UTI causes stark changes in body temperature regulation

I am an 80-year-old man in relatively good health. I don’t smoke or drink, and I have a vegetarian diet. I exercise moderately, and I am not overweight. About 30 years ago, I contracted a serious UTI that affected me while at work. I was very cold, shivering with chattering teeth.

Luckily, the local fire department was there for a false fire alarm. One of the EMTs took one look at me and called for an ambulance, and off I went to the local ER. I was diagnosed with a massive UTI and given IV antibiotics. Because I was in excellent overall health, I was discharged with a prescription for more antibiotics and to rest at home.

Since then, especially in the colder seasons, I am always cold, needing double the clothing. At bedtime, I wear socks, sweatpants and a shirt as well as a hat. We have multiple layers of blankets. Any thoughts on this? -- C.B.

ANSWER: I have conjectures.

One of the most common causes of sepsis (a syndrome of the body’s response to severe infection that it sounds like you had) are infections that start in the urinary system, often as a consequence of kidney stones or, in men, an enlarged prostate. Sepsis has persistent adverse effects on the body for years after infection.

The most commonly known are neurological and cognitive, ranging from muscle weakness, to depression and PTSD, to decreased memory and ability to think clearly. One less well-known effect are changes in temperature regulation. This is clearly reset (at the level of the hypothalamus, deep in the brain) during the infection, but many people do complain of feeling cold afterward. Thirty years is beyond my experience, though.

Another possibility is weight loss. You mention you are not overweight, but most people lose weight during a severe infection. Although most put it back on again, loss of a few pounds can certainly affect how cold you feel. I doubt this is the whole answer, but it may contribute.

The thyroid gland is affected by sepsis as well, usually causing low thyroid levels. You should have had these checked. Finally, many people get more cold-intolerant as they get older, but it sounds like this was a sudden and dramatic change when you were still quite young (50 is still pretty young from a medical perspective).

I imagine you have given thanks over the years to that sharp-eyed EMT. Once a person gets as sick as you were, there is a point in which the body cannot recover, and that EMTs’ good judgment may have saved your life.

DEAR DR. ROACH: Two weeks after having COVID-19 last April, symptoms of Parkinson’s disease began to arise: a slight tremor in one leg and a fluttering in the chest. These symptoms worsened, and in August, I was prescribed levodopa/carbidopa. My symptoms disappeared. The neurologist diagnosed Parkinson’s without any other testing. I am a 59-year-old female with no history of ill health and no family history of Parkinson’s.

I began to read of tremors reported after COVID. Is there a possibility that the tremors are directly related to the virus? Would they subside on their own with time and without progressing as Parkinson’s? -- Anon.

ANSWER: COVID-19 is rewriting textbooks. We still have much to learn, but you are correct that a small number of people develop symptoms of Parkinsonism, and that these symptoms may be short-lived and may not represent actual Parkinson’s disease. However, we don’t know just yet if getting these symptoms after COVID predicts getting Parkinson’s disease later on or whether there is an additional risk.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.