Why Am I Always Cold?

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If you tend to feel cold all the time — particularly if this has always been the case for you — you may simply have a higher core body temperature. Other common causes include being overtired or early symptoms of a cold.

But sometimes feeling cold can be the sign of a problem with metabolism, thermal regulation, or the nervous system, Celi says. And for these types of issues, getting the right diagnosis and treatment is important.

Issues with circulation can also cause someone to feel cold, but the claim of “poor circulation” is somewhat of a myth, says Jacob Teitelbaum, MD, an internist in Kailua-Kona, Hawaii. If a circulation issue is causing you to feel cold all the time, usually that’s because of an underlying condition, like Raynaud’s, rather than below-average circulation (more on this below).

Here’s what you should know about why you may feel cold all the time.

1. Thyroid Disease

The thyroid produces hormones that regulate metabolism and help control blood vessel dilation, which can affect heart rate, breathing, digestion, and more.

 When this small, butterfly-shaped gland works properly, it can help speed up metabolism and promote blood flow so your body can maintain a comfortable temperature.

But if your thyroid doesn’t produce enough hormones, your metabolism slows down and blood vessels constrict, making you feel cold, Celi says.

The thyroid regulates the metabolic processes that burn energy. For people with hypothyroidism, these processes (which are chemical reactions that produce heat) don’t happen the way they should, Celi explains.

Problems with the pituitary gland can also cause issues with the thyroid, as it regulates the thyroid.

2. Raynaud’s Syndrome

In Raynaud’s syndrome, small blood vessels in certain body parts — such as the fingers and toes — constrict more than they should and spasm, causing these areas to feel numb or cold because of restricted blood flow.

 These “attacks” usually happen in response to triggers such as cold temperatures or stress.

Feeling cold is one of the more common symptoms of Raynaud’s syndrome.

Besides the usual tips for staying warm, people with Raynaud’s syndrome may want to make lifestyle adjustments to avoid attacks, says Santhanam Lakshminarayanan, MD, a rheumatologist and a professor of medicine at the University of Connecticut in Farmington. These include rinsing refrigerated fruits and veggies in warm water before cutting them, avoiding cold beverages, and avoiding resting hands or feet on cold surfaces, like granite countertops.

“The other thing is to dress warmly when grocery shopping,” Dr. Lakshminarayanan says. Food stores are often kept at cold temperatures, which can make them very uncomfortable for people with Raynaud’s.

3. Anemia

People with anemia don’t have enough healthy red blood cells to carry oxygen and other nutrients to cells throughout the body.

 When there isn’t enough blood circulating, you’re more likely to feel cold, says Theodore Strange, MD, an internist at Northwell Health in New York City.

Low levels of vitamin B12 or folic acid (B9) can cause some types of anemia, Dr. Strange says.

Iron deficiency can also cause anemia. This type of anemia may be particularly likely to cause cold intolerance because iron is essential for the creation of thyroid hormones, as well as red blood cells, Teitelbaum says. “The thyroid hormone cannot be converted to its active form efficiently, leaving people functionally hypothyroid — and cold intolerant.”

Injuries, genetic variations, illnesses affecting the blood or bone marrow, and other conditions can also cause anemia.

4. Low Body Weight

Strange says that people with very little body fat are usually more susceptible to cold than those with more. “Fat is a great insulator,” he explains. Additionally, the body has to work harder to carry extra weight — even if it’s just 10 to 20 pounds, he says, noting that this can almost mimic exercise, causing body temperature to rise.

Moreover, people who have a low body weight due to an eating disorder, such as anorexia nervosa, are more likely to have nutrient deficiencies and anemia.

5. Sleep Deprivation

Sleep affects the hypothalamus, a small part of the brain that helps the body maintain homeostasis (or coordinate your bodily functions, so all systems are regulated and running smoothly). One of the things it helps keep in check is body temperature.

Inadequate sleep can cause the hypothalamus to malfunction, says Julia Adamian, MD, an internist, clinical professor of medicine at NYU Grossman School of Medicine, and the section chief for the division of general medicine and clinical innovation at NYU Langone Health in New York City.

“Sleep is extremely important for well-being,” Dr. Adamian says, including proper thermoregulation (or maintenance of core body temperature).

6. Nerve Damage and Conditions That Affect the Nervous System

The nervous system helps us maintain body temperature, too. For instance, we shiver to generate heat. So, anything that affects the nervous system (including Parkinson’s disease, fibromyalgia, multiple sclerosis, and stroke) may impact temperature regulation and tolerance, Strange says.

Neuropathy, a condition in which the nerves are damaged, can also cause weakness, numbness, tingling, and pain, and make you feel cold.

Poorly controlled diabetes can lead to neuropathy because over time, high blood sugar levels can damage the nerves and cause them to misfire, says Ranjani Ramanathan, MD, an endocrinologist with BJC Medical Group in St. Peters, Missouri. She says chronically high blood sugar can also damage small blood vessels and reduce circulation, causing affected body parts to feel cold.

7. Infection or Fever

When we’re sick, our hypothalamus sets our internal thermostat to a higher level to help fight off the infection. Our body then tries to generate extra heat to meet that higher set point, explains Nimmi Rajagopal, MD, a family medicine physician at Cook County Health in Chicago.

“We then feel cold — or the chills — because our temperature is below that new goal,” Dr. Rajagopal says.

Occasionally, severe infections, such as sepsis, can cause a drop in body temperature (and even hypothermia) because the body is redistributing blood flow away from the skin to more vital organs, such as the kidneys, heart, or liver.

 It may also happen when an infection damages the immune system and causes the hypothalamus to malfunction, says Deepa Iyengar, MD, a family medicine physician at UTHealth Houston.

8. Medications

Certain medications can affect the nervous system or impede blood flow to certain body areas.

Some classes of drugs that may contribute to feeling cold include the following:

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