Cold Hands & Feet: Causes & Symptoms

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Do you ever get cold feet when you're supposed to do something really big? Actually cold feet can really occur when you're really nervous. Find out how as you learn about other causes of cold hands and feet.

Fighting Over The Temperature

Have you ever fought over the thermostat at home? Some people, no matter how warm it is, always seem cold. They probably complain of cold hands and feet. Others, even when it's freezing outside, seem to walk around like nothing is bugging them. Their hands may even be warm while yours are ice cold!

So why is it that some people have cold hands and feet?


In young and healthy people, one of the most likely reasons for cold hands and feet may have to do with thermoregulation, the body's way of regulating its internal temperature with respect to internal factors (like metabolic processes) and external factors (like the outside temperature).

For example, if you are walking around outside on a cold day, those cold hands and feet are actually quite expected. See, the body will try to conserve body heat when it's cold outside. It does so by constricting the blood vessels running through your fingers and toes. By constricting these blood vessels, less blood flows through them. This means less is radiated out of your body. This mechanism helps the body keep its core body temperature up, the temperature near vital organs like the lungs and heart.

Signs & Symptoms

Of course, if the signs and symptoms of your cold hands and feet run beyond just temporarily cold hands and feet when you're cold, then there might be a more serious problem going on. Signs and symptoms you need to look out for that point to a potentially more serious problem include:

  • Persistently cold hands and/or feet even when it's otherwise warm in the environment
  • Pain in the hands and/or feet
  • A discoloration to the hands or feet, especially to the fingertips and toes. This discoloration can be a pale color, blue or purple color, red color as the hands re-warm, and in some rare cases, this may progress to a black color signaling tissue death.
  • Changes to the consistency of the skin or nails, like tightened skin, thickened skin, or a sore on the hands or feet that takes a very long time to heal or does not heal at all.


The medical causes for cold hands and/or feet are varied. They include:

  • Anemia, a disorder that results in a proper lack of red blood cells and/or their oxygen-carrying molecule called hemoglobin.
  • Diabetes mellitus, the disorder best known for causing high blood sugar.
  • Frostbite, such as when people go mountain climbing.
  • Buerger's disease, a disorder that leads to the inflammation of and restricted blood flow in the blood vessels of the legs and arms.
  • Hypothyroidism, an endocrine disease that doesn't produce enough energy boosting thyroid hormone.
  • Lupus, a type of condition where the body's own cells and molecules attack itself.
  • Scleroderma, a disease that causes the overproduction of a protein called collagen, to the point of damaging the body.

Finally, there is the potential for the cold hands and/or feet being a sign of Raynaud's disease or Raynaud phenomenon. In this disorder, the blood vessels of the fingers and/or toes spasm (suddenly constrict) in a recurrent and intense fashion.

Note this thermal image of a person with Reynauds disease (top) compared to a person without (bottom) and how there is diminished blood flow to the fingers in the former case.

This causes the fingers and toes to first turn pale, then blue/purple, and finally red as the blood flow returns. No one is exactly sure exactly why this occurs but it appears cold temperatures and stress can trigger these spasms in some people. Sometimes, this disease is relatively harmless but in other cases it is a sign of a more serious underlying problems, such as scleroderma.

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