What might explain persistent sensitivity to cold?

Q. I am cold all the time. Sometimes I get so cold that all I can do is take a really hot shower or bath. Then I wrap up in pajamas, a robe, and three or four blankets and just ride it out. This even happens in the summertime. I also cannot stand the wind blowing on me. It has gotten to the point where being so sensitive to the cold interferes with my work and life. What causes this problem?

A. While feeling colder than others around you is quite common, your symptoms are more pronounced than usual. Therefore, I would definitely suggest a visit with your doctor.

Here are some of the more common reasons for feeling colder than normal:

• Low body weight. Both fat thickness and muscle mass assist in keeping us warm. Muscle activity generates heat and fat acts as insulation. If you have lost a lot of weight recently or you have always been thin, you might be sensitive to ambient temperatures that would be comfortable for most people.
• Skipping meals. Some people get cold when they skip meals or take in too few calories. The body conserves energy and produces less heat in response to fasting.
• Being overly tired. Not getting enough sleep and feeling tired all the time may be contributing to the cold feeling.
• An underactive thyroid (hypothyroidism). Feeling cold can be a symptom of hypothyroidism. A simple blood test for TSH (thyroid-stimulating hormone) can determine if you have this problem.
• Low red blood cell count (anemia). While anemia can cause a person to feel colder than other people in the same room, it would be unusual for it to cause the extreme cold feeling you describe. Again, it's easy to check for anemia with a simple blood test.
• Raynaud's phenomenon. The normal response to cold temperatures is to shunt blood away from the skin to keep the internal organs warm. In people with Raynaud's phenomenon, that natural response is extreme. The tiny blood vessels get severely narrowed and markedly reduce blood flow to the skin, most often in the fingers and toes. One or more digits turns white or blue temporarily. People with Raynaud's tend to be much more sensitive to even minor drops in air temperature than other people. In addition to wearing gloves and thick socks, they need to keep their core body temperature up by wearing lots of layers of clothing.
• Peripheral artery disease. Narrowed blood vessels in the legs or arms can make one or more of a person’s extremities feel cold. Usually it would affect one leg or one arm rather than feeling cold all over.
• Medication side effect. Some medications, such as beta blockers, calcium channel blockers, and diuretics, can contribute to feeling colder than desired.

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