High Fever During Colds: When to Use Antipyretics

Whenever I catch a cold, I develop a high fever above 39°C, and I need antipyretics to reduce the fever?

Hello Dr.
Chen, in the past, I was able to remain active even with a fever of 39 degrees Celsius.
Even though I felt very uncomfortable, I would mistakenly think I had recovered and felt energetic as long as my fever dropped to 38 degrees, even though my actual temperature was still 38.
I typically catch a cold about once every six months, and when I do, I usually experience a high fever of 39 degrees, which requires antipyretics.
This time, it seems like I have type A influenza (I haven't been tested for the flu, but the clinic doctor suspected it, and I had a rapid test that was inconclusive).
On the first day, my temperature reached 40.5 degrees in the evening; I didn't faint and was able to get water and take my medication by myself, and I was conscious enough to chat.
My temperature remained between 38 and 39 degrees on the first and second nights and only started to slowly decrease to 37 degrees on the third day.
Today is the fourth day, and I only have a sore throat that feels like it's being cut, with my temperature around 37.0 degrees.
I feel that at my age, I shouldn't be experiencing such a high fever that requires antipyretics.
Could it be that my immune response is weaker than average? I want to understand the reason clearly.
My boyfriend suggested that I could get basic blood and urine tests to check my liver and kidney function or see a family physician, but I'm not very familiar with that.
Additionally, I noticed that I don't sweat at all when I have a high fever; I've been drinking enough water, yet I still don't sweat.
This is my situation, and I would appreciate your guidance.
Thank you!

Juzi, 10~19 year old female. Ask Date: 2023/04/13

Dr. Chen Bozhang reply Family Medicine

Hello, each person's constitution and medical condition is different.
If you have any concerns, it is recommended to visit a family medicine or internal medicine clinic at a regional hospital or higher for evaluation.
Thank you.

Reply Date: 2023/04/13

More Info

When dealing with high fever during a cold, especially when it reaches significant levels like 39°C (102.2°F) or even 40.5°C (104.9°F), it's essential to understand the body's response and the appropriate use of antipyretics (fever-reducing medications). Your experience of feeling relatively active despite a high fever is not uncommon; many individuals can maintain a certain level of functionality even when their body temperature is elevated. However, this does not negate the potential risks associated with prolonged high fever.

Fever is a natural response of the body to infection, and it plays a role in the immune response. The increase in body temperature can help inhibit the growth of pathogens and enhance the activity of immune cells. However, when fever becomes excessively high, it can lead to discomfort and potential complications, such as dehydration or febrile seizures, particularly in children.

In your case, since you experienced a high fever for several days, it is advisable to use antipyretics like acetaminophen (Tylenol) or ibuprofen to manage your symptoms. These medications can help lower your fever and alleviate discomfort. It’s important to follow dosing guidelines and not exceed the recommended daily limits, as excessive use can lead to adverse effects, particularly on the liver (in the case of acetaminophen) or gastrointestinal issues (with ibuprofen).

Regarding your observation of not sweating during high fever, this can occur due to various reasons, including dehydration or the body's response to the fever itself. Sweating is a mechanism the body uses to cool down, and if you are not sweating, it may indicate that your body is struggling to regulate temperature effectively. Ensuring adequate hydration is crucial, as fever can lead to increased fluid loss.

As for your concern about your immune response, it is possible that individual variations in immune function can affect how one responds to infections. Factors such as age, overall health, and underlying conditions can influence immune response. If you frequently experience high fevers or prolonged illness, it may be beneficial to consult with a healthcare provider for further evaluation. Basic blood tests and urine tests can provide insights into your liver and kidney function, as well as your overall health status.

In summary, while high fever can be a normal part of the body's response to infection, it is essential to monitor symptoms closely. Using antipyretics can help manage discomfort and prevent complications. If fever persists beyond a few days or if you experience other concerning symptoms, seeking medical attention is advisable. Your health and comfort are paramount, and understanding your body's signals can help you make informed decisions about your care.

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