What are the Signs and Symptoms of COPD?

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS


It is very important to recognize the signs and symptoms of COPD. It is a very common problem but can go undiagnosed. It is a very serious condition that is treatable but can not be cured.

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a group of diseases that cause breathing-related problems. The two most common diseases that are part of COPD are emphysema and chronic bronchitis. More than 16.4 million people in the US have been diagnosed with COPD.

What are the Symptoms of COPD?

While emphysema and chronic bronchitis affect the lungs differently, they both cause a person to not get enough oxygen, and they have similar causes.

They also have similar symptoms, which include:

  • Shortness of breath, especially with physical activities
  • A whistling or squeaky sound when breathing
  • Cough, often called a smoker’s cough
  • Coughing up mucus
  • Wheezing
  • Chest discomfort

In the late stages of chronic bronchitis and emphysema, symptoms can include:

  • Fatigue and loss of energy
  • Reduced appetite
  • Weight loss
  • Frequent lung infections
  • Lower muscle weakness
  • Swelling in ankles, feet, or legs
  • Sleep problems
  • Blue-tinged fingernails and lips from low oxygen levels

What Causes COPD?

COPD is not caused by a virus or bacterial infection. In the United States, the biggest contributor to COPD is tobacco smoke. Other lung irritants can also cause COPD. This can include air pollution, chemical fumes, and other toxins at home or work.

In developing nations, it is thought that indoor air quality is the most significant factor causing COPD.

Of all the cases of COPD, about 1% is caused by a known genetic condition. It is called Alpha-1-antitrypsin deficiency. Alpha-1-antitrypsin is a protein made in the liver that enters the bloodstream. Its job is to help protect the lungs. A lack of this protein can cause liver disease, lung disease, or both.

Chronic Bronchitis

Chronic bronchitis is long-term inflammation of the bronchi. The bronchi are the tubes that allow air to go into the lungs. To be diagnosed with chronic bronchitis, someone has to have a cough with mucus most days for at least three months of the year, two years in a row.

Someone with chronic bronchitis may have episodes when symptoms get worse for a few days, called acute bronchitis.

In 2016, almost 9 million Americans were diagnosed with chronic bronchitis. Just under 6 million of these cases were women. Around 75% of total cases were people over the age of 45.


Emphysema affects the lungs differently than chronic bronchitis.

Emphysema is a disease that affects the alveoli inside the lungs. When a person breathes in, air comes down the airways (bronchi) into the lungs. At the end of the bronchi are the alveoli.

Inside the alveoli, oxygen enters the bloodstream through the alveoli walls. The oxygen is then sent to all the cells of the body. Damaged alveoli do not allow enough oxygen to get into the bloodstream. Once the alveoli are damaged, they can not be fixed.

Often with emphysema, the alveoli become hard. This makes it difficult to get air back out of the lungs. This is why people with emphysema may have a harder time exhaling than inhaling.

In 2016 around 3.5 million Americans were diagnosed with emphysema. More than 90% of the cases were people over the age of 45. COPD can lead to other dangerous medical issues over time.

Long Term Effects

The symptoms of COPD can be hard to deal with, especially in severe cases. Sometimes people with COPD have flare-ups where symptoms get significantly worse for a couple of days. This also makes people more likely to get respiratory tract infections.

There are other issues that happen because COPD limits oxygen entering the bloodstream. Health complications that can develop in people with COPD can include:

  • Heart disease
  • Lung cancer
  • Gastroesophageal reflux disease (GERD)
  • Depression
  • Malnutrition and weight loss

Heart Disease

Research has shown that those with COPD have an increased risk of heart problems. A study reported that the odds of having heart disease increased by a factor of 2.7. Low levels of oxygen can lead to an irregular heartbeat. The study found that around 28.7% of those with COPD develop heart failure.

These conditions were once considered distinct, but researchers found that they are certainly linked.

Lung Cancer

There is a two-to-four fold increase in the risk of lung cancer in people with COPD. The inflammation associated with COPD might be part of the cause of lung cancer. The two health problems also have common risk factors like smoking.


GERD is a chronic issue where the contents of the stomach move in the opposite direction, back into the esophagus. Many people with COPD also have GERD, which can make the symptoms of COPD worse. These two issues may be connected because of common risk factors.

Mental Health

People suffering from COPD in the late stages can develop mental health diagnoses. A study done in 2012 shows that people with COPD are three times as likely to suffer from insomnia. That can lead to the possibility of developing depression, anxiety, or a panic disorder.

COPD Treatment

COPD cannot be cured, but lifestyle changes can help slow the progression. For example, anyone who has COPD and smokes should stop.

Often people with COPD will be prescribed medications to help treat the breathing symptoms and inflammation of COPD. COPD medications are typically inhalers, but oral medications can be used for severe symptoms. Healthcare providers will help determine the best prescription for each person.

Bronchodilators are medications to relieve shortness of breath. They work by opening up the airways in the lungs. There are long-acting and short-acting bronchodilators that come as inhalers.

Corticosteroids are oral medications that can be used for short periods of time for a COPD flare-up.

Some medications that are commonly prescribed for COPD include:

Get Help Paying For Your Prescription

Once someone needs prescription medication for COPD, they will need it for the rest of their life. There is not a cure for COPD and prescription medications are expensive.

COPD lung damage gets worse without treatment. No one should have to struggle to get the medications they need to breathe properly. The Rx Advocates can help.

At The Rx Advocates, we work with pharmaceutical company patient assistance programs to get people the medications they need at a reasonable monthly rate. Contact us today for more information on how we can help you with COPD medications and other prescriptions you may need.

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