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Body temperature

 Poster: A snowHead
Poster: A snowHead
I was slightly concerned recently in this cold weather that my body temperature might be low. Skiing a lot, and hiking up snow topped hills, prompted me to buy one of these

https://www.ebay.co.uk/itm/Digital-LCD-Thermometer-Alarm-Medical-Body-Safe-Ear-Temperature-Oral-Baby-Adult/292406133085?epid=23013021219&hash=item4414c3815d:g:H1sAAOSwKwVaWPfB

Initially I could not work out how to use it, and thought it was faulty. Then I stuck it in my mouth, and it gave a reading as per the instructions on the web listing. (no instructions in packaging to save paper I guess). Reading was low. 35.8 C. Then I had a pot of green tea, sat on a heat mat, and got the room temperature up to 20C. Blood filled my fingers and toes, and the reading was 37C after I allowed time for my mouth to cool from the hot tea.

It made me think though, that many times I could have been almost hypothermic, and the only way I would know would be to get an accurate temperature reading. So I got one cheap, and I am calibrating it against my normal readings so that I can test what reading I get on mountains.

Such a low price, I thought I would mention it as a worthwhile tool!
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@Bigtipper, Puzzled I would think those around you would know if you were hypothermic! I truly don't think a thermometer is necessary...
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@under a new name, I think Bigtipper is fond of measuring things.
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@under a new name, there are not always people around me, and there is no obvious symptom apart from when it is probably too late. For example I could make a decision to get off the mountain if it fell close to 35C
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@Bigtipper, would be worth pointing out that the thermometer you've shown has a working temperature of 0-55degC so if you were on the mountain the thermometer itself may have been outside or close to the bottom end of its accurate range. Also bear in mind that you were only 1.2 (assuming accurate measurement) down from Normal, which is only just over half way to the hypothermic boarderline. Obviously getting enough symptoms to warrant you wanting to check on your own temperature so your 'warning signals' are getting through, and compus mentus enough to recognise it and do something about it. Bottom line, make sure you're not over or under heating and don't fret too much about it.
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I have a doctor with me at all times.....just in case I should fall ill. Well you can't be too careful Confused .
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@Richard_Sideways, the tip of the thermometer goes under my tongue with my mouth shut.

My body fat is very low 11% roughly which for someone my age is really quite low. It means that cold can affect me more now than when I had a BMI over 30 and was living in a van in the Alps.

My blood pressure goes up in cold weather, due to vasoconstriction, and this as well as low body temperature can cause damage. I am older, fitter, but my body is less able to cope with extreme cold.

With all this knowledge, I need to find ways to stay warm, get out of the cold before I need to, and ways to warm up slowly when I am too cold.

Having a doctor with you who is hypothermic will not be of great assistance.@Gyro

Ultimately, you are responsible for your own health. Being prepared, and informed, is a very powerful weapon.
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This is just commonsense if you feel really cold then you are potentially on the way to hypothermia but any sensible person on feeling really cold would take steps to get warm! Checking the temperature of small children who happen to be out on the mountain on a really cold day could be a good idea but generally if they are uncomfortably cold they will whinge and parents will solve the problem. I have a medical condition which is exacerbated by cold temperatures so I no longer ski in "real winter" but I continue to ski in Canada in April when the really low temperatures are generally over and when the sun shines high up the mountains it can be really quite warm. I am very conscious of my core temperature and also not allowing my fingers and toes nor indeed my face to get cold but I wouldnt resort to carrying a thermometer, I would know inherently if my core temperature were dropping and I would go in if this were the case.
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@FFIRMIN I am not as certain that I would know inherently what my core body termperature was. Given that it is normally lower than 37C in winter time, even when I feel warm, it would not take much exposure to cold to get it to 35C.

In fact when you actually get hypothermic, you tend to feel warmer, and there are lots of cases of people stipping clothes off when they are hypothermic because they feel too hot.

I get that you ski in April, which is when it is warmer. I also like it when there is low wind too, as this really makes me shiver.

I am not sure that a theremometer would be much practical use whilst skiing, but it is useful to get an idea of how I feel when my body temperature is at a certain temperature. Also I can plot blood pressure against body temperature to see if the relationship is linear or exponenial!
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Bigtipper wrote:

It made me think though, that many times I could have been almost hypothermic, and the only way I would know would be to get an accurate temperature reading. So I got one cheap, and I am calibrating it against my normal readings so that I can test what reading I get on mountains.


That's not how hypothermia works. I think you've read something and taken it far, far too literally. The temperatures for various levels of hypothermia are for guidance only. Also, you can't measure core temperature effectively without some proper equipment.

You really don't want to be messing around trying to take a temperature on someone on a mountain that's actually got hypothermia.
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I am a nurse and I take a lot of temperatures. It isn't that often you see people with a temp of 37c as their normal, most people tend to be in the 36c range.
In the theatre recovery I work in a patient has to have a temp above 36c to be transferred back to the ward.

The body shivers when cold to generate heat, when you stop shivering you are in trouble. I understand that once you start feeling hot and stripping off you are near death.

If hypothermic, rewarming should be gradual.
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https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414703

A study here on blood pressure vs atmospheric temperature in the elderly. Not surpisingly it shows blood pressure tends to be higher in winter, particulaly systolic in elderly. Places with mild winters tend also to be places which have long life expectancy. Hong Kong, Japan, Iceland, Switzerland, Spain. Iceland appears to be the odd one out in this list, but it also has very cheap winter heating due to thermal waters from volanic rocks. People can afford cheap heating in cold winters in Iceland. Also they have a tendancy to go for winter dips in hot thermal waters, which can improve blood flow.

Some people reckon diet is the main factor in life expectancy. Fish seems the common food, and less meat in these countries. Of course wealth is also a common factor in high life expectancy. Spain perhaps being the odd one out here, although by no means a third world country.

Of course healthcare is a factor, but healthcare is a remedial effect. It is not the primary etiology of diseases of the cardiovascular system.
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@Cinsha, does the method of taking the temperature vary by patient? In the ear might be how it is taken, but up the bum or in the mouth might give a different reading by different patients. (some might have cold ears, and warm bums).
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Cinsha wrote:


The body shivers when cold to generate heat, when you stop shivering you are in trouble. I understand that once you start feeling hot and stripping off you are near death.

If hypothermic, rewarming should be gradual.


Shivering often isn't a great indicator of hypothermia (in the outdoor environment). People who are a bit cold shiver. People with hypothermia can skip shivering and go into severe hypothermia.

Rewarming should be gradual, how difficult that is depends on how severe the hypothermia is. People with moderate to severe hypothermia talk about not feeling warm again for many hours or even a day or so.

Since you can throw most written definitions of hypothermia out of the window all you can really use to diagnose hypothermia is how hard it is rewarm. If you can quickly get warm then you're a bit cold - jump up and down, rub your hands, get a drink. If that's not working your are, or are heading for, hypothermia. It's this decreasing ability to get warm again that tells you how severe things are and it's the only measure that really matters because it tells you how much help you need.
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Quote from the conclusions of the above linked study into blood pressure versus atmospheric temperature:

" seasonal variations in blood pressure were inversely associated with BMI"

A low BMI suggests your blood pressure will be more volatile in cold weather, particularly in the elderly.
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 Poster: A snowHead
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Yeah, Switzerland has really mild winters
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Bigtipper wrote:
...Such a low price, I thought I would mention it as a worthwhile tool!

If you feel cold, wear more clothing. I'd say that sticking a thermometer up your bottom would be a less useful but perhaps more entertaining approach. April 1, right?
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Problem is your clothing gets wet when climbing hills from sweat. Then you get cold. A recipie for disaster. Changing clothes in cold temperatures when you are wet and cold makes you even more cold. You really need to get out of the cold and wind before you change clothes in a warm hut of some sort.

Sure a lift would help as you would not get all wet from sweating. Carrying a complete change of undergarments might help. Granted a thermometer is not as much use. I always carry a lightweight foil blanket and a spare poncho both of which cost 50p. (never needed them, but in an emergency it could save your life if you can have extra warmth and protection from precipitation.)

I find a warm drink in a flask is usually a good warm up, particularly if you take thermometer readings in your mouth.
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Quote:

I find a warm drink in a flask is usually a good warm up, particularly if you take thermometer readings in your mouth.

Well yes..... it would be, wouldn't it. Taking your temperature after drinking a G & T with plenty of ice will make a big difference too.

However, if you are going to get serious about taking your core temperature up a mountain, I think trousers down, thermometer "up" is the only way. wink
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Bigtipper wrote:

I always carry a lightweight foil blanket and a spare poncho both of which cost 50p. (never needed them, but in an emergency it could save your life if you can have extra warmth and protection from precipitation.)


Depends what you mean by foil blankets. Products like blizzard bags are highly effective while foil sheets just aren't.

The major claim for foil sheets is that they reflect back around 80% of evaporative heat loss which isn't going to be big deal with a hypothermic casualty. More dangerously, they instantly get cold and wet then conduct that back to wet clothing. They also rip apart pretty much instantly in any sort of weather. There's zero insulation provided so you can't insulate a casualty from the cold ground.

They are quite effective after marathons and similar events because the competitor is already warm and the specific danger is they'll rapidly cool. So in that usage, foil sheets do prevent hypothermia. You might also protect other casualties with a foil sheet, and you see ambulance crews and paramedics do this, to prevent heat loss after other injuries but they're too fragile to be any real use in an outdoor setting.

Really neither a foil sheet nor a thermometer are useful for the treatment or management of hypothermia in the outdoors. They're just taking up space in an outdoor first aid kit. What does work, and will be carried routinely by professionals, are light down layers (~400-450g), blizzard bags (~350g) and emergency shelters (~250-400g 2/pers).
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I wear minimal kit, tight softshell pants and jackets, it wicks sweat well and dries extremely quickly. If you have to stop then carry a synthetic belay jacket that is designed to go on last over all your other stuff.
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@Bigtipper, Tympanic measurements of temp are routine. Temp values will of course vary according to where they are taken - per rectum, per oral, tympanic or axilla.

Values will vary for many reasons such as time of day, age or menstrual cycle.

If you show no signs of life after falling into an icy river for instance, you are not 'dead' until you are warm and dead.
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My blood pressure by body temperature (or room temperature) seems more volatile than average, probably due to my BMI being normal (about 23 currently). About 3x -5x more volatile, i.e. more affected by low temperatures.

Thread which discussed this graph (before you all start commenting on how inaccurate, and poor statistical methods have been used)

https://snowheads.com/ski-forum/viewtopic.php?t=142464&highlight=
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I think you are over thinking this.

We all could have been nearly hypothermia many times. Yet homeostasis doesn’t let it happen.

What would be interesting would be for you to take a cold shower then measure your temperature. I bet it doesn't drop much. Then do it every day for a month and measure each time. I suspect you increase your risk of hypothermia by living in a centrally heated house and blunting your homeostatic mechanisms. Unless you are proper frail and can't heat yourself up that is.
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I think you are overestimating my ability to think.

My blood pressure is volatile because I do not live in a fully centrally heated house. The house is coldest in the mornings when my body temperature is naturally lowest.

By taking my body temperature, before taking blood pressure, I can predict the blood pressure reading by the use of the relationship between body temperature and blood pressure. Thus reducing the volatility of blood pressure readings around what is expected, by the simple addition of the main factor which causes the normal volatility of blood pressure.

The main problem is that expected blood pressure is not a simple average. It varies by many factors, of which body temperature is a major factor for those who have a low BMI or low fat levels (typically older people).

www.clinsci.org/content/69/4/465

This link overthinks the body temperature issue, but is useful in determining significant factors for body temperature volatility.
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@Bigtipper, “I can predict the blood pressure reading by the use of the relationship between body temperature and blood pressure. Thus reducing the volatility of blood pressure readings around what is expected,”

And what is the point of that? I think your are unhealthily obsessing about completely irrelevant things. It doesn’t matter if your body temp goes up or down, or if your BP goes up or down, or if you have two drinks or three. Just enjoy life and stop measuring it.
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https://www.bmj.com/content/359/bmj.j5468

Does there have to be a point? There are different ways to enjoy life, different paths people can take. Some say "it is better to burn out than fade away", and often they tend to die of a drug/alcohol overdose or heart attack in their 40s or 50s or younger in extreme situations. Sure they had a life, and lived it they way they chose to.

However, if you enjoy skiing, it inevitably requires you to be health conscious as you age. Otherwise, you will need a different hobby like reading a book in front of a warm fire with your slippers on. (not that I do not do that anyway, I just do not consider it something which motivates me)

You confuse my random thinking with obsessing. I am not concerned about my health, I am interested in understanding what influences my health now and in the future. Often to understand a problem, you need to go down several dead ends until you reach nirvana.

Like "white coat syndrome". Why is it when you go to the doctor is your blood pressure always higher? Perhaps it is related to the journey to the waiting room in the cold. The wait around amongst sick people with diseases. Then the 10 minutes of time alloted to you, and all the GP wants to do is take your blood pressure? (never interested in body temperature)

Explain to me why is there so much emphasis on this in preventative medicine?
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I'm not sure that my blood pressure is always higher when I go to the G.P. I'm perfectly relaxed about having it done, I tune out, don't talk. The exception to this would be if I have been kept waiting 40 mins when I have somewhere to be.
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Sure, but you could normalise for the the effect of body temperature when taking blood pressure given it is quite significant in most studies. Particularly for those who cycle in the rain or snow for a minor ailment.

I suppose you could also take cortisol levels as well, but that is a more extensive operation than taking body temperature.

Quote from above BMJ link:

Summary statistics on temperature

Mean 36.6°C (95% range 35.7-37.3°C; 99% range 35.3-37.7°C)

Measurements at different sites (versus oral): temporal: –0.03°C; tympanic: –0.06°C; axillary: –0.26°C


suggesting my oral measurement average of 36.4C is fairly normal for a cold blooded human variety.
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Hurtle wrote:
@under a new name, I think Bigtipper is fond of measuring things.


I would have thought if you were going to measure "things" the last time you'd want to do it is freezing cold at the top of the mountain, eh Littletipper
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Yours is a reasonable concern re hypothermia, as the problem I found when I got it was that it wasn't obvious to either me, or my companions. Outside temp was -17°C but it was brilliantly sunny and with a black jacket on I felt quite comfortable. But obviously in retrospect, I was breathing cold air at that temperature and my core was getting cold. Because my companions wanted to get to a distant point in the ski area, I didn't stop for the usual chocolat chaud mid-morning. Come lunchtime they wanted to press on and very fortunately, I told them to go ahead and I'd make my way back to base at leisure. I decided to take a break and as soon as I walked into the warm room it was like hitting a brick wall: I could barely breathe and it felt like I had a 10cm cube of ice in my chest. It took two warm drinks and about 45 minutes to recover.

So I have some preventive advice: I now make it a rule to always take a break morning, lunchtime and afternoon and have a warm drink, preferably indoors. A couple of times since, I've similarly realised I was colder than I thought, although never as badly cold as on that occasion.
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@LaForet, I have never knowingly had hypothermia but I have pushed the likelihood to the limit sometimes. Now I am older, have a lower body fat percentage, I notice that even when I get into warm from being on the hill it can take up to 2 hours before I get proper feeling and blood in my fingers and toes. So I have to ramp up room temperature, and wash the dishes in lukewarm water.

Having thought about it @rogg, measuring blood pressure at the top of a very high altitude mountain which has a steep decline initially is likely to increase your cortisol levels first thing in the morning when it is cold. Somewhere like Mont-Fort would be a good place for a blood pressure measurement station where you could get your body temperature and blood pressure taken before you do the run down.

As I have done it before, it is likely not to have as great an effect on my cortisol levels as a first timer. It would make for some interesting statistics though, as it would likely produce some quite high readings.
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@Bigtipper, Are you saying that you've measured your cortisol on the mountain? I ask as I have Addison's disease (my adrenal glands packed up so I don't make cortisol or aldosterone) and I can't say I've ever noticed any effects from going to chilly high altitude first thing in the morning before my meds (swigged down with a quick coffee and croissant) have kicked in.

Although cortisol does have some effect on blood pressure it is the aldosterone (replaced by fludrocortisone) that has the major effect, without it I have high potassium and low sodium and couldn't make it up the stairs before diagnosis!
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Years ago, a military ski instructor told me they have their own “unique” way of checking if someone is pulling a flanker and feigning hypothermia to get off exercises. They insert a rectal thermometer, give it a minute or two, take it out, then say “I’m afraid it didn’t work doing it that way” and then go to insert it under their tongue. If they are genuinely hypothermic, they’ll let them. If they recoil back in revulsion, they’re trying to pull a flanker. Even if it wasn’t true, it raised a checkle with all assembled. Toofy Grin Twisted Evil
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@BoardieK, I have never measured my cortisol levels. Cortisol is known as the "stress hormone" which is released with a diurnal cycle and its release is increased in response to stress and low blood-glucose concentration. (unless your adrenal gland is compromised)

A normal reaction to an early morning coffee with caffeine, and looking down a steep might be for extra cortisol to be released. The exact relationship between that, and higher blood pressure is not something I know much about as I have never tested my cortisol levels.
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Bigtipper wrote:
Problem is your clothing gets wet when climbing hills from sweat. Then you get cold. A recipie for disaster. Changing clothes in cold temperatures when you are wet and cold makes you even more cold. You really need to get out of the cold and wind before you change clothes in a warm hut of some sort.


Dress appropriately to avoid this, I frequently unzip my ski jacket or remove it completely when about to start a boot pack to avoid sweating in the first place, I find the whole "do not wear cotton base layers" argument is nonsense, I've tried wearing so called performance base layers that "wick" moisture away from your skin, my skin just felt wetter than ever, I find cotton is a much more comfortable base layer but as I said, I take steps to cool down before getting sweaty.
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Sounds like it is time to retire.

The high mountains are no place for shivery grandpas.
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If you want something useful and informative about hypothermia have a look at this article:

http://www.everythingoutdoors.co.uk/hypothermia-facts-causes-treatment/

Aimed at fellrunners but the principles will carry over well to skiing.

If you are wearing wet gear and are cold and carrying dry gear just strip off and change it whether you can get into shelter or not.
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Definately some takeaways from that article, particularly what not to do with hypothermic people including yourself. (no caffeine, alcohol, try not to warm up too quickly, do not rub to try to get blood flowing, eat if you can, sugary hot drink like chocolate might help)
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