What causes cold feet?
Cold feet can be caused by a number of factors, including:
Poor circulation
Poor circulation reduces blood flow to the extremities like the feet, leaving them feeling cold. Things that can cause poor circulation include:
– Heart problems like atherosclerosis or valve issues
– Diabetes affecting the small blood vessels
– Raynaud’s phenomenon
– Anemia
– Pregnancy
– Thyroid issues
– Smoking
– Obesity
– Sedentary lifestyle
– Cold environment
Nerve damage
Nerve damage whether from injury, surgery, or conditions like diabetes can disrupt signals to the blood vessels that control constriction and dilation. This impairs the body’s ability to direct blood flow and regulate temperature properly.
Autoimmune diseases
Some autoimmune diseases like lupus and rheumatoid arthritis cause inflammation that constricts blood vessels, reducing circulation to the extremities.
Anxiety
Stress and anxiety activate the sympathetic nervous system, diverting blood away from the skin and extremities to support the fight-or-flight response. This can leave hands and feet feeling cold.
Raynaud’s phenomenon
Raynaud’s causes the small arteries feeding the skin to constrict in response to cold or stress. This limits blood supply to the fingers and toes, causing them to feel very cold, numb, or painful. It may progress to the point of color changes.
Hypothyroidism
An underactive thyroid slows metabolism and reduces blood flow, often leaving patients feeling chronically cold, especially in the hands and feet.
Anemia
A reduced red blood cell count impairs oxygen delivery to tissues. This can cause peripheral body parts like feet to feel cold.
Peripheral artery disease (PAD)
PAD involves atherosclerotic blockages in the arteries feeding the legs and feet. This greatly reduces circulation, often leaving the feet feeling cold.
When are cold feet normal?
Mildly cool hands and feet are very common and often normal. Situations where it’s usually nothing to worry about include:
– Exposure to cold environments
– Feeling cold when getting out of warm bed
– Feeling cold during periods of inactivity
– Temporary coldness when stressed or anxious
– Slightly cool extremities during pregnancy
– Being a naturally cold person with circulation on lower end of normal
As long as the coldness is mild, temporary, and just affects the feet, it is usually not a concern. The feet often feel cool relative to the rest of the body because they are farthest from the heart.
When should I worry about cold feet?
See your doctor if you have persistent, severe coldness in your feet accompanied by:
Discoloration
– White, waxy skin that blanches with pressure indicates impaired blood flow
– Blueish or purple skin suggests oxygen deprivation
– Reddish purple feet may signal inflammation or clotting disorders
Numbness or tingling
– May indicate nerve damage if in a stocking-glove distribution
Pain, cramping or throbbing
– Can occur with circulatory impairments or nerve problems
Sores or wounds not healing
– Sign of poor circulation to the extremities
Leg swelling
– Fluid retention in the lower legs alongside cold feet can indicate heart failure or blockages
| Symptom | Potential Cause |
|---|---|
| Discoloration | Impaired circulation, oxygen deprivation, inflammation, clotting disorders |
| Numbness or tingling | Nerve damage |
| Pain, cramping, throbbing | Circulatory problems, nerve issues |
| Non-healing sores/wounds | Poor peripheral circulation |
| Leg swelling with cold feet | Heart failure, blockages |
Inability to keep the feet warm
– Wearing socks, moving around, putting feet up does not alleviate coldness
Coldness worsens at night
– Getting into bed makes feet icy or painful
Lifestyle factors
– Smoking, obesity, sedentary lifestyle
What conditions can cause chronically cold feet?
Some common conditions linked to persistently cold feet include:
Peripheral Artery Disease (PAD)
PAD arises when atherosclerosis blocks arteries supplying the legs and feet. This greatly reduces circulation, leaving the feet feeling icy. Other symptoms may include leg pain with activity, wounds not healing, numbness, and leg swelling. PAD increases heart attack and stroke risk.
Diabetes
Neuropathy and small vessel damage from diabetes impairs circulation and nerve function in the feet. This combination frequently causes chronically cold, numb, or painful feet. It also puts feet at risk for skin breakdown and infection. Keeping diabetes under tight control can help minimize circulatory complications.
Raynaud’s phenomenon
Raynaud’s causes sudden vasospasms that dramatically reduce blood flow to the fingers and toes, making them feel ice-cold. It is often triggered by cold exposure or emotional stress. Raynaud’s occurs on its own (primary) or secondary to autoimmune conditions. Treatment centers on avoiding triggers, keeping extremities warm, and medications to open constricted blood vessels.
Thyroid disorders
Hypothyroidism is characterized by a significantly underactive thyroid, slowing metabolism. It impairs circulation, making patients very sensitive to cold. Hyperthyroidism increases metabolism, which can also leave people feeling chronically cold. Treating the thyroid disorder typically alleviates symptoms.
Anemia
Anemia decreases the red blood cells that carry oxygen throughout the body. This impairs oxygenation of the peripheral tissues. Symptoms like cold hands and feet may persist until iron, vitamin deficiencies, or other causes of anemia are corrected.
Spine conditions
Conditions like spinal stenosis, fractures, or disc herniations can compress nerves traveling to the lower body and feet. This may produce symptoms like chronically cold feet or feet that are cold but sweat excessively.
Nerve damage
Neuropathies from diabetes, autoimmune diseases, infections, toxins, or traumatic injury can affect the nerves that control temperature regulation and blood flow in the feet. This may cause persistent coldness, numbness, or painful “pins and needles.”
When to see a doctor
Make an appointment with your doctor if:
– Coldness in your feet is accompanied by pain, changes in skin color, numbness, or leg swelling
– Your feet are persistently and noticeably colder than the rest of your body
– Coldness is worsening despite efforts to keep feet warm
– Feet are cold at night and interfere with sleep
– You have risk factors like smoking, diabetes, or PAD
Seeking timely treatment is important, as chronically cold feet can in some cases signal an underlying health problem requiring management. Getting evaluated provides relief and helps prevent complications.
Diagnosing the cause
To determine the reason for cold feet, your doctor will:
– Ask about your symptoms and medical history
– Examine your feet for signs of nerve damage and circulatory impairment
– Check pulses in your legs and feet
– Order blood tests to evaluate thyroid function, cholesterol, fasting glucose, hemoglobin
– Perform imaging tests like CT or MRI scanning if spinal cord compression is suspected
– Order lower extremity arterial studies if PAD or blood clots are a concern
Relieving cold feet
Depending on the underlying cause, cold feet are treated by:
Lifestyle measures
– Quit smoking
– Exercise regularly
– Lose excess weight
– Follow a heart healthy diet
– Avoid prolonged standing/sitting
– Soak feet in warm water
– Use electric blankets or heating pads
– Wear socks or slippers to bed
Medications
– Cholesterol and blood pressure medications for PAD
– Vasodilators to improve circulation
– Thyroid hormones for hypothyroidism
– Iron supplements for anemia
– Neuropathic pain relievers for diabetic nerve damage
Surgery
– Angioplasty to open blocked blood vessels
– Coronary bypass for atherosclerotic disease
– Spinal decompression if nerves are compressed
When to seek emergency treatment
Seek immediate medical attention if your feet are:
– Deep purple and numb
– Extremely painful with skin discoloration
– Icy cold and you have chest pain or trouble breathing
These may indicate a medical emergency like:
– Critical limb ischemia with threatened tissue death
– Blood clot in the lungs or heart attack
– Aneurysm or sudden blockage cutting circulation
Rapid evaluation and treatment are needed to restore blood flow and prevent serious complications like amputation or permanent organ damage. Call 911 or go to the emergency room right away.
Preventing chronically cold feet
Some tips for keeping your feet warmer and improving circulation include:
– Exercise regularly
– Stretch your feet and legs frequently
– Avoid crossing your legs for long periods
– Elevate feet when sitting
– Wear socks to insulate feet
– Take warm baths to relax blood vessels
– Manage medical conditions carefully
– Don’t smoke and limit alcohol intake
Also be sure to see your doctor for routine checkups. Getting appropriate treatment for any underlying medical issues can help prevent problems like cold feet from developing.
Conclusion
In most cases, cold feet are normal and simply require some extra insulation for comfort. However, chronically and excessively cold, painful, numb, or discolored feet may indicate an underlying health condition requiring treatment. See your doctor if cold feet are persistent or accompanied by other symptoms of concern. Prompt evaluation and management of any issues improves outcomes and quality of life. With appropriate lifestyle habits and medical care as needed, your feet can stay sufficiently warm and healthy long-term.