Dear Alice,

I am constantly freezing. Even if it's 70 above, I am so cold. I can't always have a blanket on me with a heater. What could this mean? What can I do about it?

Dear Reader,

You’re not alone in wanting a brrrreak from being cold! In fact, many struggle with cold intolerance, or an atypical sensitivity to a cold environment or cold temperatures. And while being cold in certain parts of your body is actually adaptive — for example, having cold hands is oftentimes part of the body's natural response to regulate body temperature — feeling cold all the time could be indicative of an underlying medical condition. Read on for factors that contribute to body temperature, suggestions for warming yourself up, medical conditions that may cause you to feel cold, and what your health care provider may want to know.

Several physiological factors affect how quickly a person produces heat and how quickly that heat is lost, which might contribute to feeling like you're constantly freezing. One of these factors is diet; a diet lacking in essential vitamins and nutrients can slow down the body's metabolism, a process in which the body breaks down food and nutrients to produce energy or heat. Body composition is another contributing factor. For example, body fat is an insulator that plays a critical role in maintaining body temperature, and those with more muscle mass generate more heat. Age may also play a role in body temperature, as mechanisms that help regulate body temperature, such as vasoconstriction and shivering, are less effective in older people. Finally, males and females tend to differ in body fat and surface area (or shape), meaning that sex assigned at birth potentially influences the production and loss of heat. Relatedly, those who experience a menstrual cycle are more likely to be cold during their periods (menstruation).

Knowing what contributes to your body temperature may not be enough to change it. If you’re looking for a cheat sheet to find heat, try warming up by:

  • Wearing layers (such as long underwear) and outer garments (such as sweaters and jackets).
  • Wearing a hat or scarf to help prevent heat from escaping through your head.
  • Running your hands under warm water for a minute or two.
  • Drinking warm fluids such as tea, coffee, hot chocolate, or even just warm water.
  • Staying dry (when wet, the body loses heat at a faster rate).
  • Avoiding caffeine and nicotine since they're vasoconstrictors (substances that contract the smooth muscle in blood vessels, causing the vessels to constrict).

While occasionally feeling cold is common and can be remediated by these suggestions, a sense of persistent coldness is sometimes indicative of an underlying medical condition. These conditions include:

  • Anemia
  • Blood vessel problems (such as Raynaud's disease)
  • Underactive thyroid (hypothyroidism)
  • Diabetes
  • General poor health 
  • Chronic severe illness
  • Problem with the hypothalamus (controls body temperature)
  • Anorexia nervosa

List adapted from MedlinePlus.

If you have a persistent problem of coldness in your extremities, it’s recommended that you consult with your health care provider. They’ll likely ask several questions, such as: What parts of your body feel cold? What's the time frame in which your cold intolerance has occurred? Is it constant or just in select situations or times of the day? Is it a recent issue or have you experienced it most of your life? Has your intolerance to cold gotten progressively worse? Is it accompanied by any other symptoms, such as fatigue, weight loss or gain, muscle weakness, or joint or muscle pain? Considering the answers to these questions before meeting with your health care provider may prove helpful in better understanding your symptoms.

Whether you try some warming strategies or choose to consult with a provider, here’s hoping you can face the heat — and achieve it, too!

Alice!

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