Chills But No Fever

Are you experiencing chills without a fever? You are not alone. In fact, many people experience this symptom, and several conditions can cause it. Don’t worry. I’m here to help you determine the potential cause of chills and how to alleviate them. 

There are numerous causes of chills without temperature, including;

  • A drop in body temperature due to being in a cold environment
  • Anxiety disorder or stress
  • Low blood sugar levels
  • Hypothyroidism
  • Adverse drug reactions
  • Anaemia
  • Infections or illnesses
  • Sepsis
  • Post-traumatic stress disorder (PTSD)

It is crucial to remember that some of these conditions need urgent medical care and can exacerbate if one fails to do so. Therefore, you must consult your doctor if you experience chills.

At home try wearing warm clothing or blankets, consuming warm liquids, and taking a warm bath or shower to relieve chills. 

Maintaining proper hydration is also essential, as is addressing any underlying issues. Keep reading for more tips on managing chills without a fever.

Why do I have chills without a fever?

A lot of people experience chills and fever together. Many conditions can disrupt the thermoregulation of our body, and people experience rise and fall in temperature and have chills and fever.

However, there are several conditions where a person only experiences cold chills but no fever. 

Remember, our body functions optimally at 37°C . There are a number of ways our body produces heat, such as metabolism, digestion, muscular activity and shivering to maintain this temperature.

When shivering, our muscles contract involuntarily to generate ATP (energy) and heat. This heat will then restore the body’s core temperature. 

Thus, our body shivers and have chills anytime there is a fall in our core body temperature to restore the temperature for optimal body functions.1

Symptoms of chills without fever

The symptoms of chills without fever depend on the underlying cause. A person with anaemia experiences fatigue, shortness of breath and weakness. Similarly, suppose an infection is an underlying cause. In that case, a person may experience a runny nose, cough, sore throat, and chills.

However, the following are the common symptoms of chills without fever.2

  • Shivering or trembling 
  • Feeling cold even if the surrounding is warm
  • Goosebumps
  • Fatigue
  • Muscle aches
  • Nausea
  • Headache
  • Anxiety
  • Nasal Congestion 

Many conditions can also cause these symptoms. Healthcare providers should evaluate them to determine the underlying cause.

Causes of chills without fever

Exposure to cold

Enzymes regulate all the chemical reactions in our bodies. These enzymes work best at the optimum temperature of 37°C.. 

If the body temperature rises more than this, it will disrupt the enzyme structure and function. The body will have a fever and start sweating. Water evaporating from our body will absorb some heat, and thus perspiration helps in lowering the temperature.

Similarly, a fall in temperature below 37°C can also stop the enzymes from functioning correctly. The enzymes are inactivated at low temperatures. However, increasing the temperature can restore enzyme activity in most cases.

Substrates and enzymes do not often collide at a lower temperature as their movement is decreased. It also slows down the chemical reactions in our bodies.

Therefore, when exposed to lower external temperatures, our body contracts the muscles involuntarily to generate heat. A person experiences this as a shiver or shaking chill.1


Chills might result from nervousness or fear. The autonomic nervous system, which is the part of your neurological system that controls automatic activities, such as the pumping of your heart and the widening or narrowing of your blood vessels, causes this reaction.

According to the National Institute of Mental Health, a panic attack is an overpowering fear. Chills are one indication of it, along with symptoms like a racing or pounding heart, sweating, chest tightness, or trouble breathing.3

The panic attack feels like a heart attack, and in some cases it can occur without any trigger. Psychotherapy and certain medications can help in reducing the frequency of panic attacks. 

Sometimes, a person can experience chills when hearing sad or touching music or stories. It’s a natural emotional response, and there is nothing to worry about.4

Low Blood Sugar

Low blood sugar levels (hypoglycemia) in the body can cause chills. People who have type 1 diabetes mellitus or patients taking insulin for type 2 diabetes mellitus are prone to develop low sugar blood levels. It is because they are at risk of taking too much insulin. 

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a person will experience headache, fatigue, dizziness, and chills in mild to moderate hypoglycemia. The heart will start racing, and the person will become confused and experience blurry vision.5 6

Restoring the blood sugar levels can alleviate the signs and symptoms promptly.

Adverse Drug Reactions

Certain drugs such as antibiotics, contrast agents or anticancer drugs can sometimes cause chills, shivering, and other flu-like symptoms.

Blood transfusion reaction has also been noted with chills with or without fever. Narcotics or antidepressant withdrawal can also cause chills.


The thyroid gland in our neck produces thyroid hormones which play a vital role in regulating metabolism throughout our body.

Hypothyroidism is defined as a low production of thyroid hormones. It increases the sensitivity to cold, and people experience chills.7

Other symptoms of hypothyroidism are 

  • Constipation
  • Fatigue
  • Slowed heart rate
  • Low mood or depression
  • Dry skin
  • Dry hair
  • Joint pain
  • Muscle aches

It can be diagnosed clinically and confirmed via blood tests. Lifelong therapy is required for hypothyroidism.


Red blood cells (RBCs) carry oxygen and deliver it to every body tissue. Low RBC levels (anaemia) deliver less oxygen and reduce metabolism. It, in turn, reduces the amount of heat or energy produced and the person experiences chills and fatigue.


Both bacteria and viruses release certain substances that can cause muscle contraction and result in chills. Typically chills come before fever and can be an early sign of infection. Therefore it is important to consult your doctor if you are experiencing a chill alongwith other symptoms such as headache, runny nose, fatigue and generalised body aches.


The covid 19 virus, can also cause chills and recurrent shaking, even sometimes without fever. Therefore, look for other covid 19 symptoms such as sore throat, runny nose, cough, shortness of breath and muscle aches.8

Septic Arthritis

Certain bacteria commonly and viruses can attack a joint and cause inflammation resulting in pain, fever and chills.

Staphylococcus aureus is the most common causative agent. Some streptococcus species and gonococcus can also cause infectious arthritis.


Malaria is a parasitic infection caused by plasmodium. Chills are the characteristic sign and symptoms of malaria. People who have malaria may experience hot, sweaty, and shivering spells back to back.9

Other symptoms include high-grade fever, headache, nausea, vomiting and sweating.

Lyme Disease

Although this is a rare cause, it is possible. Certain tick species can spread Lyme disease. The bulls-eye rash, which frequently appears where the tick bit you, is the typical first sign of Lyme disease. The person will also have flu-like symptoms such as headaches, soreness, fatigue, and chills.

It is essential to consult your doctor at the earliest if you have a rash and experience chills.


Sepsis is a life-threatening condition that develops when the body’s reaction to an infection results in widespread inflammation. 

Chills without fever are one of the typical signs of sepsis. This is because sepsis alters how the body regulates temperature, causing a dip in core body temperature resulting in chills.

The body also releases certain substances in sepsis which damage blood vessels and causes inflammation. This results in blood flow reduction, and the core body temperature falls, leading to chills without fever.10

Post Traumatic Stress Disorder

There is a surge in blood adrenaline levels whenever a person experiences psychological trauma. This can alter the blood flow, cause chills, and make a person feel shaky or jittery. 


Depending on the underlying cause, treatment for chills without a fever may differ. Following are some choices for both home remedies and medical treatment.

Home remedies

It is important to immediately take some measures when experiencing chills at home to help the body raise the core body temperature. Here are some things you can do:

  • Wearing warm clothes
  • Using a blanket 
  • Taking a warm bath or shower
  • Exercise to generate heat in the body
  • Stay in a warm room
  • Drinking warm liquids such as tea, coffee or hot chocolate
  • Wearing gloves or socks

Medical treatment

Medical therapy is provided according to the underlying condition. A person may need iron supplements, vitamin B12 or a blood transfusion in anaemia. Antibiotics, analgesics or antipyretics may be required in treating the infection or illnesses and sepsis.

You may need lifelong thyroxine for hypothyroidism and intravenous dextrose to treat hypoglycemia.11 Anxiolytics or antidepressants are used to manage anxiety or PTSD.

It is essential to mention that you should never self-diagnose or take medications without a prescription. Always seek medical care and follow the advice of your doctor.


According to his underlying condition, a person may need to take specific steps to prevent chills. However, here are some general tips that you can use to prevent chills;

  • Always dress in layers and wear warm clothes
  • Avoid cold drinks in winter
  • Keep your room and workplace warm
  • Eat a well-balanced diet to maintain proper nutrient levels to support your immune system
  • Maintain overall good health
  • Maintain hygiene
  • Influenza vaccination shots can prevent you from getting a cold
  • Stay hydrated by drinking large amounts of water

When to seek medical attention

As discussed above, there are various causes of chills without fever, and some are fatal, such as sepsis or persistent hypoglycemia. Therefore, you must never assume chills are due to the flu or common cold because it is flu season or due to covid19, and it will go away on its own.

Always seek medical care and let your healthcare provider evaluate chills and all the other associated symptoms to determine the underlying cause.

Appropriate medications and therapy can be provided, and the person can get better completely.

Some warning signs of chills include:

  • High-grade fever in adults or children older than three
  • Low-grade fever in infants or kids younger than three
  • Chest pain
  • Wheezing or shortness of breath
  • Loss of consciousness 
  • Severe abdominal pain


Several factors, including exposure to low temperatures, anxiety or stress, and some drugs, might result in chills without a fever. 

A fever is an elevation in body temperature, whereas chills are a feeling of coolness accompanied by shaking.

Chills alone may not be alarming, but if they are accompanied by other symptoms like weariness, muscle pains, or an overall feeling of being sick, it is essential to see a doctor. These conditions include infections and autoimmune disorders.


  1. Greaney JL, Kenney WL, Alexander LM. Sympathetic regulation during thermal stress in human aging and disease. Auton Neurosci [Internet]. 2016 Apr [cited 2023 Jan 20];196:81–90. Available from:
  2. Chills: causes & treatment [Internet]. Cleveland Clinic. [cited 2023 Jan 20]. Available from:
  3. Panic disorder: when fear overwhelms [Internet]. National Institute of Mental Health (NIMH). [cited 2023 Jan 20]. Available from:
  4. Harrison L, Loui P. Thrills, chills, frissons, and skin orgasms: toward an integrative model of transcendent psychophysiological experiences in music. Front Psychol [Internet]. 2014 Jul 23 [cited 2023 Jan 20];5:790. Available from:
  5. Low blood glucose (Hypoglycemia) | niddk [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. [cited 2023 Jan 20]. Available from:
  6. Kenny GP, Sigal RJ, McGinn R. Body temperature regulation in diabetes. Temperature (Austin) [Internet]. 2016 Jan 4 [cited 2023 Jan 20];3(1):119–45. Available from:
  7. Hypothyroidism (Underactive thyroid) - Symptoms and causes [Internet]. Mayo Clinic. [cited 2023 Jan 20]. Available from:
  8. CDC. Covid-19 and your health [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2023 Jan 20]. Available from:
  9. Prevention CC for DC and. Cdc - malaria - about malaria [Internet]. 2022 [cited 2023 Jan 20]. Available from:
  10. Van Dissel JT, Numan SC, Van’T Wout JW. Chills in “early sepsis”: good for you? J Intern Med [Internet]. 2005 May [cited 2023 Jan 20];257(5):469–72. Available from:
  11. Underactive thyroid: Overview [Internet]. Institute for Quality and Efficiency in Health Care (IQWiG); 2017 [cited 2023 Jan 20]. Available from:
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Dr. Hassan Bashir

Bachelor of Medicine, Bachelor of Surgery (MBBS) - Allama Iqbal Medical College, Lahore

Dr. Hassan Bashir is a Medical Officer (MO), registered with the Pakistan Medical Commission.
With a strong interest in health and fitness, he is dedicated to leveraging his clinical and literary
skills to help people lead healthier lives.

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