Hands and feet get cold easily

Dear Alice,

My fingers and toes are always cold, even when it is really warm out. How do I keep them from being cold all the time?

Dear Reader,

Glad you didn’t get cold feet about asking this question! But all jokes aside, there are a lot of reasons why your hands and feet might feel cold even in warm climates, ranging in seriousness from underlying medical conditions to simply being the way your body normally functions. You know how sometimes you’ll walk down the street and notice some people are wearing shorts and a t-shirt while others have a jacket and scarf on? Individuals can vary greatly in how warm or cold they perceive the same environment to be depending on their own personal tolerance, body temperature, and other factors. Similarly, some people are simply more prone to cold hands and feet than others, and while this doesn’t necessarily indicate any medical problem, it may be a sign of an underlying condition.

Some people’s extremities get cold easily because of how their body regulates temperatures. Others may have very low body fat, meaning there’s less insulation to keep their bodies warm. Cold hands and feet may also be caused by an underlying condition, such as:

  • Anemia
  • Diabetes
  • Lupus
  • Peripheral artery disease (PAD)
  • Raynaud’s disease
  • Rheumatoid arthritis
  • Scleroderma
  • Thyroid conditions

Clearly, these illnesses range in seriousness from mild to severe, and it’s also possible to have cold fingers and toes without any of these underlying conditions. Often, when cold hands and feet are a symptom of an illness, other major symptoms are also present; when cold hands and feet are the only symptom, then it’s more likely to be a benign — though potentially annoying — feature of how the body normally functions.

However, with Raynaud’s disease, cold hands (and sometimes feet) are actually the main symptom. Part of the body’s natural response to cold temperatures is to constrict blood vessels to minimize heat loss; in someone with Raynaud’s, this natural constriction process is overly strong in the fingers and toes, resulting in cold extremities that may be accompanied by temporary changes in skin color (typically turning white, blue, or purple while cold and red once the body warms and blood vessels open again). In people with no other underlying diseases, Raynaud’s is typically benign, though the skin changing color may appear alarming to some people; however, if someone has underlying rheumatologic or vascular disease, Raynaud’s may be more serious and may require consultation with a health care provider to prevent damage to the skin of the fingers and toes.

Talking to a health care provider is the only way to determine the underlying cause of your cold fingers and toes and whether it’s anything to be concerned about. In the meantime, here are some ways to keep your extremities warm:

  • Wear well-insulated footwear: Wool socks or layers of thinner socks can help keep your feet warm.
  • Wear mittens instead of gloves: When in cold environments, consider investing in some waterproof mittens if you’ll be outdoors in wet or snowy environments.
  • Wear layered clothing: Thin, warm layers help preserve your core temperature and allow you to easily add and remove layers as the temperature, your environment, and your activity level changes.
  • Stay dry: Getting soaked is more likely to make your hands and feet cold, so try to stay out of the rain.
  • Avoid tight clothing: Wristwatch bands, shirt cuffs or too-tight gloves or mittens may cause poor circulation and result in chilly hands, so make sure your clothing and accessories fit properly.
  • Keep circulation up in your extremities: Wiggle your hands and feet regularly to maintain proper circulation and increase blood flow to your digits. 
  • Avoid caffeine and nicotine: These are vasoconstrictors that may exacerbate the effect of the cold.
  • Keep moving: Be physically active regularly to maintain good cardiovascular health.

 Wishing you a warm and toasty time ahead!

Last updated Sep 02, 2022
Originally published Nov 20, 2014

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