Do you find yourself asking, “Why am I always cold?” Or needing a blanket when dining al fresco in 70-degree weather or a hot latte to warm your hands — even though you’re indoors?
If any of the above scenarios apply to you, you’re not alone. Many people report continually feeling cold — otherwise known as “cold intolerance” — even when it’s objectively mild outside. There are several factors that may be causing you to feel cold, and while many of them are manageable and easily identified, others may require a bit more sleuthing with the help of a seasoned medical professional.
Dr. Michael Gill, internal medicine physician at Advocate Health Care, and Dr. Daniel Rausa, gastroenterology fellow at Lenox Hill Hospital in New York, share five of the most common explanations for perpetual chills.
1. Anemia
If patients aren’t getting enough oxygen via the blood, they might have anemia, a condition typically resulting from iron deficiency. It’s accompanied by feelings of fatigue, shortness of breath, and coldness, since certain tissues aren’t getting the oxygen required for normal function.
“If you’re a woman with very heavy periods and have been more tired lately, or someone who has been experiencing irregular shortness of breath during their workouts, it might be because of an iron deficiency,” says Gill.
What to do: Bloodwork would reveal any vitamin deficiency that may be causing coldness and could help doctors determine the best dosage and choice of vitamin to incorporate into your routine.
2. Hypothyroidism
Fatigue, hair loss, an altered texture or appearance of skin, and sudden weight change are all potential signs of hypothyroidism. Under this condition, the thyroid doesn’t produce the required amount of hormones for normal everyday function.
“When we think about the thyroid, we’re thinking about how fast your engine is running,” says Gill. “If it’s running too slow, you might gain weight, feel more tired, and feel colder than usual because the engine isn’t warming up like it should be.”
What to do: If bloodwork determines hypothyroidism, hormone replacement therapy may help to restore healthy thyroid levels.
3. Raynaud’s Phenomenon
If your extremities feel the biggest chill — especially in cooler temperatures — it may be due to Raynaud’s phenomenon, a condition that causes the constriction of blood vessels that people most often feel in their fingers and toes.
“When you go outside on a cold day, your blood vessels are supposed to dilate [widen] to warm your hands. But people with Raynaud’s experience the opposite reaction — the vessels narrow to make the hands feel even colder,” says Gill.
What to do: Gill’s rule of thumb when it comes to Raynaud’s? Bundle up. “When you go outside, be sure to cover your extremities as best you can — warm socks and mittens are key.”
4. Low Body Fat
Adipose tissue, or body fat, is more than just stored energy — it insulates the body, acting “as a barrier to heat loss,” according to researchers. Factors contributing to inordinately low body fat, or underfat, include disordered eating, malnutrition, genetics, illness, and even too much exercise. And if you’re underfat because of disruptions in eating, your metabolism can additionally slow down, worsening your cold intolerance.
What to do: With the help of a nutrition specialist, a doctor can recommend an eating and exercise plan that promotes healthy, sustainable weight gain.
5. Diabetes
When not carefully regulated, diabetes may cause nerve problems that can lead to the altered perception of touch and sensitivity to the cold. “When the nervous system is affected, people have a difficult time in regulating their environment,” says Rausa.
What to do: As with all of the aforementioned scenarios, Rausa recommends developing a comprehensive plan with your doctor to determine the best way to manage and resolve symptoms. “With neuropathy from diabetes, it’s important to manage symptoms with lifestyle changes, diet, and medication, depending on specific variables to be discussed with your doctor.”
Is It Normal to Always Feel Cold?
When seeing patients who complain of constantly feeling cold, Dr. Gill always starts with one important question: How long have the symptoms been occurring?
“If it’s a case where a patient has been experiencing symptoms for their entire life, it’s very possible that that’s just how their body operates. But if symptoms started for the first time a week ago, then there may be a medical issue,” he says. “It’s the reason I always ask patients if these sensations are relatively new, followed by whether they’re experiencing any other symptoms that accompany this one.”
Dr. Rausa agrees. “We always like to start with what we call a ‘review of systems,’ in which we get a broad overview of the patient’s current state and a sense for whether there are other symptoms potentially causing the primary symptom of feeling cold,” he says.
Symptoms like fatigue, hair loss, weight gain, or weight loss all might raise flags for doctors when speaking with patients. Such symptoms may signal an array of underlying medical issues, from anemia to hypothyroidism.
For this reason, Rausa stresses the importance of having a comprehensive conversation with your doctor about your health. He also suggests keeping a journal of symptoms to share with your doctor, to ensure you leave no stone unturned.
“What it boils down to is: What is the bigger picture saying? What other symptoms might be occurring that the patient and doctor can really home in on together to unearth what’s really going on to cause these symptoms?”
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