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As far as I know, nasal congestion and fever are generally regarded as symptoms of many illnesses (e.g. flu), not as mechanisms that the body uses to fight an infection. Nonetheless, a lot of people still seem to abide by the rule that you should "tough it out" and not take medicine to reduce these symptoms. Some people seem to express the belief that they will actually get through there illness faster if they suffer through it.

Is there any evidence to support that belief? It seems to me that such an argument would only be valid if one could show that the body is actually using the fever or nasal congestion to eradicate the infection. I could imagine that there might be instances like the following:

  • a certain type of microbe dies at a few degrees above body temperature, or the higher temperature significantly slows down reproduction

  • nasal congestion restricts the ability of the microbe to get to XYZ in the body, thereby limiting the effectiveness of the infection.

Are there any examples where this might be the case? Or are there some common cases in which fever or congestion can be shown to actually help fight the infection?

  • I'm not sure if common cold is a good example for your question. There is usually no fever in common cold and there is no effective treatment known, so most people probably won't even try to treat it with medicines. Flu might be a better example, what do you think? – Jan Apr 12 '19 at 6:22
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FEVER

There is still no final agreement among experts about the treatment of fever, but recently some of them lean toward not treating it unless it's life-threatening.

Fever: suppress or let it ride? (PubMed, 2015):

There are two basic fields of thought: (I) fever should be suppressed because its metabolic costs outweigh its potential physiologic benefit in an already stressed host; vs. (II) fever is a protective adaptive response that should be allowed to run its course under most circumstances. The latter approach, sometime referred to as the “let it ride” philosophy, has been supported by several recent randomized controlled trials.

The result of one of such trials Acetaminophen for Fever in Critically Ill Patients with Suspected Infection (PubMed, 2015) was:

Early administration of acetaminophen to treat fever due to probable infection did not affect the number of ICU [Intensive Care Unit]-free days.

The conclusion of another review Fever management: Evidence vs current practice (PubMed, 2012):

The accumulated data now suggest that fever has a protective role in promoting host defence against infection, rather than being a passive by-product.

NASAL CONGESTION

Does nasal congestion prevent the spread of microbes through the body?

In nasal infection, the microbes multiply in the nasal mucosa from where they can spread via airways to other parts of the respiratory system or via the blood to the entire body. At the time of infection, there are likely many more microbes in the nasal mucosa then in the outside air, so nasal congestion probably does not significantly protect from further infection.

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  • I think that you slightly misunderstood the point about nasal congestion... it seems plausible to me that if the body did not react by contesting the nose, then all of the excess microbes would result in a lot of post nasal drip, giving them a more direct pathway deeper into the body. If that is plausible, then one could view congestion as a defense against the infection – bremen_matt Apr 12 '19 at 19:03
  • Or another possibility.... early in the infection the microbes take root in your nose. If you could breathe normally through your nose, then they would have easier access to the lungs... essentially they would start multiplying in the nose, and when you take a normal breath, you start breathing in more and more of them because they are multiplying in the nose – bremen_matt Apr 12 '19 at 19:08
  • When you have blocked nose, mucus can drip from the back side of the blockage into the throat, especially when you are lying. Once in the throat, it is breathing through the mouth that can push microbes deeper down. Blockage acts as a defense if it creates a wall with microbes in front and no microbes behind. But since microbes are in the blockage they can easily move further. – Jan Apr 13 '19 at 7:54
  • And wouldn't the situation be made worse if there was no blockage? I understand that congestion is not creating a complete wall, but if it is at least partially walling off the microbes then there is still a benefit. – bremen_matt Apr 13 '19 at 7:58
  • Certainly the microbes are still getting in deeper through the mechanism you describe. But it seems to me that breathing through the nose may be a more effective distribution mechanism for the microbe because every nasal breath is essentially passing over the contaminated area in the nasal passage, carrying microbes with it – bremen_matt Apr 13 '19 at 8:00

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