universal drugs are used that bind or destroy various toxic substances. In cases of heavy metal poisoning and drug overdose, unithiol is effective.

general characteristics

Temperature readings vary in absolutely healthy people throughout the day; in the morning the values ​​are a couple of tenths of a degree lower than in the evening.
An increase in values ​​of more than 37° C when measured in the armpit indicates a pathology of thermoregulation. Body temperature often increases gradually. First, prodromal symptoms appear - headache, body aches, general malaise, and later - a subjective feeling of cold, muscle tremors. As the readings increase above 38° C, the chill is replaced by a strong feeling of heat, the skin is hot to the touch, and there is a bright red blush on the cheeks. The general condition of the patients worsens, they refuse to eat. Lips become dry and cracked, and severe dry mouth is a concern. The period of persistently elevated temperature lasts from several days to a month or more, depending on the cause of the fever. Normalization of thermoregulation processes can be abrupt - with severe weakness, profuse sweats and hypotension - or gradual, when the general condition remains satisfactory. The child’s temperature rises faster, up to 39-40° C in a few hours.

Fever is always combined with other symptoms that correspond to the underlying pathology. Most often observed are abdominal pain and dyspeptic disorders, signs of ARVI. If a temperature of 37° C or higher in an adult persists for more than 2 days, you should consult a doctor. If a child has a fever, medical attention is required already on the first day of elevated temperature, since in childhood the mechanisms of thermoregulation are not developed, the fever is more severe.

Types of thermometers

On the Russian pharmacy market you can purchase different types of thermometers. Three of them are the most popular:

1. Mercury or maximum. Budget-friendly and easy to use. The bonus is high measurement accuracy. Widely used both at home and in various medical institutions, usually axillary. Two significant disadvantages are fragility and serious measurement time. Another disadvantage is that mercury vapor is poisonous, and therefore requires very careful handling of the thermometer.
2. Electronic or digital . It appeared relatively recently, but quickly became very popular. The reasons are the speed of measurements (from half to one and a half minutes), several varieties and a very reasonable price. A bonus is the ability to use different measurement methods. The only drawback is a certain scatter of values, which demonstrates the not very high accuracy of the device.
3. Infrared. An innovative and expensive thermometer. Measures temperature in a non-contact manner. The time required for measurement is only 2-5 seconds. It is not used axillarily, orally or rectally, and therefore has a limited area of ​​use.

Which doctor should I contact?

The list of conditions that can cause hypothermia is extensive. An accurate diagnosis can only be made by an experienced doctor, taking into account the results of a comprehensive examination. At the first symptoms of a decrease in body temperature, it is recommended to seek an initial consultation with a therapist. In the future, concomitant consultation with an endocrinologist, cardiologist, neurosurgeon, neurologist, urologist, otolaryngologist, nephrologist, gynecologist, infectious disease specialist, and hematologist may be required.

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Nervous and physical exhaustion

High physical activity, prolonged stress, lack of sleep, poor diet and strict diets often lead to a deficiency of the body’s energy resources. As a result: metabolism slows down, blood circulation slows down and the temperature drops below normal by 1-2 degrees. The pathological condition is accompanied by significant weight loss, apathy, weakness, fatigue, depressed mood or increased nervous excitability. There may be frequent headaches and decreased mental abilities. The person becomes distracted and inhibited. There is a weakened immune system and hypovitaminosis.

With physical and nervous exhaustion, body temperature steadily decreases to +35–35.5°C. The condition is accompanied by chills even in warm weather. This pathology is usually not life-threatening, but it is an alarming sign that requires urgent lifestyle changes.

When is hypothermia a sign of illness?

Physiological hypothermia does not provoke disturbances in general well-being and does not worsen the quality of life of people. At the same time, during the diagnostic process, pathological changes that provoke such a symptom are not detected. However, in most cases, readings below normal are a sign of some disease.

With moderate and severe hypothermia (32-27 degrees), the human body loses the ability to warm itself. Moderate hypothermia leads to drowsiness, apathy, tremors, tachycardia, and increased plasma glucose levels. When making a diagnosis, the general clinical picture, anamnesis (including family history), and the characteristics of the patient’s body are taken into account.

Possible complications

Possible complications depend on the underlying condition that provoked the decrease in body temperature. The patient may develop fibrillation, swelling of the brain and lungs, and the risk of developing acute renal failure increases. Infectious complications may occur: pneumonia, surgical wound infection. In long-term periods, patients with hypothermia develop neurological disorders.

If warming is not performed correctly, the process of thermoregulation is disrupted and blood pressure drops. A rapid increase in body temperature causes a reflex dilation of blood vessels, and cardiac arrest is possible.

Why is it dangerous?

The hypothalamus takes part in regulating body temperature. When indicators decrease, additional warming mechanisms are launched in the form of behavioral reactions and an increase in basal metabolism.

Temperatures that pose a threat to life include:

• less than 32.3 – development of stupor, severe lethargy
• less than 30 – impaired consciousness;
• less than 26 – probability of death.

The consequences after successful resuscitation measures are unpredictable. There have been cases of complete recovery after resuscitation of patients whose core temperature has dropped to 15 degrees.

However, in most cases, such a sharp decrease in indicators is fraught with generalized coagulopathy and rapid death. The danger arises when the victim is not warmed properly: the likelihood of a sharp decrease in blood pressure and cardiac arrest increases. To eliminate hypotension, use sodium chloride solution.

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