Immune Activation
Fever therapy
Fever therapy induces a fever from the inside: a purified bacterial lysate, given intravenously under medical supervision, resets the body's thermostat so that it raises its own core temperature to 39–40 °C / 102.2–104.0 °F for one to three hours. The immune cascade that comes with a real fever is the point, and the difference from heating the body with a device.
What it is
What is fever therapy?
Fever therapy is the deliberate induction of a controlled fever with purified bacterial lysates: substances made from inactivated bacteria that act on the body's temperature center without causing an infection. It belongs to the family of heat treatments described on our hyperthermia overview, and it is the one member of that family in which the body makes the heat itself.
The idea goes back to William Coley, a New York surgeon who in the 1890s treated cancer patients with a mixture of killed bacteria after observing tumor regressions in patients who had developed high fevers. His preparation is regarded as one of the first deliberate immunotherapies, and the line from it to today's immunotherapy has been traced in the literature (Carlson et al., 2020).
At St. George Hospital fever therapy has long been part of the Lyme and oncology programs, next to whole-body hyperthermia. The two are not interchangeable. Whole-body hyperthermia heats the body from outside while the brain's thermostat resists. Fever therapy moves the thermostat: the hypothalamus raises its set point and the body climbs to the new temperature with chills, cytokine release, heat shock proteins and sweating, the full sequence of a real fever.
How it works
How does it work?
The bacterial lysate is given intravenously at a dose calibrated to you. It acts on the hypothalamus, the brain's thermostat, which raises the body's temperature set point. The body then generates fever the way it would in an infection: the muscles shiver, the skin vessels close, and the core temperature climbs over 30 to 90 minutes.
What the fever does in the immune system has been mapped in detail. Fever-range temperatures change how immune cells move, how they present antigen and how they signal; natural killer cells, dendritic cells and lymphocytes all respond to heat (Evans et al., 2015; Hasday et al., 2014). The pathways we aim at:
- Cytokine release (interleukin-1, interleukin-6, tumor necrosis factor alpha, interferons), the signaling of a systemic immune response
- Natural killer cell activity, which rises at fever-range temperatures of 39–40 °C / 102.2–104.0 °F (Dayanc et al., 2008)
- Phagocytosis by macrophages and neutrophils
- Heat shock proteins, which mark stressed cells for immune recognition and improve antigen presentation
- Microcirculation: fever increases blood flow to the tissues and with it the delivery of immune cells
- Biofilms: raised temperature is one of the conditions under which persistent bacterial communities become more accessible to the immune system and to antimicrobial drugs
Who it is for
What conditions is it used for?
- Chronic Lyme disease, where the aim is to mobilize the immune response against a persistent intracellular infection and to support the antimicrobial part of the multimodal plan
- Chronic infections that recur or have not responded to treatment, viral and bacterial
- Patients whose immune function is suppressed or dysregulated on the laboratory work-up
- Integrative oncology, as an adjunct beside standard treatment, with the aim of immune activation
- ME/CFS with an immune pattern on the work-up, in selected cases
Who it is not for: patients with unstable heart disease or severe hypertension, uncontrolled seizures, pregnancy, a severe acute infection, or an illness that would not tolerate a day of fever. The physician screens for these before the first session and decides from your findings, not from the diagnosis alone.
Could this belong in your plan?
That depends on your findings, not on the therapy. Write to the International Office with a short history; it requests your records afterwards, and a physician reviews them before the video consultation and tells you whether this treatment belongs in your program.
What a session feels like
Four to six hours in a dedicated treatment room, under continuous medical supervision.
Preparation
Vital signs and contraindications are checked, an IV line goes in for fluids, and the lysate is given at your calibrated dose. Eat lightly beforehand.
Rising fever
Chills and shivering first; blankets help. Your body raises its own temperature.
Fever plateau
Warmth and sweating at 39–40 °C / 102.2–104.0 °F. Vital signs are recorded throughout; the physician can lower the fever at any time.
Recovery
Cool-down and rest. Fatigue and mild aches that evening are normal, and a nurse checks on you. Most people feel ordinary by morning.
Evidence and safety
The immune mechanism is well described, but no randomized trial has tested fever therapy against standard care. Unstable heart disease, severe hypertension, seizure disorders and pregnancy exclude it.
Show studies, risks and side effects
The mechanism is well described. Reviews in the immunology literature set out how fever-range temperatures change lymphocyte trafficking, antigen presentation and the activity of natural killer cells and dendritic cells (Evans et al., 2015; Hasday et al., 2014), and the role of hyperthermia in natural killer cell responses against tumor cells has been dissected experimentally (Dayanc et al., 2008). The link between fever and cancer has an older literature too: a review of the epidemiological and historical data on febrile infections and tumor regression puts Coley's observations in perspective (Hobohm, 2001).
The clinical evidence for fever therapy itself, as a treatment given with bacterial lysates in chronic Lyme disease, chronic infections or cancer, is limited: there are no randomized trials that test it against standard care. It is therefore an individual treatment attempt at St. George Hospital, decided with the patient after medical consultation, and what it does is measured rather than assumed: the immune markers from the admission work-up are repeated after the course.
Safety: a fever of 39–40 °C / 102.2–104.0 °F is within what a healthy body produces in an infection. The risks come from the circulation, which is why the session runs with IV fluids and continuous monitoring, and why unstable heart disease, severe hypertension, seizure disorders and pregnancy exclude it. The physician can lower the fever at any time.
In the program
How it fits the program
Fever therapy sits beside the device-based heat treatments and is never scheduled on the same day as whole-body hyperthermia; the body needs a day between two fevers. In the Lyme program it runs in the weeks of antimicrobial treatment, where the aim is to catch the infection while the immune system is activated; the Lyme treatment page shows where it sits in the weeks. In oncology it is an adjunct beside the oncologist's treatment, in the same way as local and regional hyperthermia. The laboratory work-up at admission names the immune markers that are measured again after the course. For patients from abroad the sessions are scheduled within the hyperthermia program for international patients, with a video consultation in English before you travel.
Costs: the fever therapy sessions appear in your written, itemized cost overview, which combines a package price with individual add-ons. A deposit is paid before admission. Treatment is self-pay and reimbursement is never promised. Details are on Costs and insurance.
FREQUENTLY ASKED QUESTIONS
Common questions about fever therapy
How is fever therapy different from whole-body hyperthermia?
Whole-body hyperthermia heats the body from outside with water-filtered infrared light and the brain's thermostat works against it. Fever therapy moves the thermostat itself: a bacterial lysate makes the hypothalamus raise the set point, and the body generates the heat with chills, cytokines and sweating, as in an infection. Both reach similar temperatures; the immune signaling differs.
Does fever therapy hurt?
It feels like a fever, because it is one. The first hour brings chills and shivering, then sustained warmth and heavy sweating, often with aching muscles and a headache. Blankets, cool compresses and IV fluids take the edge off, and a nurse is in the room throughout. Most patients sleep afterwards.
Is fever therapy safe?
A fever of 39–40 °C / 102.2–104.0 °F is what a healthy body produces in a flu, and the session is run under continuous monitoring of pulse, blood pressure, oxygen and temperature with IV fluids running. It is not given to patients with unstable heart disease, uncontrolled seizures, pregnancy or a severe acute infection; the physician screens for these before the first session.
How many sessions will I need?
Sessions are single events spaced days apart so that the body recovers between them. How many belong in your program depends on your tolerance of the first one and on the markers measured before and after. The written treatment proposal you receive before admission names the planned number.
How much does fever therapy cost?
The cost depends on the number of sessions and the monitoring each one needs. After a physician has reviewed your findings you receive a written, itemized cost overview that lists each session; the costs page explains what it covers and how the invoice is written.
Where we use it
Used in these departments
References
- Fever and the thermal regulation of immunity: the immune system feels the heat. Nat Rev Immunol 2015. PMID 25976513
- Fever, immunity, and molecular adaptations. Compr Physiol 2014. PMID 24692136
- Dissecting the role of hyperthermia in natural killer cell mediated anti-tumor responses. Int J Hyperthermia 2008. PMID 18214768
- Fever and cancer in perspective. Cancer Immunol Immunother 2001. PMID 11726133
- Talkin' Toxins: From Coley's to Modern Cancer Immunotherapy. Toxins (Basel) 2020. PMID 32283684
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The initial inquiry is free of charge. The International Office reviews your message and your case directly and gets back to you.
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