Do you want to lower a fever with Tylenol or is the fever actually the body's defense?
It's conceivable that mammals evolved fever to fight infection, and some authorities believe fever is the body's way of fighting off infection, but according to Dr. Rick Malley, "On the other hand, there's no evidence that blunting the fever response prolongs illness."
Why? "When people have too much fever, they don't eat, they don't drink, and they can become dehydrated. And they feel much worse."
Over at Shots, NPR's excellent Health Blog, Dale Moss wondered if it's really wise to treat a fever.
I was interested in hearing the answer, because this is something I've always wondered about myself--but of course I've always treated my family's and my own fevers with Tylenol.
Here's Dale's Question: "The body's main defense against viral illness is a strong fever, but the medical profession appears to be suffering a mass amnesia on this point." Wasn't it the aspirin used during the Spanish flu pandemic of 1918-19 that caused many cases of flu to "morph into a raging pneumonia", and that the medicine actually killed many people?
Thankfully, Moss has it all wrong, as Dr. Malley pointed out.
And as for the Spanish flu--it turns out that aspirin may have been responsible for many deaths, but it was because the doses given at the time were twice the amount considered safe today. Here's how aspirin may have caused the pneumonia-related deaths:
Dr. Karen Starko, who writes about the phenomenon in this month's issue of Clinical Infectious Diseases, notes that the suggested dose of aspirin in 1918 was twice the daily dosage considered safe today.
Aspirin toxicity, she says, can cause leakage of fluid into the lungs and account for some of the deaths attributed to viral pneumonia.
So, if you or your child get a flu-related fever, go ahead and treat it with Tylenol or Motrin. But, Malley does offer two important cautions:
- When a flu patient gets better and then worse again, this is an important danger sign that a bacterial infection may be following on the heels of the flu virus. Continuous treatment with anti-fever drugs can mask this signal. So Malley recommends reevaluating fever symptoms when each dose of Tyelenol or Motrin wears off, rather than automatically giving the next dose.
- Parents should never give their children aspirin (and teenagers up to age 19 should never self-administer it) to treat fever. The medicine can increase the risk of Reye's syndrome, a dangerous disorder involving buildup of fat around liver, brain and other organs.
Back when my kids were little & had a fever, I used to consult a handy dandy flowchart that helped me to figure out what they had, how to treat it, and when to call the doctor. My kids are long grown-up, and that chart is "history", but I was glad to see that NPR's Richard Knox provided this helpful link from the American Academy of Family Physicians.
By the way, when Dr. Malley's own kids recently got the swine flu, he gave them ibuprofen (Motrin) to lower their high fevers.