Phantom Fevers

Last updated: March 2022

Periodically and unexpectedly, I come down with fevers. Sometimes they come with other symptoms like coughing, congestion, or headaches. But more often, they arrive and depart mysteriously.

Fever with rheumatoid arthritis

Over the years I have learned a few things that may ring true or help other people with rheumatoid arthritis to understand random fevers.

  • My natural temperature runs low. Usually my body temperature hovers around 97 degrees. My doctor says this is because prednisone, methotrexate, and the biologic I take can lower body temperature.
  • With a low temperature, it can be difficult to detect fever. I often feel weird or bad in some way before we realize I may be ill. If we check my temperature, it may be up to 98 degrees, which most will still consider low. So I have to both know what temperature is high for my body and also listen to how I am feeling— such as overall illness, sweating, more aches, or other possible symptoms.
  • Consult with your doctor about how to handle medications. I’ve had many conversations with my doctor about my medications. If I have a fever the day I’m supposed to take my biologic, I am instructed to hold until I feel better and fully recovered. If the fever goes on for more than a day, I need to call and check in with my doctor.
  • It can be helpful to increase your prednisone.Because I have been on a low dose of prednisone for a very long time, my internist recommends that when I’m sick I temporarily increase my prednisone dosage. Apparently, my body will not naturally respond to illness by producing anti-inflammatories and so the extra kick of prednisone can help with the recovery.
  • Sleep or rest is crucial for recovery. For me, when I have a fever it means I need to spend time in bed, ideally sleeping. Sure, maybe Tylenol or tea will help. But really my recovery depends on lots and lots of sleep. I can spend the whole day in bed and still have a fever.

Rest to relieve fever symptoms

I’m curious about other RA patients and their experience with fever. Do others get fevers out of the blue? How do you cope with an unexpected fever?

My feeling is to stop, rest, and recover from a fever in the hopes of pre-empting another, more serious development. Ever since coming down with pneumonia last year, I’m a bit paranoid about an illness that slowly worsens and develops into something that serious. My goal is to head a fever off, nip it in the bud.

How to cope

I am mystified by my fevers. It feels like in recent years they are somewhat more frequent and I have no idea how to prevent them or treat them except to be vigilant and quick in my response.

Perhaps it is a ridiculous thought, but I sometimes think it’s actually my RA. Like the disease is cranky and so acts out with a fever attack on my body that I can’t understand.

My husband, Richard, is helpful and patient when I get a random fever. He plies me with tea and makes sure I rest. But I am sure that it perplexes him as well. I’ve been trying to maintain my overall health and think this year I made progress with getting sick less and also not as seriously. But these fevers are still a strange mystery.

As I continue on my RA journey, I still grapple with situations I’m not quite sure how to handle. But at least I am making headway. At least with phantom fevers, I am starting to understand them a little better and tackle them immediately.

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