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When you have a fever, you feel like a hot, gross mess, and want it to be over as soon as possible. Understandable. And you may have heard people say that a good way to speed a fever out of your system is to “sweat it out.” That is, to huddle under layers and blankets or even sit in a sauna to soak yourself even more. That way you can get back to Zumba, gardening, or battling evil wherever you find it.
Well, as tempting as it sounds to sweat out a fever or even an infection, it’s a myth that it’ll work the way you want. Doctors say there are a few great reasons to wait things out instead.
First, what is a fever anyway?
“Fever is a sign that our immune system is working, that it’s doing its job,” says Mayo Clinic family medicine doctor Tina Ardon, M.D., in Jacksonville, FL. Your brilliant body raises its temperature to “burn out” the virus or bacteria, because it is harder for it to survive at a higher temperature.
Then, when whatever is causing the infection has been torched by your immune system, your temperature comes down on its own, in part via the sweat that the fever produces—liquid oozes out of your pores, the air hits it, it evaporates, and that helps cool you off. “Our bodies do a good job of regulating our temperature and part of that is the sweating process,” she says.
So isn’t more sweat even better? The answer is no.
Why “sweating out” a fever or an infection doesn’t work
“There’s this inaccurate idea that somehow a virus or bacterial infection will leave your body through sweating,” says Dr. Ardon. “That’s not correct. Whether it’s a flu or COVID, an infection doesn’t leave our body through bodily fluids, and sweating more doesn’t make a fever better,” she says.
This myth is sticky because of the notion (often repeated in wellness circles) that we can (and should) sweat out “toxins.” This, too, is incorrect, says Steven Novella, M.D., founder and executive editor of Science-Based Medicine and an associate professor of clinical neurology at Yale University School of Medicine. “Sweating is one mechanism that we use to eliminate stuff from our body,” he says, but it’s not a major one. The liver and kidneys are mainly responsible for filtering out unwelcome chemicals and substances. What’s more, a virus or microorganism isn’t a toxin. Another way to think about it: “Sweating is not the way the body fights off infection,” he says.
“Sweating it out” can make things worse
People with a cold, flu, or stomach bug may already feel weak and lethargic and have a hard time staying hydrated, so upping your output of fluid is only going to make you feel worse. “If anything, making yourself sweat more can cause harm,” says Dr. Ardon. “Dehydration is a big risk, but you could certainly put yourself at risk for heat stroke.”
You’re also probably not eating or drinking much, and you may be losing fluid through diarrhea, Dr. Novella points out. Along with dehydrating yourself, forcing yourself to sweat may leave you low on essential salts, whose job it is to maintain fluid balance and nerve function. An imbalance can affect your blood pressure or muscle function. “Mostly you’ll feel like crap,” he says.
The logic isn’t there either
Getting rid of a fever means cooling off. Wrapping yourself in blankets accomplishes the exact opposite. “The notion that you’re trying to reduce your body temperature and then you deliberately increase it doesn’t even make sense,” says Dr. Novella.
Stay with this line of thinking: The purpose of sweat is to cool you down when it evaporates, which is what happens after your body naturally lets loose with a fever — your body temperature spikes to nuke the virus, and then sweats to cool you back down to a normal body temperature.
If you interfere with that process by keeping your temperature artificially high so that you sweat even more, you just postpone the “feeling cool and comfortable and better-overall” part. And you’d be doing this for no reason, since “sweating out a fever” or virus isn’t a thing (see above). And of course, if you become dehydrated (or worse) while trying to produce more sweat, you will kick your recovery even further out.
So why do people try to “sweat out a fever”?
People try to “sweat out a fever,” even though it doesn’t work, because they’ve heard it’s a good idea and don’t have information to believe otherwise. If enough people hear advice like this, “then it becomes something ‘everybody knows,’” Dr. Novella says. And when something seems to be common knowledge, people expect it to work, perhaps producing a placebo effect “that sort of reinforces it,” he says.
Another big reason is that most of us want to do something to feel better. “People like to be active when it comes to a problem, especially a health problem,” says Dr. Novella. “It’s hard to do nothing rather than something—even when doing nothing is the best thing.” Doctors, too, fall into this habit, he says. “It just doesn’t feel satisfying to wait it out,” even when evidence shows that waiting is the best move.
So how should you treat a fever?
The evidence is pretty clear that most of the time, you shouldn’t treat a fever at all, as useless as that may make you feel. “The fever is the body’s way to fight off the infection,” says Dr. Novella. “Generally speaking, if it’s a cold or flu or any kind of a viral infection, you shouldn’t aggressively treat it.”
Instead, says Dr. Ardon, do what you can to make yourself comfortable and stay hydrated, but let the fever do its job of burning out the infection. “We struggle with this idea of fever phobia, particularly in kids,” she says, which may lead us to rush to bring a fever down with medication. While there are guidelines about how and when to treat a fever in adults and children, Dr. Ardon resists the notion of a temperature cut-off after which you should actively bring the fever down. “It’s more about the patient—I’d be more worried about a patient with a 101℉ fever who is not eating or drinking or acting like themselves than a patient with 102 who is doing well and can converse,” she says.
So here’s what you do: If your fever is making you so hot and uncomfortable that you can’t rest, eat or drink enough to hydrate and nourish yourself, or sleep—the things that actually help you recover from a virus—then consider treating it. In that case, “Tylenol or Ibuprofen can be very helpful, but even then, the goal may not be to completely resolve the fever,” she says. “It’s more about allowing the patient to feel better, get some rest and drink water.”
When you should call a doctor about a fever
If a baby under three months has anything above 100.4℉, you should call the pediatrician. And if your fever doesn’t go away in a couple of days and you don’t know why, pick up the phone. Other than that, it depends on a bunch of factors, says Dr. Ardon.
That’s why, if you have any doubt, give your doctor a call. Kids tend to get higher fevers than adults, which can be scary, but it’s because their immune systems are more robust, says Dr. Ardon. “I’m never bothered by a phone call about a fever—it gives me a chance to ask the right questions: Are they drinking, acting okay, talking to you, that kind of thing.”
But for run-of-the-mill fevers that are likely due to a virus or bug, take it easy and you should feel better after a couple of days, she says.
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