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What causes sudden, severe chills without fever and what to do?
Last reviewed: 06.07.2025
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In the absence of any diseases, chills without fever are a reflex reaction of skin thermoreceptors that protect the body from the effects of cold.
But is there a chill without a fever, not associated with hypothermia? It happens, and quite often. And in such cases, the narrowing of the blood vessels of the skin that regulate heat transfer with a decrease in their blood filling, manifested by a feeling of cold, can be a sign of various physiological conditions. Doctors also emphasize that, at first glance, causeless chills without a fever can be a symptom of some diseases.
Causes chills without fever
It should be immediately noted that there is a connection between such cholinergic processes as muscle tremors and chills without fever: with synchronous muscle contractions that occur involuntarily, the body simply increases heat production due to so-called contractile or muscle thermogenesis (by activating metabolism in skeletal muscle tissue).
And the causes of chills without fever are quite numerous. The most common signs of a cold without fever are a runny nose and chills without fever, and then a cough and chills without fever. Following this, fever may begin: a sharp increase in body temperature under the influence of pyrogens, which promotes the activation of immunity and the production of interferon.
Abdominal pain and chills without fever occur with food poisoning; chills and vomiting without fever with intestinal upset (diarrhea) may accompany irritable bowel syndrome in people with vegetative-vascular dystonia (somatoform autonomic dysfunction). In addition, due to vascular spasms in vegetative-vascular dystonia, chills at night without fever are often observed, as well as cold hands and feet and chills without fever during the day.
A similar combination of symptoms occurs with anemia - due to a low level of hemoglobin in the blood, as well as with anemia with a low level of red blood cells. For the same reasons, as well as due to insufficient body weight, chills often appear in a child without a fever.
Doctors note such risk factors for the development of anemia as internal bleeding (with gastric ulcer and duodenal ulcer, esophageal varices, etc.), bleeding with hemorrhoids, helminthic invasion, vitamin B12 deficiency. In addition to chills, with anemia, dizziness, increased drowsiness, a feeling of lethargy and weakness throughout the body, and a deterioration in appetite.
In some cases, chills without fever are observed with allergies, which manifest themselves in the form of urticaria - hives or atopic dermatitis (often chronic with relapses). Also, the first signs of anaphylactic shock developing with allergies include tachycardia, a drop in blood pressure, cold sweat, shortness of breath, sudden chills without fever and severe dizziness with loss of consciousness.
Along with headaches and painful urination, many patients with inflammation of the renal glomeruli - glomerulonephritis - complain of chills and nausea without fever.
Most often, chills without fever in oncology are observed in patients with a tumor of the adrenal medulla - pheochromocytoma, which produces not only adrenaline, but also other vasoactive (vasoconstricting) substances. However, in most cases, especially after chemotherapy, leukemia or tumors of internal organs are accompanied by fever with chills.
Among the possible causes of chills without fever, endocrine system pathologies occupy a special place. Thus, weakness, headache and chills without fever can be both in diabetes mellitus (due to a lack of insulin produced by the pancreas and the body's inability to absorb glucose), and in problems with the thyroid gland - hypothyroidism or thyroiditis, for which the indicative sign is chills and sweating, especially at night. The main role in the pathogenesis of chills in patients with hypothyroidism is played by insufficient synthesis of the hormone thyroxine and the weakening of metabolism and chemical thermogenesis associated with its deficiency.
According to clinical statistics, the pathogenesis of chills against the background of normal body temperature often lies in dysfunctions of the hypothalamus itself (regulating temperature homeostasis) with the development of hypothalamic syndrome. Among the manifestations of this syndrome, endocrinologists distinguish a number of vegetative symptoms: chills without fever and without pain with a decrease in blood pressure; increased pulse rate and a feeling of compression of the heart, as well as headache and chills during sympathetic-adrenal crises with increased blood pressure. Chills and muscle pain without fever with a sharp increase in adrenaline levels (which constricts blood vessels in the skin) under the influence of various psychogenic factors, primarily stress, hypochondria, senestopathies and neurotic disorders are associated with the hypothalamus.
Damage to the collateral fibers or neurons of the upper reticular formation of the brain stem - in concussion and other TBI, cerebrovascular accidents (strokes), infections and neoplasms of the brain stem - can lead to the development of a syndrome that includes a feeling of anxiety and unmotivated fear, increased blood pressure, increased heart rate, severe chills without fever with pilomotor hyperreaction (the "goose bumps" effect). Such attacks can be accompanied by chills and diarrhea - due to overexcitation of peripheral spinal motor neurons.
Usually, an attack of chills without fever - with nausea and vomiting - accompanies a migraine.
What can be associated with body aches and chills without fever, more details in the article - Body aches without fever.
By the way, in addition to all the listed reasons, chills without fever in men with alcohol dependence is one of the symptoms of a hangover or alcohol withdrawal syndrome, as well as acute alcoholic pancreatitis.
Chills without fever in women
The isolation of this symptom in women is due to the fact that it is not a pathology when it is caused by the special physiology of the female body.
In particular, cyclical changes in the ratio of sex hormones – estrogen, estradiol and progesterone – explain chills without fever before menstruation.
Increased levels of these hormones cause chills without fever during pregnancy in the first trimester. But in later stages, chills without fever can be a sign of anemia.
Chills after childbirth without fever are associated with increased muscle energy expenditure during labor contractions, high levels of the hormone oxytocin in the blood, and actual blood loss (up to 300 ml).
But chills without fever after a cesarean section are a consequence of the use of general anesthesia, as well as hemodynamic disturbances during this operation.
Shivering in a nursing mother without fever, but often with increased sweating, is associated with the action of prolactin, a hormone produced by the pituitary gland that ensures milk production, and oxytocin, synthesized by the hypothalamus and facilitating the movement of milk through the ducts of the mammary glands when feeding babies. But if there is constant shivering without fever during lactation, then most likely the nursing woman has a low hemoglobin level and anemia.
A sharp reduction in the production of female sex hormones causes almost all the signs of the onset of menopause, including chills without fever during menopause.
In addition, when women, trying to lose weight, stick to a low-calorie diet for a long time, after some time they may feel dizzy, generally weak and have chills without fever.
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Diagnostics chills without fever
Frequently repeated or long-lasting chills without fever require medical attention. And diagnostics of chills without fever, first of all, includes blood tests: general (for formed elements and ESR) and biochemical; for the level of hemoglobin, sugar, thyroid hormones, thyroid-stimulating hormone (TSH) of the pituitary gland and ACTH, hormones of the adrenal cortex, etc. Urine tests (including daily tests for catecholamines) and feces (for occult blood or helminths) are also taken.
Instrumental diagnostics are used, ranging from radiography, electroencephalography, angiography and ultrasound examination, up to CT and MRI of the relevant organs and the brain.
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Treatment chills without fever
What to do if you have chills without a fever? If the chills are not associated with hypothermia, menstruation, pregnancy, lactation or menopause, you need to see a doctor to determine the cause of this symptom.
It should be borne in mind that chills without fever are not treated separately from the underlying disease. Therefore, complex therapy is aimed at the above-mentioned causes.
Information on the treatment of diabetes, anemia, hypothyroidism, allergies, vegetative-vascular dystonia, hypothalamic syndrome, etc. is available in the relevant sections of the site. There you will also find the main medications used for these diseases and conditions, as well as information on what vitamins to take, how physiotherapy is carried out, and how folk remedies can help.
Complications and consequences
Chills without fever in themselves do not have complications, but all diseases in whose symptoms they are present are characterized by certain consequences and complications. For example, in diabetes mellitus, glucose levels can drop sharply to the point of developing a hypoglycemic coma. Hypothyroidism can also result in a coma - hypothyroid, and anemia can be complicated by anemic (or hypoxic) coma.
Vegetative-vascular dystonia is fraught with the development of neurotic and chronic depressive states with physical exhaustion and panic attacks, and with pheochromocytoma there is a risk of catecholamine shock.
Prevention
Similar to treatment, prevention of such a symptom as chills without fever varies with different diseases and is not possible in all cases. Full prevention of the cause of chills without fever may concern colds, anemia, allergies; partial prevention – high blood pressure, migraines, stress, alcohol addiction.
The prognosis for chills without fever, or more precisely, the frequency of occurrence of this symptom and its intensity, largely depends on the cause.