Thermoregulation maintains core body temperature at approximately 37°C via a negative feedback system centered on the hypothalamus, which integrates input from central thermoreceptors (in the hypothalamus itself) and peripheral thermoreceptors (in skin and viscera). When temperature rises above the set point, the anterior hypothalamus triggers heat dissipation: cutaneous vasodilation diverts warm blood to the skin, and evaporative sweat cooling reduces heat load. When temperature falls, the posterior hypothalamus activates heat conservation (peripheral vasoconstriction) and heat generation (shivering generates heat as a byproduct of skeletal muscle ATP hydrolysis; non-shivering thermogenesis occurs in brown adipose tissue via uncoupling proteins). During infection, pyrogens (IL-1, IL-6, TNF-α, and especially prostaglandin E2) reset the hypothalamic set point upward, producing fever — a regulated elevation, not a loss of control.
Draw both the heating and cooling responses as complete feedback loops, naming sensor (thermoreceptors), control center (hypothalamus), and effectors (sweat glands, cutaneous blood vessels, skeletal muscle). Distinguish fever (set-point elevation) from hyperthermia (uncontrolled temperature rise): in fever, the body actively generates heat to reach the new set point; in heat stroke, the regulatory system is overwhelmed. Explain why antipyretics (aspirin, ibuprofen) reduce fever by inhibiting prostaglandin synthesis — they reset the set point downward.
You already understand negative feedback: a sensor detects a deviation from a set point, a control center processes the signal, and an effector drives the variable back toward the set point. Thermoregulation is one of the clearest physiological applications of this principle, with the hypothalamus serving as both sensor and control center, and a suite of effectors distributed across the skin, blood vessels, skeletal muscles, and adipose tissue.
When core body temperature rises — say, during exercise or in a hot environment — thermoreceptors in the anterior hypothalamus detect the increase (central thermoreceptors in the hypothalamus are especially sensitive to blood temperature, while peripheral thermoreceptors in the skin detect environmental temperature). The hypothalamus responds with two complementary heat-dissipation strategies. First, cutaneous vasodilation: sympathetic vasoconstrictor tone to skin arterioles decreases, allowing warm blood to flow from the core to the skin surface, where heat radiates and conducts to the environment. Second, sweat production: sympathetic cholinergic fibers activate eccrine sweat glands, and the evaporation of sweat from the skin surface removes approximately 2,400 kJ per liter of sweat evaporated — the single most effective cooling mechanism available to humans.
When core temperature falls, the posterior hypothalamus activates the opposite set of responses. Cutaneous vasoconstriction reduces blood flow to the skin, minimizing heat loss by keeping warm blood in the body's core — this is why your fingers and toes get cold first in winter. If vasoconstriction is insufficient, shivering thermogenesis begins: the hypothalamus activates rhythmic involuntary contractions of skeletal muscle. These contractions are metabolically inefficient by design — nearly all the ATP hydrolyzed is converted to heat rather than useful mechanical work. In infants and to a lesser extent in adults, non-shivering thermogenesis in brown adipose tissue provides an alternative heat source: uncoupling protein 1 (UCP1) in mitochondrial membranes short-circuits the proton gradient, allowing the energy of the gradient to dissipate as heat rather than driving ATP synthesis.
Fever is often confused with hyperthermia, but they are fundamentally different. Hyperthermia occurs when heat gain overwhelms the thermoregulatory system — the set point is normal, but the body cannot dissipate heat fast enough (as in heat stroke). Fever, by contrast, is a deliberate resetting of the hypothalamic set point to a higher value. During infection, immune cells release cytokines (IL-1, IL-6, TNF-alpha), which stimulate production of prostaglandin E2 (PGE2) in the hypothalamus. PGE2 raises the set point — say, from 37°C to 39°C. The body now "perceives" its current 37°C temperature as too cold, and activates the same heat-generating responses (vasoconstriction, shivering) that it would use on a cold day, until core temperature reaches the new set point. This is why patients with rising fevers feel cold and shiver. When antipyretics like ibuprofen block COX enzymes and reduce PGE2 synthesis, the set point drops back to normal, the body suddenly "perceives" itself as too warm, and heat-dissipation mechanisms (vasodilation, sweating) activate — the fever "breaks."