Low Body Temperature: Causes and Management for Chronic Conditions

Q: Low Body Temperature: Causes and Management for Chronic Conditions

Hello： Your issue of having a low body temperature may be related to hypothyroidism, adrenal insufficiency, hypoglycemia, nutritional deficiencies, neuromuscular diseases, infections, and so on. <br>Additionally, the frequent cramping you experience may be associated with electro

Recently, I have noticed that my body temperature is abnormally low, at 34.7 degrees Celsius?

Hello, doctor.
I have a history of diabetes, hypertension, and kidney disease for 32 years.
My hemoglobin A1c was 6.6 in December last year.
I was diagnosed with myasthenia gravis in July 2019, and my neurologist prescribed me 2 tablets of Mestinon daily.
I have been taking Zestril 10 mg for nearly 30 years for blood pressure, which has remained stable.
After Zestril was discontinued at the end of 2019, my doctor switched me to Dapagliptin 160 mg, but my blood pressure was elevated around 170 with protein in my urine.
Subsequently, it was changed to Amlodipine 40 mg, but after some time, my blood pressure dropped (systolic 90, diastolic 55, pulse around 55).
It was then adjusted to Amlodipine 20 mg, but my blood pressure became unstable, fluctuating between high and low.
In December last year, my blood pressure started to rise again to around 170, and my doctor switched me back to Amlodipine 40 mg for observation.
During the pandemic, my temperature readings at hospitals and public places were normal (36.3-36.5 degrees Celsius).
In October last year, my thyroid T4 dropped to 0.89 and TSH increased to 23.
My neurologist added Levothyroxine 100 mcg every other day.
By the end of December, my T4 was 1.28 and TSH was 7.
Since last December, I have experienced difficulty concentrating, frequent falls, and insomnia (I have been taking Stanozolol 10 mg), and sometimes I still cannot sleep.
On January 4th, I fell and fractured a bone, and during a follow-up at the orthopedic hospital, my forehead temperature was only 34.7 degrees Celsius, consistent across several thermometers.
At home, using a Giotronic electronic thermometer, my axillary temperature has been around 35-35.3 degrees Celsius.
This has persisted, with multiple measurements throughout the day showing this temperature range.
I often wake up at night with leg cramps! I received four doses of the vaccine last October and have not contracted COVID-19.
My blood pressure is still normal.
What could be the possible reasons for this? How should I manage my medications?

Gao, 70~79 year old female. Ask Date: 2023/01/09

Dr. Lin Zhebin reply Family Medicine

Hello: Your issue of having a low body temperature may be related to hypothyroidism, adrenal insufficiency, hypoglycemia, nutritional deficiencies, neuromuscular diseases, infections, and so on.
Additionally, the frequent cramping you experience may be associated with electrolyte deficiencies.
It is recommended that you first consult with a specialist in metabolism and endocrinology.

Reply Date: 2023/01/09

More Info

Low body temperature, or hypothermia, can be a concerning condition, especially for individuals with chronic health issues such as diabetes, hypertension, and kidney disease. In your case, the persistent low body temperature readings (around 34.7°C to 35.3°C) are particularly noteworthy, especially since you have a complex medical history that includes diabetes, hypertension, and thyroid dysfunction.

Understanding Low Body Temperature
Hypothermia occurs when the body loses heat faster than it can produce it, leading to a core body temperature below 35°C (95°F). The body’s normal temperature range is typically around 36.1°C to 37.2°C (97°F to 99°F). When the body temperature drops, various physiological processes can be affected, including metabolism, cardiovascular function, and neurological health.
In your case, several factors could contribute to your low body temperature:
1. Thyroid Dysfunction: Your thyroid hormone levels indicate hypothyroidism (elevated TSH and low T4), which can significantly impact your metabolism and thermoregulation. The thyroid gland plays a crucial role in regulating body temperature, and low levels of thyroid hormones can lead to decreased heat production.

2. Diabetes and Kidney Disease: Both conditions can affect circulation and thermoregulation. Diabetes can lead to neuropathy, which may impair the body’s ability to sense temperature changes. Kidney disease can also affect fluid balance and electrolyte levels, which are vital for maintaining normal body temperature.

3. Medications: The medications you are taking, including those for hypertension and muscle weakness, may have side effects that influence your body temperature. For instance, some antihypertensive medications can cause vasodilation, leading to increased heat loss.

4. Inactivity and Muscle Mass: Muscle activity generates heat, and if you are less active due to your health conditions, this could contribute to lower body temperatures. Additionally, muscle weakness from conditions like myasthenia gravis may further reduce your ability to generate heat.

5. Environmental Factors: If you are in a cooler environment or not adequately dressed for the weather, this could also lead to lower body temperatures.

Management Strategies
To address your low body temperature, consider the following strategies:
1. Thyroid Management: Work closely with your healthcare provider to optimize your thyroid hormone levels. This may involve adjusting your medication dosage or exploring other treatment options.

2. Regular Monitoring: Keep track of your body temperature regularly, especially during different times of the day and under varying conditions. This information can help your healthcare provider make informed decisions about your treatment.

3. Medication Review: Discuss your current medications with your healthcare provider. They may need to adjust dosages or switch medications to minimize side effects that could be contributing to your low body temperature.

4. Lifestyle Modifications: Engage in regular physical activity as tolerated. Exercise can help improve circulation and generate body heat. Additionally, ensure you are dressed appropriately for the weather to minimize heat loss.

5. Nutrition: Maintain a balanced diet that supports your overall health. Adequate caloric intake is essential for energy production and thermoregulation. Consider consulting a nutritionist for personalized dietary advice.

6. Hydration: Ensure you are well-hydrated, as dehydration can affect your body’s ability to regulate temperature.

7. Consult Specialists: Given your complex medical history, consider consulting an endocrinologist for your thyroid issues and a nephrologist for your kidney health. They can provide specialized care and recommendations tailored to your needs.

Conclusion
Persistent low body temperature can be indicative of underlying health issues, particularly in individuals with chronic conditions. It is essential to work closely with your healthcare team to identify the root causes and implement appropriate management strategies. Regular monitoring, lifestyle adjustments, and medication management are crucial steps in addressing this issue and improving your overall health and well-being.

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