The People's Perspective on Medicine

Show 889: Fever and the Immune System

What is the link between fever and the immune system? Learn why the traditional advice to encourage fever until it breaks might be on target.
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Fever and the Immune System

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How do you handle the fever of flu? Many people turn to OTC flu remedies for symptom relief, but nearly all of them contain a fever reducing medication such as aspirin, acetaminophen or ibuprofen. While these may help you feel better temporarily, such medicines may prolong the infection or help it spread.

The Benefits of Fever:

A century ago, before aspirin became popular, the old wives held to the idea of piling on quilts and blankets to sweat a fever out. New research on the biological effects of fever suggests they may have had the right idea after all. What is the story on fever and the immune system?

Fever for C Diff:

Influenza isn’t the only infection that is getting media attention. The incredible rise in gastrointestinal illness caused by C diff (Clostridium difficile) has caused a great deal of suffering. It can be extremely hard to treat. Now The New England Journal of Medicine has published a study of an unusual treatment.

We welcome listener questions and stories about how they deal with fevers and their favorite approaches to staying healthy.

This Week’s Guests:

Matthew Kluger, PhD, MBA, is a professor in the Department of Health Administration and Policy (College of Health and Human Services) with an adjunct appointment in the School of Management, George Mason University. His landmark research on fever was published in 1974 in Nature. He is the author of Fever: Its Biology, Evolution, and Function. (Princeton University Press, October 1979)

Sharon Evans, PhD, is a cancer research scientist in the department of immunology at Roswell Park Cancer Institute in Buffalo, New York.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I was interested to hear in your 1/19/13 show about a beagle in the Netherlands who had been trained to sniff out the presence of C. diff. It reminded me of an occurrence at Forsyth Medical Center (NC) in 2008.
My mother (age 95 then) had been admitted for a urinary tract infection. After several days of strong antibiotics, she developed severe diarrhea. Her doctors suspected C.diff., but were reluctant to start vancomycin due to her age. Thus began a week of fluids and agonizing watchful waiting. Eventually a colonoscopy revealed a partial blockage, and she was treated for that and recovered.
What fascinated me about the Dutch beagle was remembering a conversation I had with a CNA who worked day shift on Mom’s floor. I mentioned to Debra that the colonoscopy confirmed that C.diff. wasn’t present and she reacted with complete disbelief. “That wasn’t C.diff.!” she declared. I asked how she knew. “It didn’t smell like it”, as if I (and the entire medical establishment) was the most pathetic of morons.
At the time, it crossed my mind that if the docs had consulted the people who empty the bedpans, it would have saved thousands of dollars and a week of handwringing. I also wonder just how unusual Debra’s talent actually is. She is a very sharp lady, but it’s hard to believe she is the only human who can sniff out C.diff.
Has anyone out there had a similar experience?

I heard the show three weeks too late as I had the flu starting 2013-Jan-1. I took 162 mg ASA daily throughout, not remembering that I should have stopped the ASA to let my fever run. I hope I will remember next time as I am very interested in inducing fever to activate my adaptive immune system against any cancers I may have, including the precancer I have in the form of Benign Prostatic Hypertrophy.
I was ecstatic to learn that Sharon Evans, PhD, a cancer research scientist in the department of immunology at Roswell Park Cancer Institute in Buffalo, New York, was going to be on the show today, hoping she would be asked the question: when is Roswell Park going to conduct a study that will confirm that FEVER THERAPY WILL CURE CANCER? Unfortunately, the question was never asked. I look forward to the upcoming show featuring Dr. Evans, with the hope that she will confirm that such a study will be done. I’m not holding my breath though, knowing that such a study, if successful, would severely wound the Cancer Treatment Industry, including Big Pharma, who would stand to lose many BILLIONS if such a study were done. “Follow the money.” We will see.
Sincerely, Russ S.

I am also interested in the ENT doc who phoned in on the 19th and recommended vinegar for GERD. He also mentioned that asthma could be reduced (eliminated for some) by, I think, taking vinegar. Again, how much, how often?

I heard only a portion of the interview re/ fever, but the part I heard was great– Am interested in understanding how fever should/should not be managed in a patient receiving chemotherapy.

At the onset of flu symptoms I head for a long hot bath. IE just like grandma’s sweat it out. It works for me. I got a headache and other “feels like something coming on” symptoms and did a hot soak. Saturday I heard this program while doing the mail route and feeling fine!

The Mayo Clinic promotes that Saccharomyces boulardii (a form or probiotic yeast) may be beneficial in reducing risk of c. diff.
Personally I’m in treatment for lyme disease and taking several antibiotics. I take regular probiotics as well as s. boulardii (good yeast probiotic), to help promote good bacterial balance in my digestive tract.
Here is link to Mayo Clinic mention of s. boulardii.
I also read research on Oxford Journals that shows treatment of c.diff was more successful with combination of vancomycin and s. boulardii.
I think s. boulardii is really important and not discussed enough as a proactive action that can be taken to decrease risk of c. diff. I’m sure more research needs to be done, but for those struggling with c. diff, it may help to discuss this important probiotic with your doctor to see if it’s right for you.

I too would be very interested in dosages and kind of vinegar for relief when GERD is a problem. Thanks J.

I am being treated for C-diff the second time. It began 1-21-11 I learned I had MRSA in my artificial knee put in 8-22-06. My leg got red and swollen in the night. IA orthopedic doctor replaced plastic parts and cleaned out the infection.
I was on antibiotic IV until 2-7-12. In a nursing home and took my bedridden husband along since I could not care for him at home. I became anemic and was told to take an iron supplement pill on an empty stomach. This began 7-14-12. Diarrhea began that day and I was sure it was the iron so stopped that. Diarrhea continued and got worse.
I even had a colonopsy. All good. I was misdiagnosed. I ate meals sitting on a commode while the diarrhea ran out while I ate. I could not get to the bathroom in time.
After a month it was correctly diagosed as C-diff from taking antibiotic for the MRSA in my knee too long. When I was in the hospital in December 2011 a hospitalist doctor who was an infection doctor called on me. He gave me his calling card. When lab tests changed I wondered if he was seeing them and what he thought. I phoned him and got the message only physicians and Bellin health nurses should call. I was neither. When I had to see my primary doctor again who had been ordering the blood lab tests every 3 months.
Though at first were more often. He said he was not in touch with the infection doctor. August 9th was my husband’s funeral and 8-13-12 the orthopedic doctor just cleaned the infection out of my knee. My knee had looked bad. Now there was a new infection doctor and unlike the first one this one has office and follows lab tests, answers his phone so we have been able to talk with him. My daughter and the nurses as I was back in the nursing home 8-16-12 to 9-7-12 Later lab test were poor and the orthopedic doctor removed my artificial knee. And cleaned it. I was on antibiotic IV. 10-26-12 the surgery was doe and back to the nursing home October 29th and I am still there on January 29,2013. The lab test show infection gone . I forgot date so might be 2 weeks. I was to be off antibiotic 3 weeks and then orthopedic doctor would test fluid in knee. If no infection he would put in a new knee.
But January 12th I had a fever and loose bowels. I was told I had C-diff. I was put on antibiotic and now on appointment 1-22-13 with orthopedic doctor we will learn if he will test fluid in my knee and if we must wait to not be on antibiotic again for 5 weeks. I felt better after a few days and continue on what I think is bancomyacin liquid by mouth.
So I was glad to hear on your radio program 1-19-13 about C-diff. My family and I think the MRSA got in through a scratch about a inch long on my ankle on the same leg as all the knee troubles. I had not worn compression stockings on a hot day and went to buy shoes. The shoe man saw the scratch and I had to see a doctor. It was called an ulcer and got wrapped up my leg from foot to under knee. After a week it was healed. The skin was rough so I put Vaseline or lotion on it. The skin came off with my compression stocking and was bigger than the first time.
I went to my primary doctor instead of the podiatrist I saw the first time.. He sent me to Wound and Healing clinic in Bellin hospital. Everything was clean at podiatrist and the wound Hd and healing clinic. I had to soak my ankle. Perhaps it was my pan I soaked ankle in as I had not sterilized it.

I listened with growing anger to Dr. Kluger’s heartless description of an experiment in which helpless animals (in this case lizards) were subjected to conditions resulting in varying percentages of DEATH. When reaching the point of the experiment in which he almost euphorically reported 100% mortality, he actually said “…that was interesting”. Interesting?!!!! He killed ALL of his subjects and all he can say is that it was interesting?
When will science catch up with technology and understand that torturing and killing animals is not only morally wrong, but unnecessary? Computer simulations are rapidly obviating the need for animal experimentation.
I am 100% against animal experimentation for any reason — animals of all sizes and shapes value their ONE LIFE as much as we value ours. What right has anyone to take that away from them in the name of research — even if we didn’t have better methods at our disposal?
People like Dr. Kluger make me truly sick.

Actually, viruses are completely dependent on host cell metabolism, so aren’t inhibited by “anemia of inflammation”.
And I don’t know how you can imply that a temp of 107 isn’t dangerous; it’s extremely dangerous, and is rightly considered a medical emergency.

I’m so sick of western medicine mocking older (and eastern) traditions, finally realizing western ways don’t work, then torturing innocent animals to “prove” the old ways actually DO work. Can’t we just skip the middle part? Grrrr.

Important show.
In addition to not seeing damage from fever when, at 107, I expected to find some damage, patients taking no antipyretics got better from their disease faster and with fewer complications such as pneumonia.
Hydration is usually a challenge when temps go over 101.5 but usually can be done at home. A temp of about 102, unless during flu or other viral outbreaks and with typical symptoms, should probably be checked by a doctor to make sure there is not an infection of kidneys, tonsils or ears which need more than time to heal.
Fever is your friend.
Occasionally a patient with febrile seizures is seen with low grade temperature, has their seizure and is found after their spell to have a temp. over 104 – all in 15 minutes. These patients need individualized care and generally do well.
The rare patient with Reyes’ Syndrome these days has usually had Tylenol or Ibuprofen therapy for fever. I think giving a dose or two of Tylenol for comfort if a temp is over 102.5 doesn’t do any harm – especially if the child is miserable.
Limiting meats,iron fortified formula and vitamins with iron is also important in not thwarting the immune system’s efforts in infections. All bacteria and viruses need to get iron from your body to grow – try not to feed your enemy while infected.
Good info on c. diff – Cipro is also a major culprit in these overgrowth infections. Antibiotics for c. diff. quit working 5 or 6 years ago in Missouri.

On today’s show – 1/19 – mention was made re: vinegar for help in GERD. I am taking omeperazole and would like to discontinue this medication. Please advise in what usage vinegar can be taken. What type etc.
Many thanks, Martha

The hosts expressed surprise that the doctors in one case described by a caller would have recommended continuing vancomycin after the fecal transplant treatment. One possible reason to do this is to help prevent evolution of drug-resistant strains, which is made more likely if antibiotics are not taken for the full course. This is especially important in the case of “last line” antibiotics such as vancomycin. (But perhaps fecal transplants might be considered an “end of the line” treatment?)

Is there a pain reliever that’s not a fever reducer?

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