Why Are My Hands and Feet Always Cold?

Cold hands and feet are among the most common things people notice about their own bodies, and among the easiest to shrug off. Usually your body is doing exactly what it is designed to do when it senses cold. Sometimes, though, cold fingers and toes come with other clues worth raising with your doctor.

This article explains how normal circulation responds to cold, which conditions can make your hands and feet colder than they should be, and which skin changes need prompt care. It is part of our library on everyday physical health and recovery, and it can help you decide what to do next, but it cannot diagnose you.

Is it normal for your hands and feet to always feel cold?

Yes, for many people it is. When your body senses cold, it narrows the small blood vessels in your skin, a process called vasoconstriction, so that less warm blood reaches the surface and more heat stays in your core, where your vital organs are.

Hands and feet feel this first. They sit far from your heart, have a lot of surface area for their size, and carry little muscle to make heat of their own, so they cool quickly when blood flow drops.

Some people simply run colder at the extremities than others, and that alone is not a disease. What separates ordinary cold hands from a problem worth checking is the company they keep: color changes, pain, numbness, sores, coldness on one side only, or other symptoms elsewhere in your body.

What are the most common causes of cold hands and feet?

The most common cause is ordinary cold exposure, followed by Raynaud's phenomenon, and then a handful of conditions that affect your blood, hormones, blood vessels, or nerves. Use the table as a starting point for a conversation with your doctor, not a way to diagnose yourself.

Possible cause	Clues that point to it	What usually helps or comes next
Normal response to cold	Both hands or feet cool evenly in cool conditions and warm up once you are warm, with no lasting color change	Layers, gloves, warm socks, and moving around
Primary Raynaud's phenomenon	Fingers or toes turn white, then blue, then red in the cold or during stress; usually starts before age 30	Staying warm, avoiding triggers, and not smoking; see a doctor to confirm
Secondary Raynaud's phenomenon	Similar attacks alongside joint pain, rashes, skin tightening, or sores on the fingertips	Medical evaluation for an underlying condition such as lupus or scleroderma
Anemia	Tiredness, weakness, paleness, chills, shortness of breath, dizziness	A blood test; treatment depends on the cause
Hypothyroidism (underactive thyroid)	Trouble tolerating cold, tiredness, weight gain, dry skin, thinning hair, a slower heartbeat	A blood test for thyroid hormone levels
Peripheral artery disease	One foot colder than the other, leg pain when walking that eases with rest, pale or bluish skin, slow-healing sores	Prompt medical evaluation, especially if you smoke or have diabetes
Diabetes-related nerve or circulation problems	Numbness, tingling, burning, trouble sensing temperature, sores you did not feel happen	Daily foot checks and a foot exam at least once a year
Smoking or vaping	Colder hands after nicotine, more frequent Raynaud's attacks	Quitting; circulation improves soon after you stop

What is Raynaud's phenomenon, and what does an attack look like?

Raynaud's phenomenon is a condition in which the small blood vessels in your fingers and toes overreact to cold or stress, clamping down fast and staying narrowed longer than they should. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), attacks usually affect the fingers and toes and occasionally the ears, nose, or tongue.

What color changes happen during an attack?

A typical attack moves through three stages. The skin first turns pale or white as blood flow drops, then turns blue and feels cold and numb as the remaining blood loses oxygen, and finally turns red as blood returns, often with swelling, tingling, burning, or throbbing. An attack can last minutes or hours, and not everyone sees all three colors.

The red phase is brief and follows rewarming. Palms that stay red all the time are a different pattern with different causes, which you can read about in our article on what causes red palms.

What triggers Raynaud's attacks?

Cold is the most common trigger. NIAMS gives everyday examples such as holding an iced drink or walking into an air-conditioned store on a hot day. Emotional stress, cigarette smoking, and vaping can also set off symptoms.

What is the difference between primary and secondary Raynaud's?

Primary Raynaud's is the more common form and has no known cause. It is more frequent in women, usually starts before age 30, and may run in families. Secondary Raynaud's is linked to another condition or exposure, such as lupus, scleroderma, rheumatoid arthritis, certain medications, or regular use of vibrating tools. NIAMS notes that the secondary form is less common but typically more serious, because it comes with damage to the blood vessels. Only a clinician can tell the two apart.

Could anemia or a thyroid problem be making you feel cold?

Yes, both can. Anemia and an underactive thyroid are two common, treatable conditions in which feeling cold is part of a wider pattern of symptoms, and both are checked with a simple blood test.

How does anemia make you feel cold?

Anemia means your blood has fewer healthy red blood cells, or less hemoglobin (the protein that carries oxygen), than it should. The National Heart, Lung, and Blood Institute (NHLBI) lists weakness, paleness, tiredness, chills, shortness of breath, headache, and dizziness among its symptoms. Mild anemia may cause no symptoms at all.

Iron deficiency is one of the most common causes. If a blood test shows low iron, your doctor will look for the reason and may recommend a supplement, and it also helps to know the everyday foods rich in iron. Do not start iron pills on a hunch, because too much iron can be harmful.

How does an underactive thyroid affect body temperature?

Hypothyroidism means your thyroid gland does not make enough thyroid hormone, which helps set how quickly your body uses energy. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists trouble tolerating cold alongside tiredness, weight gain, joint and muscle aches, dry skin, thinning hair, heavy or irregular periods, a slower heartbeat, and depression.

Because it develops slowly, NIDDK notes that symptoms can go unnoticed for months or even years, and only blood tests can confirm it.

When do cold feet point to peripheral artery disease?

Cold feet can point to peripheral artery disease when the coldness is on one side, comes with leg pain during walking, or comes with skin and nail changes. Peripheral artery disease, or PAD, is a narrowing of the arteries that carry blood to your legs, usually from a buildup of fatty plaque called atherosclerosis.

According to NHLBI, the most common symptom is intermittent claudication: pain, aching, heaviness, or cramping in the calf, thigh, or buttock that starts when you walk or climb stairs and eases within minutes of rest. NHLBI also lists these signs:

• One foot that feels colder than the other
• A foot or leg that looks pale, discolored, or blue
• Sores on the toes, feet, or legs that heal slowly or not at all
• Toenails and leg hair that stop growing
• Numbness, weakness, or a pins-and-needles feeling in the leg or foot

Smoking, high blood pressure, diabetes, high cholesterol, and older age all raise the risk. PAD matters beyond the legs, because people who have it often have plaque in the arteries to the heart and brain too, which raises the risk of heart attack and stroke. Pain in the foot or leg while you are resting is a sign of severe PAD and needs prompt care.

Smoking deserves a special mention. MedlinePlus explains that smoking can make blood vessels thicken and grow narrower, and NIAMS lists smoking and vaping among the triggers for Raynaud's attacks. MedlinePlus also lists better circulation among the early benefits of quitting, and 1-800-QUIT-NOW connects you with free support from your state's quitline.

How can diabetes affect your hands and feet?

Diabetes can affect your hands and feet by damaging nerves and by reducing blood flow. Both make injuries easier to miss and slower to heal.

Peripheral neuropathy is nerve damage in the feet, legs, hands, or arms. NIDDK describes numbness, burning, pain, weakness, a pins-and-needles feeling, and trouble sensing pain or temperature, often worse at night and usually on both sides of the body. When your feet cannot feel properly, a blister or a pebble in your shoe can turn into a sore before you notice it.

Reduced blood flow to the legs and feet makes those sores harder to heal and more likely to become infected. NIDDK advises people with diabetes to:

• Check both feet every day for cuts, sores, red spots, swelling, blisters, and warm spots
• Call a doctor right away about a cut, blister, or bruise that is not starting to heal after a few days
• Get a thorough foot exam at least once a year
• Wear socks to bed if your feet get cold, rather than putting a heating pad on skin that may not feel heat properly

How can you keep your hands and feet warm?

Keep your whole body warm, not just your hands and feet. Because your body cuts blood flow to the extremities to protect your core, a warm core is the best signal that it is safe to send warm blood outward again.

• Dress in layers and wear a hat when it is cold, so you lose less heat overall.
• Choose mittens over gloves in real cold, because fingers kept together share warmth.
• Wear warm, dry socks and change them if they get damp.
• Move. Working muscles produce heat and draw blood toward your limbs, and a brisk walk that actually counts is one of the simplest ways to warm up.
• Warm up gently. Use warm, not hot, water, or tuck your hands into your armpits. Avoid heating pads on numb skin, because you can burn it without noticing.

Stress is a recognized trigger for Raynaud's attacks, and the stress response can reduce blood flow to the skin in anyone. If cold, pale fingers show up during tense moments, slow breathing and warmth can help, and it is worth knowing when anxiety needs professional help if worry has become a daily feature of your life.

What skin changes on cold fingers or toes need prompt care?

Any sore, any color change that does not go away once you are warm, or any skin that looks damaged needs prompt medical attention, because it can mean tissue is not getting enough blood. An ordinary chill or a Raynaud's attack should end with normal color after rewarming. When it does not, do not wait it out.

What you notice	What it may mean	What to do
Fingers or toes turn white or blue in the cold, then recover fully with warmth	A normal cold response or Raynaud's phenomenon	Book a routine appointment if it keeps happening
Small painful sores or pits on the fingertips or toes	Severe or secondary Raynaud's reducing blood flow	See your doctor within a few days
One foot colder, paler, or bluer than the other	Reduced blood flow from peripheral artery disease	See your doctor promptly
A cut or blister on the foot that is not healing after a few days, especially with diabetes	Slow healing from nerve or blood vessel damage	Call your doctor right away
Skin that is white or grayish-yellow, hard or waxy, and numb after cold exposure	Frostbite	Get medical care now
Skin that turns black, or a sore that smells bad	Tissue death (gangrene)	Emergency care

Not every color change in the hands is about blood flow. If your palms or skin look yellow or orange rather than white or blue, the causes are quite different, and our guide to why hands turn yellow explains them.

When should you see a doctor, and when should you call 911?

See your doctor if cold hands and feet are new, getting worse, or come with other symptoms. Most causes are easy to test for.

Make an appointment with your primary care provider if you have:

• Fingers or toes that repeatedly turn white or blue in the cold or when you are stressed
• Raynaud's-like attacks that started after age 30, or that come with joint pain, rashes, dry eyes or mouth, or tightening skin
• Tiredness, paleness, shortness of breath, or dizziness alongside feeling cold
• Trouble tolerating cold together with weight gain, dry skin, or thinning hair
• Leg pain, cramping, or heaviness when you walk that eases when you rest
• Numbness, tingling, or burning in your feet or hands, especially if you have diabetes

Call 911 or go to the emergency room if you have:

• An arm or leg that suddenly becomes cold, pale or blue, and painful, especially with numbness or weakness, which can mean a blood clot has blocked an artery
• Skin that has turned black, or a sore with spreading redness, fever, or a bad smell
• Frostbite signs such as hard, waxy, white or grayish skin that stays numb
• Signs of hypothermia, a dangerous drop in body temperature: intense shivering, confusion, slurred speech, fumbling hands, or drowsiness

Nothing here can tell you which cause applies to you. A doctor can examine your hands and feet, check the pulses in your feet, and order simple tests to find out.