6 Reasons Your Hands and Feet May Always Be Cold:

Are your friends complaining that your hands are always cold? Do you find yourself longing to be warmed by the sun, sit by a blazing hot fire or turn the thermostat up to 80 degrees when others feel comfortable in a 70-degree climate? There can be many reasons that you may be experiencing these feelings of coldness when others are comfortable. Your body temperature is controlled by an area that lies deep in the brain called the hypothalamus. It keeps the temperature of your body tightly regulated by the release of hormones that help to regulate the flow of blood throughout your body. Your circulatory system is uniquely designed to help your body control temperature by changing the amount of blood flow to certain areas of our body like your hands and feet.

Weight

There are other factors that can contribute to your feelings of coldness that you may be experiencing. Your body is designed to stay warm by having a layer of insulation (also called body fat) that helps you to stay warm much like layers of clothing do. Thinner layers of clothing will make you feel colder than you would if you were to be bundled up.  If you have a low percentage of body fat, or suffer from a condition such as anorexia nervosa, which can make eating seem difficult, you may not have enough body fat to provide you with the insulation you need to stay warm. Being too thin eliminates our protection from the cold. If you suspect you may be underweight or struggle with a food related issue, it may be time to talk to your doctor about what a healthy weight may be for your frame.

Anemia

Anemia, which can be due to not having enough red blood cells or having red blood cells that are too big, can also be a factor that can lead you to feel cold. Our red blood cells carry oxygen around to the cells and tissues in your body and if your red blood cells are too few in number or too big, your cells won’t be getting enough life giving oxygen. Your body compensates for this by vasoconstricting and “shunting” or re-routing blood to the places your body needs it most, such as your core and internal organs. The result of this “shunting” process is cold hands and feet. If you suspect you may have anemia, see your doctor for some simple blood tests.

Thyroid

Thyroid disease is another cause of feeling cold or having cold extremities. You have a gland that sits at the base of your neck called the thyroid gland. This gland produces a hormone called thyroid hormone which helps you to regulate your metabolism and thus the generation of heat by your body. If there is a problem with your thyroid gland which causes you to not make enough thyroid hormone, your metabolism can be diminished and thus your body will generate less heat. The treatment for this condition involves seeing your doctor to have blood tests done and taking medicine if needed to replace the hormone your body should be making, or finding out why your body isn’t able to make enough hormone to keep you healthy.

Poor Circulation

Another culprit for causing cold hands and feet is known as poor circulation. This can be due to diseases such as atherosclerosis or hardening of the arteries and issues such as diabetes, which can impact your body’s ability to regulate blood flow and get blood to where it is needed.  If your blood vessels are narrowed by the build-up of cholesterol or atherosclerotic plaque deposits, the lack of blood flow will result in cold hands and feet.  The treatment for this condition includes prevention of plaque build-up and lots of good old fashioned exercise like walking.

Raynaud’s Disease

Another condition which can result in poor blood flow to your extremities is called Raynaud’s disease. This is a condition whereby your body has a tendency to vasoconstrict your blood vessels with even the slightest exposure to cold temperatures.  Your fingers can become white and painful due to the lack of blood flow. This condition can occur all by itself for reasons that are not completely clear or can be associated with other diseases such as autoimmune conditions whereby the body turns against itself to create illness. The best way to know if this is an issue for you, is to have a visit with your doctor who can do blood testing to help determine the cause of your symptoms. Keep in mind that medications also, such as those in the beta blocker class (eg., atenolol) can cause vasoconstriction of blood vessels as a side effect. Always check with your doctor before stopping any medications.

Stress

Finally, since stress seems to affect everything in a negative way, it’s not surprising that it can affect your blood vessels by causing the release of fight or flight hormones such as epinephrine and cortisol. These substances are made by our bodies to help our bodies “fight back” whenever a threat (real or imagined) to our well-being is encountered. These hormones get released and our blood vessels vasoconstrict and send blood to our muscles, heart and lungs, which allow us to defend ourselves against the enemy. And YES stress is an enemy. The best way to fight back against this predator is by prevention and stress management strategies such as biofeedback. Biofeedback and mindfulness based training won’t take away your stress but will help train your body to respond to the threat of stress. And, of course, there is always exercise which helps to raise your body temperature, blunt the release of cortisol and enhance the release of those calming endorphins which helps everything and everyone feel better. If you find you are having trouble managing your stress, seek help as there are lots of options available to help you better manage the stress that we know comes with life.

So, no more suffering with the adage that cold hands mean a warm heart. Keep your heart AND hands warm by tuning in to what your body needs most—TLC and lots of exercise.

Until next time, here’s to the best of your health

Elizabeth Salada MD, MPH

Internal Medicine and Wellness