Connecting dots

Sometimes it takes me a while to put together different pieces of information with this whole health-issues thing!

This week I was sitting at my cubicle desk working and complaining to myself in my head about how I always feel sweaty yet cold and clammy.  All of the sudden I thought “wait – that’s how I feel when I’m sick and have a fever.  Do I have a fever?”  I’ve been feeling like this during the day increasingly often, and for a few years I often go to bed freezing and wake up a few hours later absolutely drenched with sweat and it just occurred to me that I feel “fever-y” then, too.  (I’m only 37 – too young for menopause “hot flashes”!)

Sure enough – I did have a fever.  The last few days I’ve kept a thermometer in my purse and at times when I don’t feel fever-y sweaty I take my temp and it’s normal and then times when I do feel fever-y sweaty it’s high.  It’s not super high – it’s been in the 99-100 range.  But for me that’s high.  My temperature is typically 97.4-97.7 (I know because I have all my medical records now and I looked back through my vitals and noticed this…another reason to have and organize those records!), so 99.8 or so is enough to make me sweat and feel uncomfortable and in general not good.

So I started researching – searching for information on low grade fevers and autoimmune diseases.  There’s lots of autoimmune disease information pages (such as from specific AI disease organization pages such as sjogrens.org as well as the umbrella type pages such as rheumatology.org) that list low grade fever as a symptom for many AI diseases. and other chronic illnesses like fibromyalgia (I didn’t think they’d mind me borrowing their constant fever meme and adding other constant fever inducing disease in the caption!)

But my original training is a chemist.  I’m a scientist at heart and I wanted to know why exactly these diseases were causing chronic low grade fever.  So I began searching for that information and I found that there are two ways that a fever can be triggered in our brains – from processes that result from infection which trigger cytokines (which is how we usually think of fever processes) and those resulting from cytokines themselves (no infection-triggering necessary).  I read lots of science-y type studies and information on it (such as this one), but here’s a nice low-jargon explanation that I think would make sense to most people.

Basically inflammation is caused by cytokines (fair notice – that’s a super-simplified explanation!).  And one way fevers can be induced is by cytokines alone.  Get the link? Autoimmune disease involves inflammation which is caused by cytokines which also causes fevers.  Bam.

And you may even be familiar with the cytokine names without even knowing it.  The ones related to fever processes are TNF and Interleukin-1 (IL-1) and Interleukin-6 (IN-6).  You may be familiar with these words because they are what the “biologic” medicines used in some autoimmune diseases are trying to prevent.  For example Embrel, Humira and Remicade belong to a class of biologics called “TNF-inhibitors”  and Kineret is an IL-1 inhibitor.

So these cytokines are running around in your body causing inflammation and while they’re at it, they’re also creating low grade fevers with all the fun of adding to your fatigue, making you sweaty, or shivering, or miserable in about every way while you sit at work all day long, or make you wake with your clothes and sheets drenched.

Fun times for a Friday afternoon, huh?

They’ve been plaguing me at night for a while but now I’m feeling them during the day as well – which is making me so very uncomfortable at work.  Looks like it’s time to bring in things that could help during the day – small fan for my desk.  Permanent cubicle-sweater for times when I’m shivering.

It certainly feels like I spend an increasingly larger amount of my time accommodating for various symptoms in my day-to-day life.