When it comes to colds, there are two types of people, says Shanna Levine, MD, of Mount Sinai Hospital in New York City. “The ones who come in 48 hours after their cough starts to request antibiotics because they want it gone…and the ones who ignore it and just say they have something in their throat.”
It can be tempting to assume any old cough is “just a cold, nothing serious!” and try to push through without seeing a doctor. A 2015 ZocDoc survey even found 43% of respondents would rather diagnose and treat themselves than see a doctor if they’re feeling sick. But no matter how many episodes of Grey’s Anatomy you’ve seen, your self-diagnosis skills might be lacking.
That’s why we asked MDs to point out the signs that indicate you should probably get that “cold” checked out by someone other than Dr. Google.
Even though three weeks sounds like a long time, Levine says that it’s highly normal for a cold to last up to 21 days. “It’s coughs that last more than three weeks that tend to be concerning,” she says, warning that these prolonged symptoms could be signs of asthma, pneumonia, or a different type of lung pathology. And over the course of those three weeks, Levine says, “You want to see your symptoms not only remaining stable but improving.”
Sometimes you’ll start to feel better—only to rebound and get much worse. “There are some emergency signs that require immediate medical care,” says Cary Sennett, MD, PhD, the president and CEO of the Asthma and Allergy Foundation of America. Flu-like symptoms that seem to improve but return with a worse fever and cough is one of them, he says. According to the Mayo Clinic, you might have a “secondary infection,” which could be anything from bronchitis to pneumonia. Whatever it is, you should have your doctor take a look.
It’s common to have thickened saliva in a cold, but if your phlegm is a strange color, then something weird is going on in your body. “It’s white blood cells trying to fight infection,” says Levine. “So if you see colors like yellow, brown, green, or even blood, then that’s concerning.”
If you’re tearing up nonstop—and there isn’t an adorable puppy in sight—then there’s a chance you could have allergies rather than a common cold. Sometimes it can be hard to tell the difference, Sennett says. “There are more than a hundred strains of cold viruses. Each tends to become widespread at certain times of the year, which is why you may mistake a cold for a seasonal allergy.” Other signs of allergic reactions can include hives, tongue swelling, feeling lightheaded, stomach cramps, and more, according to the Asthma and Allergy Foundation of America.
As inspired as The Devil Wears Prada is, being one “cold” away from your goal weight isn’t a thing. “If you’re not eating, it’s one thing,” says Levine. “But if you’re actively losing weight while eating that could be concerning.” Unexplained weight loss paired with cold-like symptoms could be a sign of hyperthyroidism, a malignancy (aka cancer), a bacterial infection, or even HIV, Levine says.
“While coughing is a common symptom of a cold, if your cough is accompanied by wheezing or chest tightness, you may actually in fact be experiencing an asthma attack,” says Sennett. During asthma attacks, your airway linings swell and become inflamed, get clogged by mucus, and then become constricted due to tightening muscles. “Breathing then becomes difficult, and resembles the feeling of trying to breathe through a straw stuffed with cotton,” says Sennet. Speak with a doctor if you are suffering from these symptoms.
You should also be wary if you’re experiencing pain or pressure in one specific part of your body. For example, strep throat will obviously cause pain in your throat. Sinus infections can hurt your nasal passages or even your teeth. And of course there are ear infections. According to Levine, if you’re experiencing any “hearing loss, severe pain in the ear (like it hurts to touch), and if there’s any kind of discharge coming out of the ear, those are definitely good reasons to see the doctor.”