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Normal human body temperature 1
Normal human body temperature
Normal human body temperature, also known as normothermia or euthermia, is a concept that depends upon the
place in the body at which the measurement is made, and the time of day and level of activity of the person. There is
no single number that represents a normal or healthy temperature for all people under all circumstances using any
place of measurement.
Different parts of the body have different temperatures. Rectal and vaginal measurements, or measurements taken
directly inside the body cavity, are typically slightly higher than oral measurements, and oral measurements are
somewhat higher than skin temperature. The commonly accepted average core body temperature (taken internally) is
37.0 C (98.6 F). The typical oral (under the tongue) measurement is slightly cooler, at 36.8 0.7 C, or
98.2 1.3 F.[1][2] In Russia and former Soviet countries, the commonly quoted value is 36.6 C (97.9 F), based on
an armpit (axillary) reading. Although some people think of these numbers as representing the normal temperature, a
wide range of temperatures has been found in healthy people.[3] In samples of normal adult men and women, the
observed range for oral temperature is 33.238.2 C (92101 F), for rectal it is 34.437.8 C (94100 F), for the
tympanic cavity it is 35.437.8 C (96100 F) and for axillary it is 35.537.0 C (9699 F).[4]
Variations in body temperature are part of the circadian rhythm (see at 4:30 and 19:00).
The time of day and other
circumstances also affects the body's
temperature. The core body
temperature of an individual tends to
have the lowest value in the second
half of the sleep cycle; the lowest
point, called the nadir, is one of the
primary markers for circadian rhythms.
The body temperature also changes
when a person is hungry, sleepy, orcold.
History
In the early 18th century, Gabriel Fahrenheit originally used human body temperature as a reference point for his
temperature scale, defining it to be 100F. Later redefinition of his scale to use the boiling point of water as a
reference point caused the numerical value for normal body temperature to drift.
In 1861, Carl Reinhold August Wunderlich released his summary of the armpit, or axillary, temperatures of twenty
five thousand people, and reported the mean to be 37.0 C (98.6 F), with a range of 36.25 C (97.25 F) to 37.5 C
(99.5 F)[5] [1] . He also identified the natural variations in temperature throughout the day and the variationsbetween individuals, as well as differences based on sex and age, which were largely ignored in favor of an
oversimplified single number.[6] Wunderlich's thermometers were not calibrated to a standard settingin 1861, no
standard had been agreed uponand he never explained his methods for compiling and describing the data he had
collected, which would have been a monumental task before the availability of basic calculating machines.[6] The
one surviving, hand-made thermometer reads significantly higher than modern thermometers.[6]
http://en.wikipedia.org/w/index.php?title=Calibratedhttp://en.wikipedia.org/w/index.php?title=Carl_Reinhold_August_Wunderlichhttp://en.wikipedia.org/w/index.php?title=Fahrenheit%23Historyhttp://en.wikipedia.org/w/index.php?title=Circadian_rhythmhttp://en.wiktionary.org/wiki/nadir#Nounhttp://en.wikipedia.org/w/index.php?title=File%3ABiological_clock_human.svghttp://en.wikipedia.org/w/index.php?title=Circadian_rhythmhttp://en.wikipedia.org/w/index.php?title=Tympanic_cavityhttp://en.wikipedia.org/w/index.php?title=Russiahttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Rectalhttp://en.wikipedia.org/w/index.php?title=Human_body -
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Normal human body temperature 2
Variations
Diurnal variation in body temperature, ranging from about 37.5 C
from 10 a.m. to 6 p.m., and falling to about 36.4 C from 2 a.m. to 6
a.m.
Temperature control (thermoregulation) is part of a
homeostatic mechanism that keeps the organism at
optimum operating temperature, as it affects the rate of
chemical reactions. In humans the average oral
temperature is 36.8 C (98.2 F), though it varies
among individuals. However, no person always has
exactly the same temperature at every moment of the
day. Temperatures cycle regularly up and down
through the day, as controlled by the person's circadian
rhythm. The lowest temperature occurs about two hours
before the person normally wakes up. Additionally,
temperatures change according to activities and
external factors.[7]
Normal body temperature may differ as much as 0.5 C (1.0 F) from day to day.
Natural rhythms
Body temperature normally fluctuates over the day, with the lowest levels around 4 a.m. and the highest in the late
afternoon, between 4:00 and 6:00 p.m.[1][8] (assuming the person sleeps at night and stays awake during the day).
Therefore, an oral temperature of 37.2 C (99.0 F) would, strictly speaking, be normal in the afternoon but not in the
morning. An individual's body temperature typically changes by about 0.5 C (0.9 F) between its highest and lowest
points each day.[1]
Body temperature is sensitive to many hormones, so women have a temperature rhythm that varies with the
menstrual cycle, called a circamensal rhythm.[7] A woman's basal body temperature rises sharply after ovulation, as
estrogen production decreases and progesterone increases. Fertility awareness programs use this predictable change
to identify when a woman is able to become pregnant. During the luteal phase of the menstrual cycle, both the lowest
and the average temperatures are slightly higher than during other parts of the cycle. However, the amount that the
temperature rises during each day is slightly lower than typical, so the highest temperature of the day is not very
much higher than usual.[6] Hormonal contraceptives both suppress the circamensal rhythm and raise the typical body
temperature by about 0.6 C (1.1 F).[7]
Temperature also varies with the change of seasons during each year. This pattern is called a circannual rhythm.[6]
Studies of seasonal variations have produced inconsistent results. People living in different climates may have
different seasonal patterns.
Increased physical fitness increases the amount of daily variation in temperature.[6]
With increased age, both average body temperature and the amount of daily variability in the body temperature tend
to decrease.[6] Elderly patients may have a decreased ability to generate body heat during a fever, so even a
somewhat elevated temperature can indicate a serious underlying cause in geriatrics.
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Normal human body temperature 3
Variations due to measurement methods
Different methods used for measuring temperature produce different results.
Generally, oral, rectal, gut, and core body temperatures, although slightly different, are well-correlated, with oral
temperature being the lowest of the four.
Oral temperatures are influenced by drinking, chewing, smoking, and breathing with the mouth open. Cold drinks or
food reduce oral temperatures; hot drinks, hot food, chewing, and smoking raise oral temperatures.[7]
Axillary (armpit), tympanic (ear), and other skin-based temperatures correlate relatively poorly with core body
temperature.[6] Tympanic measurements run higher than rectal and core body measurements, and axillary
temperatures run lower.[6] The body uses the skin as a tool to increase or decrease core body temperature, which
affects the temperature of the skin. Skin-based temperatures are more variable than other measurement sites. [6] The
peak daily temperature for axillary measurements lags about three hours behind the rest of the body. [6] Skin
temperatures are also more influenced by outside factors, such as clothing and air temperature.
Variations due to outside factors
Many outside factors affect the measured temperature as well. "Normal" values are generally given for an otherwisehealthy, non-fasting adult, dressed comfortably, indoors, in a room that is kept at a normal room temperature (22.7 to
24.4 C or 73 to 76 F), during the morning, but not shortly after arising from sleep. Furthermore, for oral
temperatures, the subject must not have eaten, drunk, or smoked anything in at least the previous fifteen to twenty
minutes, as the temperature of the food, drink, or smoke can dramatically affect the reading.
Temperature is increased after eating or drinking anything with calories. Caloric restriction, as for a weight-loss diet,
reduces overall body temperature.[7] Drinking alcohol reduces the amount of daily change, slightly lowering daytime
temperatures and noticeably raising nighttime temperatures.[7]
Exercise raises body temperatures. In adults, a noticeable increase usually requires strenuous exercise or exercise
sustained over a significant time. Children develop higher temperatures with milder activities, like playing.
Psychological factors also influence body temperature: a very excited person often has an elevated temperature.
Wearing more clothing slows daily temperature changes and raises body temperature.[7] Similarly, sleeping with an
electric blanket raises the body temperature at night.[7]
Sleep disturbances also affect temperatures. Normally, body temperature drops significantly at a person's normal
bedtime and throughout the night. Short-term sleep deprivation produces a higher temperature at night than normal,
but long-term sleep deprivation appears to reduce temperatures.[7] Insomnia and poor sleep quality are associated
with smaller and later drops in body temperature.[7] Similarly, waking up unusually early, sleeping in, jet lag and
changes to shift work schedules may affect body temperature.[7]
Specific temperature concepts
Fever
A temperature setpoint is the level at which the body attempts to maintain its temperature. When the setpoint is
raised, the result is a fever. Most fevers are caused by infectious disease and can be lowered, if desired, with
antipyretic medications.
An organism at optimum temperature is considered afebrile or apyrexic, meaning "without fever". If temperature is
raised, but the setpoint is not raised, then the result is hyperthermia.
http://en.wikipedia.org/w/index.php?title=Hyperthermiahttp://en.wikipedia.org/w/index.php?title=Antipyretichttp://en.wikipedia.org/w/index.php?title=Infectious_diseasehttp://en.wikipedia.org/w/index.php?title=Shift_workhttp://en.wikipedia.org/w/index.php?title=Jet_laghttp://en.wikipedia.org/w/index.php?title=Insomniahttp://en.wikipedia.org/w/index.php?title=Sleep_deprivationhttp://en.wikipedia.org/w/index.php?title=Electric_blankethttp://en.wikipedia.org/w/index.php?title=Alcoholhttp://en.wikipedia.org/w/index.php?title=Weight-loss_diet -
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Normal human body temperature 4
Hyperthermia
Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate. It is usually caused by
prolonged exposure to high temperatures. The heat-regulating mechanisms of the body eventually become
overwhelmed and unable to deal effectively with the heat, causing the body temperature to climb uncontrollably.
Hyperthermia at or above about 40 C (104 F) is a life-threatening medical emergency that requires immediate
treatment. Common symptoms include headache, confusion, and fatigue. If sweating has resulted in dehydration,then the affected person may have dry, red skin.
In a medical setting, mild hyperthermia is commonly called heat exhaustion orheat prostration; severe hyperthermia
is called heat stroke. Heat stroke may come on suddenly, but it usually follows the untreated milder stages.
Treatment involves cooling and rehydrating the body; fever-reducing drugs are useless for this condition. This may
be done through moving out of direct sunlight to a cooler and shaded environment, drinking water, removing
clothing that might keep heat close to the body, or sitting in front of a fan. Bathing in tepid or cool water, or even just
washing the face and other exposed areas of the skin, can be helpful.
With fever, the body's core temperature rises to a higher temperature through the action of the part of the brain that
controls the body temperature; with hyperthermia, the body temperature is raised without the consent of the heat
control centers.
Hypothermia
In hypothermia, body temperature drops below that required for normal metabolism and bodily functions. In
humans, this is usually due to excessive exposure to cold air or water, but it can be deliberately induced as a medical
treatment. Symptoms usually appear when the body's core temperature drops by 1-2 C (1.8-3.6 F) below normal
temperature.
Basal body temperature
Basal body temperature is the lowest temperature attained by the body during rest (usually during sleep). It isgenerally measured immediately after awakening and before any physical activity has been undertaken, although the
temperature measured at that time is somewhat higher than the true basal body temperature. In women, temperature
differs at various points in the menstrual cycle, and this can be used for family planning.
Core temperature
Core temperature, also called core body temperature, is the operating temperature of an organism, specifically in
deep structures of the body such as the liver, in comparison to temperatures of peripheral tissues. Core temperature is
normally maintained within a narrow range so that essential enzymatic reactions can occur. Significant core
temperature elevation (hyperthermia) or depression (hypothermia) that is prolonged for more than a brief period of
time is incompatible with human life.
Temperature examination in the rectum is the traditional gold standard measurement used to estimate core
temperature (oral temperature is affected by hot or cold drinks and mouth-breathing). Rectal temperature is expected
to be approximately one Fahrenheit degree higher than an oral temperature taken on the same person at the same
time. Ear thermometers measure eardrum temperature using infrared sensors. The blood supply to the tympanic
membrane is shared with the brain. However, this method of measuring body temperature is not as accurate as rectal
measurement and has a low sensitivity for fevers, missing three or four out of every ten fevers in children. [9] Ear
temperature measurement may be acceptable for observing trends in body temperature but is less useful in
consistently identifying fevers.
Until recently, direct measurement of core body temperature required surgical insertion of a probe, so a variety ofindirect methods have commonly been used. While the rectal or vaginal temperature is generally considered to give
http://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Brainhttp://en.wikipedia.org/w/index.php?title=Tympanic_membranehttp://en.wikipedia.org/w/index.php?title=Tympanic_membranehttp://en.wikipedia.org/w/index.php?title=Infraredhttp://en.wikipedia.org/w/index.php?title=Gold_standard_%28test%29http://en.wikipedia.org/w/index.php?title=Rectumhttp://en.wikipedia.org/w/index.php?title=Hypothermiahttp://en.wikipedia.org/w/index.php?title=Hyperthermiahttp://en.wikipedia.org/w/index.php?title=Liverhttp://en.wikipedia.org/w/index.php?title=Organismhttp://en.wikipedia.org/w/index.php?title=Temperaturehttp://en.wikipedia.org/w/index.php?title=Fertility_awarenesshttp://en.wikipedia.org/w/index.php?title=Menstrual_cyclehttp://en.wikipedia.org/w/index.php?title=Therapeutic_hypothermiahttp://en.wikipedia.org/w/index.php?title=Therapeutic_hypothermia -
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Normal human body temperature 5
the most accurate assessment of core body temperature, particularly in hypothermia, its recording is disliked by
patients and medical staff alike. In the early 2000s, ingestible thermistors in capsule form were produced, allowing
the temperature inside the digestive tract to be transmitted to an external receiver; one study found that these were
comparable in accuracy to rectal temperature measurement.[10]
Methods of measurement
A medical/clinical thermometer showing the
temperature of 38.7 C
Taking a patient's temperature is an initial part of a full clinical
examination. Sites used for measurement include:
In the anus (rectal temperature)
In the mouth (oral temperature)
Under the arm (axillary temperature)
In the ear (tympanic temperature)
In the vagina (vaginal temperature)
On the skin of the forehead
Over the temporal artery In the gut (by swallowing a small thermometer)
The temperature reading depends on which part of the body is being measured. The typical daytime temperatures
among healthy adults are as follows:
Temperature in the anus (rectum/rectal), vagina, or in the ear (otic) is about 37.6 C (99.7 F)[2]
Temperature in the mouth (oral) is about 36.8 C (98.2 F)[1]
Temperature under the arm (axillary) is about 36.4 C (97.6 F) [2]
Normal human body temperature varies slightly from person to person and by the time of day. Consequently, each
type of measurement has a range of normal temperatures. The range for normal human body temperatures, taken
orally, is 36.8 0.7 C (98.2 1.3 F).[1] This means that any oral temperature between 36.1 and 37.5 C (96.9 and
99.5 F) is likely to be normal.
The temporal artery is close to the surface of the skin and therefore accessible for reading. The temporal artery is
linked to the heart by the carotid artery which is directly linked to the aorta. It forms part of the main trunk of the
arterial system. So long as the patients blood flow is permanent and regular, the method allows precise measurement
of the temperature.
Measurement devices
There is a risk of injury from cracking the original glass thermometers if too much force is applied by the teeth to
hold them in place and the alcohol or mercury contents are poisonous. This is avoided by the use of electronic
thermometers which are made from solid plastic and use a metal (thermocouple) sensor.
A plastic thermometer strip placed on the forehead gives an approximate local reading, which depends to a great
extent on ambient air temperature and local circulation effects. Using a thermometer to record the temperature under
the armpit is less affected by surrounding air temperature, but is still prone to diverge from true core temperature if
there are alterations in blood circulation.
Since the year 2000, small ear thermometers have become available and it is thought that the eardrum closely
mirrors core temperature values. These work by detecting the infrared heat emission from the tympanic membrane
and a measurement is quickly taken within one second making them popular for use with children. While the
electronic display of the temperature value is easier to read than interpreting the graduation marks on a thermometer,
there are some concerns for the accuracy of ear thermometers in home use.[11]
http://en.wikipedia.org/w/index.php?title=Tympanic_membranehttp://en.wikipedia.org/w/index.php?title=Infraredhttp://en.wikipedia.org/w/index.php?title=Eardrumhttp://en.wikipedia.org/w/index.php?title=Foreheadhttp://en.wikipedia.org/w/index.php?title=Thermocouplehttp://en.wikipedia.org/w/index.php?title=Mercury_%28element%29http://en.wikipedia.org/w/index.php?title=Alcoholhttp://en.wikipedia.org/w/index.php?title=Temporal_arteryhttp://en.wikipedia.org/w/index.php?title=Temporal_arteryhttp://en.wikipedia.org/w/index.php?title=Vaginahttp://en.wikipedia.org/w/index.php?title=Clinical_examinationhttp://en.wikipedia.org/w/index.php?title=Clinical_examinationhttp://en.wikipedia.org/w/index.php?title=Temperaturehttp://en.wikipedia.org/w/index.php?title=File%3AClinical_thermometer_38.7.JPGhttp://en.wikipedia.org/w/index.php?title=Medical_thermometerhttp://en.wikipedia.org/w/index.php?title=Digestive_tracthttp://en.wikipedia.org/w/index.php?title=Capsule_%28pharmacy%29http://en.wikipedia.org/w/index.php?title=Thermistor -
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Normal human body temperature 6
References
[1] Mackowiak, P. A.; S. S. Wasserman, M. M. Levine (1992-09-23). "A critical appraisal of 98.6 degrees F, the upper limit of the normal body
temperature, and other legacies of Carl Reinhold August Wunderlich" (http://jama.ama-assn.org/cgi/content/abstract/268/12/1578).
JAMA268 (12): 15781580. doi:10.1001/jama.268.12.1578. PMID 1302471. . Retrieved 2007-08-22.
[2] Elert, Glenn (2005). "Temperature of a Healthy Human (Body Temperature)" (http://hypertextbook. com/facts/LenaWong. shtml). The
Physics Factbook. . Retrieved 2007-08-22.
[3] Laupland KB (July 2009). "Fever in the critically ill medical patient". Crit. Care Med.37 (7 Suppl): S2738.doi:10.1097/CCM.0b013e3181aa6117. PMID 19535958.
[4] Sund-Levander M, Forsberg C, Wahren LK (June 2002). "Normal oral, rectal, tympanic and axillary body temperature in adult men and
women: a systematic literature review". Scand J Caring Sci16 (2): 1228. doi:10.1046/j.1471-6712.2002.00069.x. PMID 12000664.
[5] Wunderlich, Dr. C. A. (1871). On the Temperature in Diseases: A Manual of Medical Thermometry (http://books. google. com/
books?id=2uQEAAAAQAAJ&pg=PA82#v=onepage& q& f=false). trans. W. Bathurst Woodman, M.D. (2nd. ed.). p. 82. . Retrieved
2010-09-14.
[6] Kelly G (December 2006). "Body temperature variability (Part 1): a review of the history of body temperature and its variability due to site
selection, biological rhythms, fitness, and aging".Altern Med Rev11 (4): 27893. PMID 17176167.
[7] Kelly GS (March 2007). "Body temperature variability (Part 2): masking influences of body temperature variability and a review of body
temperature variability in disease".Altern Med Rev12 (1): 4962. PMID 17397267.
[8] Body Temperature (http://www.webmd. com/a-to-z-guides/body-temperature) at WebMD
[9] Dodd SR, Lancaster GA, Craig JV, Smyth RL, Williamson PR (April 2006). "In a systematic review, infrared ear thermometry for fever
diagnosis in children finds poor sensitivity".J Clin Epidemiol59 (4): 3547. doi:10.1016/j.jclinepi.2005.10.004. PMID 16549256.
[10] (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T94-4DDXMRG-H& _user=10& _rdoc=1& _fmt=& _orig=search&
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_userid=10& md5=6c571acbee07e8999b4e7774d3212dee)
[11] Robinson JL, Jou H, Spady DW (January 2005). "Accuracy of parents in measuring body temperature with a tympanic thermometer".BMC
Fam Pract6 (1): 3. doi:10.1186/1471-2296-6-3. PMC 545063. PMID 15644134.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T94-4DDXMRG-H&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=957411958&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6c571acbee07e8999b4e7774d3212deehttp://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T94-4DDXMRG-H&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=957411958&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6c571acbee07e8999b4e7774d3212deehttp://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T94-4DDXMRG-H&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=957411958&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6c571acbee07e8999b4e7774d3212deehttp://www.webmd.com/a-to-z-guides/body-temperaturehttp://books.google.com/books?id=2uQEAAAAQAAJ&pg=PA82#v=onepage&q&f=falsehttp://books.google.com/books?id=2uQEAAAAQAAJ&pg=PA82#v=onepage&q&f=falsehttp://en.wikipedia.org/w/index.php?title=Carl_Reinhold_August_Wunderlichhttp://hypertextbook.com/facts/LenaWong.shtmlhttp://jama.ama-assn.org/cgi/content/abstract/268/12/1578 -
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