Why Should You Use Fever Reducers Cautiously During Respiratory Infections?
Alternate use of Tylenol and Ibuprofen is a common practice for treating COVID-19
At the end of 2021, a 14-year-old boy, the son of my wife’s colleague, was infected with the Delta strain of SARS-CoV-2 and developed a high fever. With no effective antiviral treatments available, his only option was to take Tylenol to reduce the fever. Although Tylenol temporarily alleviated his fever for 4-6 hours, it returned once the drug's effect wore off. After multiple doses and cycles of fever reduction and resurgence, he was rushed to the local ER. Did the doctors offer a better solution for COVID-19? Unfortunately, no. Their recommendation was an unconventional one: alternating between Tylenol and Ibuprofen.
This approach is understandable, as Tylenol and Ibuprofen are the primary fever-reducing options available. If one doesn't work, you try the other; if neither works alone, you try both. This alternating use of antipyretic drugs gained popularity during and after the pandemic, despite the lack of clinical studies to evaluate its safety and efficacy. After several days of this treatment, the boy’s fever finally subsided, and he "recovered" from the Delta infection.
Why did he become sicker when he contracted the milder Omicron?
In the summer of 2022, the same boy contracted Omicron. Surprisingly, his symptoms were more severe than during his Delta infection. He experienced chills, fatigue, body aches, and difficulty breathing. Given that Omicron is considered less virulent than Delta, why did he experience more severe symptoms?
For those familiar with traditional Chinese medicine (TCM), the boy's response to Delta can be classified as a high-energy Yang state, whereas his response to Omicron can be classified as a low-energy Yin state. This shift from a Yang to a Yin state suggests that the antipyretic treatment during the Delta infection significantly decreased his body's energy level, compromising his immune response to Omicron. Fever is a part of the body's immune response to control viral replication, which requires sufficient energy. Thus, the absence of fever indicates a low energy level, and symptoms like chills, fatigue, and body aches are signs of low energy.
Key Questions Arise:
Is Fever Beneficial or Harmful During Respiratory Infections? Should We Reduce Fever or Not?
There's no straightforward answer. Fever is a natural immune response to infection that can suppress pathogens but can also cause tissue damage. Immune response is a double-edged sword. Instead of asking whether we should reduce fever, the focus should be balancing the immune response. A well balanced immune response should be strong enough to repress pathogens, but its tissue damage should be within the repair capacity of the body’s self-healing power. According to the recently published article (1, 2), a human's self-healing power is the most important factor for surviving infection, because it functions in controlling and repairing the damages caused by both pathogens and immune responses. And diseases are really all about structural and functional damages. Once the self-healing power is promoted, it can repair damages and allows a stronger immune response to control pathogens. Thus, promoting self-healing power and balancing immune response is the most effective way of treating infectious diseases, which is exactly how TCM treats infectious diseases (1, 2).
Why Do Fever Reducers Deplete the Body’s Energy?
Immune responses, including fever, consume a lot of energy. Fever reducers essentially suppress the body's immune responses. After taking antipyretics, the fever temporarily subsides, but returns once the drug's effect wears off. This indicates that antipyretic drugs work against the body's immune response. Prolonged use can deplete the body's energy, leading to a loss of ability to generate a fever. Moreover, these drugs have side effects. Tylenol (acetaminophen) and ibuprofen have numerous side effects, including liver damage and gastrointestinal issues.
What Alternatives Exist to Reduce Fever Without Using Fever Reducers?
Treating infectious diseases shouldn't focus solely on reducing fever, as fever is a symptom, not the cause. TCM aims to promote self-healing power and balance the immune response (1, 2). Once pathogens are controlled or eradicated, fever and other symptoms naturally subside.
So if you are sick with a fever, here are some simple suggestions for home remedies.
Even though you have a fever, which only means you have a higher body temperature, you still could either feel chilled or feel hot. To distinguish whether you feel chilled or feel hot is extremely important, because it tells you what your energy level is and what your body needs.
Feeling Chilled: Keep warm by layering clothes and drinking hot beverages, like ginger and brown sugar soup. If you start to sweat, fever will most likely subsidize.
Feeling Hot: keep cool by dressing lightly and drinking cool beverages, like lemon juice with sugar, but do not over cool down. Otherwise, you may lose too much heat energy.
In addition to the home remedies above, lifestyle adjustment also plays an important role. Here are some general suggestions:
Have a good rest, eat light and nutritious meals, avoid overeating, and drink water as needed. Avoid foods that are hard to digest, as they consume more energy. Drinking excessive water can burden the body, especially for those with low energy.
In summary, the key to recovering from an infection with fever is conserving energy and allowing the body to combat pathogens and fever naturally, rather than relying solely on fever reducers. If necessary, use fever reducers temporarily, as long-term or high-temperature fever can be harmful. If you're sick with a fever, consider consulting a TCM doctor for personalized treatment.
Reference:
Sun, J. A mathematic equation derived from host-pathogen interactions elucidates the significance of integrating modern medicine with traditional Chinese medicine to treat infectious diseases. Journal of Integrative Medicine 21(4) P: 324-331 (2023). https://doi.org/10.1016/j.joim.2023.06.004
Sun, J. Promoting self-healing power and balancing immune response: a holistic, effective strategy of traditional Chinese medicine in treating COVID-19. Pharmacol Res - Mod Chin Medicine 100199 (2022) doi:10.1016/j.prmcm.2022.100199.
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