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Should you take Paracetamol when your body temperature is 100°F? Here’s understanding fever

Usually, the normal body temperature range swings between 97°F and 99.2°F.

In clinical practice, we say anything less than 100°F is not significant. We do not advise Paracetamol if your temperature reading is even slightly below 100°F.

Is 98.6 degree Fahrenheit or 37 degree Celsius — or what we call normal body temperature — too high? Should we revise this benchmark? People ask me these questions ever since a Stanford University revealed that the average human body temperature is decreasing and, in fact, swings between degrees, challenging a standard accepted since the 19th century.

Dr Julie Parsonnet and her team at Stanford University worked with 618,306 measurements of oral temperature from adult patients taken between 2008 and 2017. They found that the normal human body temperature naturally varies between 36.2°C and 36.8°C (97.3°F and 98.2°F), suggesting that the commonly accepted value of 98.6°F may be too high. Not only that. They found that in each decade since the 19th century, the average body temperature of people in the US decreased by at least 0.05°C. The authors believe that better living conditions, health awareness, diet and better healthcare had reduced chances of diseases and infections and, therefore, lowered body inflammation.

Does this affect diagnosis of fever? Not really. In clinical practice, we say anything less than 100°F is not significant. We do not advise Paracetamol if your temperature reading is even slightly below 100°F. We recommend rest and fluids and advise usage only when the thermometer reading goes higher to 101°F. Usually, the normal body temperature range swings between 97°F and 99.2°F. It is not possible for the body to maintain a certain temperature even during the day. It is higher in the afternoon and goes up further during the evening, the fluctuation happening by a few tenths of a degree.

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This variation is because of individual metabolism, height, sex, age, weight, diet, physical activity, hormones and existing medical conditions. Body temperature tends to decrease with age, with older adults above 60 experiencing slightly lower temperatures possibly due to less muscle mass and changes in metabolism. Children have a wider range of temperature differences, between 95.9°F to 99.5°F.

Sometimes, your body temperature depends on external conditions, be it extreme cold or heat, the nourishment of your body or the use of antidepressants and sedatives.

What is fever? Anything above 100.4°F. A moderate grade fever would be between 100°F and 102°F. A high grade fever would be between 103°F to 105°F. Anything less than 95°F means that the body is in hypothermia, when the body loses heat faster than it can generate it.

Which temperature reading is the most accurate? The rectal temperature is most accurate, one degree higher than the oral reading, which is the commonest. If you are recording temperature in your armpit, add a degree to assess if you have fever. The latest contactless infrared thermometers can be slightly lower than mouth readings. So add a degree to get a fair idea. Most importantly, sense your discomfort.

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(Dr Tickoo is Director, Internal Medicine, Max Superspeciality Hospital, New Delhi)

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