Dr. Jacqueline Gerhart: Why are her feet always cold?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart:
My feet are always cold. I've talked to other women about this and many of them say they have the same problem. What's going on and should I worry?
Many people, both men and women, have cold feet. Your feet stay warm by getting appropriate blood flow. When your body is cold, sometimes the blood vessels in your feet and hands constrict, in order to push blood to the center of your body, to vital organs like your brain and heart. Blood vessels can also constrict during stress, or increased activity for the same reason: shunting blood to your core. Wearing tight or pointed shoes can also constrict blood flow to your toes.
Some people have a condition called Raynaud's disease that causes cold or pale feet. Raynaud's disease is more common in women and in people who live in colder climates. It usually starts between the ages of 15 and 30. It causes small blood vessels to spasm, and limit the blood circulation to feet and hands. There are varying degrees of Raynaud's, ranging from occasionally having cold hands and feet to noticing that certain fingers and toes turn white or blue every time you are in cold weather. In severe cases, your health care provider may prescribe a medication to help dilate the small blood vessels in your feet to allow for greater blood flow.
Having cold extremities occasionally can be something more serious. It sometimes could mean that your thyroid gland, is not producing enough hormone. Usually in this case, you may also notice some weight gain, hair loss, or feelings of sluggishness. Also, if you have numbness, tingling, or decreased feeling in your feet, this may be a sign of diabetes.
If you are a smoker, or have known high blood pressure or heart disease, you may also be at risk for having cold or pale feet from a condition called peripheral arterial disease. In peripheral arterial disease or PAD, blood doesn't flow through the arteries in your legs normally, often due to a blockage caused by a fatty buildup or plaque. Usually this happens in a single foot rather than both feet. If your physician is concerned about PAD, he or she may do a test that compares the blood pressure in your legs to the blood pressures in your arms. If there is a significant difference in those blood pressures, this could indicate that you have a blockage or plaque in your artery. Usually, patients will also feel pain, have decreased pulses, or have skin changes (often in one leg) that indicate that an artery is blocked. If you are concerned about this possibility, see your physician.
Overall, the majority of cases of "cold feet" are benign, and are related to being in cold environments. Being in Wisconsin, we can't change our climate, but we can wear warm socks and well-fitting shoes. Get out those winter boots!
Stay warm! — Dr. Gerhart
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 10/11/2011