Cold Extremities: Why Do I Have Cold Hands and Feet?

There could be an underlying cause behind your cold extremities—or it could be just a growing sensitivity to lower temperatures.

cold extremities

Cold extremities: The condition can come with age, or it could be the sign of a circulatory problem.

© Wavebreakmedia Ltd |

If you’re starting to experience cold extremities more frequently these days, you may want to share those cold hands and feet symptoms with your doctor at your next visit. Chances are there is nothing seriously wrong with your health to trigger chilly fingers and toes. But because circulation problems may be to blame, it’s worth it to find out what’s causing this change. Cold hands and feet may be the first sign of a larger health challenge.

“People can have cold hands for a variety of reasons,” says Winston Sequeira, MD, a rheumatologist and associate director of the Lupus Clinic at Rush University Medical Center in Chicago. “Most commonly the underlying cause is vascular—that is, relating to blood vessels.”

In Cold Blood

In cold weather, blood flow to your extremities dips a little to make sure important organs, such as your heart and brain, get plenty of blood. This change in circulation is also meant to retain heat in the body’s trunk, leaving the limbs to fend for themselves, so to speak.

Reduced blood flow to your limbs occurs when the arteries in your extremities spasm or narrow, constricting the space in which blood can flow.

“When we go out in the cold weather, our blood vessels spasm to prevent heat loss from the body,” says Dr. Sequeira. “In some individuals, this spasm occurs when they are exposed to cool temperatures that wouldn’t bother most people—sometimes just an air-conditioned room—and their fingers turn white, then blue, then red. This is called Raynaud’s phenomenon.”

Realities of Raynaud’s

Raynaud’s phenomenon affects less than 10 percent of the general population, with women much more likely than men to develop this condition. However, the Raynaud’s Association reports that there may be millions of people in the U.S. alone who suffer from the disorder without realizing it’s causing these responses in their hands.

Raynaud’s has two basic types: primary and secondary.

  • Primary Raynaud’s, which is sometimes called Raynaud’s disease, has no known cause. It’s simply an abnormal response by the arteries to some type of stimuli. Holding a glass of iced tea or washing your hands under cold water could trigger such as response.
  • Secondary Raynaud’s is usually more severe, and it’s the one known as Raynaud’s phenomenon. This type results from a disease or injury or as a side effect of certain medications. Some of the drugs associated with Raynaud’s include beta blockers (for high blood pressure) and migraine headache medications that contain ergotamine and sumatriptan.

“When Raynaud’s is due to a disease, it often happens in people with a connective tissue disease—one that affects blood flow to tissues and organs,” explains Paula Berry, MD, with the University of Pennsylvania.

Connective tissue diseases include Marfan syndrome and Ehlers-Danlos syndrome, as well as some autoimmune diseases (including lupus and rheumatoid arthritis).

Treating Raynaud’s usually starts with lifestyle modifications (such as wearing gloves and thick socks when the temperature drops) and avoiding triggers (medications or stress, for example). You may head off Raynaud’s attacks by soaking your hands under warm water or increasing your physical activity level. Limiting repetitive hand motions, such as piano playing or typing, may also help.

“If lifestyle modifications do not work, medications that improve blood flow to the toes and fingers, such as calcium channel blockers and prescription skin creams, can often do the trick,” Dr. Barry says.

Other Causes of Cold Extremities

Many other conditions can also leave your fingers and toes cooler than is comfortable. For example, hypothyroidism (underactive thyroid) can cause a greater sensitivity to cold temperatures and a slight decrease in body temperature. This can be felt most acutely in your extremities.


Causes of cold extremities stem from one of the physical ailments described here—but pay attention also to simple measures for staying warm in cold weather. You’ll find common-sense advice in The Old Farmer’s Almanac post How to Keep Warm in Winter.

The following conditions also affect the circulation and/or nerves in your hands and feet:

  • Anemia: This common blood disorder (sometimes resulting from low iron levels), can reduce oxygen levels in the blood. One result is cold hands and feet.
  • Diabetes: One complication of diabetes is diabetic neuropathy, which results in a loss of feeling and sensitivity in the extremities. You may feel especially cold or, even riskier, you may not realize how cold your hands and feet are in very low temperatures. This can put your hands and feet at risk of permanent harm.
  • Stress: The surge of adrenalin that accompanies stress can cause the blood vessels to constrict, reducing blood flow.

What You Should Do About Your Cold Hands And Feet

If you notice you’re experiencing cold extremities in situations where you used to tolerate just fine, pay attention to other signs that may also have developed recently. Reporting detailed symptoms will help your doctor make a diagnosis, since some conditions aren’t easily identifiable with tests or screenings.

However, conditions such as diabetes and heart disease can be diagnosed through blood tests and other screenings.

If you haven’t had blood work done recently, talk with your doctor about getting a complete blood count (CBC), as well as a test of your fasting blood glucose (sugar) to check for diabetes. And if you have any signs of cardiovascular disease, including those listed below, see a doctor soon:

You may just be a little more cold-sensitive than you used to be. But, those cold fingers may be pointing you toward a much-needed checkup.

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Jay Roland

Jay Roland has been executive editor of Massachusetts General Hospital’s Mind, Mood & Memory since 2017. Previously, he held the same position with Cleveland Clinic’s Heart Advisor, since 2007. In … Read More

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