Cold All The Time? Listen To This.

To hear the full audio recording of this podcast, click here.

Or, you can read the full Podcast transcript below.

Dr. B> Hi, I'm Dr. James Biddle and I'm here with our new patient coordinator, Joy Lambert, at Asheville Integrative Medicine. Today we're going to be talking about body temperatures.

Joy> That's right, So, Dr. Biddle, I recently read an article that was talking about the fact that our normal body temperature, has apparently decreased... away from 98.6 to about 97 degrees over the past 30 years. I was really puzzled by that, so I was wondering if we could talk about that.

Dr. B> Sure, the biggest word you just used is "Normal"

Joy> Normal?

Dr. B>  Normal! There's a huge difference between 'normal' and 'average'.

Joy > What is normal?

Dr. B>  That's a great question, what is normal! ? And we're gonna get into that, but first we should talk about 'average'. What they're actually reporting is the average body temperature has decreased, and average is not necessarily normal.

Joy>  Oh, I never thought of it that way.

Dr. B > So the average weight in the United States has increased, but that's not normal, that's obese right! ? So the first thing to understand is that we usually understand that the normal temperature is 98.6 degrees Fahrenheit. In this article that I have in front of me, out of Stanford, I's a study that was done by Julie Parsonnet who's a medical doctor and infectious disease specialist out of Stanford, and it says that the German physician in 1851, Karl Reinhold, declared that the standard human body temperature was 98.6 degrees Fahrenheit. That is not true because the Germans did not use Fahrenheit, they used Celsius as a measurement.

What he in fact said is that the average body temperature at that point was 37.0 degrees Celsius. And the first error that happened was a math conversion error, and that they are rounded off wrong to 98.6... when it was actually 98.2... So all these years, everybody in the medical profession has been using the wrong temperature... for almost 170 years. It's actually starting at 98.2. that's the first little jump.

Joy>  I see. Just because it was status quo! ?

Dr. B>  Just because it was status quo. And, this is before personal computers and everything else... when they were doing this by hand. So that's the first thing to understand.

The second thing to understand is, again, that the 'average' is not 'normal'. Now, this Doctor put theories about why the average temperature has dropped and it is true that the average temperature is dropped. And they're coming up with theories because she's an infectious disease doctor, she's come up with theories related to infectious disease that we have now, less information because we're less inflamed and less infected than back then, so that's within her wheelhouse. My background before I went to medical school is I got a biology degree in evolutionary genetics, so I actually have a Master's in Arts, not a Masters in Science, for some weird reason... because that's into philosophy... and I focused my biology degree in both genetics and evolution. So that's the way I look at things.

And from a medical perspective, we have enzymes. Everything in our body happens on an enzyme, and the enzyme is a protein with a certain three-dimensional structure, it almost always has some nutrient mineral in the middle of it, like zinc or selenium, or copper or Boron, and then it works as a lock-in a key, so that enzyme either does one of two things: it either hooks two things together or it breaks one thing apart into two things. That's about all that enzymes do! They build up proteins, they hook amino acids together, and through a series of enzyme steps you hook one amino acid to another to another to another and you build a protein, or you break something down... and that's the way it works. But, everything happens kind of randomly. These things slip into these enzymes, and fascinatingly this happens 50 to 100 times per second. These chemical reactions in our enzymes where these things fall in, and then he hooked together or broken apart and then they fall back out in to the next one falls in. But when you change the temperature, you change the shape of the enzyme, which is why if you let your body temperature go over 105 degrees, all your enzymes, change shape so much that everything falls apart and you die or when you get below about 93-94 degrees, all your enzymes change shape and everything stops working on the other end.

So, when they're hypothesizing that this is actually a natural change for us, that somehow we're changing, that's hogwash.

Joy>  So we shouldn't be getting this cool?

Dr. B>  Our genetics have not changed in 150 years. There's no way, that is not the way evolution occurs.

Now evolution does occur in jumps and shifts, but not like this. Of all of our hundreds of thousands of enzymes in our body, all have not changed to work better at 97.0 then at 98.2 degrees.

Joy>  So when you say that the enzymes change shape, 'cause I want to make sure I understand this well. Is it at all analogous to when metal gets hot or cold, and it expands or contracts, it can get loose...

Dr. B>  Yeh, or even water. Right! ? So you put ice cubes in a glass container, you put water in a glass container, and put it in your freezer and it cracks the glass because the Water expands. Or your water pipes that come into your house... if you don't keep them warm the water is going to expand when it turns to ice, it's gonna crack your glass... and that's partly because water takes a three-dimensional structure, but everything does that. Metal expands and contracts with heat and cold too.

Yeah, so it's the same thing with our enzymes if you change your body temperature, your enzymes change shape, and they work less efficiently. These thousands of enzymes in our body are all evolutionarily designed to work at that certain temperature and people come in and they say, "Well my normal temperature is this... And I say, No. No, your average temperature is that that's not necessarily normal.

Joy>  So how do we know what the normal temperature should be for enzyme functioning?

Dr. B>  You look at healthy people, because here they're taking everybody. I didn't look at this study to see exactly how many... Oh, here, they looked at 677,000 people's measurements over time, and they compared those from 1862 through 1930, and then one from 1971-75 and then one from 2007 through 2017. So they took three periods of time, right?

They took basically three quarter of a million different temperature readings from probably a half a million people and they said, This is what's average.

But of those people, how many of them were really healthy and how many of them were not so healthy?

And if you were to take some aspect, even just eye balling them, [and I have informally done this in my practice and looked at people who look pretty healthy], you're gonna find that their temperatures are more like 98.2...

And then you take people who are unhealthy for various reasons and their temperatures or going to be more like 97.1, which is the new average, so basically the average American is not healthy, that's the problem.

So you've got to look at this at reference ranges. In Integrative Medicine, we look at functional reference ranges. For example, the way they set it to a testosterone reference range is to take a 1000 men and say, "Well this is the range they are, and they throw off the top 5% and the bottom percent and make a bell shaped curve and say this is what is normal. But no, that's what's average. What's normal is what a really healthy person your age has on the average.

So that's what's wrong with our lab reference ranges and these types of reference ranges for temperature is they're looking at broad swath the people rather than perfectly healthy people.

Well, what we want to look at is what is it when you're perfectly healthy?

Joy>  So when one is perfectly healthy, we would want our temperature to be around 98.2, so that our enzymes could function properly and efficiently?

Dr. B>  Exactly! And we actually measure people's temperatures or have them measure them themselves and bring us charts... partly to look at their thyroid functioning, because thyroid controls metabolism. And what I think is going on... what these are showing is that we're actually getting toxic. I believe that what's happening is that our ambient levels of toxicities are increasing so much that they're poisoning us and we're no longer having normal temperatures, and so we're not having normal thyroid conversion, we're not having a normal hormone production, etc. For example, in the same time frame that they're looking at where these temperatures have changed the average sperm count of a young American male has also dropped to half of what it used to be.

So young men today have only half the number of sperm as their great-grandfathers had at the same age.

Joy>  Toxicity being a contributing factor!

Dr. B>  That's my theory. But you certainly can't say that that's the new normal. It's the new average.

But that's not normal, because that then leads to infertility issues and, that is a growing trend, infertility issues. And in fact, now you can even go to any drug store and right next to the pregnancy kits, there are actually sperm count kits... in the average drug store! You can buy these over the counter... it doesn't give an exact number, it gives a Good, Not Good, or Borderline reading.

Joy>  So that's become such a problem that now it's easily accessible to even test for it.

Dr. B>  That's right.

Joy>  Now I wan to make sure I'm following everything here. So you talked about the thyroid and toxicity, what exactly does the thyroid do to control our temperature how does that work?

Dr. B>  Well, thyroid hormone turns on our metabolic processes which basically means how well do we create energy and use it and burn energy. So if you're not getting enough thyroid hormone activity in your body, then all your other enzymes slow down, your temperature lowers, and all these enzymes change shape and they don't work as well.

And what's interesting is, this is kind of a circular argument almost, because it's the same things that are actually mucking up the thyroid that are mucking up all the other enzymes, because the enzyme itself... or the thyroid itself, runs on very important enzymes, and one of the most important one's is the one that activates the thyroid hormone.

Joy>  And what's that?

Dr. B>  There is an enzyme called 5-prime-diatamase that takes our pre-cursor thyroid hormone called T4, or thyroxin, and this is a molecule that has four atoms of tyrosine and four atoms of iodine, and you knock off the right iodine, one of the four, and then you make an active hormone called T3. or Tri-iodothyronine.

And that's the one that actually turns on our metabolism, keeps our temperature normal, makes us feel good. When you don't have enough thyroid hormone you feel sluggish, fatigued, constipated, mentally dull, your skin looks coarse, your facial features get coarse and rough, your hair and nails get brittle and thin... and so that's what low thyroid functioning looks like. And you can have that even with normal thyroid labs, if you're not converting your thyroid hormone from the precursor hormone of T4 to the active hormone of T3.

Joy>  Now, I've sometimes heard people talk about their metabolism mostly in regards to weight, right?

Right, weight gain is a very common symptom of low metabolism and low thyroid, which kinda go hand-in-hand.

Joy>  So there could be a chain going all the way back to toxins affecting the thyroid, affecting the metabolism, which affects your body temperature, and then your weight. So there's a huge chain of connecting this here that didn't even realize it was happening.

Dr. B> Exactly. And what we see is when we start with people and they have abnormal thyroid functioning either by lab values or by basal temperatures, and we work with them to get their thyroid working better, their temperatures improve, they may start off at this new average of 97.1, but they're going to end up closer to the 98.2 once they are feeling healthy again. This is what we see clinically, one-on-one here at Ashville Integrative Medicine.

But I want to go back to what some of this says. Here's a line that says, our bodies are cooling off in response to changes in our living environment. Over the last 200 years.

Well, yeah, but that's not adaptive, that's just toxic. That's just a toxic effect of our environment. Yes, it's a response to our environment, but it's not like, Oh, but now we have homes that have temperature controls, air conditioning, central heat comfortable settings... and we're able to maintain a stable temperature... we're spending less energy. But that actually makes it harder for us to adapt.

So, have you heard of the Wim Hoff?

Joy>  No, I don't think I have.

Dr. B>  He's a guy who has popularized cold showers and cold plunges as a way to boost your metabolism.

So it's a way of saying that we are no longer challenged enough, we were so comfortable that we don't face the daily challenges that our ancestors faced... when the house was getting colder at night, and not having air conditioning during the day. You know our bodies used to have to go through periods of heating itself and cooling itself. And now we're so comfortable that we kind of don't do that anymore. And that's maladaptive actually.

Our genetics aren't changing... our toning is changing, we're not toning ourselves. Just like if you don't go to the gym or do something to exercise regularly, you're going to get flabby, right? Well, our metabolisms are flabby, 'cause they're not challenged. Our metabolisms are couch-potato metabolisms, they're just sitting in front of the TV, We need to be challenged more.

Joy>  So then body temperature likewise wouldn't be determined by any of the seasons, or geographic location because that's still adaptive...

Dr. B>  It's determined by genetics and there's obviously a genetic differences in populations across the world but there's not huge genetic differences, and I've never seen a report of differences in average temperatures of people, for example, who live in far northern latitudes, versus as those who live in the tropics.

If that's what this author is proposing, then that's what you would see... is differences geographically... but that's not what they're reporting. They're reporting differences through time, and I think what's really happening is the high levels of toxicity that then interfere with all of our enzymes. And let's talk about how they do that.

These enzymes are proteins that have a nutrient metal or mineral right in the middle of it, like zinc or selenium. And toxins, there's two basic groups of toxins... there's toxic heavy metals like lead and mercury. And then there's 85,000 other chemical toxicities produced since the industrial evolution, like pesticides, plastics, petrochemicals, solvents, things like that. Styrofoam too! It's easier to talk about the heavy metals, but the other ones work very similarly.

Mercury for example, sits right underneath zinc on the periodic table of elements, which means it has the same shape as zinc does, and then we know of at least 200 enzymes that run on Zinc. So the mercury comes into your body, displaces the zinc in an enzyme, poisons that enzyme and kicks the Zinc out. And what we'll see is this zinc is high in the hair and actually low the body 'cause it's being displaced by the mercury.

So, you're poisoning those enzymes and, in fact, some of the enzymes that run our thyroid conversion run on Zinc.

Joy>  So if you have metals and you see Zinc coming out in your hair, then you know that those enzymes have been disrupted.

Dr. B>  That's right. Part of this is reducing toxicity levels, and we can measure these heavy metals in a variety of ways. We can measure in the hair if you're able to excrete them... if you're healthy enough to excrete them, or we can measure them in the blood, we can measure them in the urine... And we don't just measure randomly in the urine... we give people things to bind heavy metals called chelating agents, and then we measure the urine. We call that a chelation challenge. Then also from the urine we can measure 160 something of these other chemical toxicities to see how much of exposure you have there, and then we can help clean those up - first by avoiding exposures and then by helping people excrete the toxins. And that's the way to rehabilitate their enzymes to bring up the body temperatures.

Joy>  So, we won't just get rid of the toxins on our own?

Dr. B>  Well, you do... but for example... Mercury has a half-life of 25 to 50 years, which means 50 years later you've gotten rid of half of it on your own. That's too slow!

This is personal to me because I was a house painter, to put myself through college and I was scraping old leaded paint off old houses and I got extremely high levels of lead, when I finally got around to measuring myself 15 years later. And if I would have just left that there, then that would put me a much higher risk for heart disease and dementia and cancer. So with treating myself or a couple of years I was able to get that down to normal in two to three years rather than 100 years.

Joy>  And you were feeling the effects of that, even at that time, yes?

Dr. B>  I was... Well, I had lost my photographic memory and I developed gum recession, so besides that, I felt pretty good, 'cause I was still a young, healthy person, but when I started to work on the heavy metal detoxification, then I got most of my photographic memory back... and my gum recession is stabilized to a large degree. So while I respect this doctor's theory about "well, we're not infected as much, we're not inflamed as much... maybe that's the reason for this... " That may be part of it, but I think they're really not taking to account the fact that we are basically poisoned in modern American life compared to what people were 150 years ago.

Joy>  Well, that's terrifying to contemplate.

Dr. B>  It is.

Joy>  And all of this can be indicated from our temperatures.

Dr. B>  Well, I think the temperatures are a clue. Let's go back to how we take our temperatures, okay?

There's many ways to take your temperature... the latest ones that, for example, we use in our clinic is a forehead thermometer where you don't have to touch people. You just point it an inch from their forehead and that reads it. And then you can use a tympanic membrane, or ear thermometer on your ear drum and those are all very good.

A lot of people use oral digit digital thermometers. I think those are fine for reading fevers... by the way I always love when people say, "I don't have a temperature"... it's like, "Oh my gosh, you're at zero degrees kelvin! ? Haha... you have a temperature, you may not have a fever, but you definitely have a temperature! Anyway, what we do is the old fashioned way. We use a glass thermometer... and the reason we use a glass thermometer is that it gives less variability than the digital thermometers. What we found is if you take a digital reading three times in a row, you get three different numbers. Whereas if you take a glass thermometer reading three times in a row, then you can get nice, reliable readings that we can use.

The other thing that is true about temperatures is that time of day is important... we do get colder at night, our body is shut down, and then you get warmer during the day. So we prefer to take temperatures to measure what we call the basal temperatures.

We prefer to do this in the middle of the day - so between 11 AM and 3 PM is when we prefer to this and for a glass thermometer it takes about 7 to 10 minutes under your tongue, not just five minutes, that's a little bit too quick.

Now, if you're just tracking when you're ovulating, to either get pregnant or not get pregnant, then you can do your armpit first thing in the morning, that's fine, it's going to tell you when your temperature change, but it's always going to be low, you're always going to be getting a reading first thing in the morning under your arm... it's going to be something like 96.5 and 97.5 It's never going to be a 98.2.

Joy>  So I shouldn't start taking my temperature first thing every morning?

Dr. B>  Well, I mean if you're tracking ovulation, that's fine. If you want to know what your basal temperature is for the physiology of your metabolism, middle of the day is where you want to be, because that's your highest temperature. We want to know how hot you get baby. Haha.

Joy>  Maybe not hot enough. Haha. I happen to have a thermometer here. I'm going to go ahead and check and see. Oh good, I'm hot enough right now!

Dr. B>  Now shoot me on the forehead, let's see what we get. Alright! 98.1, so that's not bad. It's close to the 98.2 and that's because I've been detoxifying for over 20 years now, so my temperatures run pretty good these days, and that's what we want from people. So this temperature thing, it's fascinating! Do we have another question to go with that?

Joy>  Well, yeah, I'm wondering then what kinds of protocols are recommended for addressing the underlying cause or detoxing as we may be seeing in our temperatures?

Dr. B>  So, with detox... you can think about it as general or specific. So general, what you want do is eat organically, be clean, have a living situation where you don't have leaded paint chips and dust around, and generally avoid toxicities. And then you want to boost your liver detox, especially the glutathione pathway. Glutathione is our final common pathway of detoxification. It is a tri-peptide or three amino acids together, and one way to understand glutathione is that's what you run out of with a Tylenol overdose... running out of it is what kills you.

I used to be an ER doctor, 25 years ago, and when people would come in with a suicide attempt from Tylenol overdose or acetaminophen, we would pump their stomach and then put down in their stomach, NAC, N-Acetylcysteine, and that's the rate-limiting step amino acid of Glutathione, it's one of the three amino acids that makes it up, along with glycine and glutamine.

By doing that, we then restore people's ability to detoxify in their liver and then they get rid of the excess acetaminophen that they already absorbed. They also use NAC in medicine for saving kidneys from IV contrast dye, and I thought [25 years ago] before I was even into nutritional medicine, why don't we use this every day for people to help them detoxify... and in fact we do.

Joy>  So you can take Glutathione every day?

Dr. B>  You can take NAC every day to build your own Glutathione... if you try to take Glutathione it just breaks down your stomach acid. Now there is Glutathione NOW, surrounded by a little fat molecule called Liposomal, that protects it from being broken down. If you take that on an empty stomach you can take Glutathione directly to help you detoxify. But it's more expensive, it's more harsh for some people, some people are kind of sensitive, especially they have chemical sensitivities and they'll detoxify too fast and they'll get a kind of 'kick-back'. For long-term, it's a lot more affordable and easier to just take the NAC.

Joy>  Does that come as a supplement...

Dr. B>  Yes, a supplement, just a little capsule, usually about 500 mg and you take it once or twice a day. It also helps thin mucus... it's also known in medicine [back when I was in medical school 30 years ago] as "muco-mist" they'd use it for people having thick secretions in their sinuses or lungs to make that mucus thinner and able to get out easier. So at the same time that it helps to get rid of mucus, it helps you detoxify other things. So that's one of the things, I mean, we can talk about so many things with detox.

Joy>  Yeh... for sure!

Dr. B>  You and Lauren help teach people detox here in the clinic, and so things like pooping! People don't poop enough 'cause they don't get enough fiber... 'cause all these refined diets, and fiber helps us grab on to toxins in our bowel and get rid of it rather than re-absorb it in the colon. And so, most Americans are having sluggish bowels with stuff that sits there too long, and the colons job is to re-absorb water, but then it also re-absorbs toxins if you give it a chance.

So the way to stop that is to poop two or three times a day, not just once every other day, and drink a lot more water and eat a lot more fiber and get rid of toxins.

So but then you get into specific detox in order to detox specifically rather than generally you’ve got to measure the toxicity. So this is where we get into measuring the heavy metals and then measuring the other toxicities, and then we can get very specific about giving things to help people get rid of those and then measure it again and see how good a job we've done.

So I think that's a good hit on this temperature discussion!

Joy>  I certainly feel like I understand now why average isn't normal.

Dr. B>  Average is not normal, it is true that our average temperatures have decreased, but our genetics have not changed, and we should all still be at 98.2 degrees Fahrenheit degrees or 37.0 degrees Celsius. And if you're not, then you're probably having a thyroid problem and that problem is probably related to needing more detoxification.

Joy>  Alright, well I really appreciate that, that was very informative and I look forward to learning more.

Dr. B>  Alright, you all have a good day.