What illnesses can cause you to be cold all the time?

September 25, 2025 •

4 min read

Persistent cold sensitivity, also known as cold intolerance, can be a sign of an underlying health issue rather than just a personal preference for warmer temperatures. This feeling, where you feel colder than others around you, can point to a range of medical conditions, and understanding the root cause is the first step toward finding relief. So, what illnesses can cause you to be cold all the time?

Quick Summary

Constantly feeling cold can stem from several medical conditions that disrupt the body's temperature regulation, including hypothyroidism, anemia, poor circulation caused by conditions like Raynaud's phenomenon or PAD, and diabetes-related issues.

Key Points

Hypothyroidism: A common culprit, an underactive thyroid can slow your metabolism and reduce body heat production, leading to generalized coldness.
Anemia: A lack of healthy red blood cells hinders oxygen delivery, impairing the body's ability to regulate temperature and causing fatigue and cold sensitivity.
Poor Circulation: Conditions like Raynaud's phenomenon and Peripheral Artery Disease (PAD) can reduce blood flow to extremities, causing localized coldness in fingers, toes, and limbs.
Diabetes: Nerve damage (neuropathy) and vascular issues resulting from high blood sugar can cause a persistent feeling of coldness, particularly in the hands and feet.
Low Body Weight: Insufficient body fat, whether due to an eating disorder or natural leanness, provides less insulation and can lead to constant cold sensations.
When to See a Doctor: Seek medical advice for persistent coldness, especially if it's new or accompanied by other symptoms like fatigue, skin changes, or unexplained weight fluctuations.

Understanding the body's internal thermostat

Your body's ability to maintain a consistent internal temperature is a complex process known as thermoregulation, which involves the brain (specifically the hypothalamus), metabolic rate, hormones, and circulation. When any part of this system malfunctions, it can lead to an abnormal sensitivity to cold. A significant factor is your basal metabolic rate (BMR), the rate at which your body burns energy while at rest. Since a large portion of this energy is converted to heat, a slower metabolism can mean less heat production and a greater feeling of coldness.

Endocrine disorders affecting temperature regulation

Endocrine issues are one of the most common causes of persistent cold sensitivity due to their direct role in metabolism and heat production. The thyroid gland is a primary regulator of this system, but other hormonal changes can also play a part.

Hypothyroidism (underactive thyroid)

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. This hormone is essential for regulating metabolism and temperature, and a deficiency causes the body's processes to slow down. The reduced metabolic rate leads to diminished heat production, making cold intolerance a classic symptom.

Common symptoms of hypothyroidism:

Fatigue
Weight gain
Dry skin and hair
Constipation
Puffy face
Depression

Diabetes

Over time, high blood sugar from uncontrolled diabetes can cause nerve damage (peripheral neuropathy) and impair blood vessel function, both of which can lead to a sensation of coldness, especially in the hands and feet. The reduced blood flow and damaged nerves disrupt temperature signals to the brain.

Blood disorders: the connection to coldness

Blood plays a crucial role in distributing warmth throughout the body. When there is an issue with the blood itself, or with its circulation, it can directly cause a person to feel cold.

Anemia

Anemia occurs when the body lacks enough healthy red blood cells to carry sufficient oxygen to its tissues. With less oxygen reaching cells, the body struggles to generate and regulate heat efficiently, leading to feelings of fatigue, weakness, and persistent coldness, particularly in the hands and feet. Iron deficiency is the most common cause of anemia.

Nutritional deficiencies

Deficiencies in certain vitamins and minerals, notably vitamin B12 and iron, can lead to anemia and subsequently increase cold sensitivity. These nutrients are vital for producing red blood cells and supporting metabolic functions.

Poor circulation and vascular problems

For many, poor circulation is the primary reason for constantly feeling cold, as it prevents warm blood from reaching the extremities. Vascular conditions can restrict blood flow and lead to this sensation.

Raynaud's phenomenon

This condition causes the smaller blood vessels in the fingers and toes to overreact and constrict excessively in response to cold temperatures or stress. The affected areas turn white or blue, feel cold and numb, and can cause tingling or pain as blood flow returns.

Peripheral Artery Disease (PAD)

In PAD, plaque builds up in the arteries, narrowing them and restricting blood flow to the limbs, most commonly the legs. This results in coldness, numbness, and cramping in the legs and feet, which worsens with activity.

Other potential medical causes

Beyond the most common conditions, several other factors can contribute to cold intolerance. These include:

Anorexia nervosa: Extreme weight loss and low body fat severely compromise the body's ability to maintain warmth, and a slowed metabolic rate also contributes.
Low body weight: Simply having very little body fat, regardless of an eating disorder, can reduce the insulation needed to stay warm.
Chronic fatigue syndrome and fibromyalgia: These conditions are associated with heightened sensitivity to a range of stimuli, including cold.
Kidney disease: Severe chronic kidney disease can affect circulation and the body's core temperature.
Certain medications: Some medications, including beta-blockers and certain antidepressants, can cause cold sensitivity as a side effect.

Medical conditions affecting cold sensitivity: a comparison


Condition	Primary Mechanism	Location of Cold Sensation	Other Common Symptoms
Hypothyroidism	Slowed metabolism, reduced heat production	Generalized coldness, low core temperature	Fatigue, weight gain, constipation, dry skin
Anemia	Reduced oxygen delivery via red blood cells	Generalized coldness, but often most noticeable in hands and feet	Fatigue, weakness, pale skin, dizziness
Raynaud's Phenomenon	Exaggerated blood vessel constriction	Primarily fingers and toes (localized)	Color changes (white, blue, red), numbness, tingling
Peripheral Artery Disease (PAD)	Plaque buildup narrows arteries, reduces blood flow	Primarily legs and feet (localized)	Leg pain when walking, numbness, hair loss on legs
Diabetes	Nerve damage (neuropathy) and poor circulation	Primarily hands and feet (localized)	Tingling, numbness, slow-healing sores, high blood sugar
Low Body Weight	Reduced insulating fat and metabolic rate	Generalized coldness	Fatigue, significant weight loss, nutritional issues

When to see a doctor

If you find yourself constantly feeling cold, it is important to consult a healthcare professional, especially if the sensation is new, worsening, or accompanied by other symptoms like fatigue, unexplained weight changes, or changes in skin color. A doctor can perform tests, including a complete blood count and thyroid hormone levels, to diagnose the underlying issue. In severe cases, particularly if you have symptoms of hypothermia or sepsis (such as confusion, slurred speech, or fever), immediate medical attention is necessary.

Conclusion

Feeling cold all the time can be a symptom of a wide variety of underlying health issues, from the very common to the more severe. Conditions such as hypothyroidism, anemia, and circulatory problems are among the most frequent culprits. Rather than simply bundling up, recognizing persistent coldness as a potential sign of a medical problem is crucial. By working with a doctor to diagnose the root cause, you can find effective treatment and improve your overall comfort and health. For more detailed information on various health conditions, you can visit the MedlinePlus Medical Encyclopedia.

Frequently Asked Questions

Yes, low iron is a common cause of iron-deficiency anemia, which means your body doesn't have enough healthy red blood cells to carry oxygen. This can make it difficult for your body to regulate its temperature and cause you to feel cold.

Cold intolerance is an abnormal or exaggerated sensitivity to cold temperatures or environments. People with this condition often feel colder than others around them, even when wearing adequate clothing.

While some people naturally have colder extremities, persistently cold hands and feet can be a sign of poor circulation, Raynaud's phenomenon, or other medical issues like anemia or diabetes. If the coldness is severe or accompanied by other symptoms, it warrants medical attention.

The thyroid gland produces hormones that control your body's metabolism and heat production. An underactive thyroid (hypothyroidism) results in lower hormone levels, which slows your metabolism and reduces your ability to generate heat.

Yes, high levels of stress and anxiety can trigger a 'fight or flight' response that accelerates adrenaline and pushes blood to your core, causing your hands and feet to feel chilly.

It is best to consult a healthcare professional. They can conduct a physical exam and blood tests (including a complete blood count and thyroid panel) to determine the underlying cause and recommend appropriate treatment.

Yes, people with low body fat have less insulation to retain heat, which can make them more sensitive to colder temperatures. It can also be associated with a reduced metabolic rate.