How to Tell If Your Nasty Cold Is Actually the Flu, According to Doctors

·4 min read
Photo credit: PeopleImages - Getty Images
Photo credit: PeopleImages - Getty Images

From Prevention

This article was medically reviewed by Raj Dasgupta, M.D., an assistant professor of clinical medicine and a member of the Prevention Medical Review Board.

When you’re sick, all you care about is feeling less miserable—but once the temps drop during fall and winter, it can be tricky to figure out if you’re dealing with the flu or a common cold.

That’s because so many of the symptoms overlap, but there is one major difference. “The flu is like a cold on steroids,” says Joseph Ladapo, M.D., Ph.D., professor of medicine at the University of California, Los Angeles. “I’ve heard patients say, ‘This is worst I’ve ever felt in my life.’”

Falling ill may be especially confusing this season, thanks to the coronavirus pandemic. (Read about the difference between COVID-19 and cold symptoms here, and COVID-19 and flu symptoms here.)

In order to stop your sniffles, you need to know what’s causing them in the first place. Here, doctors explain how to distinguish a cold from the flu, so you can seek the treatment that will actually make you feel better.

Cold vs. flu symptoms

Photo credit: Emily Schiff-Slater
Photo credit: Emily Schiff-Slater

Part of the reason it can be tricky to know whether you have the flu or a cold is simply because there are only a few minor differences between their symptoms.

Cold symptoms

In general, cold symptoms show up primarily above your neck:

Flu symptoms

This includes symptoms above and below your neck. You have all the signs of a cold, plus the following:

  • Fever over 100°F

  • Chest coughs

  • Weakness and fatigue

  • Headaches

  • Chills

  • Vomiting

  • Diarrhea

  • Full-body aches

How do I know if I have the flu or a cold?

The biggest differences between the symptoms of influenza and a cold are their severity and how quickly they develop. With the flu, “one day you are feeling OK, and the next, all your symptoms arise,” says Michael P. Angarone, D.O., professor of infectious diseases at Northwestern Memorial Hospital.

Compared to the flu, a cold is milder and symptoms gradually set in. “If you don’t feel horrible, you probably don’t have flu,” Dr. Ladapo says.

Still not sure? Ask yourself these questions:

How severe does this feel?

Cold: You feel mildly icky, and things get worse slowly. The first signs might include slight aches, a scratchy throat, a headache, and/or a low-grade fever.

Flu: The flu hits you like a speeding train. You may first feel feverish at work, and by the time you get home you can barely muster enough energy to climb your porch steps. Every inch of you aches.

Can I get out of bed?

Cold: Yes, you can walk around. Though you might not want to commute to work or schlep the kids around, you can manage.

Flu: Absolutely not—you’re flat on your back. Extreme fatigue is going to incapacitate you for at least a few days.

Cold vs. flu treatment

If you aren’t sure which you have and how to treat it, talk to your healthcare provider over the phone or make an appointment to see them in person, Dr. Angarone recommends.

Cold treatment

Take it easy and rest up. Keep a water bottle nearby to ensure you’re staying hydrated. Popping a pain reliever like ibuprofen or acetaminophen may temporarily perk you up.

A cold can follow you around for as long as 10 days, but you don’t have to quarantine yourself the entire time. Once you start feeling better, you’re no longer very contagious, so you can head back to work as long as you’re up for it.

Flu treatment

Plan to hunker down for three to seven days, and ask your MD about Tamiflu. “If taken within 48 hours, it will help you get better sooner and reduce the chance that you’ll pass the virus to others,” says William Schaffner, M.D., an infectious disease expert and professor of preventative medicine at Vanderbilt University. You can go back to normal life 24 hours after your fever recedes on its own, but you’ll probably be moving slowly for a bit.

When to see a doctor about your cold or flu symptoms

Call your doctor if you experience:

  • Symptoms that overlap with signs of COVID-19

  • Contact with someone diagnosed with COVID-19

  • Trouble breathing or eating (call ASAP)

  • You have a fever higher than 100.4°F

  • You’re experiencing severe vomiting or diarrhea

  • Coughing lasts longer than 10 days, is driving you crazy, or is making it hard to sleep

  • Upper-respiratory symptoms last more than a week or 10 days

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