If you are worried that you might have COPD, you are certainly not alone. It is a common, yet scary disease, and it's important to look out for the signs and symptoms as you age.
It's an unfortunate reality that about six percent of Americans will develop COPD at some point in their lifetime. However, many people live with the disease for many years before they get diagnosed.
The earlier you catch it, the easier it is treat and manage your COPD. Early treatment can also help you live longer by slowing down how quickly the disease progresses.
That's why it's important to pay attention if you notice the early signs of COPD. In this guide, we'll explain what those signs are and how to know when it's time to see your doctor.
First, we'll go over all the early COPD symptoms and warning signs you should look out for. Then, we'll show you how to calculate your overall COPD risk by answering a few simple questions about any lifestyle and other risk factors that could increase your chances for developing the disease.
If you'd like to skip ahead to a specific topic, click any of the following links:
- How to Recognize COPD Symptoms
- General Early Symptoms
- Symptoms Characteristic of Chronic Bronchitis
- Symptoms Characteristic of Emphysema
- Why Symptoms Often Don't Appear Until Later in the Disease
- How to Estimate Your Risk for COPD
- Respiratory Infections
- Occupational Hazards
- Family History
- Chronic Cough
- Shortness of Breath
- Should You Get Tested?
How to Recognize the Early Signs of COPD
COPD is caused by lung damage that interferes with your ability to breathe. The earliest signs are usually respiratory symptoms that start out minor but steadily get worse over time.
Remember, however, that symptoms alone are not enough to rule out or diagnose COPD. You have consider a variety of different factors in order to accurately assess your risk, including your symptoms and other risk factors related to your health, your lifestyle, and your history of smoking.
Early Symptoms of COPD
The hallmark symptoms of COPD are coughing and shortness of breath. However, there's more to it than that; COPD can cause a variety of different symptoms, and these symptoms change over the course of the disease.
It's important to know that the earliest symptoms of COPD are usually very mild and difficult to detect. It's easy to attribute these minor symptoms to something innocuous like allergies or mistake them as a normal part of aging.
According to experts, these are the most common early symptoms of COPD:
- Shortness of breath
- Excess mucus
- Other breathing difficulties
- Chronic cough
You might notice that some of these ailments on that list are also symptoms of minor illnesses like the common cold. People who don't have COPD can certainly experience them, but the symptoms are temporary and go away with treatment.
On the other hand, people with COPD experience one or more of these symptoms consistently over a long period of time. COPD is a chronic disease, which means that the symptoms never truly go away, even with treatment and medication.
Every individual case of COPD is different, however, and not everyone with the disease experiences the same symptoms. What symptoms you experience, and how severe they are, depend on your individual biology, how long you've had the disease, and what kind of COPD (e.g. emphysema or chronic bronchitis) you have.
Now, lets take a closer look at each of these symptoms and how they present in people with COPD. That way, you can learn how to identify each one and how to tell whether a symptom is a sign of COPD or is caused by something less serious.
Shortness of Breath
Shortness of breath, also known as dyspnea, is the first COPD symptom that many people experience. It often starts out subtle, which is why it can be hard to notice in the early stages of COPD.
At first, you might just feel extra breathless when you exercise or do moderate-intensity activities. As it gets worse, however, it can be hard to catch your breath even during light activities like walking.
The first sign of dyspnea that many people notice is a drop in their overall exercise endurance. You might not be able to walk, bike, or do other aerobic activities as long or as intensely as you used to.
In general, people with COPD say that shortness of breath feels like struggling for air. It's often accompanied by feelings of heaviness or pressure in the chest, and the sensation that it takes extra effort to breathe.
Patients also describe dyspnea as a constricted, suffocating sensation that makes it difficult to breathe. Some COPD patients say it feels like breathing through a straw and makes it impossible to get a full, deep breath of air.
It's important to note that shortness of breath can be a sign of heart disease instead of COPD. It's easier to recognize COPD-related dyspnea if it comes with other respiratory symptoms, such as coughing and airway sensitivity.
One of the most common early symptoms of COPD is excess mucus in your lungs and airways. This causes congestion, blocks your airways, and makes it more difficult to breathe.
COPD also changes the consistency of your mucus, making it extra thick and sticky. This causes it to stick to the walls of your airways and obstruct air from flowing through.
This often first manifests as a wet, phlegmy cough or wheezing sounds when you breathe. It also traps bacteria and causes infections, which can also change the color and consistency of your mucus.
This symptom is caused by inflammation in the airways, which tends to get worse and worse as the disease progresses. This causes a chronic cough in some patients early on, but this might not show up until the later stages of the disease.
Other Breathing Difficulties
COPD can cause other uncomfortable chest and breathing symptoms besides shortness of breath. These symptoms are the result of airway constriction, trapped air in the lungs, and the fact that it takes extra effort to breathe.
For example, you might notice that your chest feels tired or sore when you breathe in and out. This happens because your breathing muscles have to work harder than usual to force air through the narrowed airway spaces.
This can also cause feelings of tightness and pressure in your chest. Some patients describe it like wearing a corset; it strains their ribs and muscles, making them hurt and making it uncomfortable to breathe.
The more severe the COPD becomes, the more the airways get narrowed and blocked, and the more effort it takes to breathe. Breathing symptoms become more frequent, persistent, and easier to trigger.
For instance, you might find that your shortness of breath gets worse when you get exposed to minor air pollutants and fumes. Things like fragrances, cleaning chemicals, and poor air quality might affect you much more than they did before.
A chronic cough is one that happens every day and lasts for months at a time. A cough is usually considered to be a strong sign of COPD if it returns frequently over the course of at least two years and doesn't respond to medication.
The cough can be wet or dry, but a wet cough is more common in people with COPD. A wet cough is a cough that brings up sputum (a mixture of mucus and saliva) from your lungs.
Certain triggers can make a COPD cough worse, such as breathing in air pollution, allergens, or second-hand smoke. The cough can also get worse when you exercise or start to feel short of breath.
The main characteristic of a chronic cough caused by COPD is that it never truly goes away. It can be managed with a proper regimen of COPD medications and other treatments, but it can never be totally cured.
Fatigue is a feeling of tiredness, exhaustion, or lack of energy to do normal activities. This is a common symptom of COPD that can show up in the early stages.
COPD-related fatigue is chronic, not just occasional. Everyone feels fatigued every so often, but people with COPD feel fatigued frequently, even when there's no apparent cause.
Early on, you might just notice you get fatigued more easily when you exercise or spend a long day on your feet. As your breathing problems get worse, however, you might feel fatigued for no reason and struggle to find the energy to do normal daily activities.
However, chronic fatigue can be a sign of many different things, not just COPD. It can be caused by depression, poor diet, lack of sleep, and many other health conditions.
In people who are otherwise healthy, simple lifestyle changes can often cure fatigue. However, if your fatigue won't go away and comes along with any other COPD symptoms, you should probably get tested for the disease.
Your Symptoms Might Depend on What Kind of COPD You Have
It's important to know that COPD—which stands for chronic obstructive pulmonary disease—is a generalized disorder that includes two respiratory conditions: emphysema and chronic bronchitis. Most people with COPD have both, but one condition might be more dominant than the other.
However, people with COPD generally require the same type of treatment regardless of whether emphysema or chronic bronchitis is the more dominant disease. Both conditions also tend to be caused by the same things, and lead to similar disease outcomes.
For these reasons and more, both conditions are grouped together under the umbrella term COPD and generally treated as one disease.
However, emphysema and chronic bronchitis can cause different symptoms, especially early on in the disease. It's also important to remember that each individual case of COPD is different, and different people experience different symptoms for a variety of different reasons.
However, it can be helpful to distinguish between emphysema and chronic bronchitis in many cases. Here is a quick overview of both conditions, their symptoms, and how the early signs tend to appear.
Chronic bronchitis is caused by chronic inflammation in the larger airways in your lungs, called the bronchial tubes. It is usually caused by inhaling smoke or other respiratory irritants repeatedly over a long period of time.
People with chronic bronchitis have bronchial tubes that are easily irritated and inflamed. This triggers the airways to secrete extra mucus in an attempt to flush out whatever particles or bacteria that might be causing the inflammation.
Because of this, the main and earliest symptom of chronic bronchitis is excess mucus in your airways. This mucus is thicker and stickier than healthy mucus, which makes it cling to the walls of your airways and resist coming out.
Chronic bronchitis also causes changes to the tissue that lines your airways. It causes the walls to thicken, narrowing the available space inside, and paralyzes the tiny cilia that are responsible for moving mucus out of your lungs.
The result is that thick mucus builds up in the airways, blocking air from easily flowing through. As your body attempts to get the mucus out, it triggers a chronic cough that often brings up sputum (a mixture of saliva and mucus).
However, the combination of narrower airways and the lack of functional cilia makes it impossible to clear all the mucus out. This causes the airways to get narrower and narrower, making it more and more difficult to breathe.
This causes frequent shortness of breath that gets worse when you exercise but can happen even when you are at rest. It can also cause wheezing and a feeling of tightness in your chest when you breathe.
Another distinct symptom of chronic bronchitis is repeated lung infections, such as pneumonia. This happens because the mucus that stays stuck in your airways creates an environment where bacteria can multiply and thrive.
Here's a quick summary of the most common COPD symptoms associated with chronic bronchitis:
- Chronic cough
- Wet cough with sputum
- Excess mucus production
- Wheezing (especially during physical activity)
- Fever (from lung infections)
- Symptoms that come and go
Unlike chronic bronchitis, which is caused when your larger airways get obstructed, emphysema (PDF link) is caused by direct damage to the air sacs—or alveoli—in the lungs. This damage usually occurs because of repeated inflammation, most often caused by breathing in smoke.
Emphysema causes the alveoli to change so that there are fewer air sacs and less surface area to absorb oxygen. This is a process researchers call “airway remodeling,” and the result is that the damaged alveoli cannot function as well.
The damage spreads and gets worse over time, making it more and more difficult for your lungs to absorb enough oxygen when you breathe. It also causes the lung tissue to become less elastic, preventing the air sacs from deflating all the way when you exhale.
One side-effect of this is that stale air gets trapped in the lungs, a symptom that's characteristic of emphysema. This leaves less space for fresh, oxygen-rich air, and makes it difficult for the lungs to completely deflate.
Over time, this causes the lungs to expand, or hyperinflate, in an attempt to make more space for fresh air. However, this forces the lungs to work harder to push even more air out with every breath.
This ultimately weakens the lungs and puts extra strain on the muscles you use to breathe. Over-inflated lungs also cause uncomfortable chest pressure and discomfort because they press on the chest cavity.
As the lungs continue to lose their ability to process air and absorb oxygen, classic COPD symptoms like dizziness and shortness of breath get worse. This leads to low blood oxygen levels, which causes physical symptoms like headaches, fatigue, and blue or grey fingernails.
However, symptoms of low blood oxygen levels tend to be more common in people with emphysema than chronic bronchitis. That's because the alveoli responsible for absorbing oxygen are damaged, which puts a hard limit on the amount of oxygen the lungs can absorb at a time.
This causes the body to get deprived of oxygen easily, especially after physical exertion. This lack of oxygen can have noticeable effects on the brain, causing mental fogginess, dizziness, reduced alertness, and even problems with memory and concentration.
Here's a quick summary of the most common COPD symptoms associated with emphysema:
- Shortness of breath
- A blue or grey tint to the fingernails (or lips)
- Fogginess and reduced mental alertness
- Difficulty doing tasks that require focus and concentration
- Chest pressure and discomfort
It is important to note that blue or grey fingernails and blue-tinted lips are very specific symptoms of oxygen deprivation. If you experience any of these symptoms, you should see your doctor right away.
Blue fingernails and lips can also be a sign of other health problems besides COPD, such as heart disease or congestive heart failure. However, it is sometimes difficult to tell the difference, since heart disease and COPD are very strongly linked.
In people with COPD, these symptoms of oxygen deprivation are almost always accompanied by noticeable breathing symptoms. If you experience blue fingernails along with shortness of breath or a chronic cough, this is a very strong indicator that you have COPD.
If you are interested in learning more about the differences between emphysema and chronic bronchitis, check out this comprehensive guide we posted previously on this blog.
Many People With COPD Don't Experience Symptoms Until Later on in the Disease
The lungs are vital organs for survival, and they are very resilient. They are pretty good at functioning and providing your body with oxygen even when conditions aren't ideal.
Because of this, COPD doesn't usually affect you in a noticeable way until the disease has already done a significant amount of damage to your lungs. In fact, research suggests that most people with COPD lose about 50-70% of their lung function before the first breathing symptoms appear.
That's because COPD is chronic, progressive disease, meaning it slowly gets worse over time. It is caused by repeated lung inflammation—most often from smoking—that gradually damages your lung and airway tissue over the span of many years.
When your airways become too obstructed or too many of the tiny air sacs in your lungs have been damaged, that's when breathing problems start. At that point, the lungs have so little healthy tissue left that they are struggling to absorb enough oxygen to meet your body's needs.
Noticeable symptoms start when the lungs can no longer compensate for the damage they've sustained. At first, your symptoms may only flare up when your lungs have to work harder than usual, such as when you do strenuous physical activity.
The first signs might be losing your breath more quickly when you exercise, or finding that activities that used to be easy now leave you struggling for air. Another early sign is a excess mucus in the airways, which can result in a wet, chronic cough.
What if You Have COPD But Don't Have any Symptoms?
It is certainly possible to have COPD and not show any symptoms, especially in the earliest stages of the disease. Even when symptoms do begin to show up, they are often ignored or misdiagnosed.
Unfortunately, it's generally impossible to diagnose COPD until noticeable lung damage has occurred. Before that point, the damage is mostly hidden and difficult to detect.
By definition, you have COPD when you score an 80 percent or less on a specific lung function test called spirometry. This test measures your ability to force air out of your lungs, and it's a good measure of how obstructed your airways are.
It usually takes many years for your lung function to decline to this level, which is why most people aren't diagnosed until they are over the age of 40. However, spirometry tests can still catch COPD earlier than other methods, since it can detect reduced lung function even it starts to cause symptoms.
If you are worried you might have COPD, the only way to know for sure is to get tested by your doctor. Unfortunately, even if your test is negative, there is no way to know for sure if you will develop COPD in the future.
However, you can estimate your overall risk for developing the disease.
How to Estimate Your Risk for COPD
If you are worried that you or someone you love might have COPD, there are some simple ways you can estimate the risk on your own. While this isn't a substitute for going to the doctor, it can help you decide whether or not you should get tested for COPD.
All you have to do is answer some basic questions about your health, lifestyle, and any respiratory symptoms you experience. Your answers will reveal whether or not you have any major COPD risk factors and give you a better idea of how likely you are to develop the disease.
Do You Smoke Now, or Have You Ever Smoked in the Past?
People with a history of smoking are more likely to develop COPD and more likely to die from the disease. In fact, the vast majority—up to 90 percent—of COPD cases are caused by smoking.
That's why “do you smoke” and “have you ever smoked” are usually the very first questions a doctor will ask a patient suspected of having COPD. The length of time that you've smoked, the number of cigarettes you've smoked, and whether or not you've quit smoking all influence your risk.
Your risk is higher the more cigarettes you smoke and the more years you have been a smoker. Women smokers are also somewhat more likely to develop COPD than men who have smoked for the same length of time.
Quitting smoking, however, can reduce your risk for both developing the disease and dying from COPD. The earlier you quit the better, and the risk is lower if you haven't smoked for at least ten years.
Even if you end up developing COPD anyway, quitting smoking can significantly reduce the severity of your disease.
If you do currently smoke, then quitting is the number one thing you can do to reduce your risk of COPD. If you have COPD already, quitting smoking can still improve your health, your quality of life, and your ability to treat the disease.
Are You Over the Age of 40?
COPD takes many years to develop, and most people don't get diagnosed until they are in their 40's or 50's. That's when the first detectable signs and symptoms usually start to show.
Most people who get COPD at a younger age have a genetic condition that accelerates the disease. However, it is possible, though unlikely, for young people to develop COPD as a result of smoking or exposure to respiratory toxins.
If you are under the age of 40, you are very unlikely to get diagnosed with COPD. However, that doesn't mean you 're totally in the clear; you may still develop COPD in the future, even if you don't have any signs of the disease now.
Do You Have Asthma?
People with asthma are up to twelve times more likely to develop COPD later in life. The risk is higher if the asthma symptoms are severe and persistent, and highest for people who had severe asthma when they were children.
Essentially, asthma can cause the same kind of lung inflammation and damage that causes COPD. This leads to asthma-COPD overlap syndrome, which happens when someone with asthma develops COPD.
If you have asthma, you can reduce your risk for this condition by minimizing your symptoms, which means taking your medications and avoiding asthma triggers. Patients who have difficulty managing their symptoms are more likely to develop COPD than patients whose asthma is well-controlled.
Unfortunately, because the symptoms of asthma and COPD are so similar, it can be difficult for people with asthma to catch the early signs of COPD. It would be easy, for example, to mistake COPD-related shortness of breath as just another asthma symptom.
The main way to tell the difference between asthma and COPD is that asthma symptoms respond to treatment and eventually go away. COPD symptoms are more persistent and don't go away completely with typical asthma treatment and medications.
Have You Had Repeated Respiratory Infections?
Having many respiratory infections over the course of a lifetime can increase your risk of COPD. However, the risk is highest if you experienced repeated lung infections, such as pneumonia, during early childhood or infancy.
Especially early in life, persistent respiratory infections, can cause permanent changes to the lungs. These changes can reduce lung function and make your lungs more susceptible to inflammation, future infections, and developing COPD.
Have You Worked Around Respiratory Hazards?
While smoking is the number one risk factor for COPD, it is certainly not the only thing that can cause the disease. There is a wide range of respiratory irritants that can damage your lungs and lead to COPD.
These include things like cleaning chemicals, diesel fumes, airborne dust, and more. However, you don't usually need to worry unless your lungs have been exposed to these hazards repeatedly over a long period of time.
This happens most often at work, which is why certain occupations can significantly increase your risk for COPD. The riskiest jobs tend to be in industry, mining, and agriculture, which can expose workers to substances that are toxic to the lungs.
Here is a quick overview of the occupations most strongly linked to COPD:
- Brick making & stonemasonry
- Pottery and ceramics
- Mining & quarry work
- Dock workers
- Flour and grain workers
- Foundry workers
- Petroleum workers
- Manufacturing and materials processing (e.g. rubber, plastics, textiles, and cadmium)
Do You Have a Genetic Condition that Causes COPD?
You may be more likely to get COPD if someone in your family has also had the disease. That's because certain genetic factors can make you more prone to developing COPD.
Unfortunately, researchers have not yet been able to pin down which genes influence a person's general COPD risk. Some research even suggests that the role of genetics is minimal, and that a family history of smoking probably has a greater impact than genetics on your chances of developing COPD.
However, genes can play a direct role if you suffer from one of a few specific genetic diseases that can cause COPD. These include cystic fibrosis and alpha-1 antitrypsin deficiency (AATD), which is a well-known genetic cause of COPD.
People who have these diseases tend to develop COPD at an earlier age than people who get COPD from smoking. In fact, some people don't even realize they have alpha-1 antitrypsin deficiency until they get diagnosed with COPD.
Do You Have Cough That Won't Go Away?
A cough caused by COPD is chronic and persistent, meaning you have it every day for a long period of time. That's what sets it apart from a temporary cough caused by minor illnesses like the common cold.
A COPD cough doesn't ever disappear completely, even if it temporarily goes away. It always comes back eventually, and when it does it sticks around for months.
It's also a sign of COPD if your cough doesn't respond to normal treatments like allergy medicine or decongestants. A wet cough (or “productive” cough) that brings up mucus is also more likely than a dry cough to be caused by COPD.
Do You Struggle to Catch Your Breath More Often than You Should?
If you feel short of breath when you haven't exerted yourself much, it could be a sign of COPD. For example, you might feel winded when you do light everyday activities, like taking a shower, going shopping, or going down the stairs.
It is normal to get winded if you exercise. However, you shouldn't feel short of breath during light activities or when you've been standing or sitting still.
To determine whether or not your shortness of breath is something to worry about, it can help to compare how breathless you get to other people of the same age. You should also consider your recent past; do you feel breathless more often now than you did a year or two ago?
You can also use the Medical Research Council Dyspnea Scale (MMRC) to evaluate the severity of your shortness of breath. Simply choose the statement that describes you best, and the corresponding number indicates where you fall on the scale.
- 0: I only get breathless with strenuous exercise.
- 1: I get short of breath when hurrying on level ground or walking up a slight hill
- 2: I walk slower than people of the same age on level ground because of breathlessness. Or, I have to stop for breath while walking at my own pace on level ground.
- 3: I stop for breath after walking about 100 yards on level ground
- 4: I feel breathless when dressing. Or, I am too breathless to leave the house
Any point above zero on this scale signals that you might experience an unhealthy level of breathlessness. If you put yourself at a 1 on this scale or higher, you should definitely talk to your doctor about getting tested for COPD.
So, Should You Get Tested?
More often than not, minor respiratory symptoms are nothing serious. But if you are a smoker or have other COPD risk factors, then you might need to take respiratory symptoms more seriously.
For example, if you smoke, are over the age of 40, and find yourself easily getting breathless, then you should probably get tested for COPD. However, if you don't have any other major COPD risk factors or only ambiguous symptoms, then you likely have nothing to worry about.
The most important things to look out for are respiratory symptoms that are persistent and don't respond to standard treatment. For example, if you have a chronic, phlegmy cough that lasts for months and doesn't go away when you take allergy medicine or decongestants.
While you shouldn't overreact to minor or temporary respiratory ailments, you should also be careful not to ignore chronic symptoms that don't go away on their own. You should always talk to your doctor if you have respiratory symptoms that are long-lasting, have no other obvious cause, or get worse as time goes on.
Using the information in this guide, you should be able to recognize the symptoms of COPD as well as other factors that could put you at risk. However, it is ultimately up to you to look out for the symptoms and decide to get tested for the disease.
Whether or not you have COPD, it's important to take care of your lungs and treat them like the vital, life-sustaining organs they are. The better you protect your lungs and protect them from harmful substances like smoke, the lower your chances are to develop COPD.