Why chills happen and what to do

The nervous system can trigger shivering after cold exposure or during a change in body temperature. Infection is another possibility: influenza, malaria, dengue fever, pneumonia, kidney infection, or a urinary tract infection may include chills as part of their presentation. The presence of chills alone cannot identify one condition. Anxiety, pain, low blood sugar, hormonal changes, and a medicine reaction can also produce shaking or a cold sensation.

Notice whether you have a measured fever, cough, sore throat, urinary burning, back pain, headache, rash, sweating, nausea, or unusual drowsiness. Timing matters: chills after travel, a new medicine, or prolonged time in heat or cold gives a clinician useful context.

Move to a comfortable temperature, change out of damp clothes, sip fluids, and rest. Check your temperature and write down the reading with the time. Eat a small snack if you may have missed a meal and can swallow safely. Do not use someone else’s prescription or take repeated doses of a medicine without checking the label or asking a pharmacist. Contact a clinician when chills recur, last, or accompany another concerning symptom.

Call emergency services for confusion, collapse, severe breathing difficulty, blue or grey lips, chest pain, a seizure, or inability to keep fluids down. Seek prompt care for violent repeated shaking, severe pain, a stiff neck, a new purple rash, or very little urine. Chills with rapidly worsening illness can be a warning sign of sepsis and should not be watched at home.

Ask what causes fit your timing and other symptoms, whether an examination or urine and blood tests are needed, and how to monitor for worsening while you wait.