There are several factors that can affect body temperature. But whatever does affect it (making it too low, too high, or unsteady) can cause all the symptoms of Multiple Enzyme Dysfunction that are characteristic of Wilson’s Temperature Syndrome. For example, people who are exposed to cold weather and become hypothermic will often become sleepy and fatigued. Also, when people eat ice cream too fast, their throats get cold causing the blood going to the brain to be more cold, and they can develop a headache.

Surface Area / Volume Ratio
We’ve discussed how the body temperature depends upon how much heat is generated within the body itself (which is regulated by the thyroid system). But it also depends upon how much heat goes in and out of the body from or to the environment.

The amount of heat going in and out of the body is determined by a couple of factors, one being what environmental conditions the body is exposed to. For example, the body will retain more heat when exposed to the heat from a shower, a sauna, or hot weather, than it will if it is exposed to cold weather or a cooling thermal blanket such as the ones sometimes used in hospitals to lower a patient’s fever. Another factor is the body surface that is exposed to the environment.

An analogy that I frequently use to illustrate this point is that if you had a lump of mashed potatoes on your plate that was too hot to eat and you wanted it to cool faster, you could spread the potatoes out on the plate. The more it is spread out, the faster it cools. The reason for this is that for the same volume of food one may increase the surface area by spreading the food out, thus exposing more of the food or mass to the surface so that the heat more easily dissipates.

The laws of physics tell us that the shape in the universe that holds its heat the best is the sphere or ball because it is the shape that has the smallest amount of surface area per unit of volume. The more a person looks like a ball and less like a stick, the harder it is to dissipate calories. This might partly explain why taller people tend to be thinner than shorter people.

Let’s consider how this ratio can be extremely important. Suppose that there are two different animals that live in very different climates. Of course, they would face different challenges. On one hand, animals that live in extremely cold climates need to retain enough body heat to maintain their body temperatures to ensure the proper functioning of their enzymes and bodily functions. However, animals that live in extremely hot climates have the challenge of dissipating enough heat to maintain a body temperature that would be adequate for their enzyme and bodily functions. For instance, the desert mouse and certain desert rodents are in some danger of becoming overheated. The shapes of their bodies are formed in such a way that encourages rapid dissipation of heat. That’s why their ears are large, their legs and tails are long, and even their bodies are more slender. Incidentally, their urine is also more concentrated so that they can better conserve water.

The desert mouse can be compared to the seal that lives in a much colder climate. To help them preserve their body heat, they have shapes that provide less surface area per unit of volume. They are plumper or more bulky in shape with smaller ears. Only their relatively short flippers are exposed to the environment.

Another simple way to see the importance of surface area/volume ratio is to observe people who are sitting outside in very cold weather. Notice that they tend to sit huddled up in a ball to conserve body heat. If it didn’t make any difference, people wouldn’t hold their arms and legs in close in cold weather. So our surface/area volume ratio can be affected by our height in relation to our weight, how we stand or sit, how we dress to an extent, and how much of our body is exposed to the environment.

The body’s temperature depends also on how much heat is generated within the body. The heat is generated by the chemical reactions of the body that change raw materials, fuel, or food into the products and functions necessary for maintenance of life. The chemical reactions take place, for the most part, within the cells of the body, and of course, the volume of the body is made up of cells. The greater the volume of cells, the greater the volume of chemical reactions, and the greater the capacity for producing heat. So the amount of heat produced in the body is roughly proportional to the volume of the body. And of course, the heat generated by the body is directly related to the metabolism (the rate or extent to which the reactions take place).

PMS and Temperature
The symptoms of Wilson’s Temperature Syndrome are principally the result of aberrant temperature patterns due to impaired conversion of T4 to T3 (thyroid hormones). It should be pointed out, however, that there are other causes of aberrant body temperature which can also cause symptoms.

For example, it is well known that the body temperature will vary up and down during a woman’s menstrual cycle, tending to peak at the time of ovulation (useful information for couples who are trying to conceive). The temperature tends to rise just prior to a woman’s period and gradually decreases as the period begins and progresses. This explains why symptoms of Multiple Enzyme Dysfunction can change in severity in relation to a woman’s menstrual cycle, a problem commonly referred to as PMS or premenstrual syndrome. If one looks at the symptoms of PMS, one sees depression, fatigue, fluid retention, headaches, bloating, irritability, craving for sweets (especially high energy sweets such as chocolate), problems with memory, and essentially the whole list of symptoms associated with Multiple Enzyme Dysfunction. They are termed premenstrual because they are most severe prior to the period. The symptoms of MED can be related to temperature patterns that are too high, too low, or unsteady. Premenstrual worsening of the symptoms of MED are most commonly related to rapid change (usually increase) in the body temperature pattern prior to the period. Interestingly, I have often seen complete relief of the PMS symptoms when the body temperature patterns have been normalized. This observation has made it obvious that the symptoms of PMS are related to body temperature patterns.

Another interesting point is that I have had a few patients whose classic signs and symptoms of “premenstrual” syndrome occurred on a predictable monthly basis just after their period (or only during the period rather than just prior to their period). One might call this “postmenstrual syndrome.” And again, in these cases, their postmenstrual symptoms of MED have often resolved with normalization of their body temperature patterns. This makes it more evident that these menstrual related symptoms of Multiple Enzyme Dysfunction are related to aberrant body temperature patterns. These symptoms seem to be related to female hormones only to the extent that female hormones can affect body temperature patterns.

Adrenal Hormone Levels Affect Daily Temperature Cycle
Addison’s Disease and Cushing’s Disease are diseases that can affect the levels of adrenal hormones. Addison’s Disease is caused by insufficient levels of cortisol in the body, and Cushing’s Disease is due to excessive levels of cortisol. It is interesting to note that these two diseases can cause symptoms that are similar to those of Wilson’s Temperature Syndrome and/or Multiple Enzyme Dysfunction. These include fatigue, fluid retention, weight gain, depression and headaches. It has long been documented that cortisol, which is the hormone that is produced excessively in Cushing’s Disease, can directly inhibit 5′-deiodinase (the enzyme that converts T4 to T3). I have seen cases where patients have developed classic cases of Wilson’s Temperature Syndrome immediately after having been given injections of cortisone or steroids. Presumably, cortisone can inhibit 5′-deiodinase and set in motion the vicious cycle that results in Wilson’s Temperature Syndrome. In such cases the symptoms can be treated with proper thyroid hormone treatment. So it’s not really hard to understand why someone, when given an injection of cortisone, can gain weight, retain fluid, get tired and depressed, and develop many of the symptoms of Wilson’s Temperature Syndrome. It’s interesting that cortisone is produced by the body’s adrenal glands under stress. It is also interesting that cortisol levels go up and down in a daily pattern.

It is well known that the body temperature tends to run lowest in the morning, gradually increasing during the day, usually being the highest in the afternoon, and tending to decrease in the evening. So the body temperature can follow both a monthly cycle and a daily cycle. This can explain why the symptoms of MED sometimes follow monthly and daily patterns.

Many of the patients that I see find that their symptoms of Multiple Enzyme Dysfunction are worse at certain times of the day. For example, they might do fairly well an hour or two after awakening and getting started in the morning, and become extremely fatigued between 2:00 p.m. and 4:00 p.m.

In the section dealing with depression we will discuss how symptoms of Multiple Enzyme Dysfunction can also follow a seasonal pattern. This might help explain what is known as Seasonal Affective Disorder or SAD. It might be a type of biological clock phenomenon similar to hibernation in animals.

Pregnancy
It should be pointed out that a fetal hormone known as human chorionic gonadotropin also can affect body temperature patterns. When a woman becomes pregnant, the baby begins to produce human chorionic gonadotropin or HCG. HCG can increase the body’s metabolism and body temperature patterns. This can explain why women suffering from Wilson’s Temperature Syndrome frequently do their best while they are pregnant. Unlike other women who often feel tired, feel depressed, and gain weight easily during their pregnancy, some women who are suffering from Wilson’s Temperature Syndrome actually fare much better during pregnancy, enjoying much more energy, less depression than usual, and often having unusual success at being able to control their weight. Some women actually report that during their pregnancies were the only times that they were capable of losing weight with proper dieting and exercise. Interestingly, HCG has been used in the past as a treatment to help people lose weight.

Blood Sugar
Blood sugar levels can also affect body temperature patterns, and body temperature patterns can affect blood sugar levels. It isn’t too hard to understand, then, why the symptoms of hypoglycemia are so similar to the symptoms of MED. It is also easy to understand how nutrition can be an important influence on overall function of the metabolism.