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Scenario :
Due to the effects of a magical overload, there are people in my world who lose their magic. Those that don't go outright insane are left with damaged nervous systems and a high body temperature for the duration of their lives. This is supplemented by an increase in physical strength and endurance, partially due to increased ability to gain muscle mass, broken limiters, and magical handwaving stuff.

Potentially useful details :

  • These people can still rarely have children, but the children will be born into and permanently be in this new state.
  • They have no super healing, but there can be external healing factors applied to them. They're immune to any magical healing things, it has to be standard healing.
  • Technology available is basically 1700-1800 USA

Question

The big question I have is how would it effect the human body to be in a long term state of mild fever (38.5-40 C) for the duration of their lives?

Primarily what would their mental state be like, and what body systems would be struggling the hardest due to increased core temperatures? Would anything physiologically need to change to allow them to survive for a long duration (10+ years)?

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A scientific article from the US National Institutes of Health titled The pathophysiological basis and consequences of fever gives a good review. From the abstract:

Where heat generation exceeds heat loss and the core temperature rises above that set by the hypothalamus, a combination of cellular, local, organ-specific, and systemic effects occurs and puts the individual at risk of both short-term and long-term dysfunction which, if severe or sustained, may lead to death.

It goes on to describe damage caused by fever in three main categories: (a) cellular damage, (b) localized effects (vascular stasis, inflammation response, etc), and (c) systemic effects. These are summarized in the following graphic: enter image description here

Cellular damage

While direct cell death occurs around 41 C, protein and DNA synthesis is disrupted at lower temperatures. This means cells replicate more slowly (or not at all). This makes sense: your body normally achieves a fever state for fighting off infections, so activating your immune system and slowing down the ability for cell growth is helpful. Chronic, long-term fever would mean more stress on organs (including organ failure), a slower repair rate for bruises and broken bones, et cetera. It would also mean, with some caveats, a lower risk of infection (because foreign invaders would not be able to replicate as easily. Furthermore, gut flora would also have difficulty replicating which means more stomach aches and problems with digestion.

Localized effects

A slower blood flow (vascular stasis), increased risk for cancer (extravasation means white blood cells "leak" through the capillaries - good for fighting infections - but also means that cancer cells "leak" into different parts of the body), and overall inflammation. Inflammation means joint pain, muscle fatigue, digestive issues, increased risk of cholesterol blockage and therefore heart attacks, and, of course, organ damage or failure.

Systemic Effects

Gastrointestinal bacterial translocation means bacteria in your gut ends up elsewhere. The biotics in your gut help you break down food (literally do part of the digestion for you). These same bacteria in other areas besides the gut suddenly become dangerous foreign invaders. As such this could lead to not only more stomach issues (fewer bacteria in the gut) but bacterial infections caused by those bacteria being elsewhere. Furthermore, "endotoxemia" means stuff that's produced by the bacteria in your gut getting into the bloodstream. So not only does the bacteria end up elsewhere, but the stuff the bacteria produces gets dumped into the bloodstream, which is not good.

All of these effects kick on pretty quick (they can be measured after 30 minutes of mild fever in animal studies), and are inconveniences in the short term (up to a few days), but chronic, long-term damage would likely result in serious organ failure and death. The article goes on to describe damage to neurons (cognitive dysfunction), issues with the cardiovascular system, serious liver damage, haemostatic system issues (how the blood coagulates in muscles and damaged skin), and so on.

In heatstroke (which is temperatures above your quoted range), a 28-day mortality rate was 58%, and a whopping 71% at 2 years. Furthermore, 33% (one in three) survivors of heatstroke have some moderate to sever functional damage, and 41% requiring institutional care after a year. Granted, this would be temperatures above your quoted range, but I would anticipate similar issues with lower fevers at longer times (such as 10/15 years).

Take into account the increased rate of water and caloric expenditure, and decreased ability to metabolize food, and your people would have to eat and drink a lot while dealing with fatigue, mental issues, organ failures, and cancer.

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    $\begingroup$ So combining the affects of the fever with the magic things, I'm probably go to end up with people that are going to require extra resources to feed and water, will be strong but probably are a bit crippled from pain and organ damage. Also lots of mental problems going on with them. If children were born would probably need to handwave something if I wanted them to survive to adulthood (infancy and puberty would have lots of difficulties), and I doubt there would be any grandchildren from them. $\endgroup$ – Nymn Oct 30 '19 at 18:46
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    $\begingroup$ @Nymn lots of medication is an option. Also anti-inflammatory drugs like ibuprofin, naproxin, and acetaminophen would be hugely beneficial. Large quantities of these have their own issues, but the need for them could be mandatory for kids. Also, steroids have anti-inflammatory powers... anabolic steroids have the same influence on the body, with the added ability to gain muscle mass (and make you more violent). I could believe a population like this would be on steroids 24/7... frightening but plausible if you're genetically predisposed to a fever. $\endgroup$ – cegfault Oct 30 '19 at 21:39
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They have syphilis.

Chronic infection can cause chronic fever. Of the chronic diseases that cause fever, the big three are malaria, tuberculosis and syphilis.

https://jramc.bmj.com/content/jramc/85/3/117.full.pdf

Notes on the Significance of

Fever in Syphilis with a Reference to Hypopyrexia" fever...may be accompanied by various symptoms including generalized muscle pains and gastric disturbance; suggesting typhoid and paratyphoid fevers. These latter are not uncommon in syphilitics in the secondary stage ; in a patient without marked gastric upset, in good general condition with a clean moist tongue suffering from this type of fever, syphilis must be considered. This continuous fever rarely :persists longer than six or seven days, but sometimes a true syphilitic fever lasts two or three weeks, or shows 2 or 3 plateaux each lasting about seven days

Syphilis has a lot of weird symptoms that are not well remembered now and would serve well in a fiction - examples being mental disturbances, neuropathy, rash and a host of others - syphilis is called "the great imitator" because of all the different symptoms the infected can manifest. It would be understandable if you did not want to actually use syphilis because youi consider an STD inappropriate for your fiction. But you could definitely have your people have a chronic infection.


They have lymphoma.

Chronic cancer is another reason for fever - persons can live for years with low grade lymphomas, which cause lumps and bumps and intermittent fever. I think the white-skinned transfusion dependent warriors in the Road Warrior remake were supposed to have lymphoma because many had a lot of lymphadenopathy in their necks, and lymphoma can compromise blood production in the marrow.


Fever means you burn calories faster and water evaporates from you faster; tjhere is a greater risk for dehydration. Higher fever can break down muscle - rhabdomyolysis. Fever can cloud the mind but these folks would be used to that. They might sit out the action if they were having a high fever day or they might chew willow bark for the natural antipyretics in it; willow bark was the precursor to aspirin which is excellent at lowering fever regardless of the cause.

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