You’re sitting on the couch, maybe scrolling through your phone or watching a movie, and suddenly it hits. That weird, prickly wave of cold that starts at the base of your neck and zips down your spine. Your muscles tighten. You start shaking. It’s not just "chilly" in the room; it’s an internal deep-freeze that no amount of thermostat-cranking seems to fix.
Learning what to do if you have the chills usually starts with one realization: your body is trying to tell you something important, and it’s usually that it’s busy fighting a battle you haven't quite noticed yet.
Most people assume chills mean a fever is coming. They aren't wrong. When your brain's internal thermostat—the hypothalamus—decides to raise your body's "set point" to fight off a virus or bacteria, your current temperature suddenly feels too low. So, you shiver. Shivering is just rapid-fire muscle contraction designed to generate heat. It’s an ancient, mechanical survival trick. But sometimes, chills happen without a fever, and that’s where things get a bit more confusing.
The First Move: Stop Fighting the Shiver
If you're wondering what to do if you have the chills right this second, the instinct is to grab every blanket in the house. Do it. But do it smartly. If you bury yourself under three heavy duvets and a heated throw, you might overshoot the mark. If a fever is brewing, trapping all that heat can make your temperature spike too fast, leading to that miserable, pulsing headache or even dehydration.
Layering is better. Start with a moisture-wicking base layer if you can find one. Cotton is okay, but if you start sweating later, it’ll stay damp and make you feel even colder once the "hot phase" of a fever kicks in. A light fleece or a wool sweater over a t-shirt is the pro move here. You want to be able to peel things off the second you start feeling "flushed."
Check the Numbers (But Don't Obsess)
You need a thermometer. Honestly, guessing by touching your forehead is useless. According to the Mayo Clinic, a "normal" temperature is generally around 98.6°F (37°C), but that's just an average. Some people run at 97.9°F naturally.
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If you have the chills but your temperature is 98.4°F, you might just be exhausted. Or maybe you're coming down from an intense workout. "Post-exertion chills" are a real thing. When you push your body to the limit, your core temp rises, and as soon as you stop, your sweat evaporates and your blood vessels dilate to cool you down. Sometimes the cooling system works too well, and you end up shivering in the gym parking lot.
However, if that thermometer reads 101°F or higher, the game has changed. You aren't just cold; you're febrile.
Hydration is the Non-Negotiable
When you have the chills, your body is burning through energy. Shivering is hard work. It uses up glucose and it uses up water. You’ve got to sip something.
Don't go for ice-cold water. It sounds counterintuitive, but room-temperature water or warm herbal tea is easier on a body that's already stressed out. Dr. Wendy Bennett from Johns Hopkins University has often noted that staying hydrated is the most critical part of managing any viral illness. Dehydration makes the body's aches feel ten times worse.
What to Do if You Have the Chills Without a Fever
This is the "lifestyle" side of the equation. Sometimes you get the shivers because your blood sugar has tanked. If you skipped lunch and it’s now 4:00 PM, your body might be struggling to maintain its core temperature because it lacks the "fuel" to keep the furnace running. This is common in people with hypoglycemia or those who are fasting.
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Then there’s the thyroid. If you’re always getting the chills while everyone else is fine, it might be hypothyroidism. Your thyroid is essentially the battery commander of your metabolism. If it’s sluggish, your internal heater stays on "low."
And let’s talk about "the emotional shiver." Have you ever had a "chills" reaction to a beautiful piece of music or a scary story? That’s a dopamine rush combined with an autonomic nervous system response. It’s harmless, but it feels remarkably similar to the start of the flu.
The Medication Dilemma: To Medicate or Not?
If the chills are accompanied by a fever that’s making you miserable—meaning you can’t sleep or your muscles ache—you might reach for ibuprofen (Advil/Motrin) or acetaminophen (Tylenol).
Here’s the thing: fever is actually a tool. It’s your immune system’s way of making your body a hostile environment for germs. Most doctors, including those at the Cleveland Clinic, suggest that if a fever is low-grade (under 102°F) and you’re generally comfortable, you might want to let it ride.
But if the chills are so violent that you're clenching your teeth and getting a tension headache, take the meds. Just follow the dosage on the bottle. Don't double up on Tylenol just because you feel "really" cold.
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When the Chills Become a Red Flag
Most of the time, the answer to what to do if you have the chills is "rest and wait." But there are specific scenarios where you should stop reading articles and call a doctor.
- Stiff Neck: If you have chills, a fever, and a neck so stiff you can't touch your chin to your chest, that's a potential sign of meningitis.
- Confusion: If you—or someone you're caring for—starts acting "spacey" or confused along with the shivers, that’s an emergency.
- The "Rigors": These aren't just simple chills. Rigors are violent, uncontrollable shaking fits. They can sometimes indicate a more serious infection like pneumonia or a urinary tract infection that has moved to the kidneys.
- Shortness of Breath: If you’re shivering and struggling to catch your breath, it’s not just a common cold.
The Real-World Strategy for Recovery
If you’re currently in the middle of a "chills" episode, here is the most effective way to handle it:
- Stop moving. Your body needs that energy for its immune response, not for you to finish the laundry.
- The Luke-Warm Bath Trick. Never, ever take an ice bath to break a fever or stop chills. It will cause your body to shiver more violently to compensate for the sudden cold. A lukewarm bath—around 85°F to 90°F—is much better. It’s cooling without being shocking.
- Monitor the "Cycle." Chills usually come in waves. You’ll feel freezing, then you’ll feel okay, then you’ll feel like you’re radiating heat. This is the "fever cycle." Document when the chills start. It helps doctors identify if you have something like malaria (unlikely for most, but relevant for travelers) or a specific bacterial infection that follows a pattern.
- Socks matter. Keeping your feet warm can actually help regulate your overall perceived body temperature more effectively than a heavy hat.
Beyond the Shiver: Long-Term Insights
If you find yourself getting the chills frequently, it’s worth looking at your iron levels. Anemia is a classic culprit. Without enough iron, your blood isn't as efficient at transporting oxygen, and one of the side effects is a constant feeling of being cold or having "internal" chills.
Also, consider your sleep. Chronic sleep deprivation wreaks havoc on your nervous system. When you’re exhausted, your body’s ability to regulate its temperature fluctuates wildly. You might find yourself shivering at noon on a sunny day simply because your brain is too tired to manage the "thermostat" correctly.
Understanding what to do if you have the chills is mostly about patience and observation. It’s rarely just about the cold; it’s about what your body is doing behind the scenes. Whether it's an immune response, a metabolic dip, or just sheer exhaustion, the shiver is your signal to slow down.
Actionable Steps to Take Right Now
- Put on wool socks and a light layer of clothing immediately.
- Drink 8 ounces of room-temperature water or a warm broth to replace lost fluids.
- Take your temperature and write it down with the time of day.
- Check for other symptoms like a sore throat, cough, or localized pain that might point to an infection.
- Set a timer for 30 minutes. If the shivering hasn't subsided or your fever has jumped significantly, contact a healthcare provider.
- Avoid alcohol. It might make you feel "warm" initially because it dilates blood vessels, but it actually causes your core temperature to drop and can lead to more intense chills later.