Chills

Definition

Chills is the common name for a feeling of coldness accompanied by shivering and possibly fever .

Causes & symptoms

Chills may occur due to the following reasons:

• Exposure to extremely low outside temperature.
• Insufficient protection from cold temperature or weather.
• Age, as newborns and elders are intolerant of cold temperature.
• Anemia , particularly in women who frequently complain of cold intolerance. The condition is frequently found in females of reproductive age due to significant monthly blood loss during menses.
• Stress or poor health condition.
• Malnutrition. Poor diet and/or B-complex vitamin deficiency often makes a person more sensitive to cold temperature.
• Hypothyroidism . Hypothyroidism is one of the most common reasons for cold intolerance in women.
• Diabetes.
• Poor immune function as in AIDS or cancer patients. In these patients, chills and shivering may be signs of infections (most likely), tumors, drug-induced fever, or malnutrition.
• Infections. Chills and fever are often caused by the common cold or viral infections. However, they may also be due to something more serious such as cystitis (bladder infection ), septicemia (blood infections), pneumonia, meningitis, malaria or tuberculosis .
• Medications. Certain medications such as beta interferons can cause chills as side effect.
• Unknown infections or diseases.

Diagnosis

Those suffering from chills should investigate possible causes if the symptoms persist or are accompanied by fever and/or night sweat. They may be a sign or symptom of something serious and may require medical attention. Doctor can make accurate diagnosis of underlying diseases through detailed questioning about the chills, accompanying symptoms if any, patient's diet, daily stress, and lifestyle. In addition, doctors may order blood tests for anemia, hypothyroidism, or infections if these conditions are suspected.

Treatment

Alternative treatment of chills includes protecting oneself from inclement weather conditions, drinking warm teas, and making appropriate dietary changes. Ayurvedic treatment might include fomenation therapy, called svedana, to aggravate the fatty tissue and force excess sweat out of the body. Svedana is used to relieve bodily stiffness, heaviness, and coldness.

In traditional Chinese medicine , those complaining of chills should follow a diet of "warming" foods and avoid "cold" foods. Reference to cold or warming does not mean the actual temperature of the food, but its internal effect. In general, the Chinese recommend cooked rather than cold, raw foods for this condition. The Ayurvedic formula for producing internal heat is trikodu, made of equal parts of ginger , black pepper, and long pepper (pippali, native to India and Java), and alleviating coldness and stagnation in the body.

Nutritional therapy

The following dietary changes are recommended to help prevent chills and cold intolerance:

• Limiting alcohol and caffeine intake and refraining from smoking tobacco products. These chemicals increase cold intolerance.
• Drinking warm tea with or without herbs such as ginger (a warming herb used in Chinese and Native American medicine ) or chamomile.
• Taking daily multiple vitamin/mineral supplement or B-complex vitamins with C. People who are deficient of B-vitamins often are sensitive to cold temperature.

Allopathic treatment

Persons should consult their doctors if cold intolerance is severe or if chills are often followed by persistent fever or night sweats. They may be signs or symptoms of serious conditions or infections. Hypothyroidism or poor thyroid function should also be ruled out in women complaining of cold sensitivity.

If cold intolerance is accompanied by other signs and symptoms of thyroid deficiency such as lethargy, obesity , and depression , persons should consult their doctor for treatment of hypothyroidism. Thyroid supplement may be necessary.

Patients should also be concerned if chills frequently occur with fever. Fever may be the body's response to infections. Persistent chills, night sweat, fever, and rapid weight loss should be brought to a doctor's attention. They may be symptoms of cancer or infections such as AIDS or tuberculosis. Chills and fever in immunodeficient patients are often signs of infections that can be serious in patients with weakened immune systems.

Fever and chills can often be treated with over-the-counter medication such as acetaminophen or ibuprofen. Aspirin should not be given to a child for fear of Reye's syndrome. Patients should be given soups, fruit juices, or water to replace fluid loss due to fever. If fever is high (more than 104°F [40°C]), occurs in newborns (less than three months old) or lasts longer than 48 hours, a physician should be contacted.

Prevention

Wearing appropriate clothes for the weather, eating nutritious foods, and taking dietary supplements may help prevent chills in some people.

Resources

BOOKS

The Burton Goldberg Group. "Chills." In Alternative Medicine: The Definitive Guide. Tiburon, CA: Future Medical Publishing, Inc., 1999.

Yoder, Ernest. "Disorders due to Heat and Cold." In Cecil Textbook of Medicine, 2nd ed. Philadelphia: W.B. Saunders Company, 2000.

ORGANIZATIONS

National Cancer Institute. Building 31, Room 10A24, 9000 Rockville Pike, Bethesda, MD 20892. (800) 422-6237.

OTHER

Strange, Carolyn J. "Fighting the (I'm) Cold War." iVillage.com http://onhealth.com/women/columnist/item,46788.asp.

PDQ. "Fever, Chills and Sweats." CBS Health Watch http://cbs.medscape.com.

Mai Tran