Why Do You Feel Cold When You Have a Fever?

It’s a common and somewhat confusing experience: you’re burning up with a fever, yet you’re shivering under layers of blankets, feeling intensely cold. This seemingly paradoxical sensation is a normal physiological response to illness. When your body is fighting off an infection, your brain actually resets your internal thermostat to a higher temperature. As your body works to reach this new, elevated set point, you may experience chills and feel cold.

This feeling of coldness is your body’s way of telling you it needs to generate more heat. Dr. Nate Favini, a primary care specialist, explains that chills are a signal that “your body tries to generate heat to raise your temperature by making your muscles contract,” leading to shivering and shaking. Essentially, your body perceives itself as being colder than its new target temperature, even though you have a fever.

Understanding Fever and Chills Duration in Adults

The duration of a fever and accompanying chills is highly variable and depends significantly on the underlying cause. According to Dr. Adalja, an infectious disease expert, fevers can range from lasting just a day with a mild viral illness to persisting for weeks or even months in cases of systemic infections.

Identifying the cause of your fever is crucial. Pay attention to other symptoms to help determine the source of your illness. Common culprits include viral infections like colds and the flu, bronchitis, pneumonia, appendicitis, gastroenteritis, mononucleosis, ear infections, sinus infections, and urinary tract infections (UTIs).

While infections are the most frequent cause of fevers, other conditions can also elevate your body temperature. These include inflammatory disorders such as lupus, rheumatoid arthritis, and Crohn’s disease, as well as cancer and blood clots, like deep vein thrombosis. Certain medications, such as penicillin, sulfa drugs, and antipsychotics, and even illicit drugs like cocaine, can also induce fever, as noted by the Merck Manual.

Managing Chills and Fever at Home

Generally, fevers and chills in adults tend to resolve within a few days, as the Mayo Clinic points out. For mild fevers, typically between 100°F and 102°F, without alarming accompanying symptoms (discussed below), rest and adequate hydration are usually the best course of action. Staying hydrated is crucial to support your body’s natural healing processes.

Despite feeling cold, it’s important to avoid overdressing or using heavy blankets. UPMC HealthBeat advises keeping clothing and blankets light to prevent overheating. Remember, while you feel cold externally, your core body temperature is already elevated. Over-insulating yourself can hinder your body’s ability to regulate its temperature effectively.

When to Seek Medical Advice for Fever and Chills

It’s essential to know when to seek professional medical help. The Mayo Clinic recommends contacting your doctor if your temperature reaches 103°F. Additionally, the Merck Manual advises consulting a healthcare provider in the following situations:

  • If you have a pre-existing serious medical condition, such as heart or lung disease, which could make even a moderate fever more dangerous.
  • If your fever persists for more than 24 to 48 hours.

Seek immediate medical attention if your fever and chills are accompanied by any of these alarming symptoms:

  • Changes in mental state, such as confusion or disorientation.
  • Headache, stiff neck, or both, which could indicate meningitis.
  • Flat, small, purplish-red spots on the skin, suggesting bleeding under the skin.
  • Low blood pressure.
  • Rapid heart rate or rapid breathing.
  • Shortness of breath or difficulty breathing.
  • Recent travel to regions with prevalent serious infectious diseases like malaria.
  • Recent use of immunosuppressant drugs.

Medication Options for Fever Relief

The Mayo Clinic suggests that in many cases, especially for healthy adults, allowing a moderate fever to run its course can be beneficial as fever plays a role in fighting infection.

However, if you are experiencing discomfort, over-the-counter fever reducers can provide relief. Acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil), or naproxen (Aleve) are common options. Always adhere strictly to the dosage instructions on the product label.

Be cautious about combining medications. Many over-the-counter remedies, including cough and cold medications, contain acetaminophen. Taking multiple products with acetaminophen can lead to liver damage if the total dose exceeds recommended limits. Always check the ingredients of all medications you are taking to avoid accidental overdose.

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