Why is my wife’s body temperature so low?

MY WIFE, who has epilepsy, has a very low body temperature — it varies between 33c and 35.5c.

Whenever she stays in hospital, staff check it continually and use a Bair Hugger (a blanket pumped with heated air) and extra covers to raise it. What is the safe minimum temperature, or do we all have different levels?

A. N. Tallentire, Darlington.

AHIGH temperature used to be confirmation of an infection. However, years of experience have taught me there is a wide variation between healthy individuals, so ‘high’ in one patient is normal in another — and studies reflect this.

Though the average ‘normal’ temperature in adults is 36.8c, statistical outliers — that is, healthy people at the extremes of the normal range — could well have a temperature of 35c without being ill.

This is not something to worry about necessarily: the human body has a finely tuned capacity for regulating its own temperature.

The central control system for this is an area of the brain called the hypothalamus, which detects the temperature of blood and the signals arriving from sensory nerves in the skin.

It then adjusts body temperature by triggering processes such as sweating and shivering.

Unfortunately, there is a tendency to adopt a one-size-fits-all mindset and assume there must be a problem if a patient’s temperature is not around 37c.

The site where the temperature is measured is also relevant. The temperature in the rectum is 0.3 to 0.6 degrees higher than the mouth, which is 0.3 to 0.6 degrees higher than the armpit.

WHaT complicates the picture further is that glass thermometers containing mercury, which are accurate and familiar to doctors, have been unavailable since 2009 due to concerns over the toxicity of mercury.

There are three other options: tympanic thermometers, which read the temperature of the eardrum; digital thermometers, which can be used in the mouth, rectum or armpit; and disposable paper strips, which usually measure temperature in the mouth but at the moment are for hospital use only.

(I’ve found these alternatives less satisfactory and less accurate than mercury thermometers.) If your wife is well and symptomfree, then her body temperature reading is of no consequence.

Her level may be considered low, but that is normal for her. Of course, if it goes up to 37c one day, this means she has a temperature two degrees elevated.

You mention that your wife has epilepsy, but I have found no evidence that the anticonvulsants used to treat it, nor epilepsy itself, have any influence over the body’s natural mechanisms for regulating its temperature.

However, on a minor point of interest, some research from 2006 found that mice with a body temperature 0.3 to 0.6 degrees lower than the ‘normal’ measurement lived 12 to 20 per cent longer.

The researchers questioned if this might be the case in humans, too. Interesting food for thought. I HAVE a history of breast cancer. An MRI scan has revealed I have chronic pancreatitis. Could you tell me more about this diagnosis? I am 78 years old.

Mrs M. Mehmet, Clacton-on-Sea. CHRONIC pancreatitis is the medical term for an inflamed pancreas, which can lead to permanent damage (unlike acute pancreatitis, where the organ becomes severely inflamed over a short period of time but usually improves after a week or two).

The pancreas, which is about 6 in long, is located high in the abdomen, the top of it tucked into the curve of the duodenum (the first section of the small intestine), close to the liver; it then extends out under the diaphragm, close to the spleen.

The organ has two functions: it is an exocrine gland, which means it secretes substances — digestive juices to break down food — via the pancreatic duct and into the duodenum, and it is also an endocrine gland, producing hormones such as insulin and glucagon that are secreted directly into the bloodstream and help to regulate blood sugar levels.

If the pancreas becomes chronically inflamed, it affects digestion and also your ability to control your blood sugar.

The most common cause is excess alcohol. But it can also be genetic, due to pancreatic stones (which develop from calcium deposits) blocking the pancreatic duct or, less commonly, the autoimmune condition lupus.

Pancreatitis may be present for months or even years before symptoms occur.

The most typical symptom is abdominal pain, usually high up under the ribs, often radiating through to the back. The pain is usually worse after eating and may be accompanied by nausea or vomiting.

For up to one in five patients, the first symptoms relate to poor digestion, particularly the inability to digest fats. This typically causes loose, greasy, foul-smelling stools.

another symptom may be high blood sugar levels — in other words, diabetes — which may be severe enough to require ongoing regular treatment with insulin injections.

But do not be too worried — if your condition wasn’t identified until the scan, it suggests you’ve had no symptoms.

If it does start to cause you pain, there are steps you can take to alleviate it, as well as treatments to improve the function of your pancreas and control any complications.

The first thing to do will be to monitor you to assess how the condition affects your digestion, and most importantly to check on the level of damage to your bloodsugar control.

If the damage is severe enough to have caused diabetes, then effective management is crucial.

If you are in pain, the usual advice is to avoid alcohol. Low-fat meals can also help, as the pancreas doesn’t have to work as hard to digest them. You may be referred to a dietitian for this.

PaINkILLeRs can also be necessary in some patients and, if these don’t help, there are nerve-blocking injections to prevent pain signals travelling from the pancreas.

Meanwhile, excessive fat in the stools can lead to poor absorption of fat-soluble vitamins a,D, e and k, so treatment with pancreatic enzyme supplements may be prescribed to replace the enzymes no longer being secreted.

I suspect your condition is unrelated to your previous breast cancer.

I hope it is not too severe, that a cause can be pinned down and that you will benefit from any advice about treatment.