Exertional heatstroke is a leading cause of death among athletes and soldiers in training, and typically occurs when someone sweats intensely while exercising in the heat.

Heatstroke occurs when the body reaches 104°F or higher and can't cool itself

Untreated, this medical emergency can result in permanent disability or death. Someone suffering from heatstroke—defined as a core temperature of 104 degrees Fahrenheit but sometimes as high as 106 degrees Fahrenheit—may appear confused and require immediate cooling, ideally with an ice bath.

Heatstroke is sometimes missed because the patient is really sweaty

Since the condition involves losing the ability to cool oneself, clinicians sometimes see someone who has exertional heatstroke—like a high school athlete who is really sweaty—and don't realize the heat-related illness has already progressed to heatstroke. Classic heatstroke typically occurs among the very young or the elderly. (Some users may encounter a paywall.)

Heatstroke—from overexertion or extreme heat—drives core body temperature to 104 degrees Fahrenheit or higher, setting off a cascade of problems in the body.

Heatstroke is when the body's core temperature becomes dangerously high—and needs to cool

Warning signs that the body is overheating include rapid breathing, cramps, heavy sweating, nausea, and feeling lightheaded. Drinking plenty of fluids, seeking shade, and cooling the body down as quickly as possible with icepacks can help reduce the risk of heatstroke.

Some research suggests that the gut microbiome influences our risk of heatstroke, with elevated exercise levels raising body temperature to unsafe levels and increasing gut permeability—causing a "leaky" gut.

67 US high school athletes died from exertional heatstroke between 1982 and 2022

Many of those deaths were from football specifically, where student athletes play in hot conditions while wearing heavy protective gear. Few states mandate heat guidelines for school athletes, and this article says that's of increasing concern with more high heat index days.

Heat exhaustion is the most likely diagnosis if someone is talking clearly

Heatstroke, true to its name, looks more like a stroke. Its symptoms include severe disorientation, irritability, and seizures, among others. A patient does not need to have collapsed in order to have exertional heatstroke, but if someone is talking clearly, they likely have heat exhaustion, and it hasn't progressed to heatstroke.

Heatstroke deaths may be massively undercounted—perhaps by a factor of 10

One often-cited average estimate of annual American heat deaths—roughly 1,200 per year—is based on death certificate data, but it may be a significant undercount because heat kills through cardiovascular, kidney, and respiratory causes that are more likely to be cited on those documents. (Separate analysis that looked at data from 1999 to 2023 found that the highest number, in 2023, was 2325.)

Heatstroke can reprogram your DNA, putting survivors at risk of future health problems.

Heat-related complications are of greater concern for distance runners than cardiac threats

Analysis of more than 130,000 runners in Tel Aviv events during a seven-year period indicated that the runners were 10 times more likely to experience heatstroke than serious cardiac problems. Scientists suggest that runners should take 10 to 14 days to acclimate to a hot climate before tackling a serious run.

Sickle cell trait can put people at elevated risk of heat-related illness

This hereditary blood disorder affects the shape and function of red blood cells. A US military study found that among recruits the incidence rate of exertional heat-related illness was 48% higher among those who had sickle cell trait as compared to those without. Easing into intense exercise and gradually increasing exertional frequency and intensity is recommended.

Korey Stringer, of the Minnesota Vikings, died of heat-related illness in 2001

In response, the NFL overhauled its heat approach and no other player has since died from heat-related illness. Even at the high school level, research suggests safety measures should include: mandating water breaks, keeping a cool tub available, and having athletes acclimate to high-temperature playing conditions for a week or longer before donning the full set of protective equipment.

Certain medications that affect blood flow or mood boost the risk of heatstroke

Drugs that narrow blood vessels, beta blockers that regulate blood pressure, diuretics, antidepressants, and antipsychotics can all affect the body's ability to regulate its internal body temperature, and so individuals taking these medications need to take special care in extreme heat and when exercising in hot conditions.

Heatstroke treatment guidelines were built almost exclusively on research in men

Protocols for the standard treatment recommendation for heatstroke—whole-body cold water immersion—were built based on studies almost entirely in men. The research wasn't replicated in women, who typically cool faster than men during cold water immersion, raising questions about standard protocol safety for women, due to the risk of overcooling.

More extreme heat days are putting human health at risk in both the short and long term

America is generally experiencing more frequent extreme heat days, over a longer period, in certain parts of the country. The heat-related death toll is rising, and beyond those direct deaths, extreme heat can also have troubling ripple effects including elevated violence and decreased productivity.

Heat-related deaths may have climbed by more than 50% over 20 years

Between 2000 and 2009 one study suggests annual heat deaths averaged around 2,670, but between 2010 and 2020 that figure was likely more than 4,000. Researchers studied 54 million death records from the contiguous US and created mathematical models to arrive at these figures, noting that a combination of aging populations and climate change drove that increase.

Health workers may cool body temperatures with convection cooling

That's spraying a patient with water and putting fans over them. Cooling the body by removing clothing and placing cold water and ice packs—and not blocking evaporation—are essential cooling steps.

Extreme heat puts people at risk of developing kidney stones

It's essential to remain hydrated in summer weather to keep your body healthy, but one reason is to help dilute minerals that naturally build up if they aren't excreted in our water-fueled urine. Doctors recommend people generally drink 64 ounces of water a day and also eat foods with salt to help ward off dehydration.

Schizophrenia increases heat death risks in several complex ways

Evidence shows that people with schizophrenia have an inherently harder time regulating internal body temperatures. They may also struggle to find safe shelter during extreme heat, and their prescribed antipsychotic medications often have dehydrating effects, collectively elevating the risk of heat-related illness and death, as illustrated by this article that focuses on the final days of Stephan Goodwin's life in 2022. (Some users may encounter a paywall.)

Heat is the leading cause of death in natural disasters

Floods are a distant second, followed by hurricanes. That's according to data reported by the National Oceanic and Atmospheric Administration.

Our bodies cool us down by sweating because water requires a significant amount of energy to change state from liquid to gas, making it an ideal medium for carrying thermal energy away from our bodies.

Extreme heat is neurologically impairing animals

Dog bites increase in summer, birds struggle to learn, and goats pick more fights. Scientists are unraveling new details about how heat impairs animals' neurological systems.

What is a heat dome?

The world is seeing regular heat waves with multiple causes, including so-called "heat domes," a term rising in use in recent years. A heat dome occurs when the atmosphere traps hot ocean air like a lid or cap, creating stifling conditions and resulting in extended periods of heat. See an illustration of this phenomenon and read how it works with this brief explainer.

How to survive hypothermia

Hypothermia is a deadly risk for those living in cold areas, causing around 1,500 deaths a year in the United States. Stay safe with tips from this article, which cites research papers to help prevent and treat the condition. Take note of the best fabric to wear when cold weather hits—not cotton but wool.

Extreme temperature resilience appears to be temporary for tardigrades

Although often considered indestructible, scientists observed these creatures could endure temperatures near 150°C for only a few minutes in their tun state. Outside this state, only half the samples in a Danish study survived 37.1 degrees Celsius (98 degrees Fahrenheit) for 24 hours, making tardigrades extremotolerant rather than extremophiles.

Supplements ahead of exertional heatstroke helped protect mice against brain damage

In the lab, mice dosed with probiotics prior to inducing exertional heatstroke, had better cognitive outcomes. This evidence underscores the links between the gut microbiome and the brain, at least in rodents.

Wind chill speeds up the loss of heat from the body

During cold weather conditions, strong winds against exposed skin can produce a sensation of temperature colder than the surrounding air temperature. The accelerated loss of body heat increases the risk of frostbite and hypothermia, with frostbite able to set in as quickly as five minutes.

Reduced inflammation from cold plunges lacks scientific support

The cold water triggers immediate cold shock, increasing heart rate and blood pressure, and prolonged exposure can lead to cold-water incapacitation and hypothermia. Plungers are encouraged to enter the water slowly and manage their breathing to reduce the risk of shock. Warm baths post-plunge are discouraged, and exercise is generally better for recovery.

Recent global health estimates suggest that inactivity is a leading risk factor for death, contributing to 6% of deaths worldwide.

Being struck by lightning has a mortality rate of about 10%

Near-immediate deaths are the result of electrical disruptions in the heart and nervous system, causing cardiac arrest, but severe skin burns, temporary paralysis, and blown eardrums are more common. About 74% of survivors are left with a long-term disability, which includes brain damage and changes in memory and mood.

City structures cause localized heat zones hotter than nearby rural areas

Urban materials like asphalt and concrete trap heat, while cities lack cooling features like trees and water. Due to hot runoff, urban streams can heat up by as much as 18°F more than forested streams.

The air around lightning can reach a temperature of about 30,000 degrees Celsius (54,000 degrees Fahrenheit)—five times hotter than the surface of the sun.

Hundreds of vulnerable Chicago residents died in 1995 during a long-lasting heat wave

Eric Klinenberg wrote a book diving into the specifics of the heat wave. His book, detailing the stories and context fueling more than 700 deaths during just one summer week, helps readers understand how social infrastructure lapses, power outages, and ineffective heat responses led to so many deaths.

Most fungal pathogens can't survive the heat of our bodies.

Thermal runaway reactions can cause batteries to catch fire or explode

If a lithium-ion battery is heated, punctured, crushed, or short-circuits due to manufacturing flaws or degradation, the cathode and anode can make contact without the resistance provided by a circuit. The ensuing spike in chemical reactions increases the temperature and can release oxygen, initiating and intensifying burning of the battery's interior.

A Death Valley shrub optimizes its cells' organelles to photosynthesize in extreme heat

Examining the cellular structure of the plant under heat, scientists observed the formation of novel, cup-shaped chloroplasts and mitochondrial relocation, which shifted the plant's optimal photosynthesis temperature to 45 degrees Celsius (113 degrees Fahrenheit) as it tripled in mass over 10 days. Engineering these mechanisms in crops may help optimize them for hotter environments.

Ranking the 10 hottest places on Earth

Death Valley in California often gets the press for the hottest recorded air temperature in the world. What about the runners-up? This list compiles the rest of the Earth's hottest spots, from Jeddah in Saudi Arabia to Kebili in Tunisia.

Traumatic brain injury is a leading cause of brain death—and TBIs are trending up

Traumatic brain injury-related deaths have generally increased between 2000 and 2023, growing from roughly 49,000 to more than 68,000 in 2023. Firearm-related suicide is the most common cause of TBI-related deaths in the US, according to the Centers for Disease Control and Prevention. People also experience TBIs from falls, motor vehicle crashes, or assaults.

Between 2006 and 2021, 444 people died from lightning strikes in the US

The National Oceanic and Atmospheric Administration reports that the odds of being struck by lightning in one's lifetime are one in 18,864. Participation in outdoor activities during the summer months in Florida, Texas, and Colorado increases one's risk of exposure.

Storm surges, not winds, are the leading cause of hurricane-related fatalities

A storm surge is an abnormal rise in water levels generated by a storm that exceeds predicted tides. It is particularly dangerous in coastal regions, where it can generate extreme flooding well before the hurricane makes landfall.

Overwork contributes to thousands of worker deaths

Can work really kill you? The World Health Organization and the International Labor Organization have estimated that long work hours contribute to thousands of death from strokes and heart attacks each year. This BBC article argues that the culture of overwork and burnout is leading to a public health crisis in desperate need of solutions.

Repeated head injuries, which may occur in collision sports at the youth, amateur, and professional levels, can lead to CTE and early dementia.

Why death is caused by a dearth of ATP

Though people die from many causes, this video makes the case that a lack of adenosine triphosphate production in the body is what kills almost all of us. Without ATP, physiological processes grind to a halt, and organs stop functioning.

Cold water swimming can induce positive stress

The tradition of cold water swimming (or taking a cold plunge, or even a cold shower) has been shown to release the same hormones triggered during a stress response. This can have the effect of increasing blood flow, improved mental acuity, and more.

Grief can trigger broken heart syndrome, a painful condition that is often mistaken for a heart attack.

Normal body temperature varies from one person to another; it's not uniformly 98.6 F, as physician Carl Wunderlich determined in the 1800s.

13 unconventional ways to stay cool during heat waves

While air conditioning is the default solution for many in a heat wave, it can get expensive while requiring the consumption of fossil fuel energy. So, how else can you stay cool during a heat wave? This list compiles some practical, at times quirky, suggestions, including an ice-pack-filled aubergine hat.

Being near a lightning strike—even without getting struck—can be fatal

Because animal tissue is generally more conductive than soil, electricity moving along Earth's surface after a strike tends to travel up and back down an animal's legs, discharging dangerous amounts of energy along the way, with risks increasing the farther apart the legs are. This ground current accounts for about half of all lightning-related deaths and injuries in humans.

Why do you shiver when cold?

Humans are warm-blooded creatures, so our bodies like to maintain internal temperatures separate from and typically above those in their environment. This is made possible by a process known as thermoregulation. When the brain's hypothalamus senses a drop in the body's core temperature, skeletal muscles may be ordered to shiver, sending out waves of muscle contractions and exothermic biochemical reactions whose byproduct includes heat and energy.

Electricity can be lethal because it can disrupt the nervous system, which controls critical bodily functions that rely on electrical signals between cells, such as breathing and heart rate.