Low Body Temperature : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 25/08/2022

Low body temperature (hypothermia) is a temperature drop below 35 degrees. The condition occurs with physical and nervous exhaustion of the body, endocrine pathology, intoxication and other urgent situations. To establish the causes of hypothermia, physical diagnosis is carried out, extended blood tests, electrocardiography and radiological methods are prescribed. To normalize the low temperature, methods of physical warming, vitamin and general strengthening agents are used.

Causes of low body temperature

Depletion of the body

A slight decrease in temperature is observed with prolonged dieting, when the body is deficient in energy compounds and important trace elements. All metabolic processes slow down, the activity of tissue respiration decreases, contractile thermogenesis in the muscles becomes insufficiently effective. I am worried about constant weakness for no apparent reason, there are headaches and dizziness.

Even with moderate physical exertion, overwork is quickly felt. The skin is pale and cold to the touch. Temperature values ​​​​are in the range of 34-35 ° C. Low temperature is a sign of exhaustion due to exhausting sports training or hard physical work. A person experiences weakness in the body, drowsiness, apathy.

Similar manifestations are characteristic of nervous exhaustion. With chronic stress, metabolic processes are disrupted, the body is unable to adapt to changing living conditions. Emotional disorders come to the fore, temperature indicators almost never fall below 34 degrees. Seek medical attention to rule out a more serious cause of hypothermia.

hypothermia

Hypothermia occurs when wearing too light clothes in the cold season, staying in the cold for a long time, getting wet in the rain or falling into cold water. If the body temperature is below 35 ° C, but above 32 ° C, a slight degree of hypothermia develops. During this period, there is a slight shiver throughout the body, a person tries to move his arms and legs to warm himself. Due to the active contractions of the masticatory muscles, the teeth begin to “knock”.

The skin quickly acquires a bluish tint, which is most pronounced on the fingertips and face. At a low temperature in the range of 28-32 degrees, the nervous system and metabolic processes are gradually inhibited. Due to the formation of a neuromuscular and vascular vicious circle, the body no longer maintains the temperature at the level necessary for life.

As the temperature decreases, sharp weakness, drowsiness, general lethargy increase, hallucinations often begin. With severe hypothermia (less than 28 degrees), the likelihood of respiratory and circulatory arrest is high. Failure to provide medical care at any stage of hypothermia is fraught with serious complications up to death.

 

Vegetative-vascular dystonia

Decreased body temperature in VVD is due to a violation of autonomic regulation and microcirculation disorders. Periods of hypothermia are characterized by weakness, trembling in the legs, darkening of the eyes. If the patient is not helped in time, he may faint. Attacks develop periodically, provoked by staying in a stuffy room, physical exertion, prolonged stress. Symptoms are more likely to occur in young emotionally labile people.

Postviral asthenia

In the recovery period after an infectious disease, a person's body temperature drops below 36 degrees, which is associated with the depletion of the body's energy reserves and low activity of the immune system. Signs of hypothermia, increased drowsiness and symptoms of general malaise (weakness, fatigue, weakness) with post-viral asthenia persist for several weeks.

With fast walking, physical activity, shortness of breath is felt, it darkens in the eyes. The duration of the period of low temperature depends on the severity of the infection and the reserve capacity of the body. Due to the lack of adaptive mechanisms in children, malaise often lasts longer than in adults. Usually, the condition improves gradually until the state of health and temperature are completely normal.

hypoglycemia

When the blood sugar level is less than 3 mmol / l, energy starvation of the brain and all tissues occurs, metabolism slows down, which causes the body temperature to drop. At first, hypothermia is insignificant, weakness and dizziness are disturbing, profuse sweat appears on the skin. If the causes of hypoglycemia are not eliminated, the condition worsens, the temperature continues to decrease. With a pronounced deficiency of glucose, a deep syncope occurs with a fall in the thermometer numbers to 34 ° C.

anemia

A decrease in body temperature is part of the anemic syndrome due to low levels of hemoglobin and red blood cells in the blood. Temperature indicators are kept in the corridor of 34-35.5 degrees. Manifestations of hypothermia are fatigue, headaches, flashing "flies" before the eyes. The appearance of hair deteriorates, nails crumble and break, taste preferences change. The main causes of anemic syndrome:

  • Deficiency anemia : iron deficiency, B12- and folic deficiency.
  • Hereditary anemia : sickle cell, thalassemia, Minkowski-Choffard microspherocytosis.
  • Posthemorrhagic anemia : with profuse external bleeding, internal bleeding, hemorrhage in the body cavity.
  • Aplastic anemia .
  • Hyperpolymenorrhea in women .

Hypothyroidism

Insufficient production of thyroid hormones slows down metabolism and inhibits the effects of the brain's thermoregulatory center. These reasons cause the appearance of a constant low temperature, independent of external factors. The skin with hypothyroidism becomes very pale, waxy, hair falls out due to microcirculation disorders. Hypothermia is accompanied by lethargy, weakness, drowsiness during the day is noted, even after a long sleep, a breakdown is felt.

Addison's disease

Corticosteroids, produced by the adrenal cortex, increase metabolic processes and help maintain normal body temperature. When they are not produced enough, the first symptoms are chronic fatigue and drowsiness, which gradually increase as adrenal insufficiency progresses and precede the appearance of other disorders.

Low body temperature develops against the background of systemic disorders caused by the pathological functioning of various organs and systems - a drop in blood pressure, tachycardia, muscle weakness. The combination of temperature indicators less than 32-33 ° C, a sharp decrease in blood pressure, lethargy or loss of consciousness means the onset of an addisonian crisis - a serious condition that requires immediate medical attention.

Depression

In depression, a change in associative connections between the hemispheres and hyperactivity of the limbic system disrupt the work of the thermoregulatory center. As a result, the body cannot maintain a normal temperature. Temperature values ​​rarely fall below 34.5 ° C, but hypothermia is prolonged. The skin, especially on the extremities, becomes cold, a marble pattern appears due to capillary dysfunction, and pathological drowsiness is often disturbing.

Pathology of the hypothalamus

With diffuse inflammation or hemorrhage in the hypothalamic region, a typically persistent drop in temperature below 32 ° C, poorly controlled by warming, is typical. With damage to the posterior hypothalamus, poikilothermia occurs - temperature fluctuations of more than 1 ° C, associated with a change in the temperature characteristics of the environment. If a person with poikilothermia enters a cold climate, a hypothermic coma with permanent brain damage is possible.

Body intoxication

The accumulation of toxic compounds in the blood and their penetration into the brain disrupts the transmission of nerve impulses and the functional activity of the brain tissue. Under the influence of toxins, body temperature decreases by 2-3 °, the general condition quickly worsens - loss of consciousness, inhibition of reflexes are characteristic. There is a waxy pallor and cooling of the skin, drops of sweat appear on the forehead. Such symptoms require emergency assistance to eliminate the cause of intoxication.

Emergency conditions

Temperature indicators rapidly decrease during shock conditions, when a pathological expansion of superficial vessels occurs, and heat transfer increases several times. The general condition of the patients is extremely severe, the body temperature drops 3-4 degrees below normal. Acute hypothermia combined with low blood pressure and chest pain indicates myocardial infarction.

The cause of low temperature can be an ischemic stroke. In violation of cerebral circulation, low temperature is accompanied by paresis of the limbs, disorders of sensitivity and speech. Stupefaction, drowsiness, short-term loss of consciousness is possible. The decrease in temperature and focal neurological symptoms usually increase gradually. In newborns, hypothermia is a consequence of asphyxia.

Complications of pharmacotherapy

Often, the intake of psychotropic drugs that depress the central nervous system leads to a low temperature: barbiturates, benzodiazepines, clonidine. A side effect is associated with the suppression of muscle tremors and a decrease in heat production, due to the expansion of skin capillaries, the body quickly loses heat. Medicinal causes cause hypothermia only if the dosages are not observed or the maximum doses are deliberately taken. An overdose of tablets leads to stupor or coma of the first degree.

Rare Causes

  • Terminal liver failure .
  • Sepsis and septicopyemia .
  • Coma : diabetic ketoacidosis, uremia, lactic acidosis.
  • Iatrogenic factors : non-observance of heat balance during operations, low temperature in intensive care units.
  • Spinal cord injury : spinal cord injury, tumors, syringomyelia.

Diagnostics

Examination of a patient with violations of thermoregulation is carried out by a specialist therapist or an emergency doctor (with critical hypothermia). The volume of diagnostic measures depends on the patient's condition and the degree of temperature decrease. At values ​​above 32°C, extended laboratory and instrumental studies can be performed to identify the cause of hypothermia; at lower values, basic methods are limited. Most informative:

  • Primary examination . First of all, to detect the cause of a person's low body temperature, thermometry is carried out. The temperature is most often measured in the rectum, and an esophageal probe is used to obtain accurate information about the internal temperature. To assess consciousness, the safety of pupillary and pain reflexes is checked.
  • Blood tests . The basic list includes the measurement of glucose, red blood cells and hemoglobin. A biochemical blood test reveals a high level of nitrogen and urea, laboratory symptoms of liver diseases. To diagnose anemia, the amount of free iron, ferritin and transferrin is determined.
  • Hormonal profile . To exclude pathologies of the thyroid gland, the content of thyroxine and free T3, thyroid-stimulating hormones of the pituitary gland, are taken into account. You also need to investigate the amount of hormones of the adrenal cortex and catecholamines. Confirmation of Addison's disease requires an ACTH stimulation test and information about basic electrolyte levels.
  • Electrographic Methods . An ECG was recommended for all patients, which allows detecting pathognomonic signs - Osborn's wave, prolongation of the PQ and QT intervals. To assess the functional activity of the brain, an EEG is prescribed. In a hospital setting, electromyography and electroneurography of peripheral nerve trunks are sometimes performed.
  • X-ray imaging . CT of the brain is the first thing to do to rule out central causes of low body temperature. On the pictures, you can detect volumetric formations or possible swelling of the hypothalamus. Thyroid scintigraphy with iodine isotopes helps to study the structure of the organ in more detail.

Treatment

Help before diagnosis

If the body temperature is more than 32 °, passive warming can be dispensed with. A person is wrapped in heated blankets or placed in a bath with warm water, and hot tea is given. With prolonged hypothermia and a satisfactory condition in the period of convalescence, specific treatment is not required - it is recommended to sleep for 8-1 hours a day, increase the calorie content of the diet, and adequate rest. If the reasons for the detected low temperature are unclear, a doctor's consultation is required.

First aid for hypothermia

 

Conservative therapy

At critically low temperatures, active warming is effective: thermal fans and heating pads, inhalations of warm humidified oxygen and intravenous infusion of heated solutions. In emergency situations, warm lavage and extracorporeal blood purification methods are used. For the etiotropic and pathogenetic treatment of diseases accompanied by a drop in human body temperature below 36 degrees, the following are prescribed:

  • Vitamins . With a general depletion of the body, B vitamins are shown, which enhance neuromuscular transmission and improve the trophism of the nervous tissue. Alpha-tocopherol is used as a powerful antioxidant. With severe weakness, glucose solutions with vitamin C are administered.
  • Hormones . Replacement therapy with levothyroxine allows you to accelerate the processes of metabolism and thermogenesis, restore normal body temperature. In Addison's disease, cortisol preparations are needed, in case of a lack of mineralocorticoids, aldosterone is additionally administered.
  • Cardiotropic agents . Medicines stimulate cardiac activity in shock and other critical conditions, normalize cardiac output and increase blood pressure. The means of choice for emergency care are solutions of adrenaline or dobutamine, in the hospital, therapy is supplemented with glycosides.
  • Antidepressants . Medicines are agonists of serotonin receptors, improve neural connections between different parts of the brain. Normalization of temperature occurs due to stimulation of the hypothalamic center and an increase in contractile thermogenesis.
  • Antibiotics . Hypothermia often masks the manifestations of a severe bacterial infection, so broad-spectrum antibiotics are indicated at very low body temperatures. Medicines are administered intravenously until the temperature values ​​​​normalize and the general condition improves.
  • Antidotes . With acute signs of intoxication, universal drugs are used that bind or destroy various toxic substances. In case of poisoning with heavy metals, an overdose of medications, unitiol is effective.

Surgery

To remove tumors of the hypothalamus, stereotaxic surgery using a gamma knife is used. The operation is performed after a course of chemotherapy or radiotherapy. Hypothyroidism, which occurs against the background of a large goiter, requires surgical treatment - from enucleation of the thyroid gland to subtotal resection of the organ. With profuse bleeding, ligation of damaged arteries or laser coagulation of blood vessels is performed.

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