Each year in the United States alone, millions of adults and children come down with the common cold. And while most colds resolve themselves within a week or two, there are countless symptoms you might attribute to a cold that don’t go away as fast as those sniffles.
“The average person gets four or five colds a year,” says Dr. David Cutler, MD, family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. “Most of the time, when you think it’s a cold going on, it’s just a cold. However, it’s impossible to tell without reviewing those symptoms with someone who knows what those could be to diagnose that with greater certainty,” says Cutler. “Unfortunately, the presentation of other serious illnesses often coincides with the occurrence of a cold.”
So, before you start dismissing those lingering symptoms, make sure you know these 27 subtle signs your cold is something way more serious—because it’s always better to be safe than sorry.
You develop a high fever.
While many people associate colds and fevers, a fever may actually be an indication that your illness is something more severe—particularly it it’s over 101º Fahrenheit. “Most people with colds don’t have fevers. They can have a fever, but most don’t. They have a sore throat, they have runny noses, and they have a cough, but usually, they don’t have a fever,” says Dr. Cutler.
You’ve been sick for more than a week.
Though some colds can last for up to two weeks (or more!), the vast majority will be knocked out in a seven-day period. If that’s not the case for you, it’s time to call a doctor. “If you’ve been sick for more than a week, it’s probably not a cold. The duration, the severity, and the specific symptoms are all signs that it’s not a cold going on,” says Cutler.
You recently traveled outside of the country.
While venturing off to exotic locales can be exciting, if you come back with a cold that won’t go away, you shouldn’t wait to get checked out by a GP. “Travel or any type of environmental exposure may mean it’s a more serious infectious illness,” says Cutler. Everything from tropical pulmonary Eosinophilia to syngamosis can present with coughs when they’re actually conditions requiring medical attention.
You have a bad headache.
Though some people with the common cold will develop headaches, a pounding pain in your head is more commonly a sign of something else. In many cases, sinus infections have similar symptoms to a cold, but also manifest with a pressure headache between the eyes that won’t go away with typical analgesics.
Your whole body aches.
Coughing for a full week can be uncomfortable, but it shouldn’t cause you to have full-body aches for a prolonged period of time. If you feel like you’ve been hit by an 18-wheeler from the moment you get up to the moment you go to sleep, it’s likely you’re dealing with something other than just a cold, like the flu.
You developed a rash.
That rash you suddenly developed along with your cold might be a sign of something more serious. Conditions like scarlet fever—a bacterial illness that often accompanies strep throat—can cause a rash on the torso, face, neck, and extremities, and needs to be treated by a doctor.
Your neck aches.
While the persistent cough accompanying your cold may cause throat pain, if your whole neck hurts, it’s important you see a doctor. Meningitis, an inflammation of the meninges—the membranes that cover the spinal cord and brain—occasionally presents with cold-like symptoms, including a cough and lethargy, but can become fatal if not treated right away.
You’re sick to your stomach.
Though some people associate digestive troubles with the common cold, if you’re having belly pain, vomiting, nausea, or diarrhea, you likely have something more serious. “Colds are usually not associated with anything else—they’re not usually associated with joint pain, rashes, nausea, diarrhea, ear pain, visual problems, or poor coordination. These are all signs of more serious illnesses,” says Dr. Cutler.
Noisy, labored breathing is a sure sign your cold is something more serious. If you’re wheezing, it’s likely your cold or a secondary infection have made their way into your lungs, or may even be a symptom of allergies or asthma. Regardless of what’s actually causing that uncomfortable wheeze, it’s well worth it to get checked out.
Your mucus is a strange color.
What your mucus should look like with a cold: yellow, maybe a little green, and low to moderate in volume. However, if you’re producing huge quantities of mucus—particularly that of the green or gray variety—that may be a sign that you have an infection. And if that mucus is streaked with blood, it may be a sign that you have bronchitis.
Your hearing has changed.
A common cold and sudden deafness shouldn’t go hand-in-hand. According to Dr. Cutler, changes in your hearing are not a typical sign of a cold. However, hearing changes can often accompany sinus infections, which need to be treated by a doctor.
You have chills that won’t go away.
Since, according to Dr. Cutler, fevers aren’t typically the companion to the common cold, chills shouldn’t be, either. If you’re dealing with serious chills, it could be a sign of an infection, the flu, or even pneumonia.
Your symptoms returned after going away.
The only good thing about the common cold? It usually goes away and stays away—at least for a little while. However, if you find yourself recovering from a cold only to find the symptoms returning a week or two later, it could be a sign that your weakened immune system made you more susceptible to an infection. That type of cyclical illness “would point to a suspicion that there’s something more serious going on,” says Cutler.
You have pressure at the base of your neck.
A little cough and some pressure in your throat may seem like little more than a common cold rearing its ugly head, but this combo should definitely be checked out by a doctor. In fact, many thyroid problems have symptoms that mimic those of a cold, but that pressure in your neck is a good indicator there’s more going on.
You only have pain in one area.
Unpleasant though they might be, colds generally cause pain in more than one area at once, meaning your eyes, nose, and throat are all typically affected to some degree or another. However, if your pain is localized to a single area, it could be the sign of something more serious, like strep or scarlet fever.
Your bones hurt.
While most colds are accompanied by a cough, if you also have bone pain, it’s time to see a doctor as soon as possible. Though it could be a sign of the flu or an infection, a cough accompanied by bone pain can sometimes be an indicator of lung cancer, too.
Your teeth hurt.
If those pearly whites are feeling worse for wear, that’s a good sign you’re dealing with more than just a typical cold. Tooth pain that accompanies a cough is often a sign of infection, so if you’ve got tooth or jaw pain you just can’t shake, it’s time to meet with your GP.
Your cough is extra loud.
Though coughs can have a variety of sounds that accompany them, if your cough is particularly loud, that could be a sign something more serious is going on. If your cough is extremely noisy or sounds more like a bark, it could be a sign you’re dealing with pertussis—better known as whooping cough.
You have pressure in your upper chest.
If your supposed cold is accompanied by pressure in your chest, it’s important to talk to a doctor as soon as possible. In addition to heart conditions, chest pressure can be a sign of a tumor in your lungs or esophagus, conditions that are potentially deadly if not treated in a timely manner.
You have chest pain.
While your ribs may hurt a little from consistent coughing, a normal cold shouldn’t cause chest pain. If you do notice a painful sensation in your chest, it’s time to make an appointment to be seen. Chest pain can be a sign of a potentially-deadly heart condition, and can also signify the presence of cancers in the upper respiratory tract.
You have trouble breathing.
Your significant other on your wedding day might leave you breathless, but your typical cold shouldn’t. If you’re having trouble breathing on top of that cough, this could be a sign or conditions like bronchitis, asthma, or certain allergies. Scarier yet, however, breathing difficulties can also be a symptom of pulmonary edema, a condition in which the lungs fill with fluid.
Your legs hurt
A cough and leg pain combined could be a sign that something far more serious than your standard cold is at play. Pulmonary embolisms, or blood clots that travel to the lungs, can cause a combination of coughing and leg pain, the latter because the condition often stems from deep vein thrombosis, a blood clot in the legs sometimes associated with travel or other prolonged periods of inactivity.
Your throat burns.
A little pain in your throat from coughing when you have a cold is normal. Burning? Not so much. If you have a cough and your throat feels like it’s on fire, that could be a sign that you’re dealing with acid reflux. Unfortunately, if left untreated, the condition can increase your risk of infection, ulcers, and even esophageal cancer.
Your eyes itch.
While the common cold can affect much of your body north of the neck, the likelihood that those ocular troubles are simply the result of a cough are low. If you’re dealing with itchy or burning eyes, it’s time to have your doctor check for allergies.
You develop heart palpitations.
If your heart starts skipping a beat when you’re dealing with a winter cold, it’s time to make an appointment with your GP. While they’re not typical cold symptoms, heart palpitations can sometimes accompany other conditions, like bronchitis, the flu, and infections that trigger electrolyte imbalances.
Your extremities are freezing.
Having a cold doesn’t necessarily make you cold. If your hands and feet are particularly chilly beginning with the onset of a cold—particularly if they start turning blue or losing feeling—it’s important to check in with a doctor as soon as possible. While cold extremities aren’t typical cold symptoms, they can be a sign of a serious infection, potentially leading to life-threatening sepsis if left untreated.
You have back pain.
Everything may hurt when you have the flu, but that shouldn’t be the case if you have a common cold. That’s particularly true in the case of symptoms like back pain. If you’re experiencing back pain in addition to that cough, it could be a sign of more serious ailments like pneumonia, a broken rib, or even lung cancer.
When in doubt, get checked out, says Dr. Cutler. “What everyone is looking for is that algorithm that tells you if this is a cold or more serious. That’s why it’s so important to talk to your doctor, who can refer you to a specialist if it’s something more rare or exotic.”
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