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Suggest Treatment For Frequent Night Sweats And Low Fever
Question: For several nights last week, I had night sweats. I went to my GP and he examined and took blood. All of the blood results were normal and ESR (sed rate) was a low 3. I probably had a low fever. (Since my baseline temperature is low, it is not always clear if I have a fever.) He said it probably was a viral infection, and to expect more difficult nights until the virus passes. I took elderberry and oregano oil and felt much better, and the night sweats stopped. But they resumed over the weekend. Is it possible that the virus was not completely gone and came back stronger the last few days? Should I be tested for something else?
Brief Answer:
there are some disorders to consider
Detailed Answer:
Hello,
night sweats can be one of the symptoms of various disorders. First of all you should consider it important if you have profuse sweating (that is if you have to change clothes, not just feel warm and moist).
The list of potential causes can be long and difficult to investigate. The following list is not exhaustive but it presents some of the causes:
- infections (tuberculosis should always be excluded or confirmed, lung abscess, endocarditis, etc)
- malignant disorders: lymphomas are well known for causing night sweats along with weight loss and fever. Other malignancies (solid tumors) are also possible.
- diabetes mellitus (particularly if you have hypoglycemia during the night)
- endocrine tumors like pheochromocytoma
- gastroesophageal reflux disease
- angina
- anxiety
- thyroid disorders
- autoimmune disorders (the low ESR almost excludes most of them)
When one of my patients has night sweats I usually suggest measuring body temperature twice a day for at least 3 consecutive days and also taking measurement from both the armpit and the rectum, since sweating may give a falsely low reading. If there is no fever basic lab tests and the patient's history may provide additional clues.
If after completing all the aforementioned actions we reach this point and there are no clues I usually go on to more testing only if the symptoms are intense (in order to exclude cases with normal sweating that the patient may confuse for abnormal). More tests would include radiological testing of the chest and abdomen to look for enlarged internal organs and lymph nodes. If clinical and lab tests have not achieved to reveal anything by now then I usually postpone further testing for later (a month or so, or when the patient has noticed new symptoms).
So in conclusion, night sweats on their own are sometimes normal. If we're talking about profuse sweating then basic lab and clinical tests should guide further investigation. Radiological tests may be used to exclude malignancies. The rest of the investigation would depend on the severity of the symptoms and the clinical context.
I hope you find my comments helpful!
Kind Regards!
there are some disorders to consider
Detailed Answer:
Hello,
night sweats can be one of the symptoms of various disorders. First of all you should consider it important if you have profuse sweating (that is if you have to change clothes, not just feel warm and moist).
The list of potential causes can be long and difficult to investigate. The following list is not exhaustive but it presents some of the causes:
- infections (tuberculosis should always be excluded or confirmed, lung abscess, endocarditis, etc)
- malignant disorders: lymphomas are well known for causing night sweats along with weight loss and fever. Other malignancies (solid tumors) are also possible.
- diabetes mellitus (particularly if you have hypoglycemia during the night)
- endocrine tumors like pheochromocytoma
- gastroesophageal reflux disease
- angina
- anxiety
- thyroid disorders
- autoimmune disorders (the low ESR almost excludes most of them)
When one of my patients has night sweats I usually suggest measuring body temperature twice a day for at least 3 consecutive days and also taking measurement from both the armpit and the rectum, since sweating may give a falsely low reading. If there is no fever basic lab tests and the patient's history may provide additional clues.
If after completing all the aforementioned actions we reach this point and there are no clues I usually go on to more testing only if the symptoms are intense (in order to exclude cases with normal sweating that the patient may confuse for abnormal). More tests would include radiological testing of the chest and abdomen to look for enlarged internal organs and lymph nodes. If clinical and lab tests have not achieved to reveal anything by now then I usually postpone further testing for later (a month or so, or when the patient has noticed new symptoms).
So in conclusion, night sweats on their own are sometimes normal. If we're talking about profuse sweating then basic lab and clinical tests should guide further investigation. Radiological tests may be used to exclude malignancies. The rest of the investigation would depend on the severity of the symptoms and the clinical context.
I hope you find my comments helpful!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the reply. In regard to the degree of sweating, only once have I come close to needing to "change my pajamas". The other times not nearly that intensive. What I find interesting, it is usually the same time at night, first between 2am and 3am, and the second between 5am and 6am. Is this significant?
Brief Answer:
does not seem to be significant
Detailed Answer:
You're welcome!
It doesn't seem to be significant because it does not ring any bells... I don't know of any disorder that causes sweating at the same time every day (or night).
does not seem to be significant
Detailed Answer:
You're welcome!
It doesn't seem to be significant because it does not ring any bells... I don't know of any disorder that causes sweating at the same time every day (or night).
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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