KNOWLEDGE YOU CAN USE

KNOWLEDGE YOU CAN USE
Your body sometimes deliberately upsets homeostasis.: (And you might not want to fight it)

Question 20.11

Q: What do you usually do when you have a fever? At the first sign of fever, many people take aspirin, Tylenol, Advil, or Motrin.

Question 20.12

Q: What is the result? Aspirin, acetaminophen (Tylenol), and ibuprofen (Advil and Motrin) quickly reduce a fever

Question 20.13

Q: Why did you have a fever? Generally, fever is not itself an illness. Rather, it is your body’s response to cues that there is a bacterial or viral infection. In response to infection, your temperature set point is raised, because pathogens are more easily brought under control by the body’s defenses at higher temperatures. (Ectotherms use a similar strategy, moving to warmer areas when they have an infection!)

Question 20.14

Q: How does reducing a fever interfere with your body’s defenses? Blocking a fever by taking aspirin or other medication may reduce your body’s ability to fight infection. A recent well-controlled study demonstrated, for example, that chicken pox lasts longer, on average, when aspirin is used to treat it, compared with placebo.

Question 20.15

Q: Is the lesson here about more than fever? Yes. There are other signs of infection that, as defenses rather than part of the illness itself, maybe shouldn’t be fought. For example: (1) Coughing: the use of codeine to block coughing after surgery increases the risk of pneumonia; the coughing is helpful. (2) Diarrhea: anti-diarrhea medications delay recovery and slow the eradication of bacteria from the digestive tract; the diarrhea is helpful. (3) Vomiting and inflammation, too, appear to be important parts of our evolved defenses and, as such, blocking them can have serious health consequences.

Question 20.16

What can you conclude? Is this the dawn of Darwinian medicine? This perspective on when to treat and when not to treat symptoms is called “Darwinian medicine.” It represents a newfound appreciation for the fact that many protective responses have evolved that may be useful to the organism. Of course, suffering is not always the solution. There can be real costs to vomiting, diarrhea, coughing, fever, and other body defenses. Opting not to treat them isn’t necessarily the best solution if, for example, antibiotics can bring an infection under control easily. Either way, bringing an evolutionary perspective to medical decision making can be valuable.

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