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Causes of Lower Than Normal Body Temperature

author image Dr. Ann M. Hester
Dr. Ann M. Hester is a board-certified internal medicine specialist and author. She is also the creator of the Patient Whiz patient engagement app for iOS and Total en Salud health app in Spanish.
Causes of Lower Than Normal Body Temperature
Drinking a cold beverage shortly before taking your temperature orally can lead to a low reading. Photo Credit pixinoo/iStock/Getty Images

You probably learned somewhere along the way that normal body temperature is 98.6 F -- but that’s not quite accurate. Body temperature varies throughout the day, reaching its lowest at about 4 a.m. and its highest at about 6 p.m. Normal body temperature ranges from about 97 F to 100 F, with some variation among individuals. Therefore, a body temperature slightly less than 98.6 F is generally nothing to worry about. However, a body temperature less than 95.8 F signals a condition called hypothermia. A lower than normal body temperature can occur for a wide variety of reasons that fall into three general categories: increased heat loss, decreased heat production and impaired temperature regulation.

Increased Heat Loss

Body temperature reflects a balance between your body’s heat production and loss. Exposure to cold environmental temperatures, particularly if you are wet, can overwhelm your body’s ability to maintain a normal temperature and lead to hypothermia. Severe hypothermia is potentially life-threatening. Serious hypothermia is more likely to occur in prolonged exposure to extreme conditions, such as if your car breaks down in a blizzard, rather than spending a few hours skiing or snowboarding in appropriate clothing. Drinking alcohol can be dangerous when in cold conditions because it triggers dilation of your surface blood vessels and increases heat loss. Newborns and adults older than 65 are most susceptible to hypothermia in cold conditions due to a diminished ability to compensate for loss of body heat.

Severe skin problems can also potentially lead to hypothermia due to excess heat loss. Widespread burns and severe psoriasis are two examples. Another condition called exfoliative dermatitis, which involves extensive sloughing of the superficial skin layer, can also lead to hypothermia. This condition can occur as a reaction to certain drugs and a complication of some cancers, including leukemia and lymphoma.

Decreased Heat Production

Your body produces heat as it uses nutrients to generate energy to fuel basic metabolic functions and muscular activity. Therefore, your metabolic rate acts as a key factor in maintaining a normal body temperature. An abnormally low metabolic rate leads to decreased heat production, which might manifest as a decreased body temperature. Hormonal disorders that influence metabolic rate are common culprits for this type of hypothermia, including:
-- underactive thyroid gland, or hypothyroidism
-- underactive pituitary gland, or hypopituitarism
-- underactive adrenal glands, or hypoadrenalism

Other disorders that might lead to hypothermia due to decreased heat production include:
-- severe malnutrition and anorexia nervosa
-- low blood sugar, or hypoglycemia, and poorly controlled diabetes
-- neuromuscular disorders, such as muscular dystrophy, myasthenia gravis and amyotrophic lateral sclerosis (ALS)
-- severe kidney or liver disease

Impaired Thermoregulation

Your body temperature is regulated in an area of the brain called the hypothalamus. This thermoregulatory center communicates with other parts of the body via nerves to effect actions that maintain a normal temperature. Neurologic disorders can impair the body's complex thermoregulatory mechanisms, potentially leading to hypothermia. Examples include:
-- stroke
-- multiple sclerosis
-- Parkinson disease
-- spinal cord injury
-- traumatic brain injury
-- bleeding in the brain
-- brain tumor
-- neuropathy, or nerve damage

A body-wide bacterial infection, or sepsis, most commonly causes fever. But approximately 10 to 20 percent of people with this condition experience hypothermia, which is believed to occur due to complex problems with thermoregulation. People with sepsis demonstrate many other obvious signs and symptoms, along with an abnormal body temperature.

Medications and Toxins

Several medications can contribute to or cause hypothermia. The mechanisms responsible for the relationship between medications and hypothermia are complex and incompletely understood. Drugs that suppress the nervous system, known collectively as sedative-hyponotics, might contribute to hypothermia by decreasing consciousness, thereby interfering with awareness and taking appropriate action in cold conditions. Hypothermia is particularly likely when these drugs are taken in excess. Examples include:
-- opioid pain relievers, such as hydrocodone (Lortab, Vicodin), oxycodone (Oxycontin, Percocet) and meperidine (Demerol)
-- benzodiazepines, such as diazepam (Valium), lorazepam (Ativan) and triazolam (Halcion)
-- barbiturates, such as phenobarbital and secobarbital (Seconal)

Other medications and toxins that can potentially contribute to or cause an abnormally low body temperature, include:
-- chlorpromazine and haloperidol (Haldol), used to treat schizophrenia
-- atenolol (Tenormin) and metoprolol (Lopressor), beta blockers used to treat high blood pressure and some heart conditions
-- clonidine (Catapres, Kapvay), used to treat high blood pressure and ADHD
-- ethylene glycol poisoning, often due to ingestion of antifreeze
-- organophosphate poisoning, often due to exposure to an insecticide

Warnings and Precautions

See your doctor as soon as possible if your body temperature is consistently or periodically lower than 97 F. Seek emergency medical care if you experience any warning signs or symptoms of hypothermia, including:
-- confusion or slow responses
-- reduced coordination or involuntary movements
-- severe or persistent shivering
-- extreme drowsiness
-- slow, fast or irregular heart rate
-- pale, bluish or purplish skin
-- slow, shallow breathing

Reviewed and revised by: Tina M. St. John, M.D.

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