You find yourself reaching for a sweater when everyone else is comfortable in short sleeves. Your hands and feet often feel like ice. What’s going on? Could something be wrong with you?  

It could be perfectly normal. Some people are naturally more prone to feeling chilled—especially women. Ironically, it stems from the way women’s bodies keep internal organs warm, which protects the uterus and future generations. In women, insulating body fat is concentrated around their core—leaving toes and fingers in the cold. Plus, when women are exposed to cold, their blood vessels contract more dramatically than men’s, which sends more blood to protect inner organs—but leaves their hands and feet colder.

Result: While a woman’s core body temperature tends to be slightly warmer than a man’s (97.8°F versus 97.4°F), her hands register about three degrees colder—87.2°F versus 90°F. But it isn’t just women who are feeling the chill. Men do, too.

Here’s why…

MEDICAL CONDITIONS THAT CAN LEAVE YOU COLD

The following two medical conditions often go undiagnosed. They affect both genders, although they’re more common in women…

Underactive thyroid. A telltale symptom of hypothyroidism—when the thyroid gland does not produce sufficient thyroid hormone—is feeling constantly cold. Other symptoms can be weight gain, constipation and fatigue. Your doctor can diagnose a low-thyroid condition with a simple blood test. Once your thyroid levels have been normalized, usually by taking daily thyroid hormone medication, your tolerance to cold should improve.

Raynaud’s disease. Cold fingers and toes are also symptoms of Raynaud’s disease. It’s a usually benign condition in which the small blood vessels in the extremities overreact to cold, as well as stress. This causes fingers and toes to feel cold to the touch and, in many cases, to change color—from white to blue or red and back to normal again.

While Raynaud’s has no cure, lifestyle modifications can help—such as keeping hands and feet warm by wearing mittens (they keep fingers warmer than gloves) and socks…or keeping hand and foot warmers in your boots or pockets.

MORE COLD CULPRITS…

Cold culprit #1: You’re too thin. Muscle generates heat, and fat acts as insulation. But if you’re underweight—with a body mass index (BMI) under 18.5—you may lack sufficient body fat or muscle to maintain a normal core body temperature.

My advice: If your low body weight is the result of extreme dieting, a nutritionist can help you adopt healthier dietary strategies. Also, certain medications, including bronchodilators for asthma and the antidepressant bupropion (Wellbutrin), can cause weight loss. If you’ve shed pounds without trying, see your primary care physician to rule out a possible serious medical condition, such as an overactive thyroid, diabetes or cancer.

Cold culprit #2: You’re on a low-carb diet. Diets that severely restrict carbohydrates, such as Atkins and Paleo, are popular for their ability to promote quick weight loss. But one of their downsides is that they can make you feel as cold as a caveman. One reason is that carb-restricted diets are very high in protein and fat, which require more energy to be digested, so after a meal your body directs more blood toward your stomach and intestines. Over the long term, a high-protein diet can also inhibit the conversion of thyroid hormone to its active form, which results in feeling cold…or eventually a full-blown underactive thyroid.

My advice: Rather than omit or limit an entire category of food, stick to a balanced 40/40/20 diet—40% of your calories from carbohydrates…40% from (healthy) fats… and 20% from protein. Aim for three meals and one or two snacks per day, depending on your activity level. Your body needs high-quality whole grains, such as brown rice and quinoa, as well as other complex carbohydrates, such as sweet potatoes and squash, for energy and essential vitamins and other nutrients.

A sample day might include a veggie omelet and two slices of rye toast for breakfast…grilled salmon and a mixed greens salad for lunch…chicken with vegetables and brown rice for dinner…and a few chocolate-covered strawberries for dessert.

Also: Don’t skip meals. Being hungry causes the body to conserve energy, producing less heat as a result.

Cold culprit #3: You don’t get enough sleep. Lack of sleep disturbs the physiological mechanisms of the brain, especially the hypothalamus, which controls body temperature.

My advice: Aim to get seven to eight hours of sleep a night. Don’t keep your bedroom too warm—the National Sleep Foundation puts the optimal room temperature for sleep at around 65°F.

If you have trouble falling asleep, give meditation a try. A JAMA Internal Medicine study found that meditating five to 20 minutes a day can help you fall asleep more quickly than using basic sleep-hygiene techniques such as establishing a bedtime routine.

Cold culprit #4: You’re dehydrated. Your body is 60% water, and if you are dehydrated, it can affect circulation, making you feel colder.

My advice: Be sure to drink plenty of fluids—and drink even more than usual if you are physically active. Water is best, but contrary to common beliefs, tea and coffee can count—your body still holds onto some of these fluids despite their mild diuretic effect.

Best self-check: If your urine is very yellow and concentrated, you are not drinking enough water and other fluids.

Cold culprit #5: You’re a vegetarian. Vegetarians are sometimes deficient in iron. Why? Red meat has plenty of iron and it’s easily absorbed, while vegetarian sources, such as beans and greens, have less iron and it’s in a less available form. Low iron intake can lead to iron-deficiency anemia—and feeling cold is a common symptom. Vegans, who eat only plant-based foods, may also be low in vitamin B-12, found primarily in animal products, including meat, fish, poultry, eggs and dairy. A B-12 deficiency can lead to “pernicious anemia,” which can cause you to feel cold as well.

Note: Antacids and proton pump inhibitors, commonly used to treat acid reflux, also can inhibit iron and B-12 absorption. And people who have Crohn’s disease and celiac disease are at risk for anemia.

My advice: If you’re a vegetarian or vegan, have your doctor run a simple blood test for iron deficiency. Warning: Only take an iron supplement if it’s prescribed, as too much iron can be dangerous.

Vegans also need a supplementary source of B-12, since it’s found only in animal foods. But so do many omnivores and lacto-ovo vegetarians.

Here’s why: Between 10% and 30% of older adults have gastritis, which interferes with the absorption of B-12 from food—but they can absorb B-12 from supplements and fortified foods. That’s why the Institute of Medicine recommends that adults older than age 50 get much of their vitamin B-12 from vitamin supplements or fortified foods.

Tip: If you rely on antacids or proton pump inhibitors, or have a condition such as Crohn’s or celiac, get your B-12 levels tested.

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