Causes of cold extremities: Are they normal or an indication of a serious illness?

Cold extremities (hands and feet) are a common health complaint affecting millions worldwide, especially with the arrival of winter and the drop in temperatures. In this context, Dr. Mohammed Taha Basha, an internal medicine specialist, explained to Al-Youm the key differences between normal coldness and that which may indicate serious health conditions.

Physiological context: How does the body react to cold?

Physiologically, the human body possesses a sophisticated defense mechanism to maintain "thermal homeostasis" and protect vital organs (heart, lungs, brain). When exposed to low temperatures, peripheral blood vessels constrict to reduce blood flow to the skin and extremities, thus conserving heat in the body's core. This process is a natural and historically established biological response that has helped humans survive in harsh environments and is not a cause for concern in transient cases.

When does cold extremities become a medical condition?

Dr. Basha pointed out that the danger arises when this coldness persists for extended periods without a direct environmental cause, or when it is accompanied by noticeable changes in skin color (paleness or cyanosis). In such cases, the condition transforms from a mere physiological reaction into a pathological symptom that may indicate disorders of the circulatory or nervous systems.

Underlying pathological causes

The specialist revealed a range of diseases behind this phenomenon, most notably:

• Hypothyroidism: where a deficiency of hormones leads to a slowing of metabolism, making the patient unable to tolerate the cold, with accompanying symptoms such as weight gain, rough skin, and voice change.
• Diabetes is a major contributing factor due to its chronic impact on arteries and nerves. High blood sugar leads to hardening of the arteries and reduced blood flow, as well as neuropathy, which can cause numbness in the extremities or make them constantly cold.
• Stress and anxiety: The psychological state directly affects the blood vessels; the body releases adrenaline, which causes the vessels to constrict and the extremities to become cold.

Raynaud's phenomenon: diagnosis and types

The doctor highlighted Raynaud's phenomenon as a major contributing factor, a condition in which the small arteries supplying the skin narrow excessively in response to cold or stress. It is divided into:

1. Primary Raynaud's disease: The most common type, it usually appears between the ages of 15 and 30 and is not associated with any other disease. It can be managed with good heating.
2. Secondary Raynaud's disease: This is the less common and more serious type. It usually appears after the age of forty and is associated with autoimmune diseases and connective tissue diseases such as (scleroderma, lupus, and rheumatoid arthritis), in addition to the effects of smoking and some medications.

Potential effects and complications

Neglecting to treat pathological cold extremities can lead to complications beyond mere discomfort. In severe cases of ischemia (especially in patients with diabetes or secondary Raynaud's disease), the skin may develop chronic ulcers, wound healing may be slow, and in rare cases, tissue death (gangrene) may occur if blood flow is completely cut off.

Medical and preventative advice

Dr. Basha concluded his remarks with a set of recommendations for prevention and management, emphasizing the importance of consulting a doctor immediately upon noticing a change in finger color to white and then blue, or the appearance of ulcers. He advised the following:

• Wear gloves and woolen socks to keep your extremities warm.
• Quitting smoking, as nicotine constricts blood vessels and worsens the condition.
• Exercise regularly to improve blood circulation.
• Controlling chronic diseases such as diabetes and high blood pressure.