What’s Causing Your Cold Hands & Feet?

May 11, 2016

Are your hands perpetually chilly? Do your cold toes want to be inside a pair of Uggs year round? Does your sweetie shiver when you grab their hand with your chilly mitt? Or do they shy away from you in bed when you want to snuggle cuz your ice cold toes make them want to jump right out of the sheets?

Cold hands and feet plague many women and they’re often given only one reason why, but there are several! And for many women it’s more than one cause, especially if you have Hashimoto’s.

Low Thyroid Hormones

This one you’ve likely heard of right? Thyroid hormones are key for the metabolism of every cell in your body. When there isn’t enough of them metabolism body wide slows down – and you get chilly. Cold intolerance or cold hands and feet are among the most common symptoms of hypothyroidism and one that often gets you a screening TSH (thyroid stimulating hormone) when you tell your doc about it.

However, how many of you have been put on thyroid meds or otherwise resolved your low thyroid but are still plagued your icy hands and frigid feet.  There are several other causes of cold hands and feet that are beyond thyroid hormone levels – and they are all very common with Hashimoto’s but can be occur in any woman. In order to warm you up, you have to know the cause so let’s dig into the lesser discussed reasons you might be running cold.

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Low Oxygen Due To Overt Or Borderline Anemia

Anemia is a compromised ability to deliver oxygen to the cells of your body. Once delivered, oxygen gets utilized in the mitochondria – a cell’s powerhouse – to form ATP (adenosine triphosphate). ATP is the basic energy source for your body and oxygen is a fundamental component in making it.

Without a steady supply of oxygen to your body’s tissues, hormones get out of whack, digestion can go on the fritz, you can’t think clearly, might struggle with weight loss as your metabolism slows and heat production goes down. You might look pale, feel tired or short of breath or be losing your hair as well.

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You can get anemic from B12, B6 and folic acid deficiency or from iron deficiency. B12 issues can arise from autoimmunity, poor digestion, lack of stomach acid or poor dietary intake. Iron can get low from excessive blood loss (i.e. heavy menses or gastrointestinal bleeding), poor dietary intake or absorption, medications or certain genetic or chronic conditions (i.e. thalassemia).

A subclinical anemia or borderline anemia is when lab values are within normal range but show a trend towards an impending anemic state. In Functional Medicine, we see these as problems just around the corner and many women are dealing with anemic symptoms, like cold hands and feet or fatigue, before they meet the official diagnostic criteria. I covered anemia in greater detail in this post on Girls Gone Strong.

But this is so common that I’d say upwards of 90% of the women in my practice have at the very least a borderline anemia, granted they all have hormonal issues  like PCOS, menopause or Hashimoto’s. Suffice to say, it’s pretty common – and very common to be concomitant with Hashimoto’s and PCOS. So don’t be too quick to write off your cold limbs and digits to your thyroid – or at least only to your thyroid.

Poor Blood Circulation

Seems obvious right? You have to be pumping blood to the farthest reaches of your body: hands, feet and head in order to nourish them and keep temperature up. However, how many of you (especially those with Hashimoto’s or adrenal fatigue) have low blood pressure. What constitutes low blood pressure?

Well, surprisingly much below 110/70 in my experience can present with compromised circulation but this is variable from woman to woman. Some of you may feel fine at 110/70 or even lower, some of you may not. I know, I know, it’s been drilled into your head that all we need to worry about is HIGH blood pressure.

I often talk with women whose blood pressure is around 100/60 and their doc was thrilled as they exclaimed “Your’e so low!”

But they have frigid hands and feet, get dizzy when they stand up and can’t put together a sentence because their sluggish, barely-firing brain isn’t getting enough oxygen. Without decent pressure, you can’t circulate blood beyond your more central/core body very well – and you need to! Not only to keep warm and think clearly, but also to remedy problems you may have with your hands and feet that aren’t so pretty like nail fungus, unhealthy nails, or dry, cracked skin on your heels.

These are all signs that those distal –AKA far away – tissues that aren’t getting proper nutrition, immune support and oxygen delivered by your juicy, nutrient rich blood. And as you probably already guessed, when you have more than one of these issues at play making your borderline anemia, bordlerine low BP and borderline thyroid more an issue when they are compounded together.

For example, you may be a touch low thyroid, have Hashimoto’s (therefore autoimmunity), running a borderline B12 or iron level and have low BP (due to autoimmunity or adrenal fatigue) and have cold feet with funky nails and very dry heels.

Remember as one hormonal system or aspect of your physiology suffer, other systems get taxed. It’s not long before mutliple systems are compromised.

Get you FREE copy of my Guide To Lab Testing & Your Hormones

This guide covers hormonal testing and thyroid patterns and will show you how to suss out the Hormonal Dealbreakers of inflammation, anemia and blood sugar problems.

Get Your Free Lab Guide Here

This is so common with the women I see with Hashimoto’s or hypothyroidism. NOTE: Poor circulation can also be caused by vessel damage from later stage diabetes or other pathologies which create poor blood flow at distal body parts but wouldn’t be solved as easily as the issues I’m covering in this post. Compromised circulation in hands in particular can be part of a condition called Berger’s disease that can result from long term cigarette use.

Trouble With Blood Vessel Constriction & Dilation

Even when you’ve got your blood pressure supporting your circulation, you may not be getting adequate flow if you have Hashimoto’s or other autoimmunity. Inadequate flow means inadequate nutrients, oxygen and the point of today’s post: heat. You control the flow of blood in your vessels in party via dilation and contraction, which is in part controlled by nitric oxide.

When you have autoimmunity, your nitric oxide system gets a bit funky.

There are three types of nitric oxide synthase (the enzyme that makes nitric oxide) and they all have various functions and consequences: nNOS (neuronal nitric oxide synthase) is as the name implies active in the brain and nervous system (it enhances nerve cell activation and adaptability), eNOS (endothelial nitric oxide synthase) is part of the blood vessel dilation/constriction system as it works on the endothelial cells (the lining of your blood vessels) and the third is where autoimmune issues come in. It is called iNOS or inducible nitric oxide synthase.

iNOS is the trouble maker and is activated by various things, including the fallout from autoimmunity. We count on healthy levels of eNOS helps us have proper circulation and tissue recovery.

It helps as well to calm the inflammation from autoimmune reactions. Without it we see not only issues with cold hand and feet but other issues (some we’ve covered) such as: weak nails, fungal infections, skin issues and wounds that don’t heal. eNOS also keeps blood vessels healthy by dissolving arterial plaques and when it comes to Hashimoto’s it is key in helping you recover from autoimmune derived inflammation and tissue destruction. One great way to turn this guy on is exercise.

So while we all have all three forms of NOS, when you have autoimmunity such as Hashimoto’s your system is imbalanced and the cytokines (think of these as hormones of your immune system) that are ramped up from having autoimmunity turn on this troublesome form called iNOS which promotes further tissue destruction, autoimmune based attacks and inflammation.

This imbalance creates lower amount of eNOS and a higher amount of iNOS. This imbalance will obviously cause a lot more than cold toes, and I have a lot more info coming on the blog about these unique nuances of autoimmunity like NOS so stay tuned. For now know that if you have Hashimoto’s or other autoimmunity, you have overactive iNOS and under active eNOS and the latter issue may be part of your cold hands and feet.

And again, you likely have multiple issues going on causing the frigid fingers (i.e. if you have Hashimoto’s you may be a bit low thyroid and iron and then also have this iNOS issue causing you to feel cold).

Also, there is a very common supplement, the amino acid arginine, found in a lot of pre workout supplements and even multi vitamins that will make matters worse. Arginine will ramp up all three forms of NOS, which is no biggie in your average Joe but it is a biggie to turn up more iNOS when you already are reeling from immune activation and inflammation from having Hashimoto’s and thus an imbalanced NOS system. So avoid supplements with arginine if you have autoimmunity and balance this system with guidance of a qualified practitioner.

You can though turn up eNOS specifically and safely with exercise. And one final issue that is very common with Hashimoto’s (and other autoimmune disease) that can play in to cold hands is something called Raynaud’s syndrome.

This is a vasospasm issue that can make tolerating cold temperatures very difficult – and sometimes quite painful. This can be a stand alone issue but it is often a hallmark of autoimmune issues including Hashimoto’s. To wrap up remember this: You likely have multiple issues causing your cold hands and feet, so be sure you’re looking at all aspects to get resolution.

Order Hangry right now!

If you’ve ever felt like a Hangry B*tch and are ready to balance your hormones and restore your joy in just 5 simple steps then Hangry is for you!


Skip the arginine if you have autoimmunity including Hashimoto’s are it will further aggravate your imbalanced NOS system and create more inflammation and tissue destruction. Cold hands and feet might seem annoying but not really a big deal, but they are symptoms that your physiology is off and worth looking into.

Finally, stay tuned for a whole lot more on the unique nuances of Hashimoto’s like NOS and glutathione and how they play into not only inflammation but into exercise tolerance and recovery as well fat loss.



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