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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18313
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I just read a thread from 6 years ago 8/4/10 about perstent

Customer Question

I just read a thread from 6 years ago 8/4/10 about perstent low grade fever and I have the same symptoms. I also have hay fever and cross allergy symptoms. Like the original person I also take adderall and Lexapro.
I had blood work done, a cat scan and an MRI. The MRI found a nodule on my pancreas and I'm scheduled for a biopsy to rule out cancer.
Do you have any new thoughts about this?
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. David replied 8 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 8 months ago.

I am sorry you are having these symptoms.

hay fever and allergy symptoms can cause a bacterial sinus infection and low grade fever as well.

you need to start on a course of antibiotics and allergy medications and steroid nasal spray to see if these help your allergy symptoms.

I doubt your pancreatic nodule is causing your fevers.

Customer: replied 8 months ago.
My doctor says I don't have an infection of any kind. An MRI of my head showed nothing.
Customer: replied 8 months ago.
I have a low grade fever every single day between 99-100. The fever is only during the day. I feel fatigued and have some mild Dolby aches when I have the elevated temp but other than that, I have not other symptoms. This has been happening for about a year
Expert:  Dr. David replied 8 months ago.

are you opposed to taking allergy medications like allegra, claritin, Nasocort, Rhinocort steroid nasal spray which can help allergic rhinitis?

those could help your allergy symptoms

you don't have sinus congestion? sinus tenderness? these can be a sign of a sinus bacterial infection.

Customer: replied 8 months ago.
I'm not opposed to allergy medication and I do use it seasonally. I have see my allergist and he also said I do not have a sinus infection. I am currently doing weekly allergy shots. I used Nasocort and Zyrtec this past summer but I still had the daily fever. I have no sinus congestion or sinus tenderness.
Expert:  Dr. David replied 8 months ago.

have you had your thyroid hormone levels checked? hyperthyroidism can sometimes cause low grade fevers.

are you taking a rectal temperature? ear thermometers, even digital can be wrong and show incorrect body temperatures.

Customer: replied 8 months ago.
My thyroid was checked recently in 2 complete blood tests. I take my temp orally and thought my thermometer might be off so I bought 2 different digital oral thermometers and took my family's temp too. They are all normal.
My blood test also show no antigens for any autoimmune disorders either. The only thing the blood test showed was that my platelets are slightly elevated at 405.
Expert:  Dr. David replied 8 months ago.

low grade temp of 99-100 for you could be normal for your situation

if you feel well and don't have symptoms, I would not worry

I bet a rectal core temperature for you would be normal.

Customer: replied 8 months ago.
What is my situation?
Before this started my temp has always been 98.5 or below.
I never have a fever late evening. Sometime the fever will start mid morning. Sometime not until mid afternoon.
I find it interesting that the original poster who had the same daytime fever also had food allergies and was taking adderall and Lexapro like I am.
I don't feel well when I have the fever. I feel fatigued and need to rest
Expert:  Dr. David replied 8 months ago.

at your age, you could be feeling hot flashes from declines of your estrogen levels.

Customer: replied 8 months ago.
I've been postmenopausal for seven years. I know what a hot flash is
Customer: replied 8 months ago.
How do you know my age? I didn't tell you.
Expert:  Dr. David replied 8 months ago.

you should check your rectal core temperature. I bet it will be normal

Customer: replied 8 months ago.
my oral temp can be off somehow?
I've had my temperature taken orally at the doctor's office and it is consistent with the readings of my two home thermometers. My family's temps are all within range using the same two thermometers that I take my temp with.
Expert:  Dr. David replied 8 months ago.

oral temp can often be inaccurate.

rectal temperature with a mercury temp can be more accurate.

Customer: replied 8 months ago.
Only my oral temp is inaccurate? How can that be?
Expert:  Dr. David replied 8 months ago.

oral temp can be wrong and not your true core body temp

Customer: replied 8 months ago.
While I'm sure that's true, I don't believe my temp reading is off considering that all 4 other members of my family all have an accurate and normal temperature in range using the same exact thermometers that I use.I hope you didn't stress yourself out too much trying to figure this out.Thanks for nothing.
Expert:  Dr. David replied 8 months ago.

that is pretty nasty of you to say something like that.

Customer: replied 8 months ago.
Are you serious? You said I should be on antibiotics before even asking me any questions. You also suggest I'm having hot hot flashes without having idea how old I am. You didn't ask me anything at all about my menstral cycle at all. You also ignore that fact that my doctor has confirmed my temp readings and that everyone else has a NORMAL temp with the same two thermometers that I'm using.
So Dr. Dave, I apologize for my comment. I can see that you are truly working to the best your ability and it's unfair of me to suggest otherwise.
Expert:  Dr. David replied 8 months ago.

you said you are 54 years old, that is a very common age for women to be at or starting or after their menopause.

I recommended that you check a rectal temperature. I bet that will be normal for you.

why do you take lexapro? for depression symptoms? for anxiety symptoms?

it sounds like your anxiety symptoms are out of control with worry about your body temp.

Customer: replied 8 months ago.
I said I was 54 after you suggested I'm having hot flashes.
Expert:  Dr. David replied 8 months ago.

I'm going to let another expert help you here.

thanks for using JustAnswer.com

Customer: replied 8 months ago.
I don't want a referral. It was a mistake to expect that I could expect some help from an online Dr. Website.
Expert:  Dr. D. Love replied 8 months ago.

Hello from JustAnswer. This is Dr. Love, a different expert.

There is a long list of conditions that can cause mild temperature elevations. By a strict medical definition of "fever', a temperature of 99-100 is not considered a fever, although it is commonly referred to as a low grade fever, as you are doing. Once infections have been excluded as a possibility, the most common causes would be some type of chronic inflammatory condition.

Certainly, chronic inflammation related to allergies can cause this, which is why allergic rhinitis is called hay fever, and if you are having other hay fever symptoms, treating the allergies more aggressively would be appropriate.

However, it is also true that chronic inflammation of the pancreas (pancreatitis) also can cause fever.. This can be related to inflammation surrounding a tumor growing in the pancreas, but also can occur from other causes of chronic pancreatitis. If this nodule turns out to not be cancer, it could be an inflammatory nodule, and the mild temperature elevation could be related to the inflammation.

You do not say whether any pancreatic blood tests have been done, such as amylase or lipase, and if not done, these tests may indicate evidence of pancreatic inflammation.

There also can be a variety of chronic inflammatory conditions that can cause lo grade temperature elevations, so if allergies and pancreatic diseases are excluded as a cause, the next step would be evaluation to look for evidence of systemic inflammatory conditions.

If I can provide any additional information, please let me know.