Sweating is a normal body function that helps regulate body temperature. However, excessive sweating or sweating without exertion or high temperatures can be a sign of an underlying medical condition. Here are some illnesses that may cause increased sweating:
Hyperhidrosis
Hyperhidrosis is a condition characterized by excessive, uncontrollable sweating beyond what is needed to maintain normal body temperature. It usually affects the hands, feet, armpits, and groin. Hyperhidrosis can be:
– Primary hyperhidrosis – Sweating is not caused by another medical condition and typically starts during childhood or adolescence. The cause is unknown but believed to involve overactivity of the sympathetic nervous system.
– Secondary hyperhidrosis – Sweating is a side effect of an underlying condition like infection, endocrine disorders, neurological conditions, menopause, obesity, or medications.
Treatment focuses on managing symptoms and may include prescription strength antiperspirants, iontophoresis (applying electric current to the skin), Botox injections, medications, or surgery.
Infections
Infections that produce fever can cause profuse sweating as the body tries to cool itself down. Infections that may cause excessive sweating include:
– Tuberculosis
– Endocarditis (infection of the heart valves)
– Osteomyelitis (bone infection)
– Meningitis (inflammation around the brain and spinal cord)
– Pneumonia (lung infection)
– Urinary tract infections
– Appendicitis
– Food poisoning
– COVID-19
Treating the underlying infection will resolve the sweating. Fever-reducing medications can provide some relief in the meantime.
Cancers
Sweating, especially at night, can be an early sign of certain cancers like leukemia, lymphoma, and bone cancer. The sweating is thought to be caused by cytokines (immune proteins) and prostaglandins released by cancer cells.
Other symptoms may include unexplained weight loss and fatigue. Seeking prompt evaluation and treatment is important with new onset of sweating and other unexplained symptoms.
Anxiety Disorders
People with anxiety disorders like generalized anxiety, panic disorders, PTSD and social anxiety may experience increased sweating from activation of the fight-or-flight response. The sweating can occur randomly or in response to stress or anxiety-provoking situations.
Cognitive behavioral therapy, medications, or complementary treatments like meditation and exercise can help manage anxiety and associated sweating.
Menopause
Many women going through menopause experience hot flashes and night sweats from decreasing estrogen levels. Hot flashes cause a sudden feeling of heat and sweating which can last from 30 seconds to several minutes.
Hormone replacement therapy, certain antidepressants, and lifestyle changes can help manage menopausal sweating. Staying cool, limiting caffeine, alcohol, and spicy foods, and dressing in breathable layers can also help.
Diabetes
Diabetics may sweat excessively when blood glucose levels are too high (hyperglycemia) or too low (hypoglycemia).
With hyperglycemia, the excess glucose acts like a diuretic causing increased urination and sweating. Hypoglycemia triggers the release of epinephrine and other hormones that can lead to sweating along with palpitations, shaking, and confusion.
Keeping blood sugar levels controlled through insulin, oral medications, diet, and exercise helps minimize hyperglycemic and hypoglycemic episodes and associated sweating.
Thyroid Disorders
The thyroid gland controls metabolism. Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroids can cause increased sweating.
With hyperthyroidism, the excess thyroid hormone increases metabolism leading to more heat production and sweating. Common symptoms include weight loss, increased heart rate, tremors, anxiety, and frequent bowel movements.
Hypothyroidism reduces metabolism. The underactive thyroid makes it harder for the body to control temperature leading to unexpected sweating. Other hypothyroid symptoms include weight gain, fatigue, sensitivity to cold, and constipation.
Thyroid disorders are treated with medications to restore normal thyroid function and relieve associated sweating.
Chronic Fatigue Syndrome (CFS)
People with CFS often experience increased night sweats along with extreme fatigue, muscle and joint pain, headaches, and problems with memory and concentration. The exact cause of CFS is unknown but may involve immune dysfunction and hormonal imbalances.
Lifestyle changes like stress reduction, dietary adjustments, gentle exercise, and better sleep hygiene can help manage CFS symptoms. Medications or supplements may also be recommended to alleviate fatigue, pain, and night sweats.
Tuberculosis
Tuberculosis is a contagious bacterial infection that most often affects the lungs. One of the primary symptoms is night sweats along with cough, fever, fatigue, and unintentional weight loss.
TB is treated with a long course of antibiotics. It’s important to take all prescribed antibiotics to fully treat the infection, even if symptoms like night sweats resolve sooner. Directly observed therapy where healthcare workers watch you take your medications helps ensure medications are taken properly.
HIV/AIDS
Excessive sweating, especially at night, is a common symptom of HIV infection and AIDS. It can be one of the early signs of infection.
As HIV destroys immune cells, the body has a harder time regulating temperature which leads to sweating, chills, and flushing. Secondary infections common with AIDS can also cause fever and sweating.
Antiretroviral therapy can effectively control HIV infection. Medications, supportive care, and lifestyle changes can provide relief from associated night sweats.
Hodgkin Lymphoma
Hodgkin lymphoma is a type of blood cancer originating from white blood cells called lymphocytes. Drenching night sweats are a classic symptom, occurring in about 30% of people with Hodgkin lymphoma.
The cancerous cells are believed to trigger immune responses and the release of cytokines that dysregulate body temperature control, leading to profuse sweating. Enlarged lymph nodes, fatigue, weight loss, and itching are other Hodgkin lymphoma symptoms.
Combination chemotherapy and radiation therapy have high success rates in treating Hodgkin lymphoma and stopping associated night sweats.
Alcohol Withdrawal
Stopping heavy, habitual alcohol use can trigger a withdrawal syndrome. Excessive sweating is a hallmark symptom along with tremors, anxiety, insomnia, elevated heart rate, and even seizures in severe cases.
Sweating and other withdrawal symptoms start within hours of the last drink as the nervous system becomes hyperactive due to decreased alcohol depressant effects. Symptoms peak around 24 to 48 hours but can persist for weeks.
Medical detox provides medications and support to safely manage alcohol withdrawal symptoms. Thiamine and magnesium are often administered to reduce sweating, tremors, and cramping.
Medications and Substances
Many different medications and substances can increase sweating as a side effect:
- Blood pressure and heart medications like calcium channel blockers and beta blockers
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
- Hormone medications including estrogen, tamoxifen, and GnRH agonists
- Antidepressants, particularly SSRIs and SNRIs
- Malaria medications
- Opioids and opioid withdrawal
- Stimulants like amphetamines and cocaine
- Aluminum-containing antiperspirants (irritant reaction)
Switching medications or adjusting dosages can alleviate sweating in some cases. Lifestyle changes like staying cool and wearing breathable fabrics can help manage sweating from medications when discontinuing them is not an option.
Acromegaly
Acromegaly is a condition where the pituitary gland produces excess growth hormone. Common symptoms include enlarged hands, feet, and face along with excessive sweating, fatigue, joint pain, vision issues, and high blood pressure.
The extra growth hormone fuels increased metabolism and heat production resulting in heavy sweating, particularly of the hands and feet. The thick, coarse body hair common with acromegaly also hinders heat loss.
Treatment involves medications and surgery to control the pituitary tumor secreting growth hormone. This can relieve symptoms like heat intolerance and excessive sweating.
Carcinoid Syndrome
Carcinoid syndrome develops when cancerous neuroendocrine tumors spread to the liver or other sites. Symptoms include facial flushing, diarrhea, wheezing, and heavy sweating.
The tumors release excess serotonin and other vasoactive substances causing widening of blood vessels and lowering of blood pressure. Profuse sweating helps restore blood pressure but also leads to dehydration and electrolyte imbalances.
Treatment for carcinoid tumors can reduce hormone secretion and provide symptomatic relief. Drugs to inhibit serotonin synthesis and activity may be used alongside chemotherapy and surgery.
Pheochromocytoma
Pheochromocytoma is an adrenal gland tumor that oversecretes catecholamines like epinephrine and norepinephrine. In addition to high blood pressure, classic symptoms include sweating, palpitations, headaches, and anxiety attacks.
The catecholamine surges prepare the body for fight-or-flight responses even without physical stress. Sweating is triggered to dissipate heat generated by increased metabolism and circulation.
Surgery to remove pheochromocytomas results in full recovery and resolves associated episodes of excessive sweating and other symptoms.
Multiple Sclerosis (MS)
Up to 80% of those with MS experience heat sensitivity and worsening of symptoms when overheated. Even minor increases in body temperature can trigger weakness, fatigue, vision changes, and profuse sweating.
It’s thought to result from demyelination of nerve fibers in the central nervous system which disrupts proper transmission of signals that control sweating and dilation of blood vessels.
Staying cool with air conditioning, cooling vests, cold showers, and avoiding hot tubs and exercise in high heat can help prevent MS symptom flares. Medications may also be prescribed to reduce sweating.
Autonomic Dysreflexia
Autonomic dysreflexia is a dangerous condition affecting some people with spinal cord injuries above the mid-chest level. In response to pain or other stimuli below the level of injury, the nervous system initiates a stress response but cannot control it due to the break in nerve signaling.
This leads to a spike in blood pressure, slowed heart rate, and profuse sweating usually located above the level of injury. Prompt treatment is needed to avoid complications like stroke, seizures, and death.
Identifying and removing the trigger, loosening any constrictive clothing, and medications to lower blood pressure comprise acute treatment. Preventative measures include avoiding triggers and using prescribed medications to control high blood pressure.
Congestive Heart Failure (CHF)
People with CHF often experience increased night sweats, especially when lying flat. Fluid congestion around the lungs is believed to stimulate irritant receptors and increase sympathetic nervous system activity.
This causes widening of blood vessels and sweating in an attempt to reduce fluid volumes. Other symptoms of worsening CHF include difficulty breathing, chronic cough, weight gain, and swelling of the legs and feet.
Adjusting position, sleeping propped up, and taking diuretics as prescribed can provide relief from night sweats related to CHF.
Obesity and Night Sweats
Those who are obese have a higher risk of excess sweating, particularly at night. Having more fat tissue leads to higher rates of metabolism and body heat production. Obese individuals also tend to have fewer sweat glands per area of skin, which reduces heat dissipation.
Losing weight through diet, exercise, and bariatric surgery can help obese individuals better regulate body temperature and reduce uncomfortable night sweats.
Idiopathic Hyperhidrosis
For some people, excessive sweating occurs without any identifiable cause. This is called idiopathic hyperhidrosis. It most commonly affects the palms, soles, and armpits.
The profuse sweating happens regardless of temperature or activity. While embarrassing and uncomfortable, idiopathic hyperhidrosis is harmless and thought to be an inherited disorder.
Antiperspirants, medications, iontophoresis, botox, and surgery are treatment options to control unexplained excessive sweating.
When to See a Doctor
Make an appointment with your healthcare provider if you experience:
– Ongoing excessive sweating with no discernable trigger
– Sudden onset of unexplained night sweats
– Sweating accompanied by other concerning symptoms like unexplained weight loss, fever, enlarged lymph nodes, cough, etc.
While increased sweating is normal with heat exposure or exercise, new persistent sweating can indicate an underlying condition needing evaluation. It’s important to identify and address the cause to improve your symptoms and overall health.
Conclusions
Sweating helps the body maintain normal temperature, but excessive or unprovoked sweating is not normal. A wide range of conditions can cause increased perspiration, including infections, cancers, hormonal disorders, side effects of medications, and primary hyperhidrosis.
Pay attention to any new onset or worsening of sweating episodes. See your doctor promptly if sweating disrupts sleep or daily life to get an accurate diagnosis and appropriate treatment. Controlling associated medical conditions can eliminate or reduce uncomfortable, profuse sweating.