Hypothermia and abnormalities in thermoregulation in patients with anorexia nervosa

Abstract

Hypothermia and other persisting disturbances in thermoregulation among weight‐recovered anorexia nervosa patients are reviewed. Possible neurobiological mechanisms that might explain these clinical features are presented along with evidence supporting the hypothesis that an increase in nonshivering thermogenesis and an underlying autonomic nervous system imbalance may contribute to the persistence of certain abnormal thermo‐regulatory responses to cold in anorectics.

High-Resolution Infrared Body Surface Temperature and Self-Perceived Warmth Distribution in Adolescent Anorexia Nervosa Patients

“…The inner canthi of the eyes, which are meant to map the core body temperature when the ambient temperature is controlled for (Mercer & Ring, 2009), were also found to be colder in AN patients. This confirms previous findings regarding a significantly lower core body temperature in AN patients (Chudecka & Lubkowska, 2016; Nishita et al, 1986), too. Thus, the results of our study suggest that the hypothermia in AN patients reaches from the extremities to the inner center of the body, but that our inpatient treatment programme could address these symptoms.…”

“…Regarding the AN group, the abdomen area approached a significant correlation of objective and subjective body warmth at admission. In line with previous research, the AN patients of this study were significantly colder at the extremities than the healthy controls in the acute phase of the illness (Chudecka & Lubkowska, 2016;Luck & Wakeling, 1980;Nishita et al, 1986). We additionally found that other distal body parts such as the face, the forehead, and the tip of the nose were colder in AN patients when compared to healthy controls which supports the results of Chudecka and Lubkowska (2016).…”

High-Resolution Infrared Body Surface Temperature and Self-Perceived Warmth Distribution in Adolescent Anorexia Nervosa Patients

“…The inner canthi of the eyes, which are meant to map the core body temperature when the ambient temperature is controlled for (Mercer & Ring, 2009), were also found to be colder in AN patients. This confirms previous findings regarding a significantly lower core body temperature in AN patients (Chudecka & Lubkowska, 2016; Nishita et al, 1986), too. Thus, the results of our study suggest that the hypothermia in AN patients reaches from the extremities to the inner center of the body, but that our inpatient treatment programme could address these symptoms.…”

“…Regarding the AN group, the abdomen area approached a significant correlation of objective and subjective body warmth at admission. In line with previous research, the AN patients of this study were significantly colder at the extremities than the healthy controls in the acute phase of the illness (Chudecka & Lubkowska, 2016;Luck & Wakeling, 1980;Nishita et al, 1986). We additionally found that other distal body parts such as the face, the forehead, and the tip of the nose were colder in AN patients when compared to healthy controls which supports the results of Chudecka and Lubkowska (2016).…”

Increasing Warmth in Adolescents with Anorexia Nervosa: A Randomized Controlled Crossover Trial Examining the Efficacy of Mustard and Ginger Footbaths

“…Patients with AN report not only lower core and skin temperatures; they also describe feeling subjectively colder than individuals who are healthy [1,3,4]. Interestingly, the craniocaudal gradient in subjective warmth was only seen for patients with AN.…”

Clinical meaning of body temperatures in anorexia nervosa and bulimia nervosa

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at-rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al, 1997(Baranowska et al, , 2008Samson et al, 1999;Schorr & Miller, 2017;Vigersky et al, 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al, 1986), and bradycardia.…”

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at‐rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al., 1997, 2008; Samson et al., 1999; Schorr & Miller, 2017; Vigersky et al., 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al., 1986), and bradycardia. Moreover, body temperature is controlled by the body biological clock: circadian rhythm activity is known to be altered by diet and physical exercise, which are two typical dysregulated features of ED patients.…”

High-Resolution Infrared Body Surface Temperature and Self-Perceived Warmth Distribution in Adolescent Anorexia Nervosa Patients

“…The inner canthi of the eyes, which are meant to map the core body temperature when the ambient temperature is controlled for (Mercer & Ring, 2009), were also found to be colder in AN patients. This confirms previous findings regarding a significantly lower core body temperature in AN patients (Chudecka & Lubkowska, 2016; Nishita et al, 1986), too. Thus, the results of our study suggest that the hypothermia in AN patients reaches from the extremities to the inner center of the body, but that our inpatient treatment programme could address these symptoms.…”

“…Regarding the AN group, the abdomen area approached a significant correlation of objective and subjective body warmth at admission. In line with previous research, the AN patients of this study were significantly colder at the extremities than the healthy controls in the acute phase of the illness (Chudecka & Lubkowska, 2016;Luck & Wakeling, 1980;Nishita et al, 1986). We additionally found that other distal body parts such as the face, the forehead, and the tip of the nose were colder in AN patients when compared to healthy controls which supports the results of Chudecka and Lubkowska (2016).…”

Increasing Warmth in Adolescents with Anorexia Nervosa: A Randomized Controlled Crossover Trial Examining the Efficacy of Mustard and Ginger Footbaths

“…Patients with AN report not only lower core and skin temperatures; they also describe feeling subjectively colder than individuals who are healthy [1,3,4]. Interestingly, the craniocaudal gradient in subjective warmth was only seen for patients with AN.…”

Clinical meaning of body temperatures in anorexia nervosa and bulimia nervosa

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at-rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al, 1997(Baranowska et al, , 2008Samson et al, 1999;Schorr & Miller, 2017;Vigersky et al, 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al, 1986), and bradycardia.…”

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at‐rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al., 1997, 2008; Samson et al., 1999; Schorr & Miller, 2017; Vigersky et al., 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al., 1986), and bradycardia. Moreover, body temperature is controlled by the body biological clock: circadian rhythm activity is known to be altered by diet and physical exercise, which are two typical dysregulated features of ED patients.…”

High-Resolution Infrared Body Surface Temperature and Self-Perceived Warmth Distribution in Adolescent Anorexia Nervosa Patients

“…The inner canthi of the eyes, which are meant to map the core body temperature when the ambient temperature is controlled for (Mercer & Ring, 2009), were also found to be colder in AN patients. This confirms previous findings regarding a significantly lower core body temperature in AN patients (Chudecka & Lubkowska, 2016; Nishita et al, 1986), too. Thus, the results of our study suggest that the hypothermia in AN patients reaches from the extremities to the inner center of the body, but that our inpatient treatment programme could address these symptoms.…”

“…Regarding the AN group, the abdomen area approached a significant correlation of objective and subjective body warmth at admission. In line with previous research, the AN patients of this study were significantly colder at the extremities than the healthy controls in the acute phase of the illness (Chudecka & Lubkowska, 2016;Luck & Wakeling, 1980;Nishita et al, 1986). We additionally found that other distal body parts such as the face, the forehead, and the tip of the nose were colder in AN patients when compared to healthy controls which supports the results of Chudecka and Lubkowska (2016).…”

Increasing Warmth in Adolescents with Anorexia Nervosa: A Randomized Controlled Crossover Trial Examining the Efficacy of Mustard and Ginger Footbaths

“…Patients with AN report not only lower core and skin temperatures; they also describe feeling subjectively colder than individuals who are healthy [1,3,4]. Interestingly, the craniocaudal gradient in subjective warmth was only seen for patients with AN.…”

Clinical meaning of body temperatures in anorexia nervosa and bulimia nervosa

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at-rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al, 1997(Baranowska et al, , 2008Samson et al, 1999;Schorr & Miller, 2017;Vigersky et al, 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al, 1986), and bradycardia.…”

“…Body temperature alterations are common in ED patients and these abnormalities are due to different (mal)adaptive mechanisms, such as reduced at‐rest metabolism (Chudecka & Lubkowska, 2016), altered (neuro) endocrine activity (Baranowska et al., 1997, 2008; Samson et al., 1999; Schorr & Miller, 2017; Vigersky et al., 1976), dysregulated vasodilation thresholds (Luck & Wakeling, 1980), neurovegetative alterations (Nishita et al., 1986), and bradycardia. Moreover, body temperature is controlled by the body biological clock: circadian rhythm activity is known to be altered by diet and physical exercise, which are two typical dysregulated features of ED patients.…”