consist of an involuntary contraction of the striated (or skeletal) muscle fibers, regulated by the cerebral centers of the brain that control body temperature (thermoregulatory centers).
They manifest themselves with widespread, sudden tremors that can extend to the head , travel the back and radiate to the limbs. This contraction mechanism is used to generate heat in response to cold and therefore to counteract the lowering of body temperature.
It is therefore essentially a physiological phenomenon implemented by the body to produce heat in order to keep the body temperature constant and therefore allow all body functions to take place within optimal parameters.
However, chills also occur in response to strong emotions, therefore as a mechanism to emotional stresses such as fear, pleasure and pain, or they can commonly manifest themselves with fever, often a consequence of a bacterial infection.
Simplifying and synthesizing chills are a very common symptom, which can occur without fever, mainly in response to cold, strong emotions or low blood pressure, or in the presence of fever, indicating an infection in progress.
Chills may also be associated with joint pain, nausea, vomiting, diarrhea, sore throat, dizziness and sweating, depending on the case.
Having seen a general picture of what cold shivers are , how they manifest themselves and what the mechanisms are, we can proceed by investigating what are the main causes triggering the phenomenon.
As already suggested, in most cases they are not an indication of pathology, but a simple response mechanism to a stimulus, while in other cases, especially if in the presence of fever, they are related to a pathological state.

What events can trigger the chills

As we have seen previously, the chills are nothing more than a completely natural reaction in which there is the involuntary contraction of the skeletal muscles, stimulated by the hypothalamic temperature-regulating centers, with the intention of generating heat;

Anxiety and Panic Attacks
We anticipated how chills can be the consequence of strong emotional states. The perpetrated stress and anxiety cause negative influences on the immune system and repercussions at the level of the hypothalamus, the site where the body’s temperature regulating centers are located, thus manifesting chills.
Furthermore, during a panic attack, strong anguish emotions are felt, stimulating the same centers, thus manifesting both hot flashes and cold sweat. This type of chills occurs suddenly and occurs without fever or without the body temperature regulation mechanisms being activated.

Anemia Anemia is
a condition in which there is a reduced number of red blood cells (erythrocytes), and therefore consequently a lower transport of oxygen to the tissues. Anemic subjects typically have cold body extremities (hands, feet and nose) and manifest a particular sensitivity to cold, even when the ambient temperature is mild. This is precisely because of the poor blood supply.

Hormonal alterations
A condition typical of pregnant women and postmenopausal women. Hormonal alterations also characterize women in the menstrual period, to which is added a slight anemia due to blood loss , easily generating chills, hot flashes and cold sweats.

Thyroid problems
Often in case of hypothyroidism it is quite common to suffer from chills without fever . This is a symptom that should never be underestimated, especially if it has been going on for some time.

Term with which we indicate the states in which there are nutritional deficiencies that lead to states of low blood levels of vitamins (avitaminosis), especially concerning those of group B and vitamin C.

Low Body Mass Index (BMI)
Typical condition of very thin subjects, who have little fat mass and very thin skin. These subjects therefore manifest a particular sensitivity to cold due to the low fat component, which in normal conditions plays a central role in thermoregulation.

This is a situation in which you have a low level of glucose in the blood, that is the substrate that supplies most of the energy to the tissues, and involved in the generation of body heat. Hypoglycemic individuals experience cold, chills , headaches, poor mental alertness, dizziness, tremors, and cold sweats.

The most common infection that occurs with fever, chills, joint pain and general malaise.

Urinary tract infection characteristic of female sex due to the anatomical nature of the pelvic district. Cystitis is caused by the proliferation of bacteria in the bladder that arise from the rectum, vagina and urethra as a result of frequent sexual intercourse.
It is a disorder that tends to occur cyclically and the most common symptoms with which it occurs are: urination disorder, pain, burning, chills , fever, urge to urinate and general malaise.

Solar erythema
It develops following prolonged direct exposure to the sun without having applied adequate shielding with sunscreen. It manifests itself as a skin redness that can be more or less limited or diffuse, due to an increased flow of blood due to vasodilation. As a reaction, chills , fever and severe burning can occur in areas subjected to direct exposure to the sun.
We remind you the importance of adequately protecting yourself from exposure to UVA and UVB rays through appropriate sun screens, especially for those with fair skin. Underestimating the danger of irresponsible exposure to the sun can be a predisposing factor to the onset of a melanoma, ie a skin tumor.

Upper urinary tract infection, mainly affecting the kidney and pelvis. Also in this case the female sex is more predisposed to the problem and the characteristic symptoms are fever, chills, pain in the side, nausea and vomiting.

Bright red skin manifestation that is mainly localized at the level of the thorax. This phenomenon occurs due to the reactivation of theHerpes Zoster virus , the agent responsible for chickenpox.
When chickenpox resolves, in fact, the virus is not completely eradicated by the body, but goes to localize itself in a quiescent state at the level of the nerve ganglia, and then reactivated when the subject has a weakening of the immune system (due to stress or pathological states ).
The shingles therefore manifests itself as a bright red spot that gives a strong burning and pain and that is associated with shivers of cold and malaise.

Diagnosis and Therapy: how to behave
We have seen how shivering is a common manifestation of many conditions, many of which do not constitute a danger to the health of the subject, but are simply a response mechanism to a stimulus.
Generally, if the chills manifest themselves as isolated episodes related to cold conditions or if they are associated with high-impact emotional states, such as pain, pleasure and fear, there is no reason to worry. It is a completely physiological and natural phenomenon that does not indicate significant conditions.
When instead the chillsthey occur frequently without an apparent reason, or if these occur associated with feverish states, widespread pain, sore throat, tremors, vomiting and dizziness, it is plausible to think of a systemic cause or an infectious cause. In these cases it is necessary to promptly contact your doctor to submit the problem and to be directed to more in-depth investigations.
One of the factors that most guide the diagnosis is the presence of fever or not, in fact, if there is suspicion, it tends to favor an infection, both bacterial and viral. On the other hand, chills without fever are very often associated with an organic cause of the subject.
A blood sample is the most important test to undergo in these cases, in fact through the analysis of its components it is possible to evaluate if there is a state of infection, if the patient suffers from anemia, vitamin deficiencies, hypoglycemia or hormonal alterations .
Once the root cause of the disorder has been identified, the doctor can indicate the most appropriate therapeutic strategy and can prescribe changes in the diet (therefore supplements of B vitamins and vitamin C), and prescribe pharmacological treatments to cure underlying altered states. In case of infection, and therefore fever, it will be necessary to identify the underlying infectious agent to take the most appropriate antibiotic.
In any case, it is recommended to ask for the consultation of your doctor and to avoid taking do-it-yourself initiatives or suggested by some articles on the internet, thus avoiding worsening or underestimating your health condition.
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