The Difference Between a Cold and the Flu, According to Doctors

Jennifer Larson
·4 min read

From symptoms to treatment options, here's everything you need to know.

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Sniffle. Sneeze. Cough. Wheeze. Yes, it’s that time again: cold and flu season. But while the two tend to flare up on the same schedule—and we're seeing a lot of that right now—it’s important to know the difference when it comes to diagnosis and treatment of both colds and flus. And COVID, too! Here's your guide.

Cold or Flu? Here's the Difference

Viruses are the culprit for both cold and flu. You can blame sneaky little rhinoviruses for your cold. And you can blame the influenza virus for your bout with the flu.

Flu symptoms and cold symptoms can seem similar at first, but if your condition rapidly worsens it’s more likely to be the flu.

Cold symptoms

  • Nasal congestion

  • Cough

  • Runny nose

  • Fever of 99-101 degrees

Related: Suffering From a Stomach Virus? Here's What to Do 

Flu symptoms

  • Nasal congestion

  • Cough

  • Runny nose

  • Fever of 102 degrees or higher

  • Headache

  • Muscle pain

  • Severe fatigue

“I ask my patients, ‘Do you feel like a Mack truck just ran through you?’” said Dr. Jack Chou, who serves on the board of directors of the American Academy of Family Physicians. That kind of crushing weakness is a sure sign of the flu.

Another key difference between the cold and the flu: a cold is unlikely to cause any complications. But influenza can lead to serious health complications, like pneumonia, myocarditis (inflammation of the heart), and encephalitis (inflammation of the brain), according to the Centers for Disease Control and Prevention (CDC). Older adults (over 65), young children, pregnant women and people with certain chronic health conditions are at greater risk, too.

As of mid-January 2020, the CDC had logged about 120,000 hospitalizations and 6,600 deaths from flu during this flu season.

Related: What Is Elderberry Syrup and Can it Help You Survive Flu Season?

How to Avoid Getting the Flu

The best way to avoid the flu altogether is to get vaccinated, whether by flu shot or nasal spray. The CDC recommends everyone 6 months and older get a flu vaccine every year. Healthy people between the ages of 2 and 49 can choose the nasal spray vaccine if they don’t have any conflicting health conditions.

Related: How to Prevent the Flu

How to Treat Cold and Flu Symptoms

If you do contract the flu, a doctor can prescribe an antiviral medication to help reduce its severity—but only if taken within about 48 hours of onset. After that, standard supportive therapy—and time to recuperate—are pretty much your only options.

Cold or flu, rest should be the first item on your to-do list for at least a few days. Make sure you're up-to-date on flu facts, and try these other tried-and-true tips for putting yourself on the road to recovery.

Flu Recovery Tips

Drink plenty of water.

Often people don’t feel like eating or drinking when they’re ill, which leads to dehydration. Staying hydrated is perhaps one of the most important things you can do when you’re sick, along with getting plenty of rest. So keep a bottle of water by your side and take frequent sips.

Stick with salt water

Rinse your sinuses with saline solution via a neti pot, or use an off-the-shelf saline nasal rinse to wash away some of that congestion. “All of those will thin out mucus and make you feel better,” says Chou. Gargle with a salt water mixture can also reduce sinus pressure and ease a sore throat.

Related: Why Are Salt Tablets OK for Dehydration But Salt Water Isn't?

Take antipyretic meds

Antipyretics are drugs that reduce fever, like the pain-relievers acetaminophen or ibuprofen. Chou says that either is fine for healthy adults, although he usually recommends acetaminophen for adults over age 65.

Take OTC cough meds if you need them

There are two main types: expectorants and antitussives. Expectorants contain the ingredient guaifenesin, which work to thin out mucus. Antitussives are the meds that suppress your cough by blocking the cough reflex. A caveat: Read the ingredient lists if you are also taking any other medication to avoid accidentally doubling up.

Be cautious about using nasal steroids

A nasal steroid can bring some quick relief to a stuffed-up nose. The AAFP notes that decongestant nasal steroid sprays shrink the nasal passages and reduce congestion, but prolonged use can make symptoms get worse when you stop using it. Don’t use these for more than two or three days.

Use a humidifier

A cool mist humidifier can provide some much-needed hydration to the air, which can help thin out mucus and temporarily reduce congestion. Don’t pour oils or other ingredients into the humidifier, Chou cautions. “Those may become irritants for the nose and cause more problems.” And don't fall for products claiming to kill viruses in the air—the EPA hasn't approved any.

Worried about getting the flu? Play defense with these tips for boosting your immune system.