But, that will not give a complete picture of your thyroxine hormone status. Introduction: My name is Wyatt Volkman LLD, I am a handsome, rich, comfortable, lively, zealous, graceful, gifted person who loves writing and wants to share my knowledge and understanding with you. If it is consistently lower, then there is a trend toward a hypothyroid (decreased function) pattern. Reports are another great feature in the CareClinic app that can provide a lot of perception into your lifestyle. It converts insights into practical strategies and subsequently makes personal . Remembering symptoms might sound simple when we talk, but in reality, keeping days in memory is complex. (R) A gluten-free diet might reduce thyroid antibodies and subsequently improve health in patients with coeliac disease associated with thyroid illness. Examples include toxic adenoma, toxic multinodular goiter, Plummers disease, etc. Iodine First and foremost, iodine deficiency is the number one cause of hypothyroidism. low body temperature (i.e., feeling cold in a warm room), altered bowel habit with frequent, loose bowel movements. They help control body temperature. That may cause an enlargement of the thyroid. You can start tracking them even before 19DPO if you experience any of the symptoms mentioned above. The best way to arrive at a diagnosis is to perform the appropriate laboratory investigations to study the hormonal levels. We talked today about how you can avoid your basal body temperature as a significant indicator of your thyroid health, instead you should turn your attention to learning more about your thyroid with the Thyroid Quiz right now (2). Latest posts by Mariano R Kanagaratnam (see all). Digestion. For over a century, the relationship between basal body temperature and thyroid disease has been known and well-documented. Barnes' Research and Insight. Menstruation also might lower your basal body temperature. If you suffer from non-thyroid-specific symptoms, you can identify them quickly by reviewing your actions. Very young children may have a rectal temperature taken but the scale should be adjusted up 2 degrees on the chart to account for the internal body temperature vs basal temperature. Gently draw fingers laterally 1-2cm. Consistently above 98.2 indicates a trend for more of an increased function (hyperthyroid) presentation. Place first two digits of both hands just below cricoid cartilage so that left and right fingers meet on the patient's midline. Inflammation of the thyroid is called thyroiditis. Part of HuffPost News. He developed a range, between 97.8 to 98.2F, where a healthy person should always be. Since we cannot remember everything happening to us daily, it is always better to keep them noted down in a convenient place. Mixed results show high and low values, which is often more indicative of a primary adrenal stress pattern. He took the idea of basal body temperature and thyroid disease one step further, and suggested that the use of basal body temperature could help with diagnosing thyroid disease - and ultimately determining the optimal dosage for those who were on replacement therapy. For example, lithium used to treat certain psychiatric disorders might affect the thyroid. , Can thyroid levels affect body temperature? This feeling of coldness can persist, even when in a warm room or during the summer months. This process is accelerated with warm temperatures, and over time. Vitamin D is essential for thyroxine production. ins.style.display = 'block'; This is so bad for you, and is an emergency room situation that is not good for you in the slightest. Basically, you would take more and more medication until you were within that optimal, and very slim, temperature range. T3 has a stronger indication of the patients thyroid status and can be correlated with symptoms. Following are the symptoms of hypothyroidism. Bottom Line: If your temperature is going up, up, up, it is most likely not due to you being thyrotoxic - except in some incredibly serious situations where you might need to go to the hospital. Factors like infections, chronic bowel inflammation, and small intestinal bacterial overgrowth would affect how your digestive tract functions. Speeds Up Your Thyroid Speeds Up Your Metabolism Burns More Fat! In the extremes on the opposite end, your temperature may run lower. Examine your face for thyroid-related signs, including loss of the outer eyebrows, puffiness in the eyes, and unusual rashes. Iodized salts can fix the gap, and keep in mind that your daily intake of iodine should be between 200mcg-300mcg daily. Feeling tired more easily. The thyroid is a small, butterfly-shaped gland in the front of your neck. Many different symptoms and metrics were tracked, in hundreds of patients over many years - included in that tracking was basal body temperature. If your thyroid gland is under active, this can cause a drop in body temperature, while an overactive thyroid gland can increase body temperature. This test shows the pattern of iodine uptake in the thyroid. If youre taking any medications, consult your physician about their effect on your thyroid gland. CareClinic app offers appropriate features to help you maintain a thyroid temperature chart. Thyroid Surgery: Removal of the whole or a significant portion of your thyroid gland will result in reduced hormone production. The thyroid influences several chemical reactions in your body. Most thyroid hormone exists bound to proteins, and only a small percentage exists as free hormone. Thyroid diseases require medications or surgery with medications. In the very distant past, however, they would measure basal metabolic rate - which is what we might understand as basal body temperature. A temperature above 98.2 indicates possible hyperthyroidism, or fever from an infection. Nervousness or irritability. In-depth information on the medications is excluded, considering the focus of this article and the complexity of the diagnosis. Thyroid hormone regulates metabolism in both animals and humans. Physicians generally check for thyroid-stimulating hormone (TSH). And feeling too hot, with a slightly elevated temperature may occur due to hyperthyroidism. var ffid = 2; Thyroid Function Tests- what your results can mean, Hydroxychloroquine Sulfate 200 mg film-coated tablets - Patient Information Leaflet (PIL), Cmo sacar la visa de turista para Canad para argentinos, Tylenol Arthritis Pain mode d`emploi, dosages, composition, analogues, effets secondaires / Pillintrip, Qu es mejor para aliviar el dolor? Apart from diet and other factors, supplements also may be beneficial to keep thyroxine levels optimal. T3 acts directly on cells to promote vasodilation, especially in the arteries of the extremities. Its pretty easy to see that this is a small range - 0.4F does not leave much room for error. handful of seeds+ Nuts ( pumpkin+ sunflower + walnuts + almonds ) W/ herbal tea coffee. Take your temperature at a fixed time every morning. Read further to know more about thyroxine abnormalities, thyroid temperature chart, and the CareClinic app to create a thyroid temperature chart. Here we will examine its effect on blood pressure through vasodilation or relaxation of the blood vessels. Selenium Typical daily dose of selenium ranges between 200mg-400mcg, Zinc Typical daily dose ranges from 15mg-40mg, Vitamin D supplementing with 1000-2000IU/day. When it comes to external factors, we can also understand that: Bottom Line: All of these factors play an important role in your basal body temperature, so why would we ever just attribute it to the function of your thyroid? A normal Total T3 level in adults ranges from 80-220 ng/dL. Thyroid peroxidase is an enzyme that catalyzes the conversion of thyroid hormones. They help control your weight, body temperature, muscle strength, and even your mood. At times, this treatment can lower thyroid hormone production to a level when permanent hypothyroidism occurs. Measuring your basal body temperature for several consecutive days using a thyroid temperature chart is the most efficient way to track your hypothyroid status. Low body temperature and feeling cold all the time can develop due to an underactive thyroid. Autoimmune Disease:Autoimmune diseases occur when your immune system produces antibodies that attack your tissues. Furthermore, maintaining therapy-related information would help you manage your time in future instances too. Symptoms of Low Thyroid Function. If the average temperature over three days is less than 97.8 degrees Fahrenheit then, according to Barnes, one may have hypothyroidism. bullet coffee with 10 ml coconut oil or 1 tbsp coconut cream. It acts as a buffer against hyperthyroidism. You can record all of your appointments so that you never forget something. These tests look at levels of specific thyroid hormones and antibodies. In some parts of the world, it's common for people not to get enough iodine in their diets. In turn, this affects how much heat can escape the body. You're always hot or always cold, but never comfortable However, those with a thyroid condition will either be producing too much or not enough thyroxine. Want to learn about a test that can give you a clearer picture about the performance of your thyroid? A pounding heart. var lo = new MutationObserver(window.ezaslEvent); Measure the readings consecutively for a set number of days. He developed a range, between 97.8 to 98.2F, where a healthy person should always be. Dr. Cs gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, cure diabetes, and regain energy. The inactive form of thyroid hormone is called free T4, and it is the form the thyroid gland stored thyroxine. These reports can be shared with your physician so that they can understand your state with more clarity. Also, you can correlate the temperature with the activity to determine whether it is due to some other external reasons or thyroid-related reasons. Your armpit temperature would be 0.5F (0.3C) to 1F (0.6C) less than the oral temperature. After doing some serious thought about this, Barnes would ultimately argue that between those extreme temperatures was a strong indicator for overall thyroid status. For example, lithium used to treat certain psychiatric disorders might affect the thyroid. Alter (slow down or speed up) your heart rate. Remember these important points when you use the thyroid temperature chart. If you use a rectal thermometer, add one degree. The following are the key markers to identify a thyroid abnormality. Bottom Line: A recent study showed that the average temperature has gone down from the initial findings way back when, but they also found that healthy people can have varying temperatures of all kinds. Thyroid disease and thyroid hormone function, synthesis pathway, feedback loop, and effects on the body reviewed. The inactive form of thyroid hormone T4 is converted into T3 when required. These hormones are integral in the regulation of many functions and aspects of the human body, such as temperature regulation, energy levels, weight, hair, nail growth and more. Viral infections cause thyroid diseases too. Qu significan los cambios de color en los labios? Normal basal body temperatures range from 97.8 to 98.2 degrees Fahrenheit, under the arm or orally. Bottom Line: What this essentially meant was that if your temperature was low, Barnes would encourage taking thyroid medication. Tracking your basal body temperature would help you find out the most probable day of your ovulation. Your doctor will assess the swelling and refer you to a specialist clinic if necessary. You can even set your a healthcare team that manages your health and pregnancy. Tests may include thyroid stimulating hormone (TSH), T 4, T 3, and thyroid antibody tests. One study found that body temperature peaks at 96-99.5F (35.6-37.5C) around the . As is explained in the previous paragraph, basal body temperature is the temperature when you are at complete rest. Always remember to discuss with your healthcare provider before starting any of the supplements or drugs. If thyroxine is present excessively in the bloodstream (i.e., in a hyperthyroid state), body temperature increases; the person feels too hot even in a colder environment. Movements, eating or drinking before temperature reading, and measuring the temperature differently on different days are the foremost reasons. But, that will not give a complete picture of your thyroxine hormone status. Add your physician, registered nurse, and family members to keep them in the loop. The following are the key markers to identify a thyroid abnormality.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-leader-1','ezslot_13',602,'0','0'])};__ez_fad_position('div-gpt-ad-careclinic_io-leader-1-0');if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-leader-1','ezslot_14',602,'0','1'])};__ez_fad_position('div-gpt-ad-careclinic_io-leader-1-0_1'); .leader-1-multi-602{border:none !important;display:block !important;float:none !important;line-height:0px;margin-bottom:7px !important;margin-left:auto !important;margin-right:auto !important;margin-top:7px !important;max-width:100% !important;min-height:250px;padding:0;text-align:center !important;}. Its a good thing that we know so much about thyroid testing today (1). Hypothyroidism is the most common condition across the population, and the following are the symptoms of hypothyroidism. Not everyone has the same symptoms, so make sure to talk with your health care provider if you think you have hypothyroidism. CareClinic offers features like a diary entry and symptom checker that would become handy for you to follow up with your symptoms and related events happening on your daily encounter. During infancy and childhood, adequate thyroid hormone is crucial for brain development. The decreased body temperature in hypothyroidism can also lead to vasoconstriction and increased . Physician with a demonstrated history of working in the hospital & health-care industry and interested in application of information technology in healthcare. var alS = 2002 % 1000; Eating healthy helps one to lead a healthy lifestyle. Including your supplements, you can maintain a complete medication history on your phone so that you carry them wherever you go without much hassle. Glands come in endocrine and exocrine varieties. The most common cause of hypothyroidism is an autoimmune disorder known as Hashimotos thyroiditis.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-box-4','ezslot_7',166,'0','0'])};__ez_fad_position('div-gpt-ad-careclinic_io-box-4-0');if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-box-4','ezslot_8',166,'0','1'])};__ez_fad_position('div-gpt-ad-careclinic_io-box-4-0_1'); .box-4-multi-166{border:none !important;display:block !important;float:none !important;line-height:0px;margin-bottom:7px !important;margin-left:auto !important;margin-right:auto !important;margin-top:7px !important;max-width:100% !important;min-height:250px;padding:0;text-align:center !important;}. Figure 17.4.1 - Thyroid Gland: The thyroid gland is located in the neck where it wraps around the trachea. There are plenty of tests that you can consider, such as: This is all about figuring out the structural health of your thyroid. TSH helps to maintain thyroid hormone levels at optimal levels. Muscle weakness. , What are signs that your thyroid isn't working properly? But, it is not that when your thyroid dose gets higher that you make a steady track up to hyperthyroid storm. Place thumbs posterior to patient's neck and flatten all fingers against the neck. The inactive form of thyroid hormone is called free T4, and it is the form the thyroid gland stored thyroxine. Thyroid problems - most common thyroid problems, symptoms and treatment, 4. Free T4 will be converted into T3 according to the bodys demand. , What is the normal range of T3 T4 and TSH? Hence no one should panic if there is a little difference noted. Consistently above 98.2 indicates a trend for more of an increased function (hyperthyroid) presentation. When you are tracking your temperature, you can check whether the average basal body temperature suggests hypothyroidism. Contributors control their own work and posted freely to our site. WTS is consistent with inadequate thyroid stimulation of the cells even though the supply of thyroid hormone from the thyroid gland or thyroid medicine is normal (TSH thyroid blood test is . In addition to them, making your dietary and lifestyle changes would help you manage your thyroid disease. Hence upon necessity, your physician might order those investigations too. Basal body temperature is your temperature when you are at complete rest. It is supporting many essential bodily functions, including maintaining the basal temperature of your body. The thyroid produces T4 and the T4 is changed to T3 throughout the body. Body Temperature Chart Differences . The basal body temperature (BBT) test is a method to help assess your thyroid function as your body temperature is regulated by the thyroid hormones and can be done right in your own home! In primary hypothyroidism, TSH levels are elevated due to the loss of negative inhibition on the anterior pituitary. Low temperature reflects lower than optimal thyroid activity. Thyroid blood tests check your thyroid function. If the body temperature is normal, everything else will work better. The entries related to your activities, temperature, and symptoms would be analyzed to generate a report which would give a holistic picture of your thyroid condition. To learn more about ovulation and pregnancy, read other articles on days post ovulation in our blog. Hence do not hesitate to expose yourself to sunlight during the day. Believe it or not, due to the unreliability of testing during that time, cholesterol levels were thought to be relevant for thyroid testing. In other words, your body should be without influences from other factors such as exercise, stress, etc. Create a self-care action plan, add medications, supplements, diet, physical activities, and therapies you receive. } The thyroid gland secretes about 3 parts thyroxin to one part triiodothyronine, and this allows the liver to regulate thyroid function, by converting more of the T4 to the active T3 when there is an abundance of energy. Do not eat, drink, or get up before taking the measurement. You would have realized how vital monitoring your days are when it comes to chronic illnesses. Women whose charts show low temperatures should try increasing iodine in their diet - Sushi is a good choice. Each state has its symptoms, as described below. He saw that the tests of the day simply were not cutting it, and he ventured forth to try and figure out a new way to help people with thyroid disease. Thyroid and Parathyroid Glands | Thyroid Disorders, What does your temperature Tell You About Your thyroid? Even though measuring temperature sounds simple, you should keep a few things in mind before measuring it to find the average basal temperature. But those with symptoms can experience a puffy face, sluggishness, weight gain, feeling cold, a slowed heart rate, constipation, depression, and thinning hair. If you have a nodule or swelling in your neck you should see your doctor with a minimum of delay. Beltline Business Center, 6210 N. Beltline Road Suite 155, Irving Texas 75063. It has been appreciated for a very long time that there is a complex relationship between thyroid disease, body weight and metabolism. The levels of hormones above or below the normal range indicate hyperthyroidism or hypothyroidism. A thyroid temperature chart can be maintained using these features of the CareClinic app. While testing can give you a clear picture of your health, acknowledging and understanding your symptoms can help you understand how these things make you feel. An adenoma is a part of the gland that outgrows and walls itself off from the rest of the normal gland, forming benign (noncancerous) lumps. As is explained in the previous paragraph, basal body temperature is the temperature when you are at complete rest. Appointments 216.444.6568; Appointments & Locations; Request an Appointment; Temperatures below 97.8F (36.6C) may indicate hypothyroidism (an underactive thyroid). Studies reveal average body temperature is between 97.8 98.2 degrees Fahrenheit when resting. The thyroid hormones are secreted by the thyroid gland, which is located in front of the neck. Hence upon necessity, your physician might order those investigations too.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-large-mobile-banner-1','ezslot_15',170,'0','0'])};__ez_fad_position('div-gpt-ad-careclinic_io-large-mobile-banner-1-0');if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-large-mobile-banner-1','ezslot_16',170,'0','1'])};__ez_fad_position('div-gpt-ad-careclinic_io-large-mobile-banner-1-0_1'); .large-mobile-banner-1-multi-170{border:none !important;display:block !important;float:none !important;line-height:0px;margin-bottom:7px !important;margin-left:auto !important;margin-right:auto !important;margin-top:7px !important;max-width:100% !important;min-height:250px;padding:0;text-align:center !important;}. The pituitary gland secretes thyroid-stimulating hormone (TSH) along with its other hormones. ins.className = 'adsbygoogle ezasloaded'; The problem is that hypothyroidism is a highly prevalent condition, and that many who would benefit from treatment remain undiagnosed - can you just imagine how many people back in the day went undiagnosed? 2023 BuzzFeed, Inc. All rights reserved. The other symptoms mentioned in previous sections are also crucial during the history-taking process with your physician. Depending on the cause of thyroid status, treatment differs. Thyroid-related conditions are commonly due to either rise or fall of thyroid hormone levels in your body. After doing some serious thought about this, Barnes would ultimately argue that between those extreme temperatures was a strong indicator for overall thyroid status. This anti-TPO is acting against this thyroid peroxidase enzyme. If the time varies please make note of . Wheres your temperature supposed to be? You can figure out which activities help improve your symptoms and which dont. You can see shifts in that, but we know that it is not a good tool to track changes in your thyroid. Cure Thyroid Problem Permanently in 4 Steps (100% Guaranteed), 6. Over the course of his research, Barnes saw that many blood tests were proposed to track thyroid disease, but they really were not very accurate. var pid = 'ca-pub-7785394903076635'; Healthcenter@parkerhealthsolutions.com. Como Quitar Un Ojo De Pescado En La Mano - Tcnico dental, Qu pasa cuando tienes la matriz grande? Common side effects may include temporary hair loss (especially in children). If you suspect your thyroid gland is sluggish, here is a handy way to find out. Many of us know what thyroid and thyroxine are, and at least one person with a thyroid-related condition. What we have now are reliable blood tests, examinations, and other methods that can really give us a fuller picture of our health. Hence physicians may suggest going up to 10 days at a stretch. In addition to them, making your dietary and lifestyle changes would help you manage your thyroid disease. All Rights Reserved. It may indicate that you might need to check your thyroid status. Mixed results show high and low values, which is often more indicative of a primary adrenal stress pattern. Stress and restless nights are other factors that affect your temperature. Which was a late consequence of severe hypothyroidism. Basal Body Temperature for Thyroid Function - A Comprehensive Guide. These follicles are the center of thyroid hormone production and that production is dependent on the hormones' essential and unique component: iodine. The most common cause of hypothyroidism is an autoimmune disorder known as Hashimotos thyroiditis. A TSH test is often the best way to monitor thyroid function. Most people start in the low 96s, which is just crazy to me. As I mentioned earlier in the text, temperature drop alone does not mean hypothyroidism. Examples include toxic adenoma, toxic multinodular goiter, Plummers disease, etc. Low TSH + low T4 = low thyroid function due to another problem, such as pituitary gland dysfunction. Keeping your immune system strong with vitamins A, D, and zinc would help you maintain good health against infections in common. More recent studies have provided evidence of how Thyroid hormones may have a direct impact on internal body temperature. Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet. , How does your body feel when you have thyroid problems? Taking afternoon temperature is also important. Increasing or decreasing body temperature. TSH helps to maintain thyroid hormone levels at optimal levels. CareClinic offers features like a diary entry and symptom checker that would become handy for you to follow up with your symptoms and related events happening on your daily encounter. What we want to know today is how was that idea borne out, and is it accurate to tie body temperature and thyroid status together? Those that had thyroid abnormalities, there was also no relationship between that and their blood pressure. The thyroid gland is a butterfly-shaped organ composed of two lobes, left and right, connected by a narrow tissue band, called an "isthmus". Affecting the rate of movement through the digestive tract. Thyroid scan. So if you take your mid-afternoon temp and find it much lower, you have been given a strong clue that you may be hypothyroid and/or undertreated (or your low cortisol is . When your thyroid is high or less, those chemical reactions in your body also will be disturbed. It can occur with or without pain. 18. Despite the treatment, keep a record of therapies you may be receiving. This change in hormone levels will confuse the body into producing either too much heat and not enough energy or vice versa. A T3 (triiodothyronine) test is a blood test that helps diagnose thyroid conditions, specifically hyperthyroidism. , Does low body temp mean thyroid problems? When you wake up in the morning, before making any movements or getting out of bed, try to place the thermometer under the tongue or armpit. It can occur due to an autoimmune condition or unknown reasons. Since the gut is essential for absorbing the nutrients needed for thyroid hormone production and conversion, your gut health is also crucial. This quiz will give you a great starting point, and can help guarantee your health in the future. The presence of these antibodies is indicating a possible diagnosis of Hashimotos disease or a potential future occurrence of thyroid disease. It acts on all your cells and organs to carry out the following functions. These hormones have an enormous impact on your health, affecting all aspects of your metabolism.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-medrectangle-3','ezslot_3',197,'0','0'])};__ez_fad_position('div-gpt-ad-careclinic_io-medrectangle-3-0');if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'careclinic_io-medrectangle-3','ezslot_4',197,'0','1'])};__ez_fad_position('div-gpt-ad-careclinic_io-medrectangle-3-0_1'); .medrectangle-3-multi-197{border:none !important;display:block !important;float:none !important;line-height:0px;margin-bottom:7px !important;margin-left:auto !important;margin-right:auto !important;margin-top:7px !important;max-width:100% !important;min-height:250px;padding:0;text-align:center !important;}. When body temperatures are too high or too low, cells don't function optimally and symptoms can result. A thyroid temperature chart can be maintained using these features of the CareClinic app. Once they are re-activated, they trigger or worsen thyroid disease. low body temperature (i.e., feeling cold in a warm room), altered bowel habit with frequent, loose bowel movements. Also see your doctor if you have signs and symptoms that may mean your thyroid gland isn't making enough thyroid hormone (hypothyroidism), which include: Feeling cold. Well, it means that the range he was trying to rely on (97.8 to 98.2F) is not indicative of good or bad health, necessarily. If you suffer from non-thyroid-specific symptoms, you can identify them quickly by reviewing your actions. If your temperature is consistently under 97.4 deg F or 36.5 deg C, then you most likely have under functioning thyroid activity. At times, this treatment can lower thyroid hormone production to a level when permanent hypothyroidism occurs. ins.style.minWidth = container.attributes.ezaw.value + 'px'; The best way to arrive at a diagnosis is to perform the appropriate laboratory investigations to study the hormonal levels. That may cause an enlargement of the thyroid. Healthcare providers typically order this test alongside other thyroid function tests. Metabolism is determined by measuring the amount of oxygen used by the body over a specific amount of time. Control the rate of metabolism i.e., rate of burning calories, affecting weight loss or weight gain. High TSH + low T4 = underactive thyroid. What we know about it, though, is that in some cases a fever will show up during a hyperthyroid storm. The simple answer is no, that it is unfortunately not true. Thyroiditis.Inflammation of the thyroid is called thyroiditis. Apart from diet and other factors, supplements also may be beneficial to keep thyroxine levels optimal. If your temperature is less than 97.8 temp, then that is toward a decreased function (hypothyroid) pattern. A thyroid temperature chart can be maintained using these features of the CareClinic app. Especially in hot weather it is useful to consider both temperature and pulse rate.