Causes, Treatment, and When to Seek Help

People typically associate shivering with being cold, so you may wonder why you shiver when you have a fever. Shivering is part of the body’s natural response to an illness. When a person shivers, it helps their body temperature rise, which helps fight off a virus or a bacterial infection.

Still, it’s important to know what to do if you’re feeling hotter than normal, and your body is shaking with chills. Read on to learn more about shivering and fevers.

Shivering helps the body warm itself.

When you shiver, your muscles contract and relax in rapid succession, and all those little movements can create heat. It’s an involuntary response triggered by your immune system reacting to an infection or a cold environment.

An increase in body temperature can help your body fight infections because infections don’t survive as well above your normal temperature of 98.6°F (37.0°C).

The part of your brain that sets your body’s temperature is called the hypothalamus. When the body has an infection, the hypothalamus responds by moving the “set point” for a higher temperature.

The muscles in your body respond by contracting and relaxing faster, which helps your body reach this higher temperature more quickly. Once your body temperature reaches its new set point, your shivering should stop.

Other conditions, such as a sudden drop in your blood sugar levels, can also bring on shivering. You may also experience shivering after surgery as a response to the anesthesia wearing off.

Additionally, certain types of anesthesia can interfere with your body’s usual temperature regulation system. When paired with a cool operating room environment, a decrease in body temperature can lead to shivering.

Can you have a fever without shivering?

You may have a fever without shivering and the chills, too. Conditions that may trigger a fever include:

• heat exhaustion
• medications, such as certain antibiotics or blood pressure-lowering drugs
• some inflammatory conditions, such as rheumatoid arthritis or cancer
• certain immunizations, including diphtheria, tetanus, and pneumonia (DTaP)

Not every fever needs treatment.

According to Mayo Clinic, rest and fluids are usually enough to treat a fever in adults and infants over the age of 2, unless the fever reaches above 102°F (38.9°C).

This treatment also applies to babies between 3 and 6 months old, as long as they are not acting out of the ordinary. Treat children ages 6 to 24 months in the same way, unless the fever stays above 102°F (38.9°C) rectally for more than a day.

When rest and fluids aren’t enough, try acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Read the labels carefully, especially when treating a child.

You should also check with a doctor or a pharmacist if you have any questions about dosing or combining medications.

Do not give medications to infants less than 6 months old.

Speak to a doctor immediately if an infant under 3 months old has a rectal temperature of 100.4°F (38°C) or higher.

Mild vs. high fever in adults

• Mild or low-grade fever: A temperature between 99.5°F (37. 5°C) and 100.9°F (38.3°C)
• High or high-grade fever: Temperature over 103.0°F (39.4°C)

Was this helpful?

If you have a mild fever with shivering, you don’t necessarily need to see a doctor or take a fever-reducing medication. You might prefer to get comfortable and wait it out. You can try:

• resting with a light sheet, rather than a heavy blanket, which can continue to raise your body temperature
• putting on an extra layer of clothes, like a sweatshirt, that you can remove if you start to overheat
• turning up the temperature in your home
• drinking plenty of fluids

When other serious signs accompany a fever and chills, you should see a doctor as soon as possible. These include:

• a stiff neck
• confusion
• irritability
• sluggishness
• a bad cough
• shortness of breath
• severe abdominal pain

You should also seek medical help if:

• you’re an adult, and you have a temperature that remains above 103°F (39. 4°C) for more than an hour following home treatment
• you’re an adult, and you have a fever that lasts more than 3 days
• a baby younger than 3 months has a rectal temperature of 100.4°F (38.0°C) or higher
• a child between the ages of 3 months and 1 year has a fever above 102.0°F (38.9°C) that lasts for more than 24 hours

If you feel your temperature starting to rise into a fever, and you’re shivering, keep in mind that your body is probably responding to an infection.

Rest and fluids are the best ways to help your body recover, but you can take acetaminophen or ibuprofen as well, especially if your temperature rises above 102°F (38.9°C).

Pay close attention to other signs, which may indicate that you need to see a doctor.

If it’s your child who is shivering with what feels like a fever, be sure to get an accurate temperature reading, so you’ll know whether to get your little one to a doctor immediately.

Causes, Treatment, and When to Seek Help

People typically associate shivering with being cold, so you may wonder why you shiver when you have a fever. Shivering is part of the body’s natural response to an illness. When a person shivers, it helps their body temperature rise, which helps fight off a virus or a bacterial infection.

Still, it’s important to know what to do if you’re feeling hotter than normal, and your body is shaking with chills. Read on to learn more about shivering and fevers.

Shivering helps the body warm itself.

When you shiver, your muscles contract and relax in rapid succession, and all those little movements can create heat. It’s an involuntary response triggered by your immune system reacting to an infection or a cold environment.

An increase in body temperature can help your body fight infections because infections don’t survive as well above your normal temperature of 98.6°F (37.0°C).

The part of your brain that sets your body’s temperature is called the hypothalamus. When the body has an infection, the hypothalamus responds by moving the “set point” for a higher temperature.

The muscles in your body respond by contracting and relaxing faster, which helps your body reach this higher temperature more quickly. Once your body temperature reaches its new set point, your shivering should stop.

Other conditions, such as a sudden drop in your blood sugar levels, can also bring on shivering. You may also experience shivering after surgery as a response to the anesthesia wearing off.

Additionally, certain types of anesthesia can interfere with your body’s usual temperature regulation system. When paired with a cool operating room environment, a decrease in body temperature can lead to shivering.

Can you have a fever without shivering?

You may have a fever without shivering and the chills, too. Conditions that may trigger a fever include:

• heat exhaustion
• medications, such as certain antibiotics or blood pressure-lowering drugs
• some inflammatory conditions, such as rheumatoid arthritis or cancer
• certain immunizations, including diphtheria, tetanus, and pneumonia (DTaP)

Not every fever needs treatment.

According to Mayo Clinic, rest and fluids are usually enough to treat a fever in adults and infants over the age of 2, unless the fever reaches above 102°F (38. 9°C).

This treatment also applies to babies between 3 and 6 months old, as long as they are not acting out of the ordinary. Treat children ages 6 to 24 months in the same way, unless the fever stays above 102°F (38.9°C) rectally for more than a day.

When rest and fluids aren’t enough, try acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Read the labels carefully, especially when treating a child.

You should also check with a doctor or a pharmacist if you have any questions about dosing or combining medications.

Do not give medications to infants less than 6 months old.

Speak to a doctor immediately if an infant under 3 months old has a rectal temperature of 100.4°F (38°C) or higher.

Mild vs. high fever in adults

• Mild or low-grade fever: A temperature between 99.5°F (37.5°C) and 100.9°F (38.3°C)
• High or high-grade fever: Temperature over 103.0°F (39.4°C)

Was this helpful?

If you have a mild fever with shivering, you don’t necessarily need to see a doctor or take a fever-reducing medication. You might prefer to get comfortable and wait it out. You can try:

• resting with a light sheet, rather than a heavy blanket, which can continue to raise your body temperature
• putting on an extra layer of clothes, like a sweatshirt, that you can remove if you start to overheat
• turning up the temperature in your home
• drinking plenty of fluids

When other serious signs accompany a fever and chills, you should see a doctor as soon as possible. These include:

• a stiff neck
• confusion
• irritability
• sluggishness
• a bad cough
• shortness of breath
• severe abdominal pain

You should also seek medical help if:

• you’re an adult, and you have a temperature that remains above 103°F (39.4°C) for more than an hour following home treatment
• you’re an adult, and you have a fever that lasts more than 3 days
• a baby younger than 3 months has a rectal temperature of 100. 4°F (38.0°C) or higher
• a child between the ages of 3 months and 1 year has a fever above 102.0°F (38.9°C) that lasts for more than 24 hours

If you feel your temperature starting to rise into a fever, and you’re shivering, keep in mind that your body is probably responding to an infection.

Rest and fluids are the best ways to help your body recover, but you can take acetaminophen or ibuprofen as well, especially if your temperature rises above 102°F (38.9°C).

Pay close attention to other signs, which may indicate that you need to see a doctor.

If it’s your child who is shivering with what feels like a fever, be sure to get an accurate temperature reading, so you’ll know whether to get your little one to a doctor immediately.

Causes of severe chills in colds and flu, how to treat this condition

Rinza®

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Colds and flu

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Severe chills, main causes and treatment

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Severe chills, underlying causes and treatment

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Author, editor and medical expert

Klimovich Elina Valerievna

Editor

Harutyunyan Mariam Harutyunovna

Contents:

• Causes
• Why does chills appear without fever?
• How to deal with chills
• Can chills be prevented?
• References

Contents of the article Causes Why does chills appear without fever? What to do with chills Can chills be prevented? References

Chills in an adult occur due to spasm of the superficial vessels of the skin and are accompanied by trembling, in which individual muscle fibers begin to contract, and a feeling of goosebumps due to contraction of the muscles that raise the hairs on the arms and legs. At the same time, a person feels cold, tries to wrap himself in a blanket or curl up. In this way the body tries to warm up ^4.5 .

Causes

Most often, chills are observed against the background of fever ³ , which accompanies almost all infectious diseases ⁴ is a universal reaction of the organism ⁴ . When microbes and viruses penetrate it, the body “protects itself” by raising the body temperature ^2.3 .

Since more heat is generated during muscle contractions ⁶ , it means that the more pronounced the chill, the higher the body temperature ² . Light chilling is characteristic of 38 – 39 ⁰ C, “teeth chattering” and severe trembling – for fever in the range of 39 ⁰ – 40 ⁰ C. Terrific chills, covering the whole body, occur at temperatures above 40 ⁰ C ^3.6 .

Chilliness and fever may be disturbed by various infectious diseases, for example, colds, flu ³ or when a focus of purulent inflammation forms in any organ, for example, in the heart, kidneys, pleura, lungs or veins ⁷ . Symptoms are caused by pyrogens, or substances that can affect the thermoregulatory center in the brain. Pyrogens can be biologically active substances that secrete bacteria, viruses and other pathogens ³ .

Sometimes it is not infectious agents that act as pyrogens, but substances that are formed in the body itself during tissue damage and decay – inflammation, bruises, hemorrhages ^2.3 .

Even if you feel cold, trembling in the body, and the thermometer shows a temperature above 37 ⁰ C, the cause may not be inflammation or even an infection, but the following conditions:

• Nervous strain. With neurocirculatory dystonia (neurosis), chills often begin in the evening or at night. It can be provoked by emotional stress ¹⁶ .
• Hormonal imbalance. Chilling in women on the background of elevated temperature (37-38 ⁰ C) is a frequent symptom of menopause ^3.7 or premenstrual syndrome ¹⁸ .
• Blood diseases. Symptoms resembling infectious fever with shivering may be a sign of hemolytic anemia or lymphoma ¹⁴ .
• Hyperthermia. Overheating of the body occurs after intense physical overstrain, if the ambient temperature is above 26.7 ⁰ C ¹⁴ . Under such conditions, heat transfer is disturbed, and excess heat accumulates in the body ⁵ . Overheating affects athletes participating in competitions in a country with an unusual climate, while not observing the correct drinking regimen, as well as people suffering from obesity ¹⁴ .

What causes chills without fever?

Chilling can also occur against the background of normal and even low body temperature ^1,2,14 . During hypothermia – for example, when staying in the cold for a long time or immersing in cold water, ^1.2 – the vessels constrict so that the body does not lose heat. For example, trained swimmers with enough body fat to retain heat typically don’t feel shivering in cold water. But thin people with low levels of physical activity in similar conditions quickly lose blood circulation, develop severe trembling, turning into chills, and body temperature may even drop ¹⁴ .

Other causes of chills without fever include:

• hypoglycemia – low blood glucose levels – in patients with diabetes mellitus ⁹ ;
• hypothyroidism – deficiency of thyroid hormones ¹⁵ ;
• hypertensive crisis – a sharp and significant rise in blood pressure ⁸ .

Shaking without fever may occur if there is a long period of time between taking antipyretic drugs. These drugs quickly bring down the temperature, but if they are used incorrectly, a side effect sometimes occurs – muscle contraction, that is, trembling in the body. To avoid such phenomena, consult a specialist, he will tell you how to take antipyretics correctly ¹⁴ .

What to do in case of chills

In case of hypothermia, it is enough to warm up – put on warm clothes, drink hot tea or milk ¹ . If the flu or cold against the background of fever (above 38 ⁰ C) and chills, the state of health worsens, the legs and hands become cold, and the skin is “marble”, it is likely that the body temperature will rise, which means that measures need to be taken ^2.10 . First of all, consult a doctor in a clinic or call a doctor at home.

To alleviate unpleasant symptoms, when you feel chills, you should:

1. Wrap yourself in a blanket and keep warm. No need to be afraid that the temperature will start to rise even faster. The body does not lose its ability to resist external heat during fever ² .
2. Wipe the body with warm water at a temperature of 41 ⁰ C and above. Evaporating from the surface of the skin, the water will remove heat and contribute to its gradual cooling. But remember that you can not wipe the skin with cold water: sudden cooling causes even greater muscle and vascular spasm, increases chills and accelerates the rise in temperature ¹⁰ . Antipyretic drug ¹⁰ should be taken 30 minutes before the rubdown.

If you wipe down without taking an antipyretic, chills may appear – due to trembling in the body, the temperature will rise again ¹⁷ .

RINZASIP® with vitamin C

To combat fever and other symptoms of colds (ARVI) and flu, paracetamol-based preparations are intended, for example, the combined RINZA® and RINZASIP®, which can be used by adults and adolescents from 15 years of age, and RINZASIP ® for children from 6 years of age ^{11 .12} .

• RINZA® tablets contain paracetamol, phenylephrine, chlorphenamine and caffeine. The drug is ready for action 10 minutes after taking ¹³ , reduces muscle and joint pain, reduces fever ¹¹ . RINZA® also facilitates breathing in case of swelling of the airways, helps to reduce sore throat, itching of the eyes and nose ¹¹ .
• RINZASIP® drink powders with vitamin C contain, in addition to paracetamol, phenylephrine, pheniramine and caffeine, ascorbic acid. RINZASIP® with vitamin C in orange, lemon or blackcurrant flavor reduces cold symptoms and improves body resistance ¹² .

Attention! You can take antipyretic drugs for no more than 5 days ^11.12 . If fever, trembling and coldness persist or recur, a specialist should be consulted to find out the cause of this condition ⁴ .

Can chills be prevented?

To avoid the occurrence of this symptom, it is necessary first of all to act on its causes – to avoid situations in which it occurs, for example, hypothermia or training in conditions of high air temperature ¹⁴ . It is also important to strengthen the immune system and start treating a cold at its first symptoms. If chilliness is not associated with a cold and occurs periodically ^8,14,16 , you should consult a doctor in a timely manner to prevent a new attack. Indeed, in such cases, chills can be a signal that the body gives in various chronic diseases ² .

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

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Chapter 2. Fever and chills

Fever is an increase in body temperature as a result of changes in the thermoregulatory center of the hypothalamus. Although the temperature is considered normal up to 37 ° C, its maximum values ​​​​are from 37.2 “C at 6 am to 37.7 “C at 4 pm. The cause of the fever is the rearrangement of the hypothalamic “reference point” by prostaglandins to another level, mediated by cytokines. There are few symptoms in clinical medicine that have the same diagnostic value as fever. Hyperthermia without fever occurs when the body cannot adequately give off the heat it produces (for example, when the ambient temperature rises) or under the influence of medications (neuroleptic malignant syndrome, malignant hyperthermia).

True fever results from infection, immune disorders, vasculitis or thrombosis, infarction, trauma, granulomatous disease (sarcoidosis), colitis, tumor (especially Hodgkin’s disease, lymphoma, leukemia, renal carcinoma, hepatoma) or acute metabolic disorders (thyroid crisis, adrenal crisis).

Clinical picture

Feverish patients report myalgia, arthralgia, anorexia and drowsiness. Most of them have chills and chilliness. With tremendous chills, severe fever, piloerection and trembling occur, the patient’s teeth chatter. Activation of heat loss mechanisms leads to sweating. Mental status abnormalities, including delirium and seizures, are more common in very young, very old, or debilitated patients.

Diagnosis

The clinical picture should be carefully evaluated. They study in detail the anamnesis, the patient’s life history, his trips, heredity. Next, a detailed functional examination of the patient is carried out, repeating it. They perform laboratory tests, including a clinical blood test with the necessary detail (plasmocytes, toxic granularity, etc.), as well as a study of pathological fluid (pleural, articular). Other tests: ESR, urinalysis, determination of the functional activity of the liver, blood cultures for sterility, urine, sputum and feces (for microflora). Special research methods include X-ray, MRI, CT (to detect abscesses), radionuclide studies. If non-invasive research methods do not allow making a diagnosis, a biopsy of the organ tissue is performed, bone marrow puncture is advisable in patients with anemia.

Fever of unspecified origin (FUN)

Diagnosis is made when body temperature rises above 38. 3 °C several times for more than 2 weeks, and the cause cannot be determined a week after hospitalization or after three visits to the patient. Most often, such a fever is associated with an infection, tumor, CBST, or vasculitis. Other causes: drugs, granulomatosis, UC, PE A, sham, Mediterranean fever, erythema multiforme, Behçet’s syndrome, Fabry disease, Whipple’s disease. It is unlikely that LDL lasting more than 6 months is associated with infection. If no cause can be found, the prognosis is usually good.

Treatment

High fever (above 41°C) should be treated with antipyretics and cooling by wiping the body with a damp sponge. Low or low fever may not be treated, except in situations such as febrile convulsions in children, pregnancy, cardiopulmonary and brain disorders. Paracetamol (650 mg) every 3 hours during the day is effective in the treatment of most cases of fever. The advantage of the drug is that it does not mask the symptoms of inflammation (which may suggest the cause of the fever), does not impair platelet function, and does not cause Reye’s syndrome in children.