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Fever in the Morning (Afternoon & Night)

Fever in the Morning (Afternoon & Night)

I slide the plastic thermometer out of my mouth and peer at the little digital screen: “99.5” flashes back at me. Again. And once again I reach for the bottle of Extra-Strength Tylenol and choke down a couple of capsules, hoping they’ll help ease this “icky fever feeling” festering in my head.

Having a low-grade fever isn’t that big of a deal, right? But when you have one every day, and your normal body temperature is around 97.6, it can make you feel pretty crappy. What’s going on? Why do I have a fever nearly all the time? Surely a constant fever, even if low, can’t be good for a person (nor can taking Tylenol every day).

Can RA be causing this uncomfortable symptom?

At a recent appointment with my rheumatologist, I asked him about my fevers and he didn’t have any answers, really. He didn’t think my RA was causing them and then advised me to bring it up with my primary care doctor. Well…hmmph. With no real answers, I left the clinic disappointed and still confused.

Why confused? Before my appointment, I had done a little researching online to see if there was any sort of RA-fever relationship. I found some results confirming the connection from a few different health sites, such as Everyday Health, Healthline, Mayo Clinic, American College of Rheumatology.

According to Everyday Health, “Rheumatoid arthritis symptoms can include fever along with aches and stiffness. You might find it connected to a flare or a far more regular occurrence.”

Everyday Health’s website also states, “Low-grade fever is one of many common rheumatoid arthritis symptoms you may experience. Some people have fevers frequently, while others may feel slightly feverish yet do not attribute it to their rheumatoid arthritis. Similarly, not everyone responds to fever medication in the same way.”

Personally, I’ve been having these low-grade fevers daily, and I can’t even remember when I first started noticing this trend–a year ago? Two years? More? No idea. I feel like it’s been going on for quite a while, though. Several questions go through my head: Have I been having fevers the entire 18 years I’ve had RA? Does the Extra-Strength Tylenol even work when I take it?

Is there a way to make this stop?

According to the Everyday Health article, some RA patients’ fevers are not helped by over-the-counter fever-reducing drugs; patients just have to put up with them. It makes me wonder if this is why I feel generally crappy/blah/fatigued/sickish most of the time. And why does my rheumatologist say my fevers aren’t from RA after I’m finding this information online? Being his patient for nearly 10 years, I usually always trust what he tells me. Confused, I do more digging.

Healthline’s website also states that one of the symptoms of RA includes low-grade fever. The article goes on to identify inflammation as one of its causes as well as an increase in metabolic rate in patients with RA. Hmm. If my metabolic rate is increased then why can’t I lose weight? More questions! Well, weight loss is a different frustrating issue (Fat and Feverish–my new memoir title?).

I do realize human bodies are extremely complicated and that having a body with an autoimmune disease isn’t easy to figure out. I wouldn’t mind a few solid answers on this “fever thing,” though. I’m getting really tired of feeling like someone whacked me with a baseball bat every day. Continually shelling out hard-earned money for acetaminophen is also annoying when I should be buying organic spinach or something.

The good news…

The good news about all of this is that low-grade fevers don’t seem to be alarming, dangerous, or all that uncommon, according to Healthline:

“Normal body temperature ranges from 97 degrees Fahrenheit to over 99 degrees. Fevers under 101 degrees are not considered serious in adults and are also not uncommon in RA patients. If your fever rises above 101, contact a doctor so that the underlying cause can be determined. If you have RA, make sure the doctor you see knows this. Be prepared to tell [him or her] what medicines you’re using for RA treatment.”

Okay, so I’m probably not dying. That’s good. There are also probably more complicated, detailed reasons for the RA-fever connection. Hopefully the few sources I mentioned above at least help give me (and you) a bit of a start to finding some answers and relief.

My next step is to make an appointment with my internist primary doctor and talk to her about these pesky fevers; I hope she’ll have a helpful answer and solution. In the meantime, I guess I’ll keep expanding my lovely Tylenol bottle collection.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Ken F
    7 months ago

    I have these fevers, or hot flashes, occasionally. They feel ‘only skin deep’, but are still uncomfortable. A cold, damp cloth applied to my head and neck areas seems to help most of the time. If it does not work, I know I am in for a long feverish day.

  • MissBeki
    10 months ago

    Angela, so sorry for your frustrating symptoms. 3 things before I forget.
    1.Methotrexate chills
    2. Probiotics
    3. Medicines that mask symptoms

    #1. I have been taking methotrexate for close to 20 years. I get really bad chills, not every week, but more so with heat or sun, but my temps are usually 97ish. I also started having weird drug interactions on it. So I looked into it, and both are balid side effects from methotrexate, and seems like fevers were on the list, but not sure.
    #2. Our immune system is in our gut, and I have been able to avoid illnesses and help my very aggressive RA by taking some good priobitics daily. Kefir is great too. Also, I do well on a plant based diet, even though my cholesterol continues to be high, another side effect of methotrexate.
    #3. Masking symptoms. I was on a biologic for about 6 years. I was having a slight cough after I ate, dr attributed to acid reflux. Long story short, it got worse, but no other problems, but I was unable to eat much. One week I developed a fever of about 102°, and felt horribly sick. Went to gastroenterologist’s P.A., she ordered a CT scan. I had had diverticulitis infection for all that time, and it had abscessed and perferated my bowel. So, many surgeries later, no more biologics for me, rheumatologist orders. The pount is that some immuno suppressant drugs can mask symptoms, so don’t ignore a high fever, or anything out of your “auto-immune” normal.
    Hope this helps, and that you get some relief.

  • PinkRose93
    10 months ago

    Guys and gals, I hate to tell you this but if your rheumatologist doesn’t know that your low grade fever and hot flashes are a normal symptom of RA, you should look for a new rheumatologist. I saw one that didn’t have a clue what my symptoms we’re and only diagnosed me with fibromyalgia. I kept having flu like symptoms and he would just tell me that I had a virus. I got fed up with him and asked my primary care physician to refer me to a different rheumatologist. Thank God he did. My new rheumatologist is extremely knowledgeable and has years of experience. He has trained other rheumatologists and nurse practitioners and even has a clinic with an in house lab, infusion center, pharmacy, x-ray, MRI, and eye doctor. He knew right away what was wrong and told me the flu like symptoms I was constantly having were a normal part of the disease process. The chronic inflammation throughout the body causes them. Your immune system is not working properly and is constantly constantly attacking your own healthy tissue so you have rises in body temperature. Your immune system has turned on you and is actually fighting you instead of foreign invaders like viruses and bacteria. Because of this, you are weak and tired and always feel sick and your immune system is actually doing the opposite of what it should be doing. Instead of protecting you from harmful illnesses, it is making you more susceptible to them. So…if your rheumatologist doesn’t know that, he needs to go back to school and change his specialty or get more training in autoimmune diseases. He should know that if he is going to treat people with RA and other forms of autoimmune arthritis. You wouldn’t take your car to a mechanic who can’t diagnose what is wrong with your engine when it’s sputtering so don’t take your body to a rheumatologist who doesn’t know the basic symptoms of RA.

  • sadie
    1 year ago

    I relate to all of these symptoms. I have been feeling particularly bad for the last two months with new symptoms popping up, a sore jaw , throats and ear and fatigue that is crushing! I am on Actemra. I went to my PC doctor who did blood work and found that my WBC was dangerously low. My Rheumy consequently took me off the Actemra. I was tested for thyroid issues and was found with a huge solid cyst . Getting biopsy this coming week. I am so hoping this is the answer to my fevers and fatigue! Very possible. We all should not assume that our symptoms of illnesses are always related to our RA diagnosis. Get your thyroid checked, even if your levels are good, which mine were. I am blessed with a very thorough doctor who wanted to rule our thyroid issue as they are very often overlooked due to doctors just going on blood levels! I was sent for an ultrasound which detected the cyst , otherwise unknown . I’ll let you all know what comes out of the biopsy and hope this info will change someone’s life! Prayers and gentle hugs, Mary

  • ruthmg
    1 year ago

    While not exactly the same as I fever I have felt the same about hot flashes. My rheumatologist said she did not consider those an effect of RA I can’t think of what else would cause those aches and hot flashes.I have had those symptoms for years.

  • Richard Faust moderator
    1 year ago

    Hi ruthmg. Sorry to hear you are having these unexplained hot flashes. In this article one of our contributors writes about her experience with sweating and what she refers to as hot flashes: She notes that this can be a side effect of some RA medications. Don’t know if this came up with your doctor, but if not, you may want to ask if this is a possibility. Best, Richard ( Team)

  • DocMAWpT2
    2 years ago

    Hello Angela,
    I can totally relate to these fevers.I have a low temp around 97.5 & get daily fevers, usually evening; not sure about morning. I believe that it has been worse fall-spring. I am not super about monitoring because no one seems to want to pay attention to them. However, if I do not have an anti-inflammatory each day, then my temp rises! My stomach does not like that:-)
    I have been struggling with some issues my entire life, but things escalated to the point of not being able to work several years ago. There is not consensus of RA at all times because it is sero-neg & I also have much OA as well as inflammatory arthritis. Some say Sicca, others Sjogrens. Also CVID. All systems are involved & the fatigue is beyond incapacitating. The mind says yes, but the body says no… I too worked in the medical field & these fevers do not seem inconsequential, nor do all my symptoms seem unrelated. The fluctuating temps & diagnoses can be as frustrating as the symptoms themselves at times. I would love to see more research regarding this.
    Thanks for your article.

  • kat-elton
    2 years ago

    Hi Angela,
    I started having fevers regularly last year as well, for the first time, and I think that for me it is related to the biologic I started. Any chance it is related to a new pharmaceutical regime? Although I think too, that it could be an RA related symptom for sure. Sorry this is happening for you and thanks for writing about this!

  • Kelly Dabel moderator
    2 years ago

    Hi Kat, Sorry to hear about your fevers. Anytime you have any new, changing or concerning symptoms, speak with your doctor right away. While fever can be a possible side effect to some medications, it’s worth mentioning to your doctor. Glad you found this article helpful, Thanks for commenting and being part of our community. Kelly, Team Member

  • wannabe-healthy
    2 years ago

    Angela, it is if you were reading my mind, really! I too have had RA for 18 years, and also my average temp is around 97.4. The past 4 years, I noticed in November I would be achy and have chills. When it first happened, I checked my temperature and saw my temp was about 99.8. I thought I could have gotten a virus and wasn’t alarmed. As weeks went by, I still had a low grade fever. My rheumatologist (whom I’ve been with since first being diagnosed) told me he did not think fever was a symptom of RA. He told me to contact my family doctor if it got above 101 degrees. My fever was hardly ever “normal”, and it lasted until March. It happened again the next Nov. to March. I’ve had every test known to man to see what it could be, even had lots of vials of blood taken at the infectious disease doctors’ office. Everything was negative.
    I’m now in my 4th year of fevers, always starting in November. This has been my worst year as far as fatigue and just feeling so bad that I have to lie down. Nothing I take helps, so the only thing I do is drink plenty of water. The 1st thing that happens that lets me know the fever is starting is my eyes start burning.
    Since our stories are so similar, I have to say I believe it is from inflammation. I must say it is annoying, but not life threatening. There is so much about RA that is mysterious, I just add the fever at the top of the list. There are days my temperature stays around 100.5 degrees all day, I just wonder why there’s something else making it even harder to deal with. After all is said and done, I know I am just going to have to adjust and keep moving.

  • Kelly Dabel moderator
    2 years ago

    Thank you for sharing! Glad this resonated with you and hopefully reminded you that you are not alone in this. Sorry to hear of your ongoing fevers. Wishing you some relief soon as March draws closer. Thank you for being part of our community. Kelly, Team Member

  • DesertStormTrooper
    2 years ago

    I had the same thing, almost every day. I also had night sweats that left every inch of my body soaked with a glaze of sweat. Every doctor I’ve ever spoken to has said that fever is an indication of infection. Hmm..But apparently, this does not apply to RA, according to the medical community.

    I want to yell at the top of my lungs to everyone and try, somehow, to convince them that RA/RD, MS, FIBRO, etc can be the result of an insidious stealth infection. Not any kind of normal infection, but one that is so stealthy that, although it is possible to beat it way down, it MIGHT be impossible to ever completely eradicate it. The jury is still out on that one.

    Why, why, why is it so difficult for everyone to grab onto the concept that their bodies are not just all of the sudden attacking themselves, but that it actually is doing the best it can to help to heal us.

    – Occasional fever
    – Flu like symptoms or body aches
    – Moving pain and inflammation

    Strange…many of these symptoms are the same thing that happens when your body is fighting a flu bug….Hmm. Nah. Just coincidence.

    What if, for one second, you give your amazing machine of a body credit and consider that there really is something in your system that your body is attacking? And what if these invaders are so skilled at evading the immune system that even though it tries and tries, it just can’t get on top of these types of infections on it’s own??

    So, the pharmaceutical community’s attack plan is to disable the immune system so that it can no longer even try to help heal you. That’s a great plan! Funny, they use the same approach for cancer. And, this approach to either one of these diseases is obviously a huge failure.

    Personally, I entertained those thoughts and treated myself as if I had one or more of these stealth infections. And, guess what? I’m not suffering anymore. I’m not perfect, I get some chronic fatigue still, I still deal with a few other minor symptoms that I’m not sure will ever go away. BUT…I’m no longer suffering like most of the rest of the people that I read about on this site. In fact, when I first started treating myself with supplements and cannabis oil, the fevers, night sweats and body aches were the first symptoms to go (within 10 days in fact).

    This disease has changed my life, for both good and bad. But…it no longer is able to keep me in agony. I hope, against hope, that others will eventually try attacking this disease in a different fashion (ie naturally instead of using harmful pharmaceutical meds).

    All the best.

  • Kelly Dabel moderator
    2 years ago

    Thank you for sharing your story DesertStormTrooper. Glad to hear you’ve found a treatment plan that’s helping you feel better. We appreciate you being part of our community. Kelly Team Member

  • Lawrence 'rick' Phillips
    2 years ago

    Angela, I am so sorry you are feeling tough. I have no sage advice, except to say I hope things get better soon.

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