Cold feet can be uncomfortable and annoying to anyone they might touch, but are they really anything to worry about? In some cases, those chronically cold feet can be a sign of illness. But in general, cold feet mean that your inner body has gotten a little too cool and your "core temperature" has dropped a little too low. To protect your vital organs (heart, lungs, and brain), your body diverts blood flow away from your hands and feet. Nervousness can cause this diversion, too, which is why "getting cold feet" means suddenly backing out of something at the last minute.

Characteristics:

Your feet feel cold, like "blocks of ice."
You might feel numbness, tingling, or pins-and-needles.
Foot color ranges from red to purple-blue to pale white.
Someone who touches your feet feels that they are cool or cold.

Duration:

This can last a few minutes or a few hours to even days or longer.
Sometimes the cold feeling never really goes away.
Your feet might warm up in warm environments but go right back to feeling cold again with exposure to cold air or water.

Who is most often affected by cold feet symptoms?

Women.
Older people.
Anyone living or working in cold conditions.
Anyone with poor circulation.
Diabetics or others with peripheral nerve disease.

Where in the world are these cold feet symptoms most common?

Cold climates produce the coldest feet, of course.

When are cold feet symptoms most likely to occur?

Your cold feet symptoms may increase when you sit or lie down.
Of course, winter weather can cause cold feet.

Are cold feet symptoms serious?

Cold feet can point to a serious problem if the circulation to them is truly impaired; you have a nerve condition that's causing the problem; you have pain in your legs when walking; or your feet only seem cold to you and not to anyone else.
Cold feet are rarely serious in a younger person with no other illnesses.

Cold feet causes and conditions

Many conditions have cold feet as a symptom. Most of them have to do with circulation and blood flow, although thyroid, anemia, and nervous system disorders can be involved.

Circulatory cold feet causes:

Poor circulation due to your feet being in a cold environment is the most common cause of cold feet. It limits the amount of blood flow and therefore heat to your extremities.
Atherosclerosis or hardening of the arteries *Smoking makes your blood vessels tighten and constrict.
Cold weather causes blood vessels in your feet to constrict.
Feeling cold or nervous causes blood vessels in your feet to tighten.
Acute blood clots to the arteries in the legs can cause one foot to become acutely cold and painful. This is an emergency.

Hormonal and deficiency related cold feet causes:

Thyroid imbalances too much or too little thyroid hormone interfere with metabolism.
Megaloblastic anemia, which is a shortage of healthy red blood cells from Vitamin B 12 deficiency, can cause cold feet that often also burn.

Nervous system cold feet causes:

Peripheral neuropathy, or nerve damage, may cause you to feel numbness and tingling in your feet which you interpret as cold.
Panic disorder sends your body into fight-or-flight mode, diverting blood into your internal organs and out of your feet leaving them cold.

###Infectious cold feet causes: ###

Mononucleosis can lead to peripheral neuropathy.
Meningitis may have symptoms of both fever and cold feet.

Physiological cold feet causes:

Low body fat will make your body divert more blood flow to vital organs, trying to keep them warm.
Sometimes having cold feet is simply normal and a trait that runs in families.

This list does not constitute medical advice and may not accurately represent what you have.

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Sepsis

Sepsis is a serious illness that is caused by the body's reaction to an infection and cause system-wide inflammation.

Rarity: Rare

Top Symptoms: being severely ill, shortness of breath, fever, feeling confused and not making sense while talking, abnormally high heartrate

Symptoms that always occur with sepsis: being severely ill

Urgency: Emergency medical service

Raynaud phenomenon

Raynaud phenomenon, also called Secondary Raynaud syndrome, is a condition that causes small arteries in the skin to abnormally constrict on exposure to cold water or air. This limits blood flow to the hands, fingers, feet, toes, nose, and ears.

Secondary Raynaud syndrome is rare and is caused by another underlying medical condition, often a connective tissue disorder such as rheumatoid arthritis, scleroderma, or lupus.

Women are more likely than men to be affected, especially if living in cold climates. Family history and smoking are also risk factors.

Symptoms include the hands and feet becoming numb and cold. The skin color changes from pale to bluish, and then to red as the skin warms again.

If not treated, patients may get ulcerated sores or deformities of the fingers and toes, or even gangrene, due to the lack of circulation.

Diagnosis is made through patient history, physical examination, and blood tests.

Treatment includes medications to help increase circulation; treatment of any underlying conditions; and lifestyle changes to gain better protection for the extremities in cold conditions.

Rarity: Common

Top Symptoms: distal numbness, cold toe, cold fingers, spontaneous toe pain, spontaneous finger pain

Urgency: Self-treatment

Peripheral arterial disease (PAD)

Peripheral artery disease (PAD) is a chronic condition that reduces blood flow in the arteries, usually arteries that lead to the legs. This reduced blood flow happens when clumps of fat (called plaques) build up inside these arteries, causing them to narrow. Symptoms include leg numbness, foot and thigh pain, cold feet, and muscle fatigue. These symptoms often occur when walking or exercising. The risk of developing PAD is higher in those who smoke or have diabetes. High blood pressure, high cholesterol, being overweight, and not getting much exercise also can put one at higher risk.

You should consider visiting a healthcare provider in the next two weeks to discuss your symptoms. Your provider can evaluate PAD with a review of your symptoms and a physical exam. An MRI may be performed as well. Once diagnosed, treatment involves medication, surgery, or procedures to open or bypass blocked arteries. Lifestyle changes regarding diet, exercise, and smoking cessation may also help.

Rarity: Common

Top Symptoms: leg numbness, spontaneous foot pain, decreased exercise tolerance, cold feet, thigh pain

Symptoms that never occur with peripheral arterial disease (pad): calf pain from an injury, thigh pain from an injury

Urgency: Primary care doctor

Mild frostbite of the lower leg

Frostbite is tissue damage caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports. It is also more likely in those who are intoxicated or have a mental disorder.

Those with suspected frostbite should have wet clothing removed. Rubbing affected areas worsens damage to the tissue. You should go to the ER by car, immediately. If rewarming can occur without chance of refreezing, it can be tried in the field. There, the doctors will guide you in gently re-warming the wounded area in 98-102F (37C-39C) water. Further, ibuprofen, antibiotics, a tetanus shot, and possibly surgery will be done to treat the pain and dead tissue. IV fluids will also be started. Hydrotherapy will be done daily to help with the wounded area.

Rarity: Rare

Top Symptoms: foot pain, swollen foot, foot numbness, foot redness, limping

Symptoms that always occur with mild frostbite of the lower leg: cold toe

Urgency: Hospital emergency room

Iron deficiency anemia

Iron deficiency anemia means that the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.

The condition is caused by:

Acute blood loss through injury, surgery, or childbirth.
Chronic blood loss through an ulcer, overuse of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs,) or heavy menstrual periods.
Inability to absorb dietary iron due to intestinal surgery or disease, or interference from certain medications.
A diet low in iron-supplying foods.

Symptoms include fatigue, shortness of breath, lack of endurance, and chest pain with rapid and irregular heartbeat.

If not treated, iron deficiency anemia can lead to heart disease because the heart has to pump extra blood to get enough oxygen to the tissues. Developmental problems in children can also occur.

Diagnosis is made through physical examination and blood tests.

Treatment includes a diet higher in iron-rich foods, such as red meat and dark green leafy vegetables, along with iron supplements. Severe cases may require hospitalization for blood transfusion and/or intravenous iron therapy.

Hypothyroidism

Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

Cold feet treatments and relief

Seek immediate treatment in the emergency room or call 911:

If you have cold hands and feet as well as fever this can be a sign of a serious infection or circulatory disorder.
If your feet are very cold and discolored, especially if they are also painful. This can mean a near-complete loss of circulation in your feet.

Schedule an appointment for:

Ongoing fatigue and feeling cold all over.
Uncomfortably cold feet which change color from white to purple to red.
Cold feet with ongoing numbness and tingling.

Try these remedies at home for cold feet treatment:

Increase exercise to improve circulation.
Layer silk or cotton socks beneath wool socks.
Warm hats and gloves preserve body heat and help prevent constriction of the blood vessels in your feet.
Drink warm beverages in cold weather.
Quit smoking.

Cold feet treatment quiz

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FAQs about cold feet

Here are some frequently asked questions about cold feet.

What causes cold feet?

Cold feet are usually caused by reduced blood supply. This can be the result of blockage or constriction of our blood vessels in the feet or lower leg. When in a cold environment, our body is designed to primarily keep our heads and torsos warm, because these areas include all organs essential for life. These organs do not function as well if they drop in temperature. To keep our brains, hearts, lungs, and digestive organs warm, the body may divert warm blood from the fingers, toes, arms, and legs to the torso so that the central organs can be warm. This is the most common cause of cold feet.

What causes poor circulation in the feet?

Cold exposure is a common cause. It can also be a symptom of certain autoimmune diseases, blood disorders, or hypothyroid disease. Exposure to select drugs and environmental factors can cause poor circulation. Accumulation of lipid and fibrous material inside the arteries (called peripheral arterial disease, or PAD) can restrict blood circulation as well. Smoking is an important risk factor for poor circulation.

How to improve circulation in the feet?

Keep your whole body warm. Don't smoke smoking can make your symptoms worse. Avoid medicines that cause blood vessels to become narrow, such as cold medicines or diet pills. Get your diabetes, high blood pressure, and high cholesterol under control (if you have these conditions.) Walking helps increase circulation and relieve peripheral artery disease (PAD) symptoms too. Medication and surgeries can be considered if PAD is severe enough.

Can cold feet be a sign of anemia?

Yes. Anemia is caused by a loss and/or impaired production of red blood cells. Blood loss and impaired production of red blood cells can both compromise blood flow to your feet, making your feet cold. The compromise of blood flow comes from a diversion of a limited blood supply. Blood will go to body parts where it is most needed, which is away from the arms and legs.

When should you see a doctor for cold feet?

See a doctor if the problem persists, or you start to develop pain or open sores on your toes. Additional symptoms, such as joint pain, muscle pain, fever, weakness, weight loss, rash, arthritis, or problems with the heart or lungs might indicate underlying medical conditions that warrant medical attention as well. Severe foot discoloration also warrants medical attention.

Questions your doctor may ask about cold feet

Has any part of your body become paler than normal?
Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
Are you eating inedible objects like ice, dirt, or paper?
Have you ever been diagnosed with diabetes?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.

Peter L. Steinberg, MD.

Assistant Professor of Surgery, Beth Israel Deaconess Medical Center

Dr. Peter Steinberg is a board-certified urologist and the director of endourology and kidney stone management at Beth Israel Deaconess Medical Center. He is also an Assistant Professor at Harvard Medical School. He received his undergraduate degree in biochemistry from Middlebury College (1999) and graduated from University of Pennsylvania Medical School (2003). He completed a urology residency a...

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