Common causes of cold hands and feet

Cold hands and feet are common. For most people, the complaints are not serious enough to go to the doctor, but they are annoying and worrying. Especially when the problem occurs regularly and does not appear to be directly caused by too long (unprotected) exposure to the cold. Impaired blood circulation often plays a role. But fluctuating hormones or an underlying illness can also lead to cold hands and feet. Cold hands and feet occur at all ages. Women suffer from it more often than men. The problem even occurs very regularly in more than a third of women. Cold hands and feet are usually caused by poor circulation. The complaints mainly occur at a lower ambient temperature. The blood vessels in the skin constrict and less blood flows to the surface (skin) of your body. This way less heat is lost. In some people, the blood vessels contract too strongly or for too long. The blood supply to your hands and feet then decreases too much and they become cold.

Cold hands and feet due to poor blood circulation

The circulatory system is the circulation of blood through the body via the veins to and from the heart. Poor circulation can be the result of a disease of the arteries. The wall of the veins can become inflamed or thicken. The vein itself can become (partially) blocked or narrowed by, for example, a blood clot, cholesterol, fats or nicotine. Nicotine causes the blood vessels to narrow and the viscosity of the blood to increase. Fats and cholesterol adhere to the wall of the vein, causing it to slowly clog. High cholesterol levels in the blood can be caused by improper diet, but also by diabetes, for example. Diabetics also have abnormally high blood sugar levels, which causes the arteries to narrow even more. Standing for long periods (varicose veins), being overweight, excessive alcohol consumption and high blood pressure increase the risk of blood clots in the veins. In serious cases, a disease of the arteries can lead to heart problems (angina pectoris or myocardial infarction), a stroke or a TIA. Signs of poor circulation include: cold hands and feet, cramps in arms or legs, stiffness, tingling or weakness in the limbs and varicose veins. If circulation problems persist for a longer period of time, discoloration of the skin and hair loss may occur.

Cold hands and feet (with discoloration) due to underlying condition

In some people, cold hands and feet are accompanied by discoloration of, for example, fingers and toes. In many cases there is a case of perniones (chilblains or chilblains). The smaller blood vessels then do not respond well to temperature changes. When you are in a cold environment, the superficial blood vessels allow less blood to pass through. This is a normal reaction of the body. This means that less blood is supplied to the skin, which means less heat is lost. If the temperature of your skin becomes too low, the blood vessels open again and the skin can warm up quickly. Bee

Perniones (winter toes) / Source: Sapp, Wikimedia Commons (Public domain)

perniones, the slightly deeper blood vessels remain closed for too long. The smallest blood vessels respond to this by opening maximally. As a result, complaints arise such as: extremely cold hands and feet with red to dark blue spots. The spots glow, tingle, itch and hurt. Sometimes blisters, sores or wounds develop on the toes or fingers, which can sometimes even become seriously infected as a result of a bacterial infection. The spots generally disappear on their own within a few weeks. The exact cause of perniones is largely unknown. Heredity, smoking and the use of certain medicines may play a role. Occasionally the condition is caused by an underlying vascular disorder. A well-known example of this is Raynaud’s phenomenon or disease.

Raynaud’s phenomenon / Source: Tcal, Wikimedia Commons (CC BY-SA-3.0)

About 5 to 20% of people suffer from Raynaud’s phenomenon . The small arteries sometimes suddenly contract due to cold or emotions. This reduces the blood flow, especially to the feet and hands. The toes and fingers first turn white and cold. Due to the lack of oxygen, they then turn blue. When blood flow is restored, the feet and hands become red and tingling. A clear cause often cannot be found. Sometimes Raynaud’s phenomenon is the result of the use of certain medicines (e.g. beta blockers), persistent vibrations (e.g. due to drills or chainsaws) or heavy strain on the fingers (e.g. typists and pianists). In a small minority of cases, there is a more serious underlying disease (such as arteriosclerosis, small blood clots or an autoimmune disease that affects the connective tissue). Fairly mild attacks, without an underlying cause, are most common. In that case, treatment is not necessary.
Acrocyanosis is the blue or red-purple discoloration of the hands and feet (but sometimes also of the nose, ears and lower jaw). The body parts feel cold and clammy and the complaints are worsened by the cold. The cause is probably reduced blood flow to the hands and feet due to the contraction of small blood vessels. Acrocyanosis can occur on its own, but can also be a symptom of an underlying disease or condition. Examples include Raynaud’s phenomenon, cardiovascular disease, anemia and anorexia nervosa. Occasionally acrocyanosis is a side effect of certain medications (including tricyclic antidepressants). Acrocyanosis is a common condition.

Hormonal causes of cold hands and feet

More than half of women between the ages of 15 and 50 suffer from premenstrual syndrome (PMS) to a greater or lesser extent. PMS is a collective name for complaints that occur just before menstruation. The most likely cause of PMS is that the balance between the female hormones progesterone and estrogen is absent in the 2nd week of the cycle. The progesterone level usually remains too low, causing estrogen to predominate. The associated symptoms are: cold hands and feet, a swollen feeling, swollen breasts, weight gain and headache. But psychological complaints such as mood swings, crying fits, anxiety, nervousness and irritability are also common. Almost all women with PMS appear to have a vitamin B6 deficiency. This vitamin is involved, among other things, in the production of serotonin, a hormone that combats depression and anxiety. The serotonin level in women suffering from PMS is too low, which may explain the psychological complaints. Characteristic of the premenstrual syndrome is that the symptoms disappear immediately after menstruation and a symptom-free period of at least 7 days follows. There are many different treatments available for PMS, ranging from diets, hormone treatments and medications to (in extreme cases) removal of the uterus and ovaries.
An underactive thyroid gland (hypothyroidism) causes a deficiency of thyroid hormones in the body. In the vast majority of cases, the cause lies in the thyroid gland itself (primary hypothyroidism). The thyroid gland is then unable to produce enough thyroid hormones. Occasionally there is a disorder of the pituitary gland (which regulates the functioning of the thyroid gland) or the hypothalamus (which largely regulates the functioning of the pituitary gland). Hypothyroidism is usually caused by Hashimoto’s disease, an autoimmune disease in which the thyroid gland becomes inflamed. The thyroid gland determines the pace at which all processes in our body take place. If the thyroid gland is underactive, these processes proceed too slowly. The result is, among other things, cold hands and feet, dry, cold and pale skin, fatigue, slowness in thinking and acting, constipation, obesity, hoarse voice, muscle weakness, shortness of breath, concentration problems and depression. About 10% of people suffer from hypothyroidism.

Measures against cold hands and feet

Cold hands and feet can also (simply) be caused by tight (glove) shoes. The blood cannot then flow optimally. The same applies when you sit or stand in the same position for too long. Due to too little exercise, the blood circulation is insufficient and the hands and feet become cold. Custom-made arch supports can also lead to cold feet, because the foot cannot move enough.
Having cold hands and feet is usually a relatively harmless phenomenon. However, if the complaints are very annoying or worsen, or if other complaints occur in addition to the cold hands and feet, it is wise to go to the doctor. In most cases, however, it is sufficient to additionally stimulate blood circulation. Exercise more and walk more often increases the chance of warm hands and feet. Woolen socks also improve blood circulation. Synthetic socks actually have a negative effect. Finally, regular massage, alternating baths and wearing well-fitting gloves and shoes can reduce complaints.

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