Systemic Heat: Symptoms and Causes in Asthma Patients

Generalized heat sensation?

The patient is a young girl with asthma and a history of frequent bronchitis.
Her normal body temperature typically ranges from 36 to 36.7 degrees Celsius, not exceeding 37 degrees.
However, since early last year, her temperature has been between 37.2 and 37.5 degrees, occasionally higher.
On July 28, she suddenly experienced severe pain in her right lower back, with a temperature of 37.5 to 37.6 degrees.
She experienced alternating chills and feverish sensations, feeling hot from within her body, while the chills caused her to shiver all over.
It felt as though she was on the verge of a fever, but she did not actually have one.
She felt generally unwell, with a sensation of having strained her back, but by July 29, the pain suddenly subsided, suggesting a gradual relief from the strain.
On July 29, she continued to experience alternating chills and feverish feelings.
In the afternoon, she began to have cramping abdominal pain and diarrhea approximately five times, along with vomiting twice.
Around 1 AM, she woke up due to wheezing, although respiratory issues are common for her due to her bronchial condition.
The primary concerns remain the alternating chills and the intense heat sensation emanating from within her body, along with a general feeling of discomfort, but she does not have a fever and is not pregnant, as she is currently menstruating.

Yvonne, 20~29 year old female. Ask Date: 2021/07/30

Dr. Hong Yuanbin reply Internal Medicine

Based on your description, the most likely cause seems to be related to your menstrual cycle.
I recommend observing whether you experience this reaction during each menstrual period.
If so, you may consider consulting a gynecologist.

Another possibility is that recent significant changes in weather, including drastic temperature and humidity fluctuations, can easily trigger allergies or asthma attacks.
I suggest considering the use of air conditioning or a dehumidifier to maintain stable temperature and humidity levels indoors.
If discomfort persists, it would be advisable to consult a family medicine physician.
Thank you for your inquiry.

Reply Date: 2021/07/30

More Info

Understanding systemic heat in asthma patients can be complex, especially when symptoms like fluctuating body temperature, discomfort, and respiratory issues are involved. In your case, it appears that you have been experiencing a range of symptoms that may be interconnected, particularly given your history of asthma and bronchial issues.

Firstly, the concept of "systemic heat" can refer to an increase in body temperature that is not necessarily indicative of a fever. In traditional Chinese medicine, for example, this might be described as "internal heat," which can manifest as sensations of warmth, irritability, and other symptoms. However, from a Western medical perspective, persistent low-grade fever (like your temperatures of 37.2-37.6°C) can be associated with various conditions, including infections, inflammation, or even autoimmune responses.

Your symptoms of fluctuating temperatures, particularly the sensation of heat emanating from within your body, could be related to several factors:
1. Infection or Inflammation: Given your history of bronchial issues, it's possible that you may have an underlying infection or exacerbation of your asthma that is causing systemic inflammation. This inflammation can lead to an increase in body temperature as your immune system responds.

2. Asthma Exacerbation: Asthma can cause respiratory distress, which may lead to feelings of heat and discomfort. When your airways are constricted, your body may react by increasing heart rate and metabolism, which can contribute to a sensation of warmth.

3. Gastrointestinal Issues: The abdominal pain and diarrhea you experienced could suggest a gastrointestinal infection or irritation. Gastrointestinal distress can sometimes lead to systemic symptoms, including fever and malaise. The fact that you experienced these symptoms alongside respiratory issues suggests a possible systemic response to an infection or inflammation.

4. Hormonal Factors: Since you mentioned that you are on your menstrual cycle, hormonal fluctuations can also affect body temperature regulation. Many women experience changes in body temperature and discomfort during their menstrual cycle, which could explain some of the symptoms you are experiencing.

5. Anxiety and Stress: Asthma can be exacerbated by stress and anxiety, which can also lead to physical symptoms such as increased heart rate, sweating, and a sensation of heat. If you are feeling anxious about your symptoms, this could further complicate your experience.

Given these considerations, it is crucial to monitor your symptoms closely. If your body temperature continues to fluctuate or if you experience worsening respiratory symptoms, it would be advisable to seek medical attention. A healthcare provider can perform a thorough evaluation, including blood tests, imaging studies, or pulmonary function tests, to determine the underlying cause of your symptoms.

In the meantime, managing your asthma effectively is essential. Ensure that you are following your asthma action plan, using your inhalers as prescribed, and avoiding known triggers. Staying hydrated and maintaining a balanced diet can also support your overall health and immune function.

In summary, while your symptoms may be interconnected, they could stem from various causes, including respiratory issues, gastrointestinal distress, hormonal changes, or anxiety. A comprehensive evaluation by a healthcare professional is recommended to identify the underlying issues and develop an appropriate treatment plan.

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