What Causes Cold Feet

On a chilly afternoon, it’s normal for feet to turn cold. But what causes cold feet when the temperature is not to blame? Having cold feet isn’t necessarily a cause for concern. However, constant cold feet may indicate an underlying medical condition like hypothyroidism (low thyroid activity). Some medications can even cause cold feet.

It’s essential to get a proper diagnosis so you can find out whether your cold feet problem is just a nuisance or something more. This article will discuss causes of cold feet, when to see a doctor, diagnosis, and treatment.

Causes of Cold Feet

Cold feet may have several causes, including diabetes, anemia, poor circulation, hypothyroidism, or Raynaud’s. 

Diabetes

Diabetes is a condition where blood sugar is high. People with diabetes may have cold feet because diabetes can cause nerve damage, particularly in the feet. You may also experience a loss of feeling in your feet, changes to the skin, such as excess dryness, calluses (hardened skin patches), and ulcers (open sores). 

It’s crucial to find out if diabetes may be causing your cold feet because, left untreated, the disease can cause many complications. While cold feet may be bothersome, diabetes-related circulation issues can cause a host of other adverse effects, including the risk of infection, which in some cases may require amputation.

If your cold feet result from diabetes, it’s important to manage your condition and check your feet regularly to prevent infection. This includes:

• Inspecting your feet daily for problems that may lead to infection
• Washing your feet thoroughly, at least once a day
• Using lotion to smooth out the skin and keep it hydrated
• Being careful when using pumice stones or toenail clippers
• Always wearing foot protection
  

To improve circulation and reduce cold feet, consider elevating your feet when sitting or lying down. Regularly moving your feet and toes can also help.

Anemia

Anemia can also cause you to experience cold feet. In anemia, there is a low red blood cell count or a problem with the hemoglobin in the red cells (the protein that carries oxygen). It can cause extreme fatigue, trouble breathing, headaches, dizziness, and cold feet and hands. 

Iron deficiency anemia is a common form of anemia. It happens because your body doesn’t have enough iron, which it uses to make hemoglobin and red blood cells. To treat iron deficiency anemia, a doctor may recommend a change in diet, such as eating more iron-rich foods. They may also prescribe iron supplements or transfusions.

Anemia may be due to other causes, such as chronic disease (including cancer), vitamin deficiencies, and sudden or chronic loss of blood. Tests can determine the cause of anemia so it can be addressed.

Poor Circulation

Poor circulation, which can be a complication of many conditions, may cause cold feet. Because of poor blood flow, it’s more difficult to warm the area.

Other symptoms of poor circulation include:

• Numbness or tingling
• Pain 
• Discomfort 
  

In some cases, lifestyle changes such as quitting smoking can improve symptoms.

If an underlying condition causes the sensation of cold feet, you may require treatment. Some conditions that can cause poor circulation include:

• Diabetes: High blood sugar damages blood vessels.
• Peripheral artery disease (PAD): This is blockage of one or more arteries supplying blood to the limbs, head, or abdomen.
• Atherosclerosis: Deposits of fat and cholesterol limit blood flow in the arteries. Risks for it include smoking and high cholesterol.
• High blood pressure: Ongoing increased blood pressure weakens blood vessel walls and reduces circulation.
  

It’s crucial to treat these underlying conditions to prevent complications from poor circulation. For example, because poor circulation can interfere with wound healing, in some cases may lead to severe infection, such as gangrene.

People who have PAD may experience cold legs in addition to cold feet. They may also notice:

• Cramping in the legs
• Change in leg color
• Hair loss on the feet and legs
• Toenail color changes and thickening 
  

Treatment for PAD may include:

• Medications 
• Surgery
• Lifestyle changes
  

Hypothyroidism

Hypothyroidism is a common thyroid disease that occurs when the thyroid does not produce enough hormones, slowing many bodily processes down. It can occur due to autoimmune disease, treatment for hyperthyroidism, or when the pituitary gland stops working. 

Symptoms can vary from person to person but may include:

• Fatigue
• Cold sensitivity
• Puffy face
• Weight gain
• Constipation
• Slow pulse
• Hand tingling 
• Muscle cramping
• Confusion 
  

A blood test that measures the amount of thyroid stimulating hormone in your body can help diagnose this disorder. Treatment will typically involve taking drugs that increase thyroid hormone levels in your blood. Frequent blood testing will ensure that your thyroid hormone blood levels remain consistent.

Raynaud’s Disease

Raynaud’s disease or Raynaud’s phenomenon is a condition that causes color changes in the extremities in response to triggers such as cold or stress. 

In the feet, symptoms can include:

• Toes turning white, blue, or red
• Discomfort
• Pins and needles sensation 
• Numbness
• Cold sensation
  

These symptoms typically come and go. In some cases, Raynaud’s disease is a symptom of another condition like rheumatoid arthritis (an autoimmune disease causing joint inflammation and damage). Other conditions that may cause secondary Raynaud’s include:

• Atherosclerosis
• Blood disorders
• Buerger’s disease: Inflammation of the small and medium-sized blood vessels of the hands and feet
• Sjögren's syndrome: An autoimmune disease that causes joint pain, dry mouth, dry eyes, and other symptoms
• Thyroid disease
• Pulmonary hypertension: Higher than normal pressure in the pulmonary artery that can lead to heart failure

If you experience this kind of response in your fingers or toes, you may wish to see a rheumatologist (a specialist in autoimmune or inflammatory diseases) who can determine if the condition is harmless or secondary to another condition that requires treatment. 

Avoiding triggers can help prevent symptoms. However, a doctor may also prescribe medication to help with symptoms of discomfort. Medications may include:

• Calcium channel blockers: Such as Norvasc (amlodipine)
• Angiotensin receptor blockers: Such as Cozaar (losartan)
• Viagra (sildenafil)
• Prostacyclins: Such as Flolan (epoprostenol sodium)
• Topical creams
• Statins
• Selective serotonin reuptake inhibitors (SSRIs)
  

In some cases, medications can actually cause secondary Raynaud’s, these include:

• Ergotamine-containing medications (used for migraine)
• Some cancer drugs such as cisplatin
• Beta blockers 
• Birth control medications
• Certain over-the-counter (OTC) medicines for allergies
  

When to See a Health Professional

Occasionally experiencing cold feet is probably nothing to worry about. But if you’re always complaining that your feet are cold, it may be time to visit a doctor.

Another sign that it’s time to see a doctor is if only one of your feet seems to get cold all the time. This can be a sign of arterial disease.

Diagnosis

To determine why you’re experiencing constant cold feet, your doctor will:

• Ask you about your medical and family history.
• Do a physical exam, looking for visible signs of illness, such as skin changes related to diabetes or color changes associated with Raynaud’s.
• Order blood tests to check for iron deficiency or signs of other underlying conditions.
  

Treatment

Treatment for cold feet depends on the underlying condition.

If the cold feet are happening because of primary Raynaud’s, you may need to avoid triggers that cause the discomfort and cold sensation.

If your doctor diagnoses an underlying condition like diabetes or iron deficiency anemia, they will likely prescribe medication to help with symptoms and prevent the problem from worsening. They may also recommend lifestyle changes to help manage your condition. 

Summary 

People can get cold feet for several reasons. Sometimes cold feet happen because the room or environment is freezing. However, cold feet can also occur for medical reasons.

Conditions like anemia, peripheral artery disease (PAD), and diabetes may cause foot-related symptoms, including cold feet. Many conditions can also cause reduced blood flow, diabetes and PAD included. With less blood flowing to one or both feet, your foot will have trouble warming up. 

A Word From Verywell 

Most of the time, having cold feet is nothing to worry about. Just turn up the thermostat or put on warm socks. But if you’re regularly experiencing a cold sensation in one or both of your feet, it may be time to check with a doctor and tell them about this and other potential symptoms.