Lower Fever

Fever: when should it be lowered?

What is fever?

Fever is a known defensive strategy implemented by the body to enhance the immune mechanisms that protect it from the spread of bacterial or viral infections.

The sponging of fresh water (not too cold) on the forehead, neck, arms and legs represent an excellent remedy to lower high fever

Fever, which can also be the consequence of food poisoning, severe trauma or heavy psycho-physical stress, requires forced rest, given the sense of general malaise that accompanies it, interfering negatively with daily activities. Even this temporary respite from routine commitments is of considerable help for the recovery of health.

When to Lower it?

Lowering fever when it is not strictly necessary can therefore slow down the patient's healing process, proving to be counterproductive. This unconscious practice is generally used spontaneously to relieve the unpleasant symptoms often associated with high fever (headache, muscle and joint pain, nausea, general malaise), but also for fear of permanent brain damage. However, this danger only becomes real when the body temperature rises above 41 ° C; for this reason the use of antipyretics (drugs able to lower fever) in healthy adults should be considered a must only for severe hyperpyrexia (> 40 ° C), while for those "at risk" - as heart patients, elderly (in whom the febrile reaction is generally less intense), diabetics, debilitated patients or those with respiratory or renal insufficiency - the use of antipyretics to lower fever can be undertaken, on medical advice, even in more modest feverish states.

Fever is not a disease

Fever is a sign that something is wrong with the body, therefore, instead of asking "how to lower it?" it is good to ask yourself first of what caused it.

What should alarm a patient is therefore not the fever itself, but the presence of any concomitant symptoms; for example, when the fever rise is caused by the inflammation of the membranes lining the brain (meninges), the risk of permanent and irreversible neurological lesions is real, even for temperatures below 40 ° C. The patient should not therefore be frightened by the high fever itself, but by the concomitant onset of specific symptoms such as (in the case of meningitis) drowsiness, irritability, headache, muscle stiffness, hypersensitivity to light, rash (in bacterial forms) and possible convulsions (children). In pneumonia, a continuous-remitting fever is accompanied by cough, shortness of breath and polypnea (increased respiratory rate with short breaths).

How to Lower Fever

The symptomatic treatment of fever is, as a rule, of secondary importance with respect to the identification of the causes that produced it

Body temperature can be reduced by physical or chemical means. The former, often underestimated, include the generous intake of liquids and the sponging of lukewarm water, not too cold, on the body, particularly on the wrists, neck and legs.

drugs

The chemical means imply the use of antipyretic drugs, among which paracetanol stands out (active ingredient of the known registered medical specialties Efferalgan, Sanipirina, Tachipirina). The dosage in the adult is 300/500 mg every 4/6 hours; paracetamol can become dangerous at doses above four grams per day (in general it is advisable not to exceed 2.6 g / day); in the presence of liver disease it is preferable to use aspirin. Of all the NSAIDs, paracetamol is the drug with the lowest gastrolesive power. For these reasons it is the first choice antipyretic in patients with gastropathy and in children (8-15 mg / kg per os every 4/6 hours), who have no contraindications to its use.

Aspirin, despite having the advantage of minor hepato-toxicity, is characterized by some side effects to be taken into consideration before use: it interferes with blood coagulation, so its use must be carefully considered in patients at risk of bleeding ( for example in therapy with anticoagulants such as Coumadin, or antiplatelet agents); it has a gastrolesive power superior to paracetamol (attention in the presence of gastritis, peptic ulcer and gastroesophageal reflux disease); it must not be used by children under the age of 14 due to the known risk of Reye's Syndrome; it must not be used by people who are hypersensitive to acetylsalicylic acid (see aspirin allergy).

The dosage of aspirin as febrifuge in adults is 1.5-2 grams per day, divided into four doses.

As an alternative to aspirin, other NSAIDs can be used - such as oxicams (eg naproxen - Aleve, Momendol), ibuprofen (eg Moment, Antalgil, Nurofen) and diclofenac (eg Novapirina) - which they exhibit a powerful anti-inflammatory and antipyretic effect. Propionic acid derivatives (especially Ibuprofen, but also Naproxen and Ketoprofen ) are the best tolerated, often used for antipyretic purposes.

Even corticosteroids have a marked antipyretic activity, but they are not used for this purpose except for the presence of complications that justify their use.

Natural remedies

With medical advice, it is possible to use herbal remedies useful to lower fever and get some relief, making it better tolerable (it is not necessary, in fact it is not advisable, to bring the body temperature back to normal values ​​through the massive use of antipyretics). Among all, the bark of white willow stands out, rich in salicylates from which the famous acetylsalicylic acid (aspirin) already mentioned in the article is derived. The same goes for the Spirea Olmaria, from which the name Aspirin derives; for these two herbal drugs the same indications and contraindications of the known synthetic drug are valid. Diaphoretic drugs, medicinal plants capable of inducing profuse sweating, dispersing excess heat and consequently reducing body temperature can also be helpful in lowering body temperature; often taken in the form of hot herbal tea, they include: Lime, Chamomile, Cinnamon, Mint, Elderberry, Eucalyptus, Centaurea, Gentian and Rhododendron.