What is the cause of impaired thermoregulation (body temperature regulation)?

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From the Guidelines

Poor body temperature regulation is primarily caused by dysfunction in the hypothalamus, the brain's temperature control center, as well as various conditions including hypothyroidism, diabetes, infections, neurological disorders, autonomic nervous system dysfunction, and certain medications, with age being a significant factor, especially in elderly individuals 1. The hypothalamus normally works with the autonomic nervous system to trigger responses like sweating when too hot or shivering when too cold. When this system malfunctions, the body struggles to maintain its core temperature of approximately 98.6°F (37°C). Some key factors that contribute to poor body temperature regulation include:

  • Hypothyroidism, which can lead to decreased metabolic rate and impaired heat production 1
  • Diabetes, which can cause nerve damage and disrupt normal thermoregulatory mechanisms
  • Infections, which can lead to systemic inflammation and alter the body's temperature regulation
  • Neurological disorders, such as spinal cord injuries, which can disrupt the communication between the hypothalamus and the rest of the body
  • Certain medications, such as antipsychotics, sedatives, and some antidepressants, which can interfere with temperature regulation by affecting the central nervous system
  • Dehydration, which can significantly impair the body's cooling mechanisms
  • Malnutrition, which can reduce the metabolic resources needed for proper temperature control Treatment depends on identifying and addressing the underlying cause, which may include hormone replacement for thyroid issues, better glucose control for diabetes, or medication adjustments when drugs are responsible. According to the 2024 American Heart Association and American Red Cross guidelines for first aid, heat loss occurs through four methods: conduction, convection, radiation, and evaporation, and hypothermia can progress through predictable stages to death if not properly managed 1. It is essential to consider the patient's characteristics, such as advanced age, when assessing the risk of poor body temperature regulation, as older individuals often have diminished temperature regulation capabilities 1.

From the Research

Causes of Poor Body Temperature Regulation

  • Poor body temperature regulation can result from various conditions, including fever, hyperthermia, and hypothermia 2
  • Hyperthermia results from abnormal temperature regulation, leading to extremely elevated body temperature, while fever results from a normal thermoregulatory mechanism operating at a higher set point 3
  • Heat-related illness encompasses heat rash, heat cramps, heat exhaustion, and heat stroke, in order of severity, and can be induced by drugs or environmental exposure 3
  • Hypothermia is the reduction of body temperature to levels below 35°C from environmental exposure, metabolic disorders, or therapeutic intervention 3

Factors Influencing Body Temperature Regulation

  • The human body constantly exchanges heat with the environment, and temperature regulation is a homeostatic feedback control system that ensures deep body temperature is maintained within narrow limits 4
  • Various morphological features, intrinsic factors, diseases, and injuries can influence deep body temperature during exercise and/or exposure to hot ambient temperatures 4
  • Intrinsic factors such as morphology, heat adaptation, biological sex, and age can affect the regulation of deep body temperature during heat stress 4
  • Diseases such as neurological, cardiovascular, metabolic, and genetic disorders can also impact body temperature regulation 4

Relationship Between Thyroid Function and Body Temperature Regulation

  • There is no direct evidence in the provided studies to suggest a link between thyroid function and poor body temperature regulation 5, 6
  • However, thyroid function can be affected by certain medications, such as metformin, which may have a TSH-lowering effect in patients with diabetes mellitus 5
  • Treatment of hypothyroidism with levothyroxine can restore normal thyroid-stimulating hormone (TSH) concentrations, but overzealous treatment of subclinical hypothyroidism may contribute to dissatisfaction among hypothyroidism patients 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Disorders of temperature regulation: prehospital implications.

JEMS : a journal of emergency medical services, 2003

Research

Disorders of body temperature.

Handbook of clinical neurology, 2014

Research

Metformin and thyroid: an update.

European thyroid journal, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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