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Thyroid Hormones
Cold intolerance is a commonly-known symptom of a condition called hypothyroidism. It occurs when the thyroid gland does not produce enough thyroid hormones. Thyroid hormones help regulate our metabolism and temperature. When the thyroid gland is not producing enough hormones, the body’s processes tend to slow down.

Generally, women tend to feel colder than men because the blood vessels near the skin constrict faster to divert blood to necessary organs.

Hypothyroidism
Your thyroid is a butterfly-shaped gland at the base of your neck. It helps to regulate your metabolism, the chemical reactions that maintain the body. If this gland does not make enough thyroid hormone, or if your body cannot process that hormone effectively, you may become hypothyroid.

Besides feeling cold, other symptoms of hypothyroidism include:

Although you might naturally tend to be cold, many conditions could explain why you shiver whilst everyone around you seems to be unaffected. Top of the list is general ageing – people become more sensitive to the cold due to decreased metabolic rate and the thinning of fat under their skin.


Main symptoms that may appear in Anaemia.
Attribution: Häggström, Mikael (2014). “Medical gallery of Mikael Häggström 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. Public Domain.orBy Mikael Häggström, used with permission. Public domain, via Wikimedia Commons

Referenced as: eMedicineHealth > anaemia article Archived 2009-04-17 at the Wayback Machine Author: Saimak T. Nabili, MD, MPH. Editor: Melissa Conrad Stöppler, MD. Last Editorial Review: 12/9/2008.
File URL: https://upload.wikimedia.org/wikipedia/commons/9/91/Symptoms_of_anemia.png

Main Symptoms of  Anaemia
Feeling cold all the time can be a sign of a more serious medical condition, so it’s important not to ignore these symptoms.

Could It Be Anemia? [1]
Anaemia (also often referred to as low haemoglobin) happens when your system can’t make enough normal red blood cells to carry oxygen through your body. There are several different types of anaemia. A tendency to feel cold is a common symptom for many of them.

Other symptoms of anaemia:

  • Fatigue
  • Looking pale
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain
  • Cold hands and feet
  • Headaches

Anaemia is a condition where you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. According to a 2010 study published in American Family Physician, the condition is commonly overlooked in older people, with more than 10% of people over 65 being anaemic and the prevalence increasing with age. Lack of the essential vitamin B12 and iron deficiency can cause anaemia and lead you to feel cold. Good sources of B12 are chicken, eggs and fish.[2]

There are several types of anaemia. Mayo Clinic[3] lists several:

A pair of hands with a ring

Description automatically generated with medium confidence
The hand of a person with severe anaemia (on the left, with ring) compared to one without (on the right)
Attribution: James Heilman, MD, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0&gt;, via Wikimedia Commons

File URL: https://upload.wikimedia.org/wikipedia/commons/4/47/Anemia.JPG

Could it be a blood vessel problem? [4]
If you feel cold in your hands and feet, you may have a blood vessel disorder in which blood flow to your arms and legs is restricted. Blood vessel problems include conditions such as:

  • Clotting disorders
  • Arteriosclerosis (narrowing of blood vessels)
  • Raynaud’s disease (spasms of narrowing arteries to the fingers and toes)
  • Vasoconstriction (see below)

Besides feeling cold, symptoms of blood vessel problems include:

  • White or blue colouring in fingers and toes
  • Tingling, throbbing, or numbness in your arms and legs
  • Clammy and cold skin

Vasoconstriction[5] is the narrowing of the blood vessels resulting from the contraction of the muscular wall of the vessels, particularly the large arteries and small arterioles[6]. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in controlling haemorrhages and reducing acute blood loss. When blood vessels constrict, the blood flow is restricted or decreased, thus retaining body heat or increasing vascular resistance. This makes the skin turn paler because less blood reaches the surface, reducing heat radiation. On a larger level, vasoconstriction is one mechanism by which the body regulates and maintains mean arterial pressure[7].


3D Medical animation still showing normal blood vessel (L) vs. vasodilation (R)
Attribution: www.scientificanimations.com, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0&gt;, via Wikimedia Commons

File URL: https://upload.wikimedia.org/wikipedia/commons/2/2d/Vasodilation.jpg

Medications causing vasoconstriction (known as vasoconstrictors) are one type of drug used to raise blood pressure. Generalised vasoconstriction usually increases systemic blood pressure, but it may also occur in specific tissues, causing a localised reduction in blood flow. The extent of vasoconstriction may be slight or severe depending on the substance or circumstance. Many vasoconstrictors also cause pupil dilation. Medications that cause vasoconstriction include antihistamines, decongestants, and stimulants. Severe vasoconstriction may result in symptoms of intermittent claudication[8].

Might it be Diabetes?
The kidney damage that happens due to diabetes is known as diabetic nephropathy. One symptom of diabetic nephropathy is feeling cold all the time.

Other symptoms of diabetic nephropathy include:

  • Nausea and vomiting
  • Itchiness
  • Loss of appetite
  • Shortness of breath
  • Confusion
  • Swelling in the face, feet or hands

Diabetes can cause anaemia and kidney and circulation problems, resulting in feeling cold. It can also lead to nerve damage and peripheral neuropathy.[9]

Could it be Peripheral Artery Disease? [10]
Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease (PAD), your legs or arms — usually your legs — don’t receive enough blood flow to keep up with demand. You can often successfully treat peripheral artery disease by exercising, eating a healthy diet, and quitting smoking.

Peripheral artery disease signs and symptoms include:[11]

  • Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other side
  • Sores on your toes, feet or legs that won’t heal
  • A change in the colour of your legs
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • Shiny skin on your legs
  • No pulse or a weak pulse in your legs or feet
  • Erectile dysfunction in men
  • Pain when using your arms, such as aching and cramping when knitting, writing or doing other manual tasks

Peripheral artery disease is often caused by atherosclerosis, where fatty deposits build up on the artery walls and reduce blood flow. Although atherosclerosis is usually focused on the heart, the disease can, and usually does affect arteries throughout the body. When it occurs in the arteries supplying blood to your limbs, it causes peripheral artery disease.[12]

Could it be Anorexia? [13]
Anorexia is a type of eating disorder. People with anorexia become dangerously thin because they overly worry about gaining weight.

Feeling cold is one of the symptoms of being anorexic. Other symptoms are:

  • Being 15% or more below the typical body weight for your height.
  • Constantly thinking about your weight.
  • For women before menopause, not having had a period for three months or more.

Could it be due to Kidney Disease? [14]
Diabetes and high blood pressure often lead to kidney disease, which means that your kidneys don’t function properly in filtering your blood. Waste can build up to dangerous levels, which can cause lower core body temperature.

Could it be due to Medication Complications? [15]
According to the Cleveland Clinic, some drugs may make you feel colder as a side effect, including beta-blockers used for heart disease. These blockers help the heart relax but also may cause you to feel dizzy, tired, nauseous, and colder in your hands and feet.

Other medications that may cause coldness (with links to a description of the drug together with the frequency and degree of coldness) include: [16]

Could it be due to Raynaud’s Disease? [17]
Raynaud’s Disease (aka Raynaud’s syndrome, or Raynaud’s phenomenon) affects the arteries in the fingers, toes, or both. These arteries become narrow, which reduces blood flow. During these episodes, the fingers and (less commonly) toes, can turn blue or white. As blood flow returns, the fingers and toes can become red and feel numb or painful. Rarely, the nose, ears, or lips are affected. The episodes classically result in the affected part turning white, then blue.

Episodes are typically triggered by cold or emotional stress.

A picture containing person, indoor, hand Description automatically generated
Example of Raynaud syndrome on the hand of a female airman
Attribution: Profpedia at English Wikipedia, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0&gt;, via Wikimedia Commons

File URL: https://upload.wikimedia.org/wikipedia/commons/1/1f/Raynaud_syndrome_on_female_airman%27s_hand.jpg

Primary Raynaud’s, also known as idiopathic, means that it is spontaneous, of unknown cause, and unrelated to another disease. Secondary Raynaud’s occurs as a result of another condition and has an older age at onset; Secondary Raynaud’s can occur due to a connective tissue disorder such as scleroderma or lupus, injuries to the hands, prolonged vibration, smoking, thyroid problems, and certain medications, such as birth control pills. Diagnosis is typically based on the symptoms. The primary treatment is avoiding the cold. Other measures include the discontinuation of nicotine or stimulant use.

About 4% of people have the condition. The onset of the primary form is typically between ages 15 and 30 and occurs more frequently in females. The secondary form usually affects older people. Both forms are more common in cold climates. Cold temperatures and stress can trigger episodes of Raynaud’s. Treatment involves avoiding triggers if possible and, for some people, medication or surgery.

What Should I Do About My Coldness?
If you feel cold frequently, even when you’re in a warm place or long after you’ve come in from cold temperatures, check with your doctor to find out what might be going on.

Symptoms and Signs of Hypothyroidism
Attribution: Häggström, Mikael (2014). “Medical gallery of Mikael Häggström 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. Public Domain. By Mikael Häggström, used with permission., CC0, via Wikimedia Commons.

File URL: https://upload.wikimedia.org/wikipedia/commons/9/9f/Signs_and_symptoms_of_hypothyroidism.png

Signs and Symptoms of Hypothyroidism
The treatment for your chronic coldness will depend a lot on the cause. For example, if you have a blood vessel disorder and you are a smoker, quitting smoking will probably go a long way toward helping with the problem. If your feelings of constant coldness are caused by a thyroid condition, on the other hand, you may need medication to reverse your low thyroid.

Sources and Further Reading

Caution: No advice is implied or given in articles published by us. This guide is for general interest only and is compiled from the sources stated but has not been medically reviewed. It should never be used as a substitute for obtaining advice from your Doctor, a consultant Thyroidologist/Endocrinologist or other qualified clinician/medical practitioner. If you have already been given dietary advice you should not make changes without first talking to your GP, consultant or dietitian. Any medications mentioned may include names for US drugs. The information contained in this paper is provided for informational purposes only. There is no implied endorsement or promotion by the writer of any organisation. The facts are believed to be correct as at the date of publication, but there may be certain errors and omissions for which we cannot be responsible. The hyperlinks were valid at the date of publication.

  1. Source: https://www.webmd.com/a-to-z-guides/understanding-anemia-symptoms
  2. Source: https://www.aarp.org/health/conditions-treatments/info-2018/reasons-for-being-cold-fd.html
  3. At: https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360
  4. Source: https://www.webmd.com/a-to-z-guides/rm-quiz-blood-basics
  5. Source: https://en.wikipedia.org/wiki/Vasoconstriction
  6. An arteriole is a small-diameter blood vessel in the microcirculation that extends and branches out from an artery and leads to capillaries. See Maton, Anthea; Jean Hopkins; Charles William McLaughlin; Susan Johnson; Maryanna Quon Warner; David LaHart; Jill D. Wright (1993). Human Biology and Health. Englewood Cliffs, New Jersey: Prentice Hall. ISBN 0-13-981176-1.
  7. The definition of mean arterial pressure (MAP) is the average arterial pressure throughout one cardiac cycle, systole, and diastole. Source: National Library of Medicine at: https://www.ncbi.nlm.nih.gov/books/NBK538226/
  8. Intermittent Claudication is muscle pain that happens when you’re active and stops when you rest. It’s usually a symptom of blood flow problems like peripheral artery disease. Over time, this can get worse and lead to serious health problems and complications. The condition is usually treatable, especially with early diagnosis. Source: Cleveland Clinic at: https://my.clevelandclinic.org/health/symptoms/22046-intermittent-claudication
  9. Source: https://www.aarp.org/health/conditions-treatments/info-2018/reasons-for-being-cold-fd.html
  10. Sources: https://www.aarp.org/health/conditions-treatments/info-2018/reasons-for-being-cold-fd.html, https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557
  11. Source: https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557
  12. Ibid
  13. Source: https://www.webmd.com/mental-health/eating-disorders/signs-of-eating-disorders
  14. Source: https://www.aarp.org/health/conditions-treatments/info-2018/reasons-for-being-cold-fd.html
  15. Sources: https://www.aarp.org/health/conditions-treatments/info-2018/reasons-for-being-cold-fd.html, http://sideeffects.embl.de/se/C0234192/pt and https://health.clevelandclinic.org/why-am-i-always-cold/
  16. Source: http://sideeffects.embl.de/se/C0234192/pt
  17. Sources: https://www.medicalnewstoday.com/articles/325151#causes and https://en.wikipedia.org/wiki/Raynaud_syndrome

 


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