Cold Hands? Ask the Doctor!

We asked emergency room physician Barbara Lock why we always need our mittens.

Q. As soon as the weather changes I have to start wearing gloves because my hands get so cold. Is this a sign of poor circulation?

A. Many people notice that their hands and feet get colder in cool weather. When the cool hands and feet become troubling, requiring wearing gloves and warm socks when everyone else is still wearing sandals, if your cold hands are also painful or pale, if you are tired all the time, or if you are losing weight unintentionally, it's high time that you consider medical causes of your symptoms with your doctor.

There is a type of poor circulation known as Raynaud's phenomenon in which people develop a spasm of the blood vessels supplying the extremities, causing cold hands and feet. People with Raynaud's phenomenon are counseled to stop smoking, to stay warm, and to avoid caffeine and
emotional stress. Sometimes medications are prescribed to improve blood flow to the extremities. Sometimes medications that a patient is taking are identified as triggers of the disease. Patient's with Raynaud's disease are more likely to have attacks of angina and migraines than others (both are can be associated with spasm of blood vessels, supplying the heart and brain respectively).

When Raynaud's phenomenon occurs as a result of a separate identifiable underlying disease, management of that disease or condition is the best way to manage the symptoms of cold hands and feet. Common related causes include many of the so-called collagen-vascular disorders or rheumatologic problems including scleroderma and lupus, causes of obstructed blood flow such as atherosclerosis (arteries clogged with cholesterol plaques), and other causes.When a person is cold all the time, even in summer, and not just in their hands and feet, other medical causes have to be considered. Being too thin can cause cold hands and feet, and feeling cold all over. I once knew a woman who wore a sweatshirt, hat and gloves inside during the summer because the air conditioner made her too cold. She was dramatically, dangerously thin, having no fat underneath her skin to insulate her from heat or cold. It was clear that she would be cold outside on a sunny summer day. People who are too thin because of anorexia nervosa, bulimia, other eating disorders, or other medical causes such as cancer or chronic illness can be cold for a separate reason, not just because of lack of fatty insulation. People who are too thin do not store sufficient fat to be broken down into food (substrate) when they get hungry. There is not enough "back up fuel" available to stoke the furnace to keep the body warm.
Another cause of being cold all the time is hypothyroidism. When a person's thyroid gland does not produce enough thyroid hormone, the chemical-hormonal signaling pathway for the production of energy, including heat energy, goes awry. People who are hypothyroid will frequently get tired easily, may develop thickened skin and loose hair on their lower legs and on the outsides of the eyebrows. Supplementation with the mineral iodide or a synthetic thyroid hormone such as synthroid may be in order.If your visit to the doctor reveals no identifiable cause of cold hands and feet, try these approaches: stay warm as much as you can; avoid tobacco, nicotine, and caffeine products; eat plenty of fruits and vegetables, especially those high in magnesium such as swiss chard, spinach, kale, zucchini and summer squash, and bottled mineral water. These lifestyle approaches, however, are no substitute for a visit to the doctor. About the Author: Barbara Lock MD is Editor-in-Chief, Chief Strategist of the medical website MedPie.com LLC
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