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What do I have? Cold vs. Flu vs. Allergies

We all know the feeling. You wake up one morning with that familiar soreness in the back of your throat, the cringe with every swallow. Up next is the runny nose, cough, body aches, and the list might go on. If you’re stuck wondering if you have the full-blown flu, a cold or just allergies, you’re not alone. Overlapping symptoms make each of these diagnosis a bit harder to differentiate.

TimelyMD’s Chief Medical Officer Alan Dennington, MD weighs in on which symptoms align with which infections and the best way to seek treatment.

Cold/Upper Respiratory Infection

This viral infection typically starts off with a mild to moderate sore throat as the virus accesses your body through your respiratory tract. As the virus replicates, it ruptures and destroys cells in the throat. Those replicated viral bodies then go out into the rest of your body causing other aggravating symptoms.

After this initial stage, your body will start to recognize that it has an infection and will generate an immune response. This immune response is responsible for the long list of additional symptoms you might feel, such as:

  • Stuffy nose/sinus congestion
  • Cough
  • Chest discomfort
  • Fatigue
  • Body aches/pains
  • Fever

Influenza (the flu)

The flu attacks the body in the same way as other viruses that cause upper respiratory infections.  As such, it will present with many of the same symptoms. The differentiating factor is that the flu virus is much better at replicating within the body and can cause a more severe infection.  This can heighten some of the typical cold symptoms and possibly cause much more serious issues like pneumonia, bacterial infections or hospital stays.

Knowing that the difference between the presentation of the flu and a common cold is the level of severity, these symptoms should be closely monitored as they are more commonly associated with the flu:

  • Fever (might have quicker onset with the flu)
  • Body aches
  • Chills
  • Fatigue
  • Chest discomfort
  • Headache


Like the other two illnesses mentioned above, allergies share a lot of same symptoms, though you typically won’t experience fever, body aches or chills. What you may notice are symptoms associated with a lot of histamine release which can cause:

  • Runny nose
  • Nasal drip
  • Sneezing
  • Congestion
  • Itchy, watery eyes
  • Some fatigue


While each diagnosis produces similar symptoms, they are often treated differently.

A common cold will usually require symptomatic treatments (medications to treat the symptoms). These might include over-the-counter medications like cough medicine or a decongestant, or in some cases, prescriptions cough medicines or inhalers. Always get lots of rest and plenty of fluids.

If you suspect you might have the flu (example: sore throat on day one, fever on day two), it’s imperative to seek medical care within the first 48 hours of symptoms. This is because any medications that physicians are able to prescribe to combat the flu virus itself are only effective during that time. Should you notice shortness of breath or chest pain, you should immediately seek medical attention, as those symptoms might warrant a chest X-ray to check for pneumonia.

Allergies are commonly treated with antihistamines, preventative medicines (such as intranasal steroids) or immunotherapy (allergy shots, drops, etc.).

If any of these illnesses and their symptoms last more than 10 days, present a fever, produce shortness of breath or difficulty breathing, you should immediately seek medical care.

Thankfully, each of these conditions can be treated via telehealth, which is where TimelyMD comes in. We make it easy, immediately accessible for patients to take timely action for any ailment.


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