What Are the Stages of COPD?

February 05,2022

COPD, Chronic Obstructive Pulmonary Disease, is a group of lung conditions that cause your airway to narrow down, making it difficult to breathe. It is estimated that almost three million people in the UK are affected by COPD. Nearly 15% of adults with characteristics of obstructive lung disease may have coexisting asthma and COPD, and almost 50% of people with COPD remain undiagnosed.

COPD is the most common in smokers and people over 40. The disease is barely noticeable in its early stages and worsens over time. Hence, the earlier you know its existence, the better it is for you to treat it.

We have broken down the four COPD stages categorised by GOLD. Keep reading to learn more.

What is the GOLD System for Categorisation of COPD?

GOLD, Global Initiative for Chronic Obstructive Lung Disease, is a program started by the National Heart, Lung, and Blood Institute and WHO - World Health Organization. They issue international guidelines that doctors worldwide follow to diagnose and treat COPD.

The GOLD system classifies COPD in four stages using the Refined ABCD Assessment Tool that considers:

  • Spirometry Result - this confirms the initial COPD diagnosis and measures airflow obstruction
  • The British Modified Medical Research Council (mMRC) Questionnaire and the COPD Assessment Test (CAT) - which determines the severity of your symptoms and their effects on your life
  • Your risk of having a flare-up

Your COPD is classified from Stage or Grade 1 to 4. It gives your doctor valuable insight into monitoring and treating your COPD.

The Four Stages of COPD

Through the classification of stages 1 to 4, your doctor gets an idea about your level of airflow obstruction, which is measured by a machine called a spirometer.

With a spirometer, the doctor measures the total volume of air that you can breathe in one go - called the forced vital capacity (FVC), and the amount of air you can breathe in the first second after a hard exhale - called the forced expiratory volume in 1 second (FEV1).

Stage 1: Early

Your doctor will assign you a stage 1 COPD if your FEV1 is between 80 and 100 per cent of your predicted value.

  • Symptoms

At this stage, you may not have any noticeable symptoms. However, if you have some signs, they may include a cough and increased mucus production. It is common to mistake these COPD symptoms with a common cold.

  • Treatment

Your doctor may recommend a bronchodilator as medication to broaden the airways in your lungs. These medications are taken through an inhaler or nebuliser. They may also recommend that you get flu and pneumonia vaccines to prevent further complications with your respiratory symptoms.

Moreover, you should also consider changing your lifestyle habits if you smoke by quitting smoking and avoiding passive smoking to prevent COPD progression.

Stage 2: Mild

When your FEV1 drops to 50 to 79 per cent of your predicted value, your COPD is considered stage 2.

  • Symptoms

Your cough and mucus production increase and you may experience shortness of breath while walking and exercising. Generally, it is at this stage that people realise something is wrong with them and seek a doctor’s help.

  • Treatment

Your doctor may prescribe you a bronchodilator medication to increase the airflow to your lungs. They may even recommend you pulmonary rehabilitation, a group program designed to raise awareness and learn how to manage your condition in a better manner.

Stage 3: Severe

Stage 3 of your COPD is a severe stage where your FEV1 is between 30 to 50 per cent of your predicted value.

  • Symptoms

You may start getting frequent flare-ups at this stage, and your coughing may worsen. You may even find yourself gasping for air while doing everyday household chores and get more tired than usual.

Apart from this, other potential symptoms may include frequent cold, swelling in your ankles, tightness in the chest, wheezing, and trouble breathing deeply.

  • Treatment

Your doctor may recommend similar treatment options to stage 2. Moreover, depending on your severity, you may need oxygen support.

Stage 4: More Severe

Your FEV1 at this stage is less than 30 per cent of your predicted value, and you may even see a dip in your blood oxygen levels.

  • Symptoms

You may experience frequent flare-ups that can be potentially fatal, along with trouble breathing even while at rest.

  • Treatment

Treatment options for this stage are similar to stage 2, and your doctor may also recommend lung surgery. Surgery options include lung transplant, bullectomy and lung volume reduction surgery.

Consult our medical experts to find out the stage and severity of your COPD.

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Living With COPD

It does not matter what stage your COPD is at; you need to change your lifestyle habits.

Lifestyle changes to make to cope up with COPD

Start with quitting smoking. Smoking will continue to damage your lungs, progressing the severity of your COPD.

Your doctor may also recommend medicines such as Atrovent & Clenil Modulite. Take them as suggested. Regular exercise improves your cardiovascular health and strengthens your respiratory muscles, decreasing COPD symptoms.

Additionally, maintain a low-carb diet filled with vegetables, healthy fats, protein, and unprocessed foods to control the symptoms and maintain a healthy weight. Avoid eating fruits like peaches and apricots. They cause bloating, which may add up to your breathing problems.


COPD is not a curable disease, but you can control its progression and flare-ups with early diagnosis and treatment. The key is to manage it well. A healthy lifestyle, medication, and regular exercise recommended by your doctor are what will help you.