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Why Are My Hands Always Cold?

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Written by
Petrina Craine, MD.
Assistant Clinical Professor of Emergency Medicine, Columbia University
Medically reviewed by
Last updated December 1, 2022

Cold hands quiz

Take a quiz to find out what's causing your cold hands.

Hands that are cold all the time may be a sign of poor circulation, a thyroid problem, anemia, or Raynaud’s phenomenon. It can also happen in cold weather. If your hands become really cold when outside, warm them up slowly but right away—and know the signs of frostbite.

What cold hands mean

Cold hands usually mean that not enough blood is going to your hands. Your body protects vital organs like your heart, brain, and lungs by making more blood flow to them and away from your hands.

If your hands get cold often—or turn red, purple, blue,  and start to feel numb—it may be a sign of poor circulation. But it can also be caused by conditions like anemia, Raynaud’s phenomenon, or a thyroid problem.

It can also happen when you're in a cold place and your body’s core temperature drops. If you are outside and your hands are turning white, get out of the cold right away. Then place them in warm (but not hot) water or cover them with a warm washcloth.

Pro Tip

Cold hands are a sign that your body is trying to protect core (can’t live without) organs like your heart. —Dr. Petrina Craine

Cold hands quiz

Take a quiz to find out what's causing your cold hands.

Take cold hands quiz

Causes

1. Raynaud’s phenomenon

Symptoms

  • Cold hands and feet
  • Tingling, numbness, and pain in hands and feet
  • Rapid skin color changes (often alternating between red, blue, and white)

Raynaud’s phenomenon is a condition that commonly makes hands feel cold. It can affect your entire hand or just a few fingers, and can also cause cold feet. It is sometimes a sign of autoimmune and connective tissue diseases like systemic lupus erythematosus, rheumatoid arthritis, and scleroderma.

An attack can last from a few minutes to a few hours and may be triggered by a stressor, like cold temperatures. Symptoms range from mild to severe. Frequent or long attacks can cause skin sores (ulcers) or even deformities of the hand.

Dr. Rx

I once had a patient who visited the ER because of the sudden onset of cold hands after a particularly stressful event. He was even told by some people to not go as 'that seems silly.' He ended up being diagnosed with primary Raynaud’s. It’s an important condition to not miss. Don’t let anyone be dismissive of your symptoms. —Dr. Craine

2. Iron-deficiency anemia

Symptoms

  • Cold hands
  • Feeling tired or weak
  • Shortness of breath
  • Pale or gray-ish skin
  • Feeling dizzy or lightheaded
  • Inability to exercise at full strength
  • Palpitations
  • Fainting

If your diet is low in iron, you may develop anemia. When you have iron-deficiency anemia, you don’t have enough healthy red blood cells. This makes it hard for oxygen to reach your hands and feet, which can make them feel cold.

Go to the ER if you have severe symptoms of anemia.

3. Hypothyroidism

Symptoms

  • Cold hands
  • Increased fatigue
  • Weight gain
  • Depressed mood
  • Difficulty concentrating
  • Memory problems
  • Changes to hair and skin (like increased hair loss and drier skin)
  • Constipation

Hypothyroidism, or “underactive thyroid,” is when the thyroid gland in your neck isn’t producing enough of its hormones. When thyroid hormones are low, your metabolism slows down. This increases your sensitivity to temperature changes, so your hands may feel colder than they usually do.

Don’t ignore symptoms of hypothyroidism—see your provider. If symptoms get worse, they can cause very low blood pressure and body temperature or even a life-threatening coma.

4. Peripheral artery disease

Symptoms

  • Cold hands
  • Pain when using your arms
  • Darker or shinier hands
  • Sores on your arm that don’t heal
  • Decreased pulse
  • Slower growth of arm hair

Sometimes cold hands can be a symptom of blood vessel disease, like blockages or a buildup of a fatty substance called plaque. This can reduce blood flow to your limbs, causing peripheral artery disease (PAD). While PAD is more common in the legs and feet, it can affect the hands.

PAD occurs more often in adults 50 years of age and older because the risk of blockages increases with age. It also affects smokers and people with diabetes.

If you have a sudden change in hand color and temperature and a decreased or no pulse, go to the ER. These are signs of an acute blockage that needs to be treated immediately, possibly with surgery.

5. Peripheral neuropathy

Symptoms

  • Cold hands
  • Tingling, burning, or sharp pain (“pins and needles” sensation)
  • Muscle weakness
  • Sensitivity to temperature changes
  • Rapid changes in your heart rate and blood pressure
  • Feeling off balance (if affecting feet)
  • Decreased sensation

Peripheral neuropathy is caused by problems with your peripheral nervous system, which is made up of nerves that connect the rest of the body to your brain and spinal cord. Damage to one nerve (mononeuropathy) or multiple nerves (polyneuropathy) most commonly occurs in the hands and feet and can make them feel cold. Symptoms vary depending on the type of nerve that’s affected.

Cold hands quiz

Take a quiz to find out what's causing your cold hands.

Take cold hands quiz

6. Frostnip/frostbite

Symptoms

  • Cold hands
  • Changes in skin color (like becoming red, white, blue-white, gray-yellow,  or black)
  • Hard and waxy skin
  • Severe joint or muscle stiffness
  • Tingling and numbness in other areas, such as your nose, cheeks, ears, fingers, and toes
  • Blistering (usually happens when your skin warms up)

Frostnip and frostbite are skin injuries caused by exposure to cold. Frostnip is milder than frostbite. As the hands cool down, less blood goes to the tissues in your hands.

Frostbite is more serious and causes ice crystals to form within your skin. In severe cases, it affects tissue deep within the body and can lead to tissue death. Both conditions usually happen when you’re doing outdoor activities (camping, snow sports, hunting) in the cold.

Frostnip and minor frostbite should go away when you are back in a warm place. Putting your hands in warm (not hot) water or covering them with a warm washcloth can help. You can also apply aloe vera to your skin to relieve any pain.

Severe frostbite can be life-threatening and you need to go to the ER.

Pro Tip

Infants and children have less body fat than adults to insulate them from drops in temperature, so they may have cold hands even in warmer temperatures. Someone who is older or pregnant may also be more likely to develop cold hands. —Dr. Craine

7. Hypothermia

Symptoms

Hypothermia is a dangerous condition that occurs when your body temperature drops to 95°F or lower. Parts of your body (known as the extremities, like your hands) start to feel cold and numb. It typically happens when you’re exposed to cold weather or cold water.

Cold hands caused by minor hypothermia often go away after you warm up. But severe hypothermia is a life-threatening emergency and you need to go to the ER.

Cold hands quiz

Take a quiz to find out what's causing your cold hands.

Take cold hands quiz

When to call the doctor

Make an appointment with your primary care provider if you’re worried about your cold hands. You may also be referred to a specialist like a vascular surgeon, rheumatologist, or an endocrinologist.

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Dr. Grand is a board-certified Internal Medicine Physician. She received her undergraduate degree in Psychology from New York University (2010) and graduated from Rutgers-Robert Wood Johnson Medical School (2014) where she was inducted into the Gold Humanism Honor Society. She completed an Internal Medicine residency program at Cooper University Hospital (2017) where she served as a Chief Resident...
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