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Many people notice changes in how their body feels with the seasons — from feeling chilly to sweating more in the heat. For people living with lupus, symptoms like fever, chills, and sweating may also be linked to the condition itself. However, these symptoms aren’t always caused by lupus directly. They could be side effects of medications or signs of another health issue that occurs alongside lupus.
Members of MyLupusTeam often share their experiences with body temperature changes. “I get the chills so bad I cannot warm up. Even during Florida summer months I would be so cold, bundled up and freezing — I just couldn’t get warm. Now I am sweating, then get chills randomly throughout the day,” a member shared.
Another member wrote, “Not a good day today. Fever of 100.3 with chills and so much pain.”
If you have lupus and experience fever, chills, or sweating, talk with your doctor. Learn more about the causes behind these symptoms and what you can do to manage them.
People with systemic lupus erythematosus (SLE) — the most common type of lupus — often experience a low-grade fever (below 101 degrees Fahrenheit). A fever may signal a lupus flare, other inflammation, or an infection.
A low-grade fever is a common symptom of lupus and may appear early in the disease. It’s also more common among white people with lupus.
“Yesterday, I felt so hot and sick. I felt like I had a fever, and I was 99.1 degrees Fahrenheit,” one MyLupusTeam member wrote.
Research shows that up to 60 percent of fevers in people with lupus are due to disease activity or a lupus flare. In autoimmune diseases such as lupus, the immune system is overactive and releases proteins that trigger fever. When functioning normally, these proteins are part of the body’s defense against disease and infection, but in autoimmune disease, they can cause inflammation and fever on their own.
People with lupus have an increased risk of infection of all kinds. A fever may be a sign of infection caused by viruses, bacteria, or fungi. In people with lupus, immune system problems and immunosuppressive treatment both reduce the body’s ability to fight germs.
Respiratory infections, skin infections, yeast infections, and urinary tract infections (UTIs) are some of the more common infections that can affect people with lupus.
It’s important to be aware of the signs of infection. If you have a fever that won’t go away, or if it rises over 101 degrees Fahrenheit, seek medical advice right away. Always let your rheumatologist or doctor know if you have any new or worsening symptoms.
Common lupus treatments such as prednisone (a corticosteroid) can cause side effects like fever, chills, and sweating. This can happen because corticosteroids affect the adrenal glands, which change hormone levels.
Corticosteroids also weaken the immune system, which raises the risk of infection. Other immunosuppressant medications used for lupus can also raise your risk of infection. Always talk with your doctor about potential side effects of your medications.
A fever may also be caused by another health condition. Some conditions that may cause a fever and affect people with lupus more than the general population, include:
If you have a fever that lasts more than a day or two, contact your doctor or rheumatology healthcare team.
People with lupus may also experience chills. Chills are a feeling of being cold and often happen with a fever when body temperature is higher than normal. This is different from hypothermia, which is a potentially dangerous drop in body temperature below 95 F.
Several MyLupusTeam members have reported feeling chills. One member wrote, “I can be at a perfectly comfortable temperature for hours and not feel cold. Then, suddenly I will get chills over my whole body, or sometimes over a single body part, like a thigh.”
Another member said, “Mornings are the worst. It can take up to three hours for me to get somewhat warm.”
Here are some of the reasons you may feel cold with lupus.
Some medicines can increase the risk of hypothermia, including certain antidepressants, antipsychotics, anesthetics, and sedatives. Very rarely, high doses of corticosteroids have also been linked to hypothermia in people with lupus.
The reason for this is not fully understood. One possible explanation may be problems with the hypothalamus, a part of the brain that can be affected by lupus or problems with body temperature regulation. It may also be a rare trait of the disease itself.
Along with feeling cold, hypothermia can cause drowsiness, confusion, and slurred speech. If you notice these symptoms, seek emergency medical care right away.
Some health conditions that are more common in people with lupus may also cause chills or hypothermia.
Hypothyroidism (underactive thyroid) is the most common thyroid disease among people with lupus. The condition changes your hormonal balance and slows your metabolism. Symptoms can include chills or sluggishness. About 15 percent to 19 percent of people with lupus develop hypothyroidism, compared to about 5 percent of the general population.
In extreme cases, hypothyroidism can lead to hypothermia, which is considered a medical emergency. A common treatment for underactive hypothyroidism is hormone replacement therapy.
About half of people with lupus develop anemia. Anemia happens when you don’t have enough red blood cells to carry oxygen to the cells and organs. Chills are a common symptom of anemia, along with fatigue, dizziness, headache, and changes in skin tone — such as pale or yellow skin — which may be harder to notice in people with darker skin. In these cases, paleness may be more visible in areas like the lips, inner eyelids, or palms.
Treatment for anemia depends on the severity and underlying cause of anemia, and may include:
Older research has linked iron deficiency, a common cause of anemia, to hypothermia.
Raynaud’s phenomenon affects about 33 percent of people with lupus. It causes blood vessels in the feet, hands, or other body parts such as ears, lips, or nose to constrict (narrow) when exposed to cold. Reduced blood flow can cause numbness and a chilled feeling in these areas.
Raynaud’s can affect the temperature of certain parts of the body. Symptoms usually last about 15 minutes and does not cause hypothermia or lower the body’s core temperature.
Treatment options for Raynaud’s depend on severity. Dressing in layers can help with milder cases. In more severe cases, medication or surgery may be necessary.
Some lupus medications — such as corticosteroids, immunosuppressants, and biologics — can cause side effects that include chills, often together with a fever. It’s important to know that chills and fever can be a sign of infection that needs immediate treatment.
Excessive sweating, especially at night, can happen with lupus. Sweating often happens with a fever, which may be a symptom of lupus.
Another reason people with lupus experience a lot of sweating is because lupus can cause the immune system to attack the autonomic nervous system (ANS), which causes autonomic dysfunction. The ANS controls automatic functions such as heart rate, breathing, body temperature, and sweating. Damage to the ANS can cause heat or cold intolerance, where you’re very sensitive to heat or cold. For some people with lupus, heat intolerance may cause overheating or hot flashes.
One MyLupusTeam member mentioned waking up often in the middle of the night from sweating, feeling “wet and cold.” Another member wrote, “Does anyone else deal with a sweaty scalp … for really no reason? I will be doing chores around the house and my scalp breaks out in a sweat.”
In people with lupus, heavy sweating can also be a side effect of corticosteroids. Sweating from other medications may be a sign of fever and infection, which could be serious.
If you think you may have a fever, it’s a good idea to take your temperature. Be sure to let your doctor know if a fever doesn’t go away or if it’s about 101 F or lower if you are taking immunosuppressive treatment.
For mild changes in body temperature, you can take steps to help improve your comfort and quality of life:
Taking precautions in hot or cold weather can help you avoid lupus flare-ups and ease uncomfortable symptoms such as joint pain and skin rashes. Cold temperatures can cause blood vessels to narrow, which may worsen symptoms or trigger certain reactions (such as Raynaud’s) in people with lupus.
Heat can also make lupus symptoms worse and lead to a flare-up. Sun exposure is another trigger for many people with lupus. Always protect your skin by using sunscreen, wearing protective clothing, and staying in the shade.
On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.
If you’ve experienced temperature fluctuations, like fevers or chills, how do you manage these symptoms? Let others know in the comments below.
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I'm like an extremist. I have Raynauds so I feel cold. Yet then I feel like I'm entering menopause because of the hot flashes
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