When I was little and became sick with a cold or the flu and a fever, my 200 lb., 100% German mother would stand over me with an ice-filled glass of ginger ale and utter one word: drink. No please or pretty please needed. My temperature was monitored, and I remember one time it reached 103℉. She immediately put me in a lukewarm bath with an ice-cold rag on my forehead. Presto, the fever went down, plus I continued pounding ginger ale. My mother was raised on a dairy ranch west of Missoula, Montana, on the Clark Fork River and had learned from her German mother that you didn’t eat when you were sick plus, apparently, quite a bit of German hydrotherapy. After I had reasonably improved, she would test me with a piece of dry, white toast. If my symptoms didn’t relapse, I was off again to the food races.

Animals appear to be as smart as my mother. An example was my son’s cat several years ago. He was the best hunting cat I’ve ever seen. When he walked outside, all the Steller’s jays began squawking to warn everyone. Every day and night, out he went to satisfy his killer instinct. One afternoon, he didn’t move from the couch. He didn’t arise to eat or drink and just wouldn’t budge. I took him to the vet the next day who used a rectal thermometer to ascertain he had a fever. A subcutaneous pouch of water and a subcutaneous antibiotic later had him harassing birds the very next day.

So, fever—thumps up or thumbs down? If you believe the marketing departments of various over-the-counter cold and flu remedies, thumbs down. If you believe in vis medicatrix naturae, thumbs up. My father taught me to walk down the middle of the road though, so we’ll see that fever can be both a thumbs up and a thumbs down depending, of course, on the individual situation.

I taught physiology at a small junior college in Northeastern California for 30 years. On the first day of class, I would try to demonstrate the wisdom of the body by outlining what positive and potentially negative physiological effects fever provides in your body. First off, when a microorganism invades your body, it releases a microbial product called an exogenous pyrogen which is phagocytized by a white blood cell and the WBC subsequently releases an endogenous pyrogen (Interleukin-1). Interleukin-1 travels to the hypothalamus where it raises the temperature set point for your body and leads to the following:

• Shivering
• Increase in your metabolic rate
• Restricting blood flow to the skin to minimize heat loss
• Piloerection (raising the small hairs), which suppresses sweating (sweating is a cooling mechanism)
• Sleep to preserve energy for the immune system to battle the invading microbes
• Muscle aches caused by break down of muscle tissue to ship amino acids to the liver to build immune system proteins
• Liver building proteins for optimal functioning of the immune system (complement, antibodies)

• Decreased appetite due to increased amino acids in the bloodstream
• Increased temperature: Most bacteria and viruses reproduce more effectively at lower temperatures than those created by endogenous pyrogens
• Decreased gastrointestinal motility, which also leads to decreased appetite.

Quick Side Thought: Eat or fast when sick? Analogy: Try to sleep after a large meal; it leads to issues sleeping because the body is trying to digest the meal. The same should apply to acute illnesses. Digesting a complex meal requires a substantial energy outsource, which logically would take away from the energy needed by the immune system to fight the invading microbe.

The fever, in turn, launches several beneficial bodily processes that either directly or indirectly help to ward off the invading microbes. Some of these benefits include the following:

• Increase in antibodies produced by cells trained to specifically attack the exact type of invader that your body is suffering from

• Increased white blood cells to improve the innate immune system response
• Additional interferon, a natural antiviral and anticancer substance that helps block the spread of viruses to healthy cells
• Walling off iron, which bacteria feed on
• Improved phagocytosis of microbes by white blood cells

Fever also impairs the replication of many bacteria and viruses.

Remember, the point of the fever is to stimulate the immune system and create an inhospitable environment for invading organisms, essentially turning up the heat high enough to impair multiplication of the invading microbes and render them more effectively neutralized. So anytime you lower a fever artificially, you’re making your body more hospitable to the invading pathogens. Lowering a fever with medications also masks your symptoms, which may lead to return of your normal activities too soon, when your body could still benefit from extra rest.

Multiple studies over the years have shown negative immunological sequelae with the use of analgesic/antipyretic medications. One study in 1990 showed that use of aspirin and acetaminophen was associated with suppression of the serum neutralizing antibody response, a longer duration of viral shedding, and increased nasal symptoms and signs.¹

Another more recent and extremely more relevant study from Yale investigated the effect of NSAID’s on SARS-CoV-2 in human lung cells in vitro and in infected live mice. On the positive side, the NSAID’s dampened the inflammatory cytokines that can lead to a cytokine storm and death in SARS-CoV-2. On the negative immunological side, the NSAID’s dampened the production of protective antibodies against the SARS-CoV-2 virus.²

In most cases, rest, herbal remedies, and plenty of fluids are all that’s needed when a fever strikes. Fever does increase fluid loss. It’s important to drink plenty of fluids, even if you don’t feel thirsty, to prevent dehydration.

There are some instances, however, when a fever does require medical attention:

• Fever in an infant younger than 6 months (at any temperature)
• Fever above 104
• Fever that lasts longer than 3 days or the cause is not known

In children 5 years and younger, fever can also lead to a type of seizure, known as a febrile seizure. Though this can be frightening, it typically will cause no lasting effects. During a febrile seizure, lay your child on his/her side, loosen any tight clothing, and support the child to prevent injury. When the seizure stops, you should seek medical attention right away to be sure the seizure was not caused by something other than the fever, such as meningitis or bacteria in the blood.

So, final analysis: fever is a positive reaction of your body to an invading microbe. Cognitive dexterity is required to differentiate when supporting the fever is the positive choice and when the fever and microbe have gained the upper hand and medical help is required.

N.B. I have taken zero money from ginger ale producers. Thanks to my mother for being my first naturopathic hydrotherapy teacher.

References

1. Graham NMH, et al. Adverse Effects of Aspirin, Acetaminophen, and Ibuprofen on Immune Function, Viral Shedding, and Clinical Status in Rhinovirus-Infected Volunteers. J Infectious Diseases. Dec. 1990;162 (6): 1277-1282

2. Chen JS, et al. Non-steroidal anti-inflammatory drugs dampen the cytokine and antibody response to SARS-CoV-2 infection. J Virol. Published online January 13, 2021:JVI.00014-21, jvi;JVI.00014-21v1.