Cold Feet (Literally)? Here’s Why, According to Experts — And What You Can Do About It

If you’ve ever gotten cold feet after a day in the snow or a barefoot jaunt across a tile floor in winter, you know how uncomfortable the sensation can be. In these cases, cold feet are a response to environmental conditions like cold weather climates and cool surfaces. Typically, wearing warm socks — wool socks, in particular — will prevent your feet from freezing, and once you’re removed from the environmental exposure, your body temperature naturally warms back up.

There are people, however, for whom having cold feet isn’t related to the environment that surrounds them. In these cases, cold feet are the result of chronic and/or acute underlying conditions. (The temperature of our bodies can tell us a lot about underlying health conditions, and can both affect and be affected by certain medications.)

Below is information on the causes of cold feet, and how you can begin managing them at home and with the support of your doctor.

What causes cold feet?

“Why are my feet always cold?” The answer to this question depends on several factors, as there are several causes. Chronically cold feet is a surprisingly common condition wherein feet are cold even in warm environments and have difficulty warming up after exposure to cold. To relieve it, a clear understanding of its underlying causes is necessary. Here’s a closer look at some of the most common causes of cold feet. 

1. Poor Blood Flow

One of the most common causes of cold feet is poor circulation, which is the reason that your feet may appear blue, purple, or white in color, in addition to feeling cold. Poor blood flow occurs when blood is delayed in reaching extremities. This typically occurs when blood vessels in the body narrow or develop blockages, both of which can slow the flow of blood to the feet. There are many underlying causes for circulation problems and restriction of blood vessels, so speaking to a doctor who can assess your unique needs is vital. The good news here is that improving blood flow is possible, and this, in turn, can support in treating chilly feet. Simple steps you can take to improve blood flow to your feet and throughout the rest of your body include walking, stretching, and yoga. You can also wear compression socks. 

2. Chronic Medical Conditions

Chronic medical conditions are another cause of poor circulation and reduced blood flow to the feet. Among conditions most often associated with cold feet are heart disease and peripheral artery disease. These directly impact blood flow and can result in delayed circulation. In the case of peripheral artery disease, the arteries narrow and limit blood flow to the feet. Type 2 diabetes can also contribute to poor circulation and even, in the case of diabetic neuropathy, nerve damage. Speak to your healthcare provider if you believe you have high risk factors associated with diabetes.

Other chronic conditions that may cause cold feet include nerve conditions like fibromyalgia, which can dysregulate blood flow due to increased sensory nerves. Hormonal changes, like hypothyroidism, can also be at play. An underactive thyroid can affect your ability to tolerate cold and make you more sensitive to colder temperatures, especially in your extremities. In some cases, low thyroid hormones can be managed with the help of medications or supplements.  

3. Medications

In addition to chronic conditions, certain medications can trigger cold feet. Additionally, certain medications affect circulation, which can in turn, trigger coldness in your feet. An example of this is beta-blockers for high blood pressure, which lower blood pressure by slowing the speed at which blood moves through the body, thereby increasing the sensation of coldness in the feet and other extremities. Pay close attention, too, to the effects of medications used for migraine and headache relief, as well as certain cold medications. Ergotamine found in migraine medications can make you more sensitive to the cold, and certain decongestants can affect blood pressure. Because reactions to medications vary, it’s important to talk to your healthcare provider about their potential risks.

4. Raynaud’s Phenomenon

Raynaud’s Disease, or Raynaud’s Phenomenon, is a condition that causes the fingers and toes to go numb after exposure to cold conditions and/or stress. Here, the small arteries responsible for delivering blood to the skin narrow, affecting circulation before it has a chance to warm the extremities. When this occurs, skin may become white, then turn blue and eventually pink and red as blood begins to flow back into the affected areas.

In some cases, Raynaud’s Disease is not emblematic of an underlying condition; rather, it is a condition on its own — one that, unfortunately, cannot be treated, but can be managed with medications and best practices. In other cases, however, Raynaud’s Disease is a symptom of a more complex condition, which is why you should speak to your doctor if you experience any of the indications mentioned above. Among the common conditions with which Raynaud’s Disease is associated are autoimmune diseases and diseases that affect the connective tissue, including Lupus, rheumatoid arthritis, thyroid disease, pulmonary hypertension, and Buerger Disease. 

5. Anemia

Anemia is another condition that can cause cold hands and feet. With anemia, also called low hemoglobin, the body lacks sufficient red blood cells to carry oxygen to tissue, resulting in inadequate blood flow. This inadequate blood flow then causes a cold sensation in the hands and feet. Anemia can be triggered by several factors, including long-term chronic illnesses, poor diet, and certain medications. Most commonly, anemia develops due to low iron, which is why it’s common in pregnant women — whose bodies require more iron. Cases can range from mild to severe, and can cause an array of symptoms and side effects, including tiredness, weakness, dizziness, headaches, chest pain, and shortness of breath.

Simple changes, like adding certain foods to your diet or switching your medications, can be useful for addressing and managing anemia and consequently, cold hands and feet. 

6. Stress

If you find that you get cold feet in stressful situations, you’re not alone. (The experience is so common as to have its own idiom, as in “having cold feet” in anticipation of an event of activity that makes one nervous.) Common symptoms associated with anxiety include increased heart rate, sweaty palms, shortness of breath, and cold feet. 

During moments of stress, we often produce more sweat, particularly in the soles of the feet. This moisture retains coolness, chilling the feet and keeping them colder longer. Anxiety also changes blood flow, causing our hearts to beat either faster or slower. Hyperventilation, which is a change in breathing associated with stress, can slow blood flow by constricting blood vessels. If you often experience cold feet during periods of stress, speak to a medical professional about best practices for management and relief.

The Cold Feet Conclusion

Cold feet are relatively common, and are not always a sign of something sinister. That said, understanding the root cause of cold feet will help you establish methods for managing its effects. Common causes include poor circulation, chronic conditions, anemia, and Raynaud’s Disease. Knowledge is power — and once you figure out why your feet are cold, you can take the necessary steps to help them feel warm and cozy once again.