Low "normal" temperature

[liz2mac]

Hi all, hope the sun is shining on you today, its grey here but very warm.

Do any of the rest of you have a normal temperature that is below what is usually thought of as "normal" I do. Mine is a constant 36.3. If it starts edging up from that I'm getting in to trouble and at 37 I've got into trouble.
The problems this causes me when I'm being seen by any Dr's / Nurses other than my Immuno team are not only annoying, it means I am sometimes denied treatment until things have really got out of hand. Next question. When my temp is taken in my ear, one ear is always hotter than the other. How can I have a temperature in one ear and not in the other?? Please tell me I'm not alone in these particular weirdness es.
Liz

[emsy]

Me too. My Temp is always low or normal when I feel ill which makes me think I'm measuring it wrong or something! I've just measured it now, I'm well (apart from a sniffley nose) and Its 35. I dont ever recall having a temp which is classed as high. TBH this is the 1st time I've checked what my "normal" temp is so at 35 degrees, no wonder I feel ill when its 36 or 37.

Do you tell your Docs what your normal temp is? because apparantly even a rise of 1 degree means there is a problem.

Regarding the differing temps in your ear....No idea! but it sounds like a typical CVID wierd thing that always seems to flummox everyone!

[gilliem]

Hi Liz and Emsy. My normal is 36.4 with very little variation. I think you'll discover that people with CVID very rarely run a fever, even when ill.
Best wishes,
Gillie

[mali42]

Hi Liz
temperatures has never been an issue with me,maybe because I have never been hospitalised but when I am ill with an infection i can be in my car on a very hot day and it feels great but Pat is gasping for air and wanting to stick her head out of the window.
I have just ordered my thermometer so I can see what mine is :-)

[susand]

Hi all,
Me too! My " normal" is between 35 -36, the average being 35.5.
When it reaches 37 I am really unwell.
I was told that temperature can vary in one ear or the other - once it was 33.9 and the other ear (the regular one) was 35 ish.

I have frequently run into nurses - not immuno ones though - who say "no temperature" when it comes up as 37. They just don't hear the explanation of my "normal" and cheerily insist that 37 is normal so nothing to worry about. Only when the trembling and shivers set in do they begin to get it!
Have a good weekend
Sue

[slf]

Hi
Susan that evokes so many memories,my fights with nurses over what is 'my'normal about 35.3 and theirs.
i have a feeling' normal 'changes according to circs. an italian nurse told me 38 but he just wanted to discharge me into the street,had to change his mind when he saw the x ray.
Presumably their must be a sort of science and discipline to having a certain figure.
take care
Steve

[mitchellle]

yep. My immuno actually uses it as a diagnostic marker now. Makes me nervous for my daughter.
Lora

[marksmom]

Hi all,
Mark is exactly the same. He has run a fever once or twice in the past ten years and we were in serious trouble when that happened -- although he does take chills when he's sick. His baseline temp is always low.

The way I understood Mark's immuno to explain this to me is that a fever is the first line of defense against infection -- if your body doesn't have a line of defense (i.e., no immunoglobins), there's nothing there to trigger that response. Hence, no fever when ill. Mark's fortunate to be surrounded by a team of great docs who really pay attention to what's going on and treat everything seriously. If we're in the ER and I'm not getting through, I have them call Mark's immuno, and they tend to take him a little more seriously after that.
Best wishes,
Rachel mom to Mark 10 CVID

[s162216]

Hi,

Fever is not really a product of immunoglobulins per say, its more a result of the release of inflammatory mediators and cytokines by neutrophils, macrophages etc as part of the primary immune response of which only IgM plays a part in. CVID, XLA etc doesn't really affect the primary immune response (except if your deficient in IgM but this doesn't play the biggest role in the primary response). If we didn't have any primary immune response then we would all be dead by now as there would be no system to at least try to reduce the infection until an 'adpative' secondary response can be generated. Fever is part of the primary immune response as it slows some bacteria from reproducing and spreading, but the problem is that just a one degree rise can start cause damage as proteins start to be denatured, hence why death occurs if the core temperature rise goes too high.

I certainly know that I get fever sometimes when I am ill, although the last time I was also in diabetic ketoacidosis as a result of the infection so thats a likely co-factor as well. I felt extremely cold despite wearing 3 fleeces and a coat yet I actually had a core temperature of 39.5 degrees when it was measured in the ED!

Sam

[liz2mac]

Sam, thank you for this. I sort of understand what you're sying, but it's so technical that I'm losing a bit of the thread of understanding.
Ok, the fever is set off by the parts of the immune system that start off the inflammatory response? IgM has a role to play in this set of actions of the immune system which involves cytokines,neutrophils, macrophages and other things?
Ok, if I've got that correct, does that mean that those of us who don't have IgM or who have neutropeania are possibly going to have problems getting a high temperature, which is a first line of defence that the immune system triggers?
Sorry to be so slow, but I'm trying to understand important stuff that is vert technical.
Liz

[liz2mac]

Hi Mitchelle,
the immuno who's told you about low temp being a diagnostic marker, is she/he based in the UK? Reason I'm asking is we're working on a UKPIPS poster for GP surgeries about diagnosing, and I'd love to talk to this immuno about it before we finalise it with our medical advisors.
Liz

[s162216]

Hi Liz,

Not quite - IgM has nothing really to do with inflammation, all it does is bind to and identify pathogens for destruction but its not very specific like IgG or IgA, these come with the secondary response.

Its the release of cytokines such as TNF-alpha and IL-1 from the 'innate' cells of the primary response, such as macrophages that cause fever, these enable the release of PGE2 (an inflammatory mediator) through the arachadonic acid pathway, this causes the shivering and alters the 'set point' of the bodies temperature in the hypothalamus causing a temperature rise, until its no longer present.
However, some bacteria also activate this pathway when macrophages bind to them to destroy them as they directly cause the release of cytokines in response.

Fever is actually useful to the body as it enhances some parts of the immune system such as T-cel proliferation and has actually been shown to reduce deaths from infections compared to when it is not present. In actuality its not until about 40 degrees or so that fever is a large worry, when it reaches 42 degrees though, thats when anyone is in trouble.

Sam

[slf]

Sam
So the GP all those years ago told me my thermostat was faulty was'nt so far out,or do I misunderstand. I have regularly (hundreds) suffered these violent shivering spells over the years so I really would like to understand why
Steve

[liz2mac]

Sam,
thank you so much for trying to make me understand. You know and understand so much. It would be so good if we can get together an "idiots guide" to all of this so that it makes sense to those of us without a scientific back ground.
Task nos 009 for UKPIPS? Lol!
Liz

[mitchellle]

Liz, unfortunately, no. I'm American, specifically in Ohio. (I was a long-time PIA support board member and am a mod on the Facebook page.)
That being said, both my Immunologist and Infectious Disease specialists have said essentially the same thing- that it's really normal in Immunodeficient patients. If you have limited resources for fighting off disease, wasting them on a body temp isn't efficient.
It's worth noting that it IS a diagnostic marker to move HIV patients from Stage 1 to Stage 2, for exactly those reasons. We may be a different mechanism, and usually a different piece of the immune system, but the science is the same so I expect it will be included officially sooner than later for us.

[liz2mac]

Hi Mitchelle,
wow, it's so good to have you here. Seems to me that the more of us get talking worldwide, the better our chances of treatment for our children & ourselves. I have to get this symptom recognised in UK medical circles. It's nearly cost some of us our lives.
Thank you so much for your input.
Liz

[bamber]

I spoke to my G.P this morning and told him I had very sweaty nights last two nights and shivering together. He said to me with your history - you must be bad? Think he understood that just taking temp not enough. I must have got bad to have those effects so needed extra care.