What Are COPD GOLD Stages?

The GOLD COPD Stages

While staging is useful for a physician to understand the severity of a patients breathing limitation it doesn’t necessarily relate to how a patient is feeling. A patient at GOLD 1 stage can be less symptomatic than a patient at GOLD 2.

In order to have a precise idea of a patient’s quality of life new guidelines have been introduced.

COPD Assessment Test (CAT) and COPD Control Questionnaire (The CCQ) have been added to the diagnostic guidelines to give a better overall picture of a patient’s disease and quality of life. These questionnaires identify in more detail the symptoms a patient is experiencing as well as any hospital admissions.

Identifying as many factors as possible which effects a patient will give doctors and respiratory professionals the ability to individualize pharmaceutical and non-pharmaceutical treatments.

Stage 1 of COPD

Many patients have told me their COPD diagnosis was made after significant damage to their lungs had already taken place.

This is quite common as many patients don’t notice their symptoms in the early stages. It’s not until their symptoms have become limiting that they make a doctor’s appointment.

This where it’s important for doctors and the general public to be aware of the risk factors for COPD:

  • Cigarette smoke – Still one of the primary causes of COPD.
  • Indoor and outdoor pollutants – Wood fires and poor ventilation inside the home, air pollution outdoors.
  • Asthma – If poorly managed, Asthma may develop into COPD.
  • Genetic factors – Alpha-1 antitrypsin is hereditary if there is a family history you should contact your doctor immediately.

Stage 2 of COPD

At this stage, a patient could expect to notice shortness of breath and possibly an increase in coughing and sputum production.


Daily routines can start to become more challenging and affect your quality of life. Slowing COPD can be beneficial if a COPD management plan can be put in place in the early stages.

Stage 3 of COPD

When lung function falls below 50 percent, COPD becomes very tiring and burdensome.

Activities may be made more challenging for patients who don’t manage their disease. With the lack of management, patients may expect to see new symptoms or existing ones progress quickly.

Walking up inclines such as hills or stairs can cause significant breathlessness and the number of exacerbations a patient has during the year can increase.

Stage 4 of COPD

Patients at this stage of COPD will be breathless all the time and will battle with fatigue due to the extra energy required just to breathe. Infections are common in patients with severe and very severe COPD.

Minimizing exposure to people who are sick is paramount. Exacerbations and hospital admissions can increase dramatically at this stage with the immune system constantly under attack.

Respiratory failure is more common when COPD has reached the very severe stage. Respiratory failure is when the respiratory system fails to exchange oxygen and carbon dioxide effectively, resulting in a state of hypoxia.

Hypoxia is a lack of oxygen in a patient’s blood. It can be corrected by the use of oxygen therapy.

Symptoms of hypoxia may include:

  • A change in skin color, ranging from blue to red
  • Disorientation
  • Fast heart rate
  • Rapid breathing rate
  • Shortness of breath

If you’re experiencing any of these symptoms contact your doctor immediately.

Next page: Understanding COPD progression, what the end stage means for you, and treatment options to live a fuller life. 

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