# Disabling symptoms associated with increased axillary temperature in patients with functional hyperthermia

## TL;DR

This study shows that many patients with functional hyperthermia experience disabling symptoms like fatigue when their axillary temperature rises slightly above 37°C, even though this is considered normal by many doctors.

## Contribution

The study quantifies the prevalence and types of disabling symptoms associated with mild increases in axillary temperature in functional hyperthermia patients.

## Key findings

- 80% of patients with functional hyperthermia reported disabling symptoms linked to increased axillary temperature.
- Worsening fatigue was the most common disabling symptom, reported by 75% of patients.
- Most disabling symptoms, except headache, were not alleviated by antipyretic drugs.

## Abstract

I previously reported a case of functional hyperthermia (FH) in a patient with an axillary temperature just slightly above 37.0 °C who persistently requested treatment. Because the severity of her fatigue increased remarkably when her axillary temperature increased above 37.0 °C, she felt that the temperature of 37.0 °C was disabling. In the present study, I analyzed a larger number of patients with FH to investigate the incidence of disabling symptoms with increasing body temperature, the kinds of symptoms associated with increased body temperature, and the temperatures at which these symptoms became disabling.

Twenty patients with FH (7 men, 13 women; mean age ± standard deviation, 31.2 ± 10.9 years) who visited my department were asked whether they had any disabling symptoms associated with an increase in axillary temperature and, if so, at what temperature the symptoms became disabling. Sixteen of 20 patients (80.0%) responded that they had such symptoms, which included worsening of general fatigue (n = 12, 75.0%), feelings that their brain did not work properly (n = 5, 31.3%), inability to move (n = 4, 25.0%), hot flashes/feeling of heat (n = 3, 18.8%), headache (n = 2, 12.5%), dizziness (n = 2, 12.5%) and anorexia (n = 1, 6.3%). The axillary temperatures at which patients felt worsening fatigue ranged from 37.0 °C to 37.4 °C in 7 of the 12 patients (58.3%) who experienced worsening fatigue. The patients also reported that the disabling symptoms, with the exception of headache, were not alleviated by antipyretics.

Many patients with FH reported worsening fatigue as a disabling symptom associated with increased axillary temperature; more than half of those patients experienced worsening fatigue in the temperature range of 37.0 °C to 37.4 °C. These findings suggest that the reasons patients with FH consider 37 °C disabling and seek medical treatment are that physical symptoms such as fatigue worsen at 37 °C, although this temperature is assumed by many physicians to be within the normal range or just above the normal range of axillary temperature, and that most hyperthermia-associated symptoms are not alleviated by antipyretic drugs.