If Fever Helps Fight Infection, Should I Avoid Fever-Reducing Drugs? (2018)
nytimes.com
nytimes.com
"Mild fever helps clear infections faster, new study suggests
Research on fish shows waiting before reaching for medications may be beneficial for humans"
So basically nobody has a clue, but we are working on it.
Because for me, significant fever is always accompanied by some degree of malaise. Without drugs, the only way to relieve it is to conserve energy and immobilize.
My thought is that if you take the pain reliever so that you feel better and are able to do another task then this will likely increase the time needed to recover, since the body is not able to focus as much of it's resources on the immune system while you are doing something else.
If you take a pain reliever and it allows you to rest more effectively than you would be able to without it, maybe that would actually benefit the immune system though.
I’m going to bet the resting is more important than the not resting with a fever. But I’d love to know the scientific answer too.
When illnesses get really bad for me it’s usually because they’ve only let me sleep like five total hours in three nights or something like that, due to fever chills or lots of snot and a very-sore throat. The lack of sleep is what wrecks me.
Like I would expect microbes specialized to the human/mammalian system environment to be able to deal with the relatively small temperature range of fevers.
The selection pressure of fever is pretty well-suited to microbial evolution. It's very incremental, and microbes are known to live in a wide variety of temperatures. It seems much easier to get around than antibiotics, for example, which has of course happened.
However, there may have been a time when fever didn't yet exist and therefore the microbes were not yet able to handle it. As the feature evolved in mammals it was successful for a while since it dynamically changed the microbe's environment.
If this arms race process was slow enough the feature may be pretty deeply baked into the mammalian genome and persist today despite a relative lack of usefulness compared to the past and even some increased rate of death in the case of high fever.
When I have had a fever, it is not a significant absolute temperature change. Seems reasonable that the infection can handle it. It probably always needs to survive room temperate->human temps, so has mechanisms to cover a large gradient.
It's even possible that an excessive fever that kills you fast and takes the deadly disease along with it, rather than forcing your kin to spend resources caring for you and potentially catching the disease themselves, is evolutionarily beneficial.
EDIT On the former though I think we’d expect babies to be able to tolerate fever well and they really don’t.
Evolution doesn't care about babies, they are easily replaceable. Evolution doesn't care about the elderly, they have served their purpose. The most important thing is to keep people in their late teens to early thirties alive at all costs as these are the ones statistically most likely to successfully produce and raise offspring. It is no coincidence that this is also the age where people reach peak physical condition. Nature is brutal, but efficient.
Lots of mammals stand up and start doing things literal moments after they are birthed.
What’s also interesting is that we still have no idea about the mechanism by which acetominophen/paracetamol actually works despite studying it for 150y. https://medicine.tufts.edu/news-events/news/how-does-acetami...
There is a similar argument for inflammation, if you have a sporting injury or you have worked out and your muscles are sore, should you be taking anti-inflammation drugs or using massage guns which reduce inflammation, when inflammation is your bodies response to rebuild itself. By taking them you are reducing your bodies ability to repair itself, however you may experience less pain and discomfort as a result.
I also take a combination of Ibuprofen and Paracetamol (Acetaminophen), but only if I am in quite a lot of discomfort.
I find that in the winter it's important to eat warming food like soups, stews, broths. If I eat a cold sandwich or salad for lunch in the winter then I will often start to feel sick in the afternoon like I'm going down with a cold - a healthy evening hot meal will then restore my health.
Not everything, just enough that this is bad advice without serious qualification.
I feel like this covers that problem, no? Surely the kill-you-in-three-days problems must be very painful? And if they aren’t very painful, I wouldn’t be going to the ER anyways, so I’d die before my scheduled visit — surely at least a week out in most places I’ve visited
My hypothesis for COVID, that I don’t have good data for, was that it has an unusual immune system reaction profile with the long fuse being an under reaction followed by an overreaction and this overreaction could result in particularly damaging spiking high fevers. As someone with a preexisting auto immune condition the overreaction in particular worried me. I was worried that the use of fever suppressants early on in that process might exasperate the effect. I planned ahead of time to ride out the fever and was doing research into changes in mortality rates for Covid based on fever suppressants and I couldn’t find good data and was surprised by the lack of research to what seemed to me to be an obvious and extremely important question. Not having a good answer, especially for the Covid specific case, I decided to risk it.
When I did get Covid, post vaccine, it was a very rapid onset with a spiking fever of 106f (41c) which I knew was dangerous but again by the time that happened I couldn’t seek help. Thankfully that only lasted for about an hour and by the end of the day the Covid was basically gone.
I think in general I will try to ride out flus without fever suppressants and my N of 1 experiment seems to suggest that works. But agains selection criteria bias on that one. I really wish proper research gets done on this but I guess there isn’t much money in it.
Possibly a very high fever or some sort of dehydrating bowel disease?
I guess you could call applying pressure to and binding a wound OTC, and you could possibly die if you simply choose not to do that?
> The best evidence suggests that there is neither harm nor benefit to treating a fever with fever-reducing medications like acetaminophen or ibuprofen.