Dr. Nesochi comments on how anemia, low b12, and hypotension may cause cold fingers on Prevention.

10 Reasons Your Fingers Are Always Cold

When you venture outside on a cold day, chances are you feel the biggest chill in your fingers. That’s normal. The extremities tend to be a bit cooler because the body sends more blood and warmth to the vital organs (the heart, brain, and lungs) first, explains David A. Friedman, MD, a cardiologist at North Shore-LIJ Health System in Great Neck, NY. However, if your fingers always feel like little glaciers even in warmer temps, it may be a sign of something more. Here are some common reasons for icy digits.

Raynaud’s Syndrome

This disorder is a common cause of cold fingers. “Raynaud’s is a condition in which there is a narrowing of the blood vessels in the fingers—and sometimes the toes, ears, and nose—in response to cold or emotional stress,” says Orrin Troum, MD, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, CA. During an episode, the fingers turn white, then blue, as little or no blood flows to the area; they then turn red once the vessels open and blood flow returns. Oftentimes the fingers are cold, numb, tingly, or painful during an attack, Troum says. Most cases of Raynaud’s have no known cause. The good news is that Raynaud’s is mostly bothersome rather than harmful. Lifestyle changes, such as dressing warmly, wearing gloves or mittens when in cold environments (even when taking food out of the fridge, depending on how severe your reactions are), and avoiding emotional stress are usually enough to manage the disorder.

Autoimmune Diseases

Sometimes an underlying condition can cause Raynaud’s. Lupus, a disorder in which the immune system attacks its own tissue; scleroderma, a disease that leads to hardening and scarring of the skin and connective tissues; rheumatoid arthritis; and other autoimmune disorders can lead to Raynaud’s, says Troum, though doctors aren’t sure exactly why there’s a connection. This is known as secondary Raynaud’s. Usually, other symptoms are present when there’s an underlying cause. Once the original condition is diagnosed and under control, the Raynaud’s symptoms tend to improve.

Hypothyroidism

It’s not uncommon to have frigid fingers if your thyroid gland is out of whack. “The thyroid is essentially the thermostat of the body,” says Ali Ajam, MD, a rheumatologist at the Ohio State University Wexner Medical Center. “When it’s underactive, most of the body functions slow down and you can have symptoms like fatigue, constipation, weight gain, and the feeling of always being cold, fingers included,” he says. Hypothyroidism is most common in women and people over 50.

Circulation Problems

This is probably what most people think cold fingers indicate. “Poor blood circulation occurs when nutrient- and oxygen-rich blood flow is diminished when circulating through the body, either from poor pumping ability of the heart [as in heart failure conditions], physical obstructions to blood flow [such as cholesterol blockages in large arteries or smaller capillaries], or other causes,” Friedman says. When the heart can’t get enough blood around the body like it’s supposed to, you’ll feel it in your hands and feet—in the form of coldness, numbness, or tingling—since they’re farthest from the heart. (Try eating more of these 21 foods that lower cholesterol naturally.)

Anemia

Anemia occurs when your body doesn’t have enough red blood cells or the amount of hemoglobin in your blood is low. “Anemia results in decreased oxygen supply to the body, which may cause cold hands,” says Nesochi Okeke-Igbokwe, MD, MS, an internal medicine specialist at NYU Langone Medical Center in New York City. Some possible causes include not getting enough iron in your diet, blood loss (due to heavy menstrual periods, ulcers, gastrointestinal bleeding), some cancers, and digestive disorders (like celiac or Crohn’s disease). In addition to cold hands, anemia can cause fatigue, headache, dizziness, shortness of breath, and pale skin. In most cases, iron-deficiency anemia and its symptoms can be treated with an iron supplement.

Vitamin B12 Deficiency

Vitamin B12, found in meat, poultry, eggs, milk, and other dairy foods, is important in red blood cell formation. “A deficiency in this vitamin level can lead to decreased red blood cell production [and subsequent anemia],” Okeke-Igbokwe says. A B12 deficiency is common among those who eat a vegetarian or vegan diet, and many people over 50 may lose the ability to absorb the vitamin from foods. Same goes for people with digestive disorders like Crohn’s or celiac disease. A simple blood test can detect whether a B12 deficiency is to blame for your cold fingers. If it is, supplements usually help, and symptoms tend to resolve within a few weeks to a month, says Arielle Levitan, MD, a doctor of internal medicine and author of The Vitamin Solution.

Low Blood Pressure

“Hypotension, or low blood pressure, can occur due to a range of reasons, including dehydration, blood loss, certain medications, and endocrine disorders,” says Okeke-Igbokwe. When your blood pressure is low, your blood vessels will shift blood away from your extremities and direct it toward the vital organs, which can leave your fingers feeling chilled. If you have symptoms of hypotension, such as dizziness, blurry vision, fatigue, nausea, weakness, and confusion, bring it to your doctor’s attention.

Stress and Anxiety

You already know stress can do a number on other parts of your body, and your hands are no exception. When you experience chronic stress or anxiety, your body goes into “fight or flight” mode. Adrenaline surges, and one result is that the blood vessels of the extremities constrict, leading to cold fingers and hands (as well as toes and feet), says Friedman. Getting your stress in check can ease symptoms.

Medications

As crazy as it may sound, your meds could be making your fingers icy. “There are many medications that can constrict the blood vessels, in particular the arteries, and when they do, one of the side effects may be Raynaud’s,” says Friedman. Some of these medications include beta-blockers (prescribed to regulate blood pressure), some cancer drugs, migraine medicines, and OTC decongestants. Talk to your doctor or pharmacist to find out if any of the medications you take could be causing your symptoms.

Smoking

As if there weren’t enough reasons to give up cigarettes, here’s another: Nicotine from smoking causes the blood vessels to constrict, and it can also cause plaque buildup in the arteries, further reducing blood flow to the extremities, says Friedman.

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