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Cold hands, especially if persistent for longer than usual, are caused by poor circulation due to the hardening of blood vessels over time, hypothyroidism, anxiety, or infections. Often blood circulation causes both cold hands and feet.
Symptoms of cold hands
Cold hands are uncomfortable both to you and to anyone they touch, but are they really anything to worry about? Sometimes those constantly cold hands can be a sign of illness. But most often, cold hands simply mean that your inner body has gotten a little too cool and your "core temperature" has dropped a little too low.
To protect your vital organs, such as your heart and lungs, your body diverts more blood flow to them and that leaves less blood circulating to your hands and feet. The term "cold hands, warm heart" is quite literally true.
Common characteristics of cold hands
If you're experiencing cold hands, they can likely be described by the following.
- Your hands feel cold: Like "blocks of ice."
- You might feel numbness, tingling, or pins-and-needles
- Hands color ranges from red to purple-blue to pale white
- Someone who touches your hand feels that it is cool or cold
Duration of cold hands symptoms
This can last a few minutes, a few hours, a few days, or longer. Sometimes the cold feeling never really goes away. Your hands might warm up in warm environments but go right back to feeling cold again with exposure to cold air or water.
Who is most often affected by cold hands?
The following individuals are more likely to experience cold hand symptoms.
- Older people
- Anyone living or working in cold conditions
- Anyone with poor circulation
- Diabetics or others with peripheral nerve disease
Are cold hands serious?
Cold hands may point to a serious problem if the circulation in them is truly impaired or you have a nerve condition that's causing the problem. Cold hands are rarely serious in a younger person with no other illnesses.
Cold hands causes and conditions
Circulatory causes of cold hands
Issues with circulation may result in cold hands.
- Poor circulation: This is the most common cause of cold hands. It limits the amount of blood and therefore heat flowing through your veins and arteries.
- Hardening of the arteries clogs your blood vessels over time
- Smoking makes your blood vessels constrict
- Cold weather causes your blood vessels to constrict
- Feeling chilled or nervous can cause your blood vessels to suddenly tighten: Your cold hands may appear red, purple, or pale white.
- Thoracic outlet syndrome: This can occlude the blood vessels to your arms this is very rare.
Hormonal and deficiency causes of cold hands
The following can also result in cold hands.
- Thyroid imbalances: Too much or too little thyroid hormone interferes with metabolism.
- Megaloblastic anemia: This is a shortage of healthy red blood cells from Vitamin B12 deficiency, which can cause cold feet that often also burn.
Nervous system causes of cold hands
Disorders of the nervous system can result in cold hands.
- Peripheral neuropathy: Or nerve damage, causes numbness and tingling in your hands which you may interpret as cold.
- Panic disorder: This sends your body into fight-or-flight mode, diverting blood to your internal organs and out of your hands leaving them cold.
- Anxiety and nervousness: These both cause sweating and constriction of your blood vessels, which is why your hands may feel both cold and clammy.
Infectious causes of cold hands
Infections may result in cold hands.
- Any viral or bacterial infection: This may cause fever, which is part of fighting the infection. Cold hands result because your body redirects blood to vital organs.
- Mononucleosis: This can lead to peripheral neuropathy.
- Meningitis: This may have symptoms of both fever and cold hands.
Physiological causes of cold hands
The following physiological causes may result in cold hands.
- Low body fat: This will make your body divert more blood flow to your vital organs.
- Family trait: Sometimes having cold hands is simply normal and a trait that runs in families.
This list does not constitute medical advice and may not accurately represent what you have.
Iron deficiency anemia is a condition in which the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.
The condition can be caused by acute blood loss through injury, surgery, or childbirth;chronic b..
Raynaud phenomenon, also called Secondary Raynaud syndrome, is a condition that causes small arteries in the skin to abnormally constrict on exposure to cold water or air. This limits blood flow to the hands, fingers, feet, toes, nose, and ears.
Secondary Raynaud syndrome is rare and is caused by another underlying medical condition, often a connective tissue disorder such as rheumatoid arthritis, scleroderma, or lupus.
Women are more likely than men to be affected, especially if living in cold climates. Family history and smoking are also risk factors.
Symptoms include the hands and feet becoming numb and cold. The skin color changes from pale to bluish, and then to red as the skin warms again.
If not treated, patients may get ulcerated sores or deformities of the fingers and toes, or even gangrene, due to the lack of circulation.
Diagnosis is made through patient history, physical examination, and blood tests.
Treatment includes medications to help increase circulation; treatment of any underlying conditions; and lifestyle changes to gain better protection for the extremities in cold conditions.
Top Symptoms: distal numbness, cold toe, cold fingers, spontaneous toe pain, spontaneous finger pain
Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.
The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.
Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.
Diagnosis is made through a simple blood test.
Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.
Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches
Urgency: Primary care doctor
Mild frostbite of the upper limbs
Frostbite is tissue damage caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports. It is also more likely in those who are intoxicated or have a mental disorder.
Top Symptoms: hand numbness, hand pain, hand redness, cold hands, cold fingers
Symptoms that always occur with mild frostbite of the upper limbs: cold fingers
Urgency: Hospital emergency room
Thoracic outlet syndrome
The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.
The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.
Symptoms vary depending on the structures being compressed:
- Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hand, and fingers.
- Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.
It is important to see a medical provider about these symptoms so that the damage does not become permanent.
Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.
Treatment involves physical therapy, pain relievers, and sometimes surgery.
Top Symptoms: pain in one shoulder, spontaneous shoulder pain, arm weakness, arm numbness, pain in one shoulder blade
Urgency: Primary care doctor
Cold hands treatments and relief
When cold hands are an emergency
Seek immediate treatment in the emergency room or call 911 if:
- You have cold hands and feet: And you also have fever. This can be a sign of a serious infection or circulatory issue.
- There is severe pain with pale, numb, hardened skin: This can mean frostbite, which is actual freezing of the tissue of your hands.
When to see a doctor for cold hands
You should schedule an appointment for:
- Ongoing fatigue and constantly feeling cold
- Chronically cold hands with numbness and tingling
- Constant feelings of anxiety and even panic
- Uncomfortably cold hands which change color from white to purple to red
At-home treatments for cold hands
For mild or occasional cold hands, you can try the following remedies at home.
- Layer gloves: When outside, silk or cotton gloves can be layered beneath wool mittens.
- Wear fingerless gloves indoors: When indoors, fingerless gloves will help keep your hands warm while still leaving your fingers free for work.
- Warm hats and socks preserve body heat
- Exercise and hand massage: These can help improve circulation in your hands.
- Stop smoking
- Drink warm beverages in the winter
FAQs about cold hands
What causes cold hands?
Cold hands are usually caused by reduced blood supply to the hands. This can be the result of blockage or constriction of our blood vessels in the hands. This occurs when an individual is in a cold environment and the body must conserve heat. It does this by diverting blood from the hands to more essential organs like the heart, lungs, brain, and intestines.
What causes poor circulation in the hands?
Cold exposure is a common cause. It can also be a symptom of certain autoimmune diseases, blood disorders, or hypothyroid disease. Exposure to certain drugs or environmental factors; emotional stress; and damage to the vascular system of the hands can also cause poor circulation in the hands. Smoking is an important risk factor for poor circulation.
How to improve circulation in the hands?
Try not to let your body get cold too quickly and/or change temperatures too quickly. Keep your whole body warm. Don't smoke — smoking can make your symptoms worse. Avoid medicines that cause blood vessels to become narrow, such as cold medicines or diet pills. Use gloves, or better yet mittens, in very cold temperatures. Try to relax and reduce the stress in your life.
Can cold hands be a sign of anemia?
Yes. Anemia is caused by loss and/or impaired production of red blood cells. Blood loss and impaired production of red blood cells can both compromise blood flow to your hands, making your hands cold. If your body is producing limited quantities of blood, it may first divert blood from extremities (e.g. hands and feet) in an attempt to conserve blood for vital organs (e.g heart, lungs, intestines).
When should you see a doctor for cold hands?
See a doctor if the problem persists, or you start to develop lasting blue discoloration, pain or open sores on your fingers. Additional symptoms, such as joint pain, muscle pain, fever, weakness, weight loss, dry eyes, dry mouth, rash, arthritis, or problems with heart or lungs, might indicate underlying medical conditions that warrant medical attention as well.
Questions your doctor may ask about cold hands
- Has any part of your body become paler than normal?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Have you been experiencing dizziness?
- Were you recently exposed to the freezing cold (under 32F or 0C)?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Janeen has worked over eight years as a full-time medical transcriptionist, specializing in pain management and gynecologic oncology. She later began transcribing reports for hospital emergency rooms and acute care admissions. This background gave her a strong medical vocabulary as well as a heart for making medical information accessible to the average person, leading her to work as a medical writer. She began as a pre-veterinary medicine major at Texas State University.
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