Most people will experience fevers in their lifetime, yet there is little common knowledge about what exactly a fever is. 

Our body temperatures are ruled by the hypothalamus gland, which regulates body temperature through metabolic processes, either heating or cooling as necessary. 

Physiologically, a fever is created by the hypothalamus gland raising the body temperature in response to detecting bacterial proteins in the body, or the detection of cytokines, which are chemicals released in the body at the site of an infection. The raising of the body temperature is a defense mechanism of the immune system that attempts to kill various viruses and bacteria because they do not tolerate high temperatures. 

The following list demonstrates the relationship of body temperature to pathogen disruption. It is taken from Bergner’s Acute Symptoms CD set. 

99⁰: Influenza can no longer replicate

104⁰: Gonococcus is negatively affected

104⁰: polio virus is reduced

106⁰: pneumonia dies (hydration is extremely important) 

106⁰: spirochetes die (syphilis and lyme’s)  

Paul Bergner sites human fever trials in which researchers concluded that lowering a fever with aspirin or NSAIDs increases the severity of subjective symptoms and length of infection. 

Not only does the temperature of the body affect pathogenic growth, but fevers also increase blood circulation through the body, thereby helping to deliver a better immune response. Bergner reports that antibody production is increased 20 fold during a fever. 

Rethinking 98.6

We commonly think of 98.6 as being a “normal” static temperature; however, there is actually a range of temperatures that are considered normal, and it’s more likely that a person’s temperature will vary throughout the day. Anyone regularly taking their temperature can quickly see that morning temperatures can vary significantly from afternoon temperatures. It’s a good idea to know what your “normal” is. If your normal temperature is 98^o, then having a temperature of 99^o is more of a fever for you than someone whose normal temperature is 98.6^o. 

The following information pertains to a healthy adult. Cautions when dealing with children, the elderly, and people with compromised vitality will be addressed later. 

Starve a fever

Ever wonder why it’s commonly said to starve a fever and feed a cold? When a person’s temperature rises one degree past their normal set point their natural appetite disappears. This is due to amino acids in the body being used for the immune response rather than for digestion. Ingesting bone broth soups and nutritious teas and infusions will serve you much better than eating while you have a fever. Once a temperature returns to normal, regular foods can be introduced back into the diet. 

Bergner also points out that during a fever the body experiences natural detoxifications. The body’s increased circulation and pulse mean increased blood flow through the liver and kidneys. Sweat releases toxins through the pores. Even the intestine can act as a detoxifying organ as well if a person is not eating. 

The Four Stages of Fever

In this next section we will be looking at the four stages of a fever. These are outlined as clear and distinct phases to give you a way of thinking about how a fever is manifesting in the body. It is most helpful to think of these stages as guidelines to support you in making herbal choices while also keeping in mind that these stages may fluctuate and blur around the edges. 

First stage of the Fever

The first stage of the fever is the immune system gearing up. As discussed above, the hypothalamus detects the need to raise the body’s set point temperature. In this first stage the patient often feels cold as the body attempts to heat up. Shivering, which raises the metabolism up to 30%, may occur and there is usually an aversion to cold and to wind. 

In this stage we often instinctually reach for more clothes, take a warm bath, or crawl under the covers. By taking these actions we are helping the inherent wisdom of the body by taking care to warm up! 

We can further help by administering warming herbs and warming or stimulating diaphoretics. Warming/stimulating diaphoretics increase the core temperature that then radiates to the surface. 

WARMING AND STIMULATING DIAPHORETICS 

Yarrow (Achillea millefolium)

This stimulating diaphoretic works by opening the pores to let the heat out. Yarrow has a strong taste and I like to tame it a little by using the tea blend mentioned on page 17. You can also take a dropperful of the tincture in a quarter cup of warm/hot water. 

Garlic (Allium spp.)

Take one bite of a fresh clove of garlic and you’ll have no doubt about this potent herb’s facility to heating the body. Garlic has many healing properties that make it an invaluable herb for colds and the flu. You can read more about garlic on page 18.

Bee balm (Monarda spp.) and Thyme (Thymus spp.)

These two herbs have very similar actions, although I find bee balm to be even spicier. These are two delicious herbs that can be enjoyed as teas. 

Ginger 

I love to drink ginger decoctions or as a chai blend. More about ginger can be found on page 17. 

Since we are trying to raise our body temperature, it makes sense to drink our teas hot/warm during this stage. Also, it’s important to note that many diaphoretic herbs are more diuretic when taken cold. 

Second Stage of the Fever

The second stage is when the body temperature has reached the set point. (Physiologically antibody production is optimized at 103^o. Bergner recommends paying attention to fevers over 104^o.) 

In the second stage of the fever the pulse may be rapid and strong, and the skin may feel warm and dry. Drowsiness may also result. No longer is the patient shivering. 

Of course, once we have a fever the temperature is rarely set in stone. It’s quite normal to see temperatures rising and lowering slightly. 

During a fever it’s common to experience general achiness throughout the body. These aches are from muscle tissue being broken down as a result of amino acids being taken from the muscles. Once these amino acids are freed up they are utilized in anti-body production, white blood cell production, and tissue repair. Boneset, which we will discuss below is specific for helping this phase of a fever. 

During this stage having a ventilated room is important and emphasis is on lukewarm drinks rather than hot beverages. Hydrotherapy can also be employed by taking tepid (not cold) baths. 

During the second stage of the fever we use relaxing diaphoretics including: 

Boneset (Eupatorium perfoliatum) 

Boneset has been an important herb historically during intense flu outbreaks. The common name most likely refers to its use during an illness when the “bones feel like breaking.” It was used extensively during the flu outbreak of 1918 as well as for dengue (an acute febrile infection in the tropics) outbreaks. 

It is specific for when you feel the aches and pains of a fever. 

Boneset also has immunostimulant properties and has been clinically shown to increase phagocytosis more effectively than Echinacea (Buhner page 75). This may make it another important regimen at the beginning stages of a cold or flu. 

If you feel the aches creeping in, have a ½ cup serving of warm boneset tea. Drink this bitter herb too hot and it can cause vomiting. Not safe for use during pregnancy. 

Herbalist Sausha Daucas commonly uses boneset as a tincture. She reports: 

“I use ten drops of the tincture in hot water, every half hour for up to five doses to encourage sweating. For ongoing flu symptoms (or herpes) I use 10 drops 4 times daily. If taken during the prodromal stages of flu or herpes, very often neither condition will express. If used later in the course of a flu, many cases will clear up quickly. It should be taken no more than 5 days running, which is seldom necessary: I advise clients that if it’s working, they’ll feel better after the first day or two at most.”

 

Bergner also recommends it as a wonderful preventive. 

Elderflower (Sambucus nigra, S. canadensis)

Elderflower is a relaxing diaphoretic that is effective, yet extremely gentle. Young children, expecting mothers, and elders can use this herb as needed. One common formula is to mix elderflowers with mints. I usually take my elderflower in a tea blend as on page 17. You can also place a cup of elderflowers in a quart mason jar, fill with just boiled water, strain after a half hour and then drink lukewarm. 

Catnip (Nepeta cataria)

Another safe yet effective plant, catnip can be especially useful during fevers due to its high potassium content. Its mild taste makes it a good choice for little ones. 

Lemon Balm (Melissa officinalis)

Another relaxing diaphoretic, lemon balm can also soothe the nerves to allay stress and reduce the duration and painfulness of fever blisters (herpes virus). 

The Third Stage

During the third stage of fever the hypothalamus lowers the set point temperature to normal. The body’s cooling response is to sweat profusely. This “breaking of the fever” involves profuse sweating and is often accompanied by the throwing off of the covers. 

It’s normal during this third stage for there to be a fluctuation of temperatures, so a person may feel chilled and then too hot, then chilled and then too hot and so on. In the end the temperature can often linger about a degree too high and will then, eventually, fall to normal. 

In this stage the highest risk from harm is due to dehydration. Throughout all the stages of a fever a person should be kept well-hydrated, but this becomes especially important during this stage due to the large loss of liquid through the sweating process. 

According to Heather Nic an Fhleisdeir you can make your own electrolyte blend by mixing together the following in a cup of warm water. 

Electrolyte Blend: 

Teaspoon of apple cider vinegar or citrus

Teaspoon of honey

Pinch of salt

Fourth Stage of the Fever

The fourth stage involves repairing and healing. Bergner recommends bed resting for two days for every three days of fever. It’s also important to eat easily digestible protein, to shower, to change sheets and generally making sure you are nourished, rested, clean, and comfortable. Returning to a regular regime too quickly can further compromise your immune system, leaving you more susceptible to sickness in the future. 

Cautions and Considerations with Fevers

In a normal person a fever has to get extremely high before it will cause injury. Human cells start dying at 110^o. 

Truly the highest risk from fevers is from dehydration and electrolyte imbalance. 

However, there are special considerations when dealing with infants and the elderly or anyone who has a compromised immune system such as AIDS, cancer, or prolonged illness. 

For example infants and elders with a fever of 101^o can be considered the equivalent of someone else having a fever of 104^o. 

Unfortunately it is still common to immediately give aspirin to someone who has a fever, even though the fever is an important function of the immune system. 

Bergner relates a review published in the conservative medical journal The New English Journal of Medicine that looked at the treatment of fevers. It concluded that there are three classes of people for whom lowering the fever is beneficial. 

• People with heart disease (because the heart has to work really hard during a fever). 
• Very weak patients (increased metabolic demand may be too much). 
• Some cases of pulmonary disease. 

Febrile seizures: 

A febrile seizure is a convulsion triggered by a rise in body temperature. 

Bergner points out that it is a myth that high fevers cause febrile seizures. If children are prone to febrile seizures then that seizure will happen as easily at 101⁰ as it will at a higher temperature. 

Paul Bergner:

Febrile seizures in children are not correlated with the severity of the fever. The cause is generally unknown, and they affect 3-5% of children in the U.S. and about 15% in some countries. Giving antipyretic drugs does not reduce the incidence of future seizures in children. Most disappear by age five. Most do not indicate a serious cerebral disease 

If a baby is experiencing a febrile seizure it is recommended to place the baby on their side to allow for saliva to flow from the mouth to keep the baby from choking. If a seizure lasts longer than 5 minutes call 911. 

Herbalist Kiva Rose told me about using elderflower for those children who are prone to febrile seizures. It’s believed to help reset the fever mechanism. 

In treating fevers use your best judgment and remember our job is to support the body’s natural functions, not quell symptoms. Fevers can be serious – if in doubt see your family practitioner. 

A fascinating amount of information can be found on the acute CD symptoms set by Paul Bergner including more physiological understandings and historical formulations for the different stages.