By Tamara Hew-Butler, Wayne State College
As flu season progresses, so does the refrain of recommendation, skilled and in any other case, to drink loads of fluids and take fever-reducing medicines, like acetaminophen, ibuprofen or aspirin.
These suggestions, well-intentioned and firmly entrenched, supply consolation to these sidelined with fever, flu or vaccine unwanted side effects. However it’s possible you’ll be shocked to study the science supporting these suggestions is speculative at greatest, dangerous at worst and comes with caveats.
I’m an train physiologist who focuses on learning how the physique regulates fluids and temperature. And primarily based on a large physique of proof, I can inform you that elevated fluid consumption and taking fever reducers, whether or not aspirin, acetaminophen or ibuprofen, might not all the time assist in your restoration. In actual fact, in some instances, it may very well be dangerous.
There’s a cause why folks say fevers must be lowered when sick or after a vaccine. Each aspirin and acetaminophen, resembling Tylenol, cut back fever, complications and muscle aches. However on the identical time, seminal and newer research, together with broad meta-analysis research, present that these medicines might weaken the immune response to an infection or have undesirable unwanted side effects.
What’s a fever?
First, some background: Fevers are a regulated improve in core physique temperature as a response to undesirable microbial invaders.
The extra extreme the an infection, the upper the fever.
Having a fever shouldn’t be all dangerous; it’s how the physique has developed to recuperate from an an infection. For a lot of species, fevers are advantageous and helpful for survival.
However fever comes with a price. A physique temperature that’s too excessive will be lethal. For each improve of 1.8 levels Fahrenheit, metabolism goes up 10%; the physique begins to burn extra energy than regular, temperature continues to rise and the physique releases hormones to maintain fever below management.
Many research show what can occur when fever reducers are thrust into this complicated dance. It seems aspirin or acetaminophen might trigger contaminated folks to really feel higher, however additionally they unfold extra virus whereas suppressing their very own immune response to the an infection.
In a single double-blind, placebo-controlled research, wholesome folks contaminated with a chilly virus who took aspirin or acetaminophen for every week had a lowered immune response and a rise in viral shedding – which means producing and expelling virus particles from the nostril. One other research confirmed that taking aspirin successfully lowered fever signs however elevated shedding.
Though a few of these conventional research occurred a long time in the past, their outcomes nonetheless maintain up at the moment. A latest research warned that if everybody took fever suppressants, there could be even extra flu instances and flu-related deaths. Moreover, elevated physique temperature – or fever – may also help battle COVID-19 by lowering the progress of the virus inside the lungs. In different phrases, fevers may also help the physique battle viruses whereas lowering the speed of dying and illness.
To stop dehydration, the Facilities for Illness Management and Prevention recommends consuming extra fluids when one has a fever or an infection, or has acquired a COVID-19 vaccine. However there may be scant scientific proof to help this advice.
It’s true that consuming fluids when dehydrated is vital to cut back fever. However not everybody with a fever is dehydrated. For many who aren’t thirsty, forcing fluids past thirst, which is commonly disagreeable, is probably not advisable.
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A research that evaluated the recommendation to “drink loads of fluids” decided that growing fluid consumption when sick might not supply advantages, and that extra high-quality research are wanted. Certainly, there was a possible danger from overhydration. For some folks, three liters, or about 12 eight-ounce glasses, is an excessive amount of. Overhydration could cause nausea and vomiting, complications and cramps; in extreme instances, extreme fluid consumption could cause seizures or coma.
Right here’s why this occurs. To cease harmful escalations in fever, the physique releases antidiuretic hormones. Urination is diminished, so the physique retains water by way of the actions of the kidneys. So if somebody with a fever drinks extra water than vital, water intoxication – or hyponatremia, a probably deadly medical situation through which a affected person’s blood sodium ranges are too low – might comply with.
One research discovered that just about 1 / 4 of sufferers who got here to the hospital with COVID-19 had hyponatremia upon admission. In that research, hyponatremia elevated the necessity for respiratory help within the type of air flow. And one other research confirmed that the situation can result in poorer outcomes in COVID-19 sufferers.
So perhaps it’s time to rethink the traditional knowledge. If the fever is delicate or average, keep heat, even use blankets, quite than attempt to actively cut back it. Relaxation, so your physique can battle the fever. Preserve power as a result of your metabolism is already on overdrive. Use fever-reducing medicines sparingly. Drink fluids, however solely to tolerance, and ideally when thirsty.
And one ultimate suggestion that must be soothing: When combating a fever or vaccine unwanted side effects, contemplate sipping heat liquids that include sodium. Broths containing sodium, like bullion, might assist keep away from hyponatremia. And though the precise scientific proof is sparse and conflicting, rooster soup could also be a greater antidote than water when warding off a fever or flu signs.
Tamara Hew-Butler, Affiliate Professor of Train and Sports activities Science, Wayne State College
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