Some people are naturally more sensitive to chilly temperatures, but constant coldness—known as cold intolerance—can also signal an underlying health issue. Conditions like anemia, thyroid disorders, poor circulation, or even lifestyle factors such as dehydration and lack of sleep may all play a role.

If you often find yourself bundled up when others are comfortable, understanding the possible reasons can help you know when it’s time to seek medical advice.

1. Anorexia Nervosa

Anorexia nervosa is an eating disorder that leads to extreme weight and muscle loss, reducing the body’s ability to stay warm.

Other symptoms may include:

  • Dry or yellowing skin

  • Fine body hair

  • Depression and memory issues

  • Osteoporosis or brittle bones

What to do: Treatment focuses on restoring healthy weight and improving eating habits. Hospital care, supervised nutrition, and cognitive behavioral therapy (CBT) may be needed.

2. Beta-Blockers

Medications like metoprolol slow your heart rate and can reduce blood flow to the hands and feet, leaving them cold.

What to do: Ask your healthcare provider if your medication could be contributing. In the meantime, wear warm socks and gloves to ease discomfort.

3. Blood Sugar Issues

  • Peripheral neuropathy: Long-term high blood sugar damages nerves in the hands and feet, causing numbness and coldness.

  • Hypoglycemia: Low blood sugar can trigger chills, confusion, and weakness.

What to do: Manage diabetes through diet, exercise, and prescribed medications. For low blood sugar, eat 15 grams of fast-acting carbohydrates (like juice or honey) and recheck blood sugar after 15 minutes.

4. Dehydration

Water regulates body temperature. Without enough fluids, your body becomes more sensitive to cold.

Signs of dehydration include: dark urine, dizziness, dry mouth, and fatigue.

What to do: Drink 91–125 ounces of fluids daily, including water, fruits, vegetables, and soups. Severe dehydration may require IV fluids.

5. Hypothyroidism

A sluggish thyroid leads to low hormone levels and slows metabolism, reducing heat production. Nearly 5% of U.S. adults have hypothyroidism.

Other symptoms: weight gain, hair loss, dry skin, irregular periods.

What to do: Thyroid hormone replacement therapy restores balance and helps improve cold intolerance.

6. Iron Deficiency Anemia

Low iron reduces oxygen delivery in the blood, making you feel cold. It can also slow thyroid function.

Other signs: pale skin, brittle nails, shortness of breath, difficulty concentrating.

What to do: Eat iron-rich foods like lentils, beans, poultry, and whole grains, paired with vitamin C for better absorption. Iron supplements or IV iron may be prescribed if diet alone is insufficient.

7. Lack of Sleep

Sleep deprivation affects both metabolism and temperature regulation. People who don’t get enough rest may feel chilled more often.

What to do: Aim for 7–8 hours of sleep. Improve sleep hygiene by limiting caffeine, avoiding late meals, and keeping a consistent bedtime routine.

8. Low Body Weight

A BMI below 18.5 means less insulating fat and reduced muscle mass, both of which generate body heat.

What to do: Work with a provider to gain weight safely. Eat balanced meals with carbohydrates, fats, and proteins, and include strength training to build muscle.

9. Poor Circulation

If your hands and feet are cold while your core feels warm, circulation issues may be to blame. Causes include Raynaud’s disease, heart problems, or smoking.

What to do: Keep extremities warm, soak hands in warm water during Raynaud’s flares, and avoid smoking. Medications may also help improve circulation.

10. Peripheral Artery Disease (PAD)

PAD happens when plaque buildup narrows arteries, cutting off blood flow. This may cause one leg to feel colder than the other.

Other signs: pale skin, painful legs when walking, slow-healing sores, weak leg pulses.

What to do: Treatments include heart-healthy lifestyle changes, blood pressure medication, statins, and in severe cases, surgery to restore circulation.

11. Vitamin B12 Deficiency

Vitamin B12 is essential for red blood cell production. Without enough, anemia develops, causing cold sensitivity.

Other symptoms: fatigue, pale skin, swollen tongue, irritability, or numbness in hands and feet.

What to do: Eat B12-rich foods like eggs, dairy, poultry, shellfish, and fortified cereals. Supplements or injections may be recommended, especially for vegetarians and vegans.

Diagnosis

If you’re always cold, a healthcare provider may order tests like:

  • Complete blood count (CBC): Checks for anemia.

  • Thyroid hormone tests (TSH and T4): Screens for hypothyroidism.

  • Iron studies and vitamin levels.

What You Can Do

While bundling up can help in the short term, lifestyle changes support long-term comfort:

  • Stay hydrated.

  • Eat a balanced diet with enough protein, fats, and micronutrients.

  • Exercise regularly to improve circulation.

  • Get 7–8 hours of sleep each night.

  • Avoid smoking and limit alcohol.

When To Seek Care

Call your doctor if:

  • You are cold when others aren’t.

  • Symptoms appear suddenly or worsen.

  • You also notice swelling, chest pain, shortness of breath, or unexplained fatigue.

These may be signs of anemia, thyroid problems, circulation disorders, or other serious conditions that require medical treatment.

Quick Review

Feeling cold all the time can stem from lifestyle factors like dehydration or poor sleep—or from health issues like hypothyroidism, anemia, PAD, or circulation problems. If cold intolerance persists despite lifestyle adjustments, consult your healthcare provider for testing and treatment.