Cold feet can be alarming. Many people think that cold feet mean that they have poor circulation. But the cause for cold feet is rarely poor circulation. It is much more common for the cause to be a problem with the peripheral nerves. Like neuropathy leg pain, many people have the cold sensation mainly at night.
Cold Feet Causes
The complaint of feeling that your feet are cold is very common. The cold sensation can be when the actual temperature drops, but it can also happen when the temperature is not cold.
The Room is too Cold
Some people just need a higher temperature around them. If your feet feel cold, the most common cause will be that the temperature around you is too cold. This may not sound sophisticated, but it is a reality. And this may change over time. For some people a temperature that was okay when they were younger, may not be high enough as they grow older.
Peripheral Neuropathy
The most common abnormal condition that causes cold feet is neuropathy. This means that the nerve endings that reach the feet are signaling as if the feet are cold, even when they are not. Many people know that neuropathy can cause a tingling sensation. But the truth is neuropathy can cause many types of symptoms. Sometimes there is pain. And other times there is a cold sensation.
A Problem with Hormones
Hormones play a major role in regulating the temperature in our body. Low levels of certain hormones will cause the temperature to drop. The classic example is low thyroid hormone levels. Many people suffer from low thyroid hormone levels. Most of these are women. Other less well known hormones also play a role in keeping our temperature where it needs to be. For instance, mineralocorticoids. These are steroid hormones that our adrenal gland secretes. Problems with these hormones are far less common.
Misbehaving Arteries
The way our body keeps our feet warm is by pumping blood there. The blood flows through arteries into the toes. Sometimes the arteries dilate, and other times they constrict. This regulates the amount of blood that reaches the toes and keeps their temperature constant. In some people this mechanism malfunctions. If your arteries do not dilate and constrict properly, you may not get enough blood into your feet. When there is not enough blood, the temperature of your feet will drop.
Cold Feet from Poor Circulation
People who suffer from cold feet are often concerned about poor circulation. But in fact, this is not common. Poor artery blood flow needs to be quite severe to cause the feet to be cold. People who have severe peripheral artery disease will often have other symptoms. For instance, rest pain. So if your feet feel cold, but otherwise, you are doing okay, chances are the problem is not poor circulation.
Anemia
Blood flow is what keeps us warm. That is basically the definition of being warm-blooded. Lack of blood, or anemia, can cause us to feel cold. I have known people who felt cold, and the cure was to improve their blood count. For instance with iron supplementation. If your feet are cold and especially if you feel colder than others do in the same room, think about checking your blood count. It is done with a simple blood test.
Cold Feet Treatment
It may sound too simple, but the main treatment for cold feet is to keep them warm. Some people underestimate the amount of effort it takes to do that. In cold weather it may not be enough to wear normal socks and shoes. You may need special socks, such as thermal socks or wool socks. Also, you may need isolated shoes that are made for cold weather. In fact, some people will even need hand warmers (that can practically also be foot warmers).
Some People will Need Medication
For some people, keeping the feet warm will just not be enough. Signs that keeping your feet warm is not enough include:
- A cold sensation despite keeping the feet warm
- Feet are turning colors. They can turn pale or blue (or purple). This may be a sign of a condition called acrocyanosis or a condition called Raynaud
- Small wounds on the feet. These may be a sign of a condition called Pernio. Another name for this condition is Chilblains
- Painful wounds on the tips of the toes. Of all the signs this is the most important one because it usually means there is something more serious happening
If you have any of these signs or symptoms, you may need medication. The medication will have one of two effects:
- Dilating the arteries to create more blood flow to the toes. More blood flow will bring more warmth
- Treating neuropathy. Because the most common cause for cold feet is a problem with the nerves, sometimes neuropathy treatment is the correct treatment for this symptom as well
Sometimes the best treatment for feet that feel cold is actually to stop medication. Some medicines constrict the arteries that feed the toes. The constriction can impair blood flow to the toes and prevent them from warming up. An example of such medicines are amphetamines. These are medications that are used to help people concentrate. For instance Adderall.
Treat the Underlying Problem
Obviously, if there is a specific cause for the cold feet, you will need to fix that cause for your feet to feel better. Sometimes identifying the cause is easy. For instance, stopping a medication. Other times, it is easy to identify the cause, but harder to fix it. For instance, smoking will constrict the arteries. You might need to quit smoking for your feet to feel better. Finally, if the cold feet are part of a disease, you will need to address that disease. For instance, you might need thyroid hormone replacement.
When to Involve a Doctor?
You should involve your doctor whenever symptoms are severe. If you cannot improve the cold sensation simply by staying warm, it might be safest to get professional advice. Of course, if there are other issues such as pain, or wounds, get to your doctor earlier rather than later. This will help prevent long term issues you might be able to avoid.
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