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What Are the Tests for COPD?

COPD Basics

May 14, 2024

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RgStudio/Getty Images

RgStudio/Getty Images

by Elizabeth Pratt


Medically Reviewed by:

Nick Villalobos, MD


by Elizabeth Pratt


Medically Reviewed by:

Nick Villalobos, MD


Here are the tests used to diagnose and monitor COPD and how they can determine your best treatment options.

COPD can cause damage to your airways and lungs, making it difficult to breathe. Your care team may use a variety of tests to diagnose chronic obstructive pulmonary disease (COPD), rule out other conditions, and monitor how your disease is progressing over the years.

According to the American Lung Association (ALA), you’ll need ongoing tests to monitor your symptoms. These might include lung function tests, imaging, blood work, exercise tests, and more.

There are a lot of terms to learn and understand — which can feel overwhelming at first. We’re here to break down the different types of tests for COPD:

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Lung function tests

A lung function test can help your doctor figure out how well your lungs are working. These tests aren’t painful.

The ALA says that your COPD care may include the following lung function tests:


A spirometry test helps healthcare professionals identify COPD before you notice your symptoms might be related to a condition. It’s the main method of testing for COPD.

Spirometry measures how much air you can breathe out, as well as how fast you can blow air.

It involves taking a deep breath in, then blowing as hard as you can into a tube connected to a spirometer machine. According to the National Heart, Lung, and Blood Institute, you might feel lightheaded or tired from the effort it takes to breathe this way. Your care team will give you a chance to feel better before repeating the test or moving forward with your appointment.

Your doctors might also use spirometry to rate how severe your condition is and understand which treatment option is best for you.

Peak expiratory flow (PEF) test

A peak expiratory flow test may use a spirometer machine or a small handheld device. Similar to a spirometry test, a PEF test measures the rate of how fast you can blow air when using the maximum effort possible.

FeNO test

A fractional exhaled nitric oxide (FeNO) test measures the level of nitric oxide in your breath.

High amounts of nitric oxide could mean that you have inflamed airways in your lungs, which can make breathing difficult. During a feNO test, a healthcare professional will ask you to breathe out steadily into a tube.

Lung volume test

A lung volume test measures the amount of air you can hold in your lungs. You’ll be asked to sit in a small room with clear walls. You might be told to breathe in a mix of gases and wear a clip on your nose.

This test is also similar to spirometry, so some people may feel lightheaded or tired after the test.

Lung diffusion capacity test

A lung diffusion capacity test involves breathing in and out steadily into a tube for several minutes. This test will help your doctors analyze how well oxygen makes it into your blood from the air you inhale.

You may also be asked to undergo a blood test to measure your hemoglobin levels (a protein in red blood cells that carries oxygen).

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Imaging tests involve taking pictures of your lungs and the structures in your chest. They often include CT scans or chest X-rays.

CT scan

A CT scan may be used to determine the type of COPD you have, the progression of your disease, or the severity of your disease.

You’ll be asked to lie flat on a bed that moves through a doughnut-shaped scanner device. You’ll need to stay still and hold your breath for a few seconds.

Chest X-ray

A chest X-ray is versatile. It can be done while you’re standing, lying down, or sitting. During an X-ray, a technician will take images of the inside of your chest, including your lungs, heart, blood vessels, and ribcage.

While an X-ray isn’t used to diagnose COPD, it can be used to help rule out other conditions that might cause similar symptoms, like heart failure. Plus, your care team might order X-rays to find any changes to your lungs that could happen due to COPD.

Blood tests

You’re probably familiar with getting blood work done regularly over the course of your life — whether it’s a routine physical or follow-up blood work to check numbers or ranges for specific diseases.

A blood test may be used to help doctors diagnose you with COPD or monitor your oxygen levels during treatment. Here are a couple of blood tests you might see on your medical records:

Arterial blood gas test

An arterial blood gas test measures how much carbon dioxide and oxygen are in your blood.

This is usually done in a hospital, but it can be completed outpatient in a doctor’s office. It involves a blood sample being taken from an artery, usually the wrist.

Alpha-1 testing

Many organizations recommend that people living with COPD get tested for alpha-1 antitrypsin (AAT) deficiency.

This is a rare genetic disorder, meaning it can be passed down in families. It can affect the lungs and lead to COPD.

A simple blood test can determine the level of AAT in your blood.

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Exercise tests

Your doctor may order an exercise test to determine how short of breath you are when exercising. This will also happen during pulmonary rehabilitation. You’ll be closely monitored to ensure you’re safe and not overexerting yourself.

6-minute walking test

The 6-minute walking test is an exercise or stress test that measures the distance you can walk in 6 minutes.

This test will help your care team see your level of exertion during the exercise, as well as your oxygen levels during exercise.

The distance you can walk in a 6-minute period can help determine how severe your lung disease is. The test may be repeated in the future to monitor the progression of your disease.


Your healthcare team may use a variety of tests to diagnose you with COPD as well as rule out other possible conditions, like heart failure, that could have similar symptoms.

They can also use these tests to monitor your COPD progression and severity over the years.

These tests include lung function tests, imaging, blood work, and exercise tests. Your healthcare team can answer any questions or concerns you have before each test.

For support from others living with COPD, check out our forums on Bezzy COPD.

Medically reviewed on May 14, 2024

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About the author

Elizabeth Pratt

Elizabeth Pratt is a medical journalist based in Australia. She has a master’s degree in health communication and has worked across all forms of media. Her work has appeared in a variety of outlets like the Australian Broadcasting Corporation, Huffington Post, Fox News, Salon, The Sydney Morning Herald, Escape, and Theravive. When she’s not writing stories, you’ll find her in her yellow armchair, planning her next trip. Connect with her on Twitter.

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