Why Your Hands and Feet Are Always Cold—and What Your Body’s Trying To Tell You

Whether you’re lying on the sofa, sitting at work or walking around outside, your hands and feet are always cold. Maybe your partner has commented on this, too, when they held your hand. Maybe you’ve noticed you’re always searching for a pair of socks. Regardless, what’s up with the constant cold in your extremities? Is it a bad thing?

“Persistent cold hands and feet often indicate an underlying issue,” says Dr. Deepak Khanna, DO, an internist and family medicine physician at UPenn and the founder of dandRX.Ahead, he and another doctor share and explain possible reasons.

Why Your Hands and Feet Are Always Cold

Here are possible reasons why your hands and feet are always cold:

A vascular issue, such as peripheral artery disease or poor circulation

AKA, something related to your blood vessels. “This is the one I want to personally make sure I check for first,” Dr. Khanna says. “I want to first assess pulse [and] capillary refill, and make sure there is no vascular issue that needs further testing.”One potential problem that may be wrong here, he continues, is peripheral artery disease, which can get serious very quickly. Symptoms include muscle weakness, hair loss, decreased or absent pulses in the feet, and sores or ulcers on the feet that don’t heal.A less scary-sounding possibility is poor circulation. Besides cold hands and feet, you may notice muscles that hurt or feel weak when you walk, a “pins and needles” sensation, a pale or blue skin color, and numbness. “When blood flow to the extremities is reduced, the body has a harder time keeping those areas warm,” explains Dr. Jennifer Habashy, NMD, MS, a naturopathic doctor and assistant medical director at Claya. She says poor circulation is “one of the more common reasons.”

What helps, Dr. Habashy continues, is staying active with daily movement, wearing warm socks or gloves and trying contrast hydrotherapy (so alternating warm and cold water on your hands and feet).

Raynaud’s disease

Raynaud’s is when small blood vessels narrow in response to cold temperatures or stress. Signs include areas of skin turning white then blue, and a numb, prickly feeling or stinging pain upon warming up or easing stress.The good news is it’s treatable. “With Raynaud’s or circulation-related issues, keep warm, avoid smoking, limit caffeine and manage stress,” Dr. Khanna says. To manage stress, he recommends cognitive behavioral therapy (CBT) and mindfulness.

Hypothyroidism 

Hypothyroidism is an underactive thyroid. But how does that affect the temperature of your hands and feet? Dr. Habashy says it’s “where a sluggish thyroid slows down metabolic activity, reducing the body’s ability to generate heat.”

Other signs include fatigue, weight gain, joint and muscle pain, constipation, dry skin, thinning hair and more. “Cold intolerance is very common in hypothyroidism,” Dr. Khanna adds. “I always check for this.” To determine if you have this condition, these doctors recommend getting a full thyroid panel at your doctor’s office.

Anemia

Anemia is a common blood disorder in which a person doesn’t have enough red blood cells, or the ones they have don’t function properly.

“Anemia is also a frequent contributor, as low iron levels impair oxygen delivery to tissues, which can make the extremities feel cold,” Dr. Kabashy explains. Additional signs include weakness, shortness of breath, dizziness, irregular heartbeat, headache, chest pain and others.

This condition needs to be assessed by your primary care provider, Dr. Khanna says, who can order a CBC (AKA, a complete blood count) test and iron studies. He and Dr. Habashy also recommend addressing the nutritional side of things; make sure you get enough iron, B12 and folate in your diet. Some of the foods that have those nutrients include: 

• Iron: Strawberries, shrimp, sweet potatoes, rye bread, maple syrup

• B12: Clams, 100% fortified breakfast cereal, fortified soy milk, nonfat plain Greek yogurt, ham

• Folate: Dark green leafy vegetables, peanuts, sunflower seeds, whole grains, eggs

Nutritional deficiencies 

To add to that earlier point, being deficient in vitamin B12, magnesium or healthy fats can also affect nerve function and circulation, according to Dr. Habashy. So, remember to eat those foods listed above. You can also get labs to assess which nutrients you’re deficient in.

“Persistent cold hands and feet aren’t always something to brush off,” she concludes.

“Paying attention to your patterns (and getting the right testing) can help uncover the root cause.”