Why does the temperature not go astray and what to do about it

Doctors recommend Fever treatment: Quick guide to treating a fever not to bring the temperature down to 38, 9 ° C (for children of the first months of life - up to 38 ° C), since up to this level it does not harm the body, but allows it to cope with the infection. But if the temperature is higher or lower than this value, but you do not feel well, you must fight it.

This is usually done with antipyretics such as paracetamol or ibuprofen. However, sometimes medications don't work. And for good reason.

Where does the temperature come from and what is it like

Temperatures above The pathophysiological basis and consequences of fever 38, 3 ° C are called fever or hyperthermia. Often these terms are used interchangeably, but this is not entirely correct: some doctors believe that there is a difference between them, albeit a subtle one.

What is fever

Fever is a physiological reaction that occurs in Pathogenesis of Fever when the amount of substances called "pyrogens" increases in the body.

Most often, pyrogens enter the bloodstream from the outside (these are called exogenous). These are, for example, viral particles, the membranes of various bacteria, as well as toxins produced by microbes. But sometimes the body produces pyrogens on its own (in this case, they are endogenous). This happens in various tumor processes, as well as in the overproduction of proteins released during the reactions of the immune system.

Pyrogens, along with the blood, enter a region of the brain called the "hypothalamus". In the human body, it plays the role of a thermostat: it sets, maintains and regulates body temperature.

If the hypothalamus detects that the level of pyrogens has increased, it begins to increase the temperature.

In general terms, this mechanism is simple and effective. Let's consider it on the example of a viral or bacterial infection.

A virus or bacterium enters the body → the amount of pyrogens increases → the hypothalamus raises the temperature → harmful microbes and viruses die under its action → the level of pyrogens falls → the hypothalamus reacts to this and lowers the temperature to normal. The infection is defeated, the person is healthy again.

This is how fever works against the background of ARVI. And that is why doctors do not recommend bringing down the temperature in case of a cold: it is necessary to cope with the infection. And after the victory, the hypothalamus "turns off" the heat itself.

However, there is an important but. Temperature acts well on exogenous pyrogens, destroying their source. With endogenous, everything is more complicated. For example, if they are formed due to a malfunction of the immune system, which for some reason begins to overproduction of protective proteins (these include cytokines, and the failure can manifest itself as a cytokine storm or other autoimmune reaction), then the hypothalamus will raise the temperature. But this will not destroy proteins, so it will not affect the level of pyrogens. As a result, fever can persist until the immune dysfunction ends.

What is hyperthermia

Not every case of high temperature is pyrogenic. The most obvious example of a non-pyrogenic origin is overheating. If you stay in an excessively hot room for a long time, your body temperature will begin to rise. Although there seems to be no inflammation in the body, and the level of pyrogens in the blood is not increased.

This reaction of the body, when normal thermoregulation is disturbed, is called KEY CONCEPT: WE TAKE A PATIENT'S TEMPERATURE BECAUSE AN ABNORMALLY HIGH OR LOW BODY TEMPERATURE INDICATES THAT SOMETHING IS WRONG; EXTREMES IN EITHER DIRECTION CAN KILL hyperthermia.

Hyperthermia can also occur after a traumatic brain injury that damaged the hypothalamus. Or for another reason that can disrupt the function of the "thermostat": due to failures in the blood supply to the brain and in the work of the nervous system, due to tumors, autoimmune diseases (the same systemic lupus erythematosus).

However, the line between pyrogenic and non-pyrogenic temperature increases is very blurred.

There is ample evidence of the pathophysiological basis and consequences of fever that conditions that are considered non-pyrogenic do cause an inflammatory response (eg, heatstroke). As a result, fever also joins hyperthermia - and it is almost impossible to determine which of these two factors plays a more important role in the increase in temperature.

Why the temperature does not go astray and what to do

Popular antipyretics in the most general terms cope with fever so the relevance of the use of NSAIDs in the treatment of fever in children.

First, they penetrate the bloodstream, are carried through the bloodstream throughout the body and reduce the activity of inflammatory processes. This reduces the amount of pyrogens. Second, they block the transmission of information about inflammation to the hypothalamus. As a result, the internal "thermometer" assumes that everything is in order with the body, the disease is defeated, and lowers the temperature. At least until the drug effect ends.

Based on this, several reasons can be deduced why sometimes the temperature is not knocked down by drugs.

Something is wrong with the antipyretic

Perhaps you did not look at the instructions and took too little dose. Or maybe the medicine has expired. Or it has lost its properties due to improper storage: for example, the tablets were left open in the bright sun or in a room with high humidity.

Sometimes drugs turn out to be fakes altogether - and, naturally, do not give the expected effect.

What to do

Morals like "Read the instructions" or "Watch the expiration date" are perhaps inappropriate here (although they are justified). If the pill did not work, that is, the temperature did not decrease after 30–40 minutes. Relevance of NSAIDs in the treatment of fever in children, an alternative can be taken.

For example, if a paracetamol-based product has failed you, take a medicine that contains ibuprofen. Or vice versa. It is considered safe to use these drugs together. Can I take paracetamol and ibuprofen together? for people over 16 and one of the tablets may work. To evaluate the effect, wait at least another 30-40 minutes after administration.

You do not meet the conditions necessary to lower the temperature

It is difficult to achieve a decrease in temperature if you lie under a warm blanket in a hot room, decide to actively exercise or, for example, have not drunk water for a long time: the liquid is needed so that the medicine dissolves faster and gets into the blood.

What to do

Your job is to help the body get rid of excess heat. Therefore, after taking an antipyretic, follow a few important Fever: First aid rules:

Get some rest. It is best to lie down and try not to move: when moving, the body temperature rises.
If possible, strip naked or wear as thin, breathable clothing as possible. The body must sweat, and the sweat must actively and without obstacles evaporate from the surface of the skin: it is this process that ensures effective natural cooling.
Check the room temperature. Ideally, it will not exceed 18–20 ° C.
Drink plenty of fluids. Even if you don't want to. Moisture is needed both for the production of sweat and for the effective action of antipyretic drugs.

Fever is caused by severe inflammation or other dangerous causes

Antipyretic drugs based on paracetamol or ibuprofen can easily cope with pyrogens with, say, ARVI. But if a more serious infection joins the cold, there are so many of these substances in the body that it is impossible to hide them from the hypothalamus.

The temperature may stop getting lost if the temperature in coronavirus - complete information viral infection has developed into extensive bacterial pneumonia.

Also, antipyretics do not work when it comes to systemic disorders in the body, provoking either a massive release of endogenous pyrogens or hyperthermia - we mentioned them above.

What to do

If, despite taking antipyretics and other measures, the temperature stubbornly remains above 38, 9 ° C, and even more so if it reaches Fever treatment: Quick guide to treating a fever 39, 4 ° C and continues to rise, contact your physician immediately and follow his directions.

If there is no way to consult a doctor, call an ambulance. Unbreakable high fever is a threatening symptom that often requires urgent medical attention.