The most common answer to the question "What's causing your cold feet?" is usually: "Being a woman!" Yes, the fairer sex really is naturally inclined to have ice-blocks for feet and hands. But there are several medical conditions that can be to blame too.
How does our body temperature work?
Our bodies have amazingly sophisticated mechanisms to keep our vital internal organs at exactly the right temperature. One of these is shutting off circulation to your extremities - mostly hands and feet - and directing all the warm blood to your inner organs.
Blood flow can reduce by 99% in the cold - and it's women who do it best. Part of this is hormone-related, so your tendency to suffer cold feet will vary during your menstrual cycle. Women also have a higher proportion of fat under the skin - great for insulating their internal organs but bad for blood supply to the skin.
Women are also much more prone to a condition called Raynaud's syndrome, probably for the same reasons. In Raynaud's, your fingers and sometimes toes turn cold and white, then go blue and numb when exposed to cold.
Episodes can last from minutes to several hours. There's usually no obvious cause, although some autoimmune conditions (where your body's immune system turns on itself), like rheumatoid arthritis and scleroderma, can be to blame. It can be brought on by medicines which affect blood flow - including beta-blockers for heart conditions, some cancer medicines, and decongestants.
Prolonged use of vibration tools used in building work can damage tiny blood vessels in your hands, making you prone to Raynaud's. A tablet called nifedipine, taken either daily or just in cold weather, may sort the problem out.
Peripheral arterial disease
Blockage or furring up of bigger blood vessels supplying your feet with blood can lead to cold, numb feet, as well as pain - usually starting in your calves. The main disease is called peripheral arterial disease (PAD).
PAD is mostly down to all the same risk factors as heart attack and stroke - after all, these are both caused by blocked arteries in different parts of the body. But while high blood pressure and cholesterol are the biggest culprits for stroke and heart disease, the single most important cause of PAD is smoking.
The first symptom of PAD is usually pain in your calves, which comes on after you've been walking a set distance and settles when you stop. The distance gets shorter as the condition progresses, as well as if you're walking uphill or into a wind.
You can lose hair on your legs and get numb, cold feet and ulcers. Stopping smoking is key, but regular exercise is also essential to improve circulation. Several medicines can help, and in severe cases surgery to restore blood flow through the blocked arteries may be recommended.
Diabetes and cold feet
Damage to your nerves can also cause cold feet. Diabetes is a major cause of this - high blood sugar affects your nerves, with feet most often the first to feel the strain. If you have diabetes, keeping your blood sugar well controlled will cut your risk of foot problems dramatically. Your doctor should check your feet at least once a year for foot damage.
However, it's also essential to examine your own feet regularly. As well as feeling cold, you may get burning, shooting pain at night. You can lose the ability to feel pain, so may be more prone to injuries which don't heal well. Foot ulcers are also a real risk without proper attention to your feet. If in any doubt, see your doctor.
Underactive thyroid gland
An underactive thyroid gland can leave you with freezing feet. Your thyroid gland regulates your metabolism - so if this slows down you can feel the cold more. You may also be tired and constipated, and put on weight for no reason. Regular tablets will put your thyroid back into balance.
A few final tips
Just for once, I'm not banging on about the dangers of being overweight! Being very underweight can cause cold feet and hands. Whatever the cause of your cold feet, stopping smoking can help. Smoking shuts down warming blood circulation.
With thanks to 'My Weekly' magazine where this article was originally published.