Why Am I Always Cold?

Feeling cold is a sensation that your body notices and alerts your brain about. Then your brain goes into problem-solving mode. Your body might start shivering to make you feel warmer, or you might try to make some changes — like getting a blanket or moving to a new area — to make yourself warmer.

Sometimes, however, people feel cold more than normal. Your body controls your body temperature through a process called “thermoregulation.” If this system malfunctions or has trouble working due to another medical condition, it may be more difficult for you to feel comfortable temperature-wise.

Here, we’ll go over the issues affecting your body temperature, why you may feel cold more than others, and what you can do to feel more comfortable.

How is my body temperature controlled?

It’s important for your body to stay in a certain temperature range, regardless of the temperature of the environment that you are in. This is so that your cells and organs function correctly. Your body accomplishes this using a process called “thermoregulation.” It’s a complex process, but the basic idea involves your body continuously monitoring the temperature (using cells called “thermoreceptors”) and changing what it is doing to make you warmer or colder if you fall out of your ideal temperature range.

There are some other processes in your body that can impact your temperature, too:

• Metabolism: Your metabolism, or the way your body processes energy, can make you warmer or colder. Your thyroid gland regulates your metabolism. (More on this later.)

• Hormones: Body temperature can change with different hormone levels, particularly in women. In the days after ovulation, your body temperature can be 1°F higher on average than just before ovulation. 

• Time of day: Your body temperature rises throughout the day. An average person’s temperature will increase as much as 1°F from when they wake up to the end of the day.

• Infection: Your body temperature may increase and you may develop a fever when you are sick and fighting an infection. Your body is trying to stop the virus or bacteria with the higher temperature. 

Is being cold all the time a sign of a medical condition?

There are several medical conditions that can cause you to feel cold. Some of these are serious conditions, which is why it is important to let your healthcare provider know if you are feeling cold and are not sure why.

Anemia

When your body is having difficulty making blood or your body is losing blood, you can develop low blood levels (anemia). Your blood helps spread the warmth and oxygen throughout your body, and not having enough blood can lead to you feeling cold. Anemia can be dangerous, and we need to investigate what is causing it when we find it.

Hypothyroidism

When your thyroid is underfunctioning (hypothyroidism), your metabolism slows down. Your body stops producing as much heat and you can feel cold. Hypothyroidism is common and affects up to 4% of adults in the U.S. Luckily, it is easily treatable with medication that supplements your thyroid hormone and speeds your metabolism back up.

Blood flow problems

Your arteries are the blood vessels in your body that bring blood filled with oxygen to the rest of your body. Sometimes, arteries can develop areas where there is narrowing and even blockages. We call this “peripheral artery disease.” When blood flow is blocked or limited, it can lead to feelings of pain and coldness past where the blockage or narrowing is. 

Nerve problems

You can think about your nerves as “messengers” that take and deliver messages from your brain to the rest of your body. Over time, nerves can become damaged. Lots of things can cause nerve damage, including some vitamin deficiencies and high blood sugars. We call this nerve damage “neuropathy,” and it can lead to problems with temperature control.

Diabetes

When you have too much sugar in your blood over a long period of time, this can lead to diabetes. This excess sugar can cause damage to nerves — neuropathy, as described above — and lead to issues controlling temperature.

Eating disorders

People with the eating disorder anorexia may have very limited fat stores on their body. Fat stores help to keep warmth inside your body. (Think of your fat stores as part of your insulation). Because of limited fat stores, people with anorexia can have difficulty staying warm. 

Raynaud’s

This is a condition that is common and affects the very small blood vessels in your hands and feet. With temperature changes, these small blood vessels can “act up” and make your fingers and/or toes change colors. Sometimes, they will turn white and feel cold, and sometimes they will turn almost a blue-purple color and feel warm.

What are cold hands or cold feet a sign of?

Your hands and feet are the most common parts of your body to feel cold. This is for several reasons. First, they are the parts of your body furthest away from your heart, so when blood gets to them it may be cooler. They are also small in size (relative to other parts of your body) and have very small blood vessels. Sometimes, these blood vessels can get inappropriately small or large with changes in temperature (that concept of Raynaud’s, which we discussed above). Blood flow can be blocked or limited to your hands and feet due to disease in your arteries (called “peripheral artery disease”). This leads to a cold sensation in your hands and feet as well.

Are there medications that make you feel cold?

There are some medications that can make you feel cold. 

The most common medication class to cause you to feel cold are beta blockers. These are medications used for people with heart disease to slow the heart rate and lower blood pressure. They are important medications that can keep you alive longer if you have heart disease, so you should not stop a beta-blocker without discussing it with your healthcare provider. There may be other options for medication if beta-blockers are causing you to feel cold and uncomfortable. 

Many people take thyroid medication to help manage their thyroid if it is not functioning normally. It is sometimes hard to get the right dose for thyroid medication. If you don’t take enough medication for low thyroid (typically levothyroxine), you can feel cold. There are also several medications that treat an overactive thyroid, including propylthiouracil and methimazole. If these medications are dosed incorrectly, this can also lead to feeling cold, too. 

What makes older people feel cold?

It’s very common to feel colder as you age. At baseline, older adults have lower temperatures than younger adults. There are a few reasons that this happens. First, your metabolic rate decreases as you get older. This means you require less food, but it also means you generate less heat from metabolizing food. There is also a tendency for older adults to lose muscle. This is a process called sarcopenia, and it can lead to less “insulation.” 

What can I do about feeling cold?

If you are feeling cold all of the time, you should discuss this with your healthcare provider. If the cold feeling is due to a medical condition (like the ones discussed above), treating the medical condition can make you feel warmer. If there is a medication contributing, stopping the medication can improve your symptoms.

There are also changes that you can make to keep yourself feeling warmer: 

• If you smoke, quitting smoking can improve how well your blood flows through your blood vessels and keep you warmer. 

• You can also wear multiple layers to help manage your temperature from the outside (provide more insulation if you need it, or decrease insulation by taking off excess layers). 

• Adjusting the heating can also help, as well as changing environments if needed.