You wake up in the middle of the night feeling like your body is on fire. What's wrong?
You likely have a fever, and you will need to do something to bring your temperature down.
A fever occurs when your body temperature surpasses the usual average. The Cleveland Clinic says that most health care providers consider temperatures of 100.0 degrees Fahrenheit (F) to 100.4 degrees F or higher as indicative of a fever.
A fever is your body's natural defense against infections and illnesses, often resolving as the underlying cause fades. Yet, elevated fevers can prompt concerns and may make you question what to do.
This article provides expert guidance from Dr. James Keany, co-director of the emergency department at Providence Mission Hospital in Orange County, Calif. It explores adult fever temperature ranges, causes, fever reduction strategies, guidance for seeking medical aid and the validity of the "feed a cold, starve a fever" adage.
What's a fever in adults?
A fever is not an illness in and of itself, according to Johns Hopkins Medicine. Instead, it serves as an indicator that something is amiss in the body. The presence of a fever doesn't necessarily explain its underlying cause or signify the presence of a specific disease.
"Fever in adults can be caused by various factors, such as infections [like the flu or a bacterial infection], inflammatory conditions, certain medications, heatstroke or underlying medical conditions. The immune system's response to these factors leads to an elevated body temperature," Keany said.
“The immune mediators signal your brain to raise the temperature, like a thermostat in your home being set to a higher temp. Your body then causes you to shiver, to produce heat, or clamps down on the blood flow to your skin to reduce heat loss, and your temperature rises,” he added.
What are fever symptoms?
Typically, aside from the fever itself, you may experience one or more of the following signs and symptoms, the Mayo Clinic says.
- Perspiration
- Cold spells and tremors
- Aching head
- Muscular discomfort
- Decreased desire to eat
- Restlessness
- Lack of hydration
- Overall fatigue
Fever in adults: When to worry
An article from Harvard Health suggests that though any temperature above the normal range is considered a fever, there are grades of fever severity. The fever temperature chart for adults is:
- Low-grade fever: 99.1 to 100.4 degrees F (37.3 to 38.0 degrees C)
- Moderate-grade fever: 100.6 to 102.2 degrees F (38.1 to 39.0 degrees C)
- High-grade fever: 102.4 to 105.8 degrees F (39.1 to 41 degrees C)
This begs the question, when should you worry about fever in adults? Harvard Health suggests that if you have a fever of 104 degrees F or higher, you should call your doctor. Additionally, it is important to seek medical attention immediately if the high fever is accompanied by any one or more of these symptoms:
- Seizure
- Loss of consciousness
- Difficulty breathing
- Confusion
- Stiff neck
- Severe pain anywhere in the body
- Swelling or inflammation of any part of the body
- Discolored or smelly vaginal discharge
- Painful urination or odorous urine
How to reduce a fever in adults
The Mayo Clinic says that the primary reason to break a fever is to relieve discomfort and allow you to rest. Know also that when an adult has a fever of 103 degrees F or higher, they will generally look sick. To treat an adult fever at home, do the following:
- Drink plenty of fluids
- Dress in layers and wear lightweight clothing
- Cover up with a light blanket if you feel chilled
- Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Follow the directions on the label
Carrie Krieger, a clinical pharmacist in medication therapy management at the Mayo Clinic, shares in a video that, “Our first go-to medication is typically acetaminophen [Tylenol]."
Does ibuprofen help reduce a fever?
“Ibuprofen can help treat a fever in adults. It's a non-steroidal anti-inflammatory drug (NSAID) that can reduce fever, inflammation and pain. However, it's essential to follow the recommended dosage and guidelines, and you should consult a health care professional if you have any underlying health conditions or are taking other medications," Keany said. "People on blood thinners, steroids or lithium should avoid NSAIDs like ibuprofen. People with a history of bleeding ulcers or kidney problems should also use ibuprofen cautiously.”
Should I feed a cold and starve a fever?
Many have heard the old adage that you should feed a cold and starve a fever. This advice dates back as far as 1574, and this was common medical advice back in the day.
However, the Cleveland Clinic shares that this guidance doesn’t match today’s approach to modern medicine. Dr. Simon Hodes, general practitioner for Cleveland Clinic London, said, “Maybe feed a cold and a fever … and most of all, make sure to drink enough, too. Listen to your body. It will tell you what to do.”
When to seek medical attention for a fever in adults
"While high fevers make bacterial infection more likely, the height of a fever does not correlate to the severity of illness," Keany said. "Persistent fevers over 102.2 degrees F are just a sign that you should be checked. Once a bacterial infection has been ruled out, we often send presumed viral illness patients home with simple reassurance and self-care instructions.
“In elderly or immune-compromised people, any fever [above 100.4 degrees F] should be considered serious," he added. "A medical evaluation should occur as soon as possible, to rule out early sepsis in those individuals."
It's generally advisable to seek medical attention for fever in adults under the following circumstances:
- If the fever persists for more than a couple of days and doesn't improve with over-the-counter medications.
- If the fever is persistently high (above 102.2 degrees F).
Some circumstances may require immediate medical attention, such as:
- If the fever is accompanied by severe symptoms such as difficulty breathing, chest pain, confusion, severe headache or rash.
- If the fever is present in individuals with compromised immune systems, chronic medical conditions or during pregnancy.
SOURCE: James Keany, MD, co-director, emergency department, Providence Mission Hospital, Orange County, Calif.
