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When Should You Treat a Fever?

Elevated temperature can help the body recruit the immune system against infection. That's why you may not want to treat a fever unless it is very high.

The worldwide pandemic of COVID-19 has re-ignited an old controversy. When should you treat a fever, and when should you leave it alone? Fever is one of the primary early symptoms of this coronavirus infection, so many people have been taking fever-reducing medications. We heard recently from a doctor who points out that not every fever needs to be lowered.

Should You Treat a Fever With Ibuprofen?

Q. The French Ministry of Health warned against using ibuprofen to lower a fever from COVID-19. The public health experts might be right.

Americans often worry about fever. Many families and some institutions do their best to get it down. However, fever is a basic part of the immune system.

A miserable patient taking Tylenol, NSAIDs or even aspirin every once in a while is rarely a problem. How the drugs are used is critical, though. Generally, fever is your friend in case of infection.

Years ago when I was in medical school, sick children, babies and nursing home patients got alternating aspirin and Tylenol every four hours until well or dead. Too many patients did poorly.

In 2018, I found some nursing homes in Missouri were still attacking fever vigorously. I think that is probably a mistake.

Figuring Out When Not to Treat a Fever:

A. A few generations ago, healers recognized that fever could be an ally in fighting off an infection. They would pile on the quilts to try to keep patients warm when they had the chills.

When drugs like aspirin, acetaminophen and ibuprofen came along, many health professionals started recommending them to lower fevers. However, in the case of infections, fever may indeed stimulate the innate immune system (Nature Reviews Immunology, May 15, 2015).  The authors of this analysis point out that using drugs to treat a fever increases the likelihood of death from influenza by about five percent.

They add that lowering fever

“negatively affects patient outcomes in the intensive care unit.”

Of course, a really high fever requires medical attention. It can be be a marker for a dangerous situation, as it appears to be for COVID-19 (Journal of Gerontology. Series A. Biological Sciences and Medical Sciences, April 11, 2020). In some instances, healthcare professionals may deem it best to bring the fever down.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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