Afternoon Fever: Is It Normal or a Cause for Concern?

Elevated body temperature in the afternoon?

Hello, doctor.
Since mid-January, I have noticed that my ear temperature upon waking up is around 36.5-36.8°C, and from noon to around 10 PM, it ranges from 37-37.3°C.
After 10 PM, it drops to about 36.4-36.6°C.
My afternoon temperature tends to be higher, and I feel a bit warm, with occasional dryness in my mouth and warmth in my left armpit.
However, the doctors I consulted, including specialists in pulmonology, otolaryngology, hepatobiliary and gastroenterology, and hematology-oncology, could not find any issues after conducting numerous tests, including the following: complete blood count (4 times), urinalysis, chest X-ray, chest ultrasound, gastroscopy, nasal endoscopy, abdominal ultrasound, abdominal X-ray, neck ultrasound, and blood tests for ANA, ESR, LDH, and RF.
All these tests came back normal.
Is this temperature considered a low-grade fever, or is it normal? Could it be related to lymphatic or blood disorders?

A-Zhe, 30~39 year old female. Ask Date: 2018/03/16

Dr. Huang Xunying reply Family Medicine

The body's temperature is inherently variable and tends to be higher in the afternoon.
Therefore, we usually recommend that individuals drink more water during that time.
Your blood tests have already been conducted and show no abnormalities, and your temperature has not reached the definition of a fever.
It is advisable to increase your fluid intake, engage in regular exercise, and boost your immunity.
However, if you experience any fever symptoms, it is recommended to seek medical attention promptly.

Reply Date: 2018/03/16

More Info

Understanding afternoon fever can be quite perplexing, especially when it occurs without any apparent underlying cause. From your description, it seems that you have been experiencing a pattern of elevated body temperatures during the afternoon and evening, which can be concerning. However, it is important to note that slight fluctuations in body temperature throughout the day are normal due to various physiological factors.

Firstly, the human body operates on a circadian rhythm, which can influence body temperature. Typically, body temperature is lower in the morning and gradually increases throughout the day, peaking in the late afternoon or early evening. This natural variation can be influenced by factors such as physical activity, food intake, and even emotional stress. Therefore, a body temperature ranging from 36.5°C to 37.3°C during the afternoon and evening is generally considered normal, especially if it does not exceed 37.5°C.

Your experience of feeling "hot" or having a dry mouth during the afternoons could be attributed to several factors. Dehydration, for instance, can lead to a sensation of increased body heat. It is essential to maintain adequate hydration, particularly if you are active or in a warm environment. Additionally, anxiety or stress can also cause a subjective feeling of warmth, even if your actual body temperature remains within the normal range.

Regarding your extensive medical evaluations, it is reassuring that multiple tests, including blood tests, imaging studies, and endoscopies, have returned normal results. This significantly reduces the likelihood of serious underlying conditions such as hematological disorders or malignancies. Conditions like lymphatic or blood diseases often present with more pronounced symptoms, such as significant fatigue, unexplained weight loss, or persistent fever, which you have not reported.

If your body temperature continues to fluctuate within the range you mentioned and does not exceed 37.5°C, it is likely not classified as a fever. A fever is typically defined as a body temperature above 38°C (100.4°F). However, if you are experiencing discomfort or if the pattern of temperature changes becomes more pronounced or is accompanied by other symptoms, it would be prudent to follow up with your healthcare provider.

In summary, while your afternoon temperature readings may seem unusual, they fall within a range that can be considered normal for many individuals. The absence of significant findings from your medical evaluations is a positive sign. However, if you continue to feel unwell or if new symptoms arise, seeking further medical advice is always a good approach. It is essential to listen to your body and consult with healthcare professionals who can provide personalized guidance based on your specific situation.

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