How to Check and Record — Your Temperature on Chemotherapy
During chemotherapy, a raised temperature is not an ordinary fever. It can mean your white cell count has dropped too low to fight infection, and that needs a hospital assessment the same day — not tomorrow, not after you see if it settles.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026
- Use a digital thermometer — Only a digital oral thermometer gives a reading accurate enough for your oncology team to act on.
- Check twice a day during nadir — The nadir is when your white cell count is lowest — usually days 7 to 14 after each cycle. This is when risk is highest.
- Record every reading — Write down the number, the time, and how you feel. A pattern matters as much as a single reading.
- Act on any raised reading — Do not wait to see if it settles. A raised temperature during chemotherapy is a same-day call every time.
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Use a digital oral thermometer. During your chemotherapy nadir — the period when white cell counts are at their lowest — check your temperature at least twice a day, morning and evening. Record every reading. Call your oncology team the same day if you get any raised reading, without waiting to see whether it settles.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
How to take your temperature correctly
- Use a digital oral thermometer — not a forehead strip, ear thermometer, or mercury thermometer.
- Wait at least 15 minutes after eating, drinking anything hot or cold, or smoking before you check.
- Place the tip under your tongue, close your mouth, and stay still until the thermometer beeps.
- Read the number immediately and write it down with the time and date.
- Check morning and evening every day during your nadir period.
- Clean the thermometer tip with alcohol before and after each use.
- Call your oncology team the same day if you get any raised reading.
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Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
When should you check your temperature?
Check twice daily — morning and evening — during your nadir. The nadir is the period when your white cell count is at its lowest, usually around 7 to 14 days after each chemotherapy cycle. Your team will tell you your specific window.
Check any time you suddenly feel cold, shivery, hot, or generally unwell — even outside your usual checking times. Infection can develop quickly during the nadir and does not wait for scheduled checks.
Keep a written record of every reading, including the time and how you felt. When you call your team, this record is the first thing they will ask for.
What does your reading mean?
| Reading | What it means | What to do |
|---|---|---|
| Your usual resting temperature | White cell count likely within a safe range | Continue twice-daily checks as normal |
| Any increase above your usual | Possible early infection response | Call your oncology team today — do not wait |
| 38°C (100.4°F) or above | Possible neutropenic fever — the threshold named in NCCN and ASCO guidance | Go to the emergency department now |
| Feel hot or shivery but no thermometer available | Treat it as a possible fever | Go to emergency or call your team immediately |
| Typically starts | Nadir: usually days 7–14 after each cycle — your team will give your specific window | Check morning and evening throughout this period |
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Frequently asked questions
Which thermometer is best for checking temperature during chemotherapy?
A digital oral thermometer is the right choice. It is accurate, inexpensive, and easy to read. Place the tip under your tongue with your mouth closed until it beeps. Forehead strips are not accurate enough for clinical use. Ear thermometers can read falsely low if not positioned correctly. Mercury thermometers should not be used because they are hazardous if broken. Ask your oncology team to recommend a specific model if you are unsure.
What is the nadir and when is the risk of infection highest?
The nadir is the point in your chemotherapy cycle when your white blood cell count drops to its lowest level. At this point your body has very little protection against infection, and a temperature that would be unremarkable in a healthy person can become serious within hours. The nadir usually falls between 7 and 14 days after each cycle, but it varies by regimen. Your oncology team will give you your specific window — during that period, twice-daily checks are the safe default.
My temperature went up and then came back down on its own — do I still need to call?
Yes. A temperature that rises then settles on its own is not a reassuring sign during chemotherapy. It can mean your body is starting to respond to an infection before a sustained fever develops. Your team needs to know about any raised reading, including one that has since come down, so they can decide whether a blood count check is needed. Never assume a settled reading means it is safe to wait.
I feel hot and shivery but the thermometer shows a normal reading — what do I do?
Trust how you feel and call your oncology team immediately. Thermometers can read falsely normal early in an infection, particularly if you checked very soon after symptoms started or before your temperature had time to rise. Your symptoms — sudden chills, shivering, feeling very unwell — are signals that matter as much as the number. If you cannot reach your team quickly, go to the emergency department rather than wait.
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