Why Am I Always Cold? 16 Reasons and What to Do About It

If you feel like you’re always cold, it may be because of a condition known as cold intolerance. Cold intolerance is not an illness but simply an abnormal sensitivity or hypersensitivity to cold environments or cold temperatures. You may have an exaggerated reaction to cold, causing discomfort and/or the avoidance of cold.

The causes of cold intolerance are varied and often due to a variety of issues. Medical conditions, including hormonal, circulatory, nervous system, and metabolic problems, are causes of cold sensitivity. Anemia, being too thin, or a combination of multiple factors, including those influenced by lifestyle, may also contribute to cold intolerance.

Medical Causes of Cold Intolerance

A variety of medical conditions can lead to cold intolerance and sensitivity. Broad categories include hormonal problems (like hypothyroidism), circulatory problems, and nervous system disorders (that alter your perceptions of cold). Cold sensitivity may also be caused by metabolic problems or even anemia and/or vitamin deficiencies.

1. Thyroid Disease

Hypothyroidism, or low thyroid function, is one of the most recognized causes of cold intolerance.

The thyroid glands produce hormones that are essential for regulating metabolism, which influences how your body uses energy reserves. In colder environments, thyroid hormones can boost metabolism to maintain a normal body temperature.

When you have hypothyroidism, low hormone production disrupts this process, making you more prone to feeling cold. Hormone therapy can help normalize thyroid levels and alleviate symptoms of cold intolerance.

2. Estrogen

Estrogen regulates female reproduction, and its levels fluctuate throughout life, including during the menstrual cycle, pregnancy, and menopause.

These fluctuations can increase cold sensitivity, especially as females approach menopause.

In pre-menopause, changing estrogen levels can cause hot flashes followed by a sudden drop in body temperature. The drop is thought to be caused by estrogen’s effect on nerve receptors that regulate the widening and narrowing of blood vessels.

Such fluctuations might also explain why some experience cold intolerance just before menstruation. During the luteal phase, after ovulation, estrogen peaks, which can lead to increased coldness and shivering.

3. Anemia

Anemia is a condition in which you don’t have enough red blood cells to transport oxygen through the body. It can also occur if don’t have enough of an iron-containing protein, called hemoglobin, that is responsible for carrying oxygen molecules.

Iron deficiency anemia is a type of anemia caused by the lack of iron in the body. Iron is not only needed to make hemoglobin but is also essential in producing ample quantities of red blood cells.

Cold intolerance is strongly linked to iron deficiency anemia for two reasons:

• Lack of oxygen: Oxygen is not only involved in the burning of calories for energy and heat but also in the narrowing of blood vessels to help conserve heat. With all types of anemia, including pernicious anemia (caused by a lack of vitamin B-12) and aplastic anemia (caused by bone marrow problems), the lack of oxygen reduces both of these abilities.
• Lack of iron: Iron is also needed to produce thyroid hormones. In people with iron deficiency anemia, low iron levels reduce the production of these hormones, further increasing cold sensitivity.

Iron deficiency anemia can be treated with iron supplements and prescription drug therapies.

4. Raynaud’s Syndrome

Raynaud’s syndrome is a condition in which a person’s fingers or toes turn blue or white upon exposure to cold and then bright red upon rewarming. It is caused by the abnormal narrowing of blood vessels (vasoconstriction) in response to cold or stress. In some people, it can affect one finger or hand but not the other.

Although the cause of Reynaud’s syndrome is unknown, it is often experienced in people with connective tissue disorders like scleroderma or lupus.

The abnormal constriction of blood vessels deprives the tissues of oxygen. This, in turn, reduces the skin temperature and increases its sensitivity to cold. Other symptoms include numbness, tingling, or throbbing pain.

Reynaud’s syndrome is treated by managing the underlying cause, if any. It also includes avoiding cold, stress, and smoking (which increases vasoconstriction).

5. Anorexia

Anorexia nervosa, or simply anorexia, is an eating disorder characterized by a limited food intake. People with anorexia often eat so little that they cannot sustain basic bodily functions.

Cold intolerance is common in people with anorexia for several reasons:

• Malnutrition: The inadequate intake of food deprives the body of iron, B vitamins, folate, manganese, and sulfur needed to maintain metabolism. It also affects the production of hormones that regulate the core body temperature.
• Cachexia: Body fat helps insulate the body from cold. When enough body fat is lost, a person is less able to withstand cold. Cachexia is muscle wasting accompanied by the loss of body weight and body fat. It occurs in people with anorexia when the body has to turn to muscle and fat for fuel.

Medications, support groups, and talk therapy commonly treat people with anorexia.

6. Diabetes

Diabetes is a group of diseases that causes excess glucose (sugar) in the blood. Persistently high glucose levels can cause progressive damage to many organs in the body, including the kidneys, circulatory system, and nerves.

Complications of diabetes can lead to cold intolerance in different ways:

• Kidney damage: Diabetic nephropathy is kidney damage caused by diabetes. When this happens, a waste product called urea can accumulate in the blood, triggering a decrease in the core body temperature. Low body temperature is characteristic of advanced kidney disease.
• Circulation problems: Persistently high blood glucose levels can damage the lining of blood vessels and reduce blood flow. This not only reduces the temperature of the legs and feet in particular but can lead to the development of slow-healing sores.
• Nerve damage: Diabetic neuropathy is nerve damage caused by diabetes. Symptoms include numbness, burning, pins-and-needles sensations, and an increased intolerance to cold. In some people, even a cold breeze can cause extreme discomfort.

Managing diabetes with diet, exercise, and medications can help you avoid complications that lead to cold intolerance.

7. Peripheral Artery Disease

Peripheral artery disease (PAD) occurs when one or more blood vessels servicing the arms, legs, head, or trunk become partially or fully blocked. It is usually caused by the build-up of fatty deposits on the walls of arteries, referred to as atherosclerosis. PAD is common in people over 50 with a history of diabetes or smoking.

The reduced blood flow caused by PAD can increase cold sensitivity in the same way as vasoconstriction. This coldness is most commonly felt in the feet (particularly in the morning or right after exercise) but can also affect other body parts.

If left untreated, PAD can damage peripheral nerves (those located outside of the brain or spinal cord). This can lead to nerve pain that further exaggerates a person’s response to cold.

PAD is treated with medications and lifestyle changes, including a low-fat diet, weight loss, and routine exercise. Severe cases may require vascular surgery.

8. Nerve Issues

Cold intolerance can occur when the peripheral nerves are damaged. This typically occurs when the insulated coating on nerves, called the myelin sheath, is damaged or stripped away. This can cause nerve cells to misfire, triggering shock-like pain, numbness, tingling, or burning.

The condition, known as peripheral neuropathy, can be so extreme that the weight of a bedsheet or a light breeze can cause pain. Peripheral neuropathy can increase a person’s sensitivity to cold, making it difficult to hold a cold soda or walk across a cold floor.

Causes of peripheral neuropathy include:

Peripheral neuropathy can be difficult to treat but may benefit from nonsteroidal anti-inflammatory drugs (NSAIDs), antiseizure medications (ASMs), and antidepressants.

9. Fibromyalgia

Fibromyalgia is a chronic condition that causes pain all over the body as well as memory problems, fatigue, and sleep difficulty. The cause of fibromyalgia is unknown, but it is thought to be the result of multiple factors, including genetics, mood disorders, past diseases, and chemical imbalances that increase pain hypersensitivity.

Research has shown that people with fibromyalgia often have trouble adapting to temperature changes and have high levels of intolerance to both heat and cold. This is thought to be caused by problems with a process known as pain inhibition in which the nervous system slows down pain signals whenever it is faced with chronic pain.

This, in turn, can lead to cold intolerance by slowing down the body’s response to cold. Because the body does not respond as quickly, the person may feel cold far more intensely than others.

Physical therapy, stress reduction, and medications like antidepressants and muscle relaxants may help people with fibromyalgia better manage their symptoms.

10. Vitamin B12 Deficiency

Vitamin B12 deficiency can cause you to feel cold. If you are deficient in this vitamin, you will likely also have other symptoms such as:

• Numbness in your hands
• Trouble focusing 
• Fatigue and weakness
• Pain in the joints and muscles
• Nausea and changes in appetite

Untreated vitamin B12 deficiency can cause serious problems like neurological disease. Older people, people who have had weight loss surgery, and people who follow vegetarian diets are more likely to develop a vitamin B12 deficiency.

11. Infection or Fever

When you have an infection like the flu or gastroenteritis, your whole body may feel cold even as you are burning up with a fever. You may even experience chills and shivers, known as rigors, that are so intense that you cannot stop.

Feeling cold during an infection is largely due to the consumption of extra energy to help fight the infection.

Rigors, on the other hand, are triggered by the presence of chemicals called pyrogens in the blood. The immune system produces pyrogens to raise the body’s temperature to help fight infection. But, they can trigger a contradictory reflex resulting in severe shivering and chills.

Chills are caused by the rapid contraction and relaxation of muscles that aim to bring the body temperature up.

With some infections, like atypical pneumonia (also known as “walking pneumonia”), a person may only experience a sore throat, fatigue, and a constant feeling of coldness. Although walking pneumonia is milder than regular pneumonia, recovery can take up to six weeks, during which you may always feel cold.

Bacterial infections may resolve on their own or require antibiotics. Common viral infections are often left to run their course but, in some cases, may benefit from the early use of antiviral drugs.

Lifestyle Factors and Other Causes

Lifestyle factors, like certain calorie-restricting diets or a lack of sleep, can also cause cold sensitivity and should be discussed with a medical professional, along with any other medical conditions. Other factors, such as taking specific medications, can impact blood circulation and cause other medical problems that impact one’s sensitivity to cold.

1. Low Body Weight

Even in people who do not have anorexia, having a low body weight increases susceptibility to cold. For some, low body weight is caused by an underlying health issue or can lead to other medical problems. However, this isn’t the case for everyone, as some underweight people have a high metabolism and higher core body temperatures.

With that said, low body weight is inherently linked to less subcutaneous body fat. This is the layer of fat tissue just below the skin. The loss of this insulating layer increases the risk of cold intolerance.

In addition to reducing subcutaneous fat, low body weight is linked to an increased risk of anemia.

2. Dehydration

Dehydration (or a condition in which the body does not have enough water to function properly) has a disruptive effect on temperature regulation. When severe, it can cause heat exhaustion or heat stroke (which are medical emergencies) and can be accompanied by chills (similar to what happens when one has a fever) or cool, clammy skin. Fever, though, can also cause dehydration.

Dehydration also has an effect on blood vessels, causing them to constrict in order to maintain hydration in the core and prevent blood flow to the extremities. This can result in hypothermia and increased sensitivity to cold.

Drinking plenty of fluids can prevent dehydration or rehydrate in mild cases, although one should always contact a medical provider for guidance when infants or children are dehydrated. People over 60 are also more susceptible to dehydration.

When severe, dehydration should be treated as a medical emergency. Intravenous (IV) fluids might be needed (even with moderate dehydration) to hydrate the body and return it to a state of homeostasis.

3. Lack of Sleep

As odd as it may seem, chronic lack of sleep can increase your sensitivity to cold while awake.

In well-rested people, blood flow in the skin will fluctuate during sleep so that temperature changes in one part of the body change consistently with other parts of the body.

Sleep deprivation disrupts this process. As the sleep deficit builds and you lose more and more sleep, blood flow will progressively shift to the center of the body and decrease in the limbs. This promotes heat loss from the feet and hands, making them feel colder.

Sleep deprivation can be treated with improved sleep practices (referred to as sleep hygiene) and medications.

4. Medications

Certain medications can cause cold sensitivity. They do so by either impeding blood circulation or damaging nerves that regulate skin sensations.

The classes of drugs commonly associated with cold sensitivity include:

5. Skipping Meals

Calorie-restricted diets such as intermittent fasting or skipping meals for other reasons can lead to adverse effects such as cold sensitivity. 

Calorie-restricted diets are thought to slow the resting metabolic rate, or the number of calories you burn when your body is at rest. This can cause a decrease in core body temperature, which may cause you to feel colder.

Symptoms of Cold Intolerance

Cold intolerance is an elusive condition with a subjective response that is irrespective of the ambient temperature. The response is largely physiological (related to the body), although it may also have psychological components (related to the mind).

There is much variation in the sensitivity to cold that different people experience. Some may only shiver and put their hands in their pockets in response to the cold. Others may require layers of clothes to keep warm.

In addition to an abnormal response to cold, symptoms of cold intolerance may also cause:

• Numbness
• Stiffness
• Pain or burning sensations
• Weakness
• Swelling of the skin
• Skin color changes
• Sensitivity to touching cold objects

How to Stop Feeling Cold

Whether you are feeling cold because of an underlying medical condition or because you’ve always been sensitive to cold, there are things you can do to warm up:

• Make sure you are eating enough calories each day.
• Wear thick socks to bed or around the house.
• Choose comfortable pajamas that keep you warm without overheating.
• Dress in layers.
• Fix drafty windows.
• Drink warm liquids like herbal tea.
• Engage in exercise.