Cold Feet

There are a lot of reasons why your feet could be cold, ranging from cold climates, cardiovascular troubles, nerve disorders, to a sign of a serious medical condition. The most common cause of cold feet is poor blood flow in your legs and feet.

Cold Temperatures

Cold feet are one of the body’s normal reactions to colder temperatures. When the body is exposed to cold, it acts to keep vital organs warm. Small vessels in the skin (thermoregulatory vessels) constrict, redirecting blood from arteries near the surface to those deeper in the body, to protect against heat loss. This reduces the blood flow to the skin, which also reduces the amount of heat the body loses. The extremities are the parts of the body furthest from the vital organs, so reducing blood flow to the extremities also helps keep warmth and blood flow in the more important body parts.

Over time this reduced blood flow can cause decreased oxygen in the tissues, which may cause them to take on a bluish color. When temporary, these symptoms are not usually serious, and the body will return to normal as it warms up again.

Raynaud’s Phenomenon 

Some people have Raynaud’s phenomenon, where exposure to cold temperatures or high stress causes them to experience limited blood circulation, resulting in cold or numb fingers and toes.

Raynaud's phenomenon affects mostly the hands, often the feet, and more rarely, the nose, lips, and ears, causing them to suddenly lose color and become cold and numb. More common in women than in men. 

Raynaud's can be more dangerous when it's related to some underlying condition. This rarer form of the disorder, called secondary Raynaud's phenomenon, occurs later in life and often in people (men as well as women) with connective tissue diseases, such as systemic lupus erythematosus, or other autoimmune disorders. 

About 30% of first-degree relatives (parents, children, sisters, and brothers) of people with primary Raynaud's also have the condition. 

Stress and Anxiety 

Being in a state of high stress or anxiety may also cause cold feet. 

Sweating

One of the most forgotten reasons that anxiety and stress lead to cold feet is because anxiety and stress increase sweating. Sweat production is biologically primed to keep your body cool, so that you don't overheat when you are stressed. Unfortunately, your soles sweat a great deal and are prone to feeling cold more than other areas of the body. The feet have more than 250,000 sweat glands that require more hydration than other parts of your body. 

Hyperventilation

Stress and anxiety also can lead to faster breathing and hyperventilation. Hyperventilation causes blood vessels to constrict, which slows down blood flow dramatically. It's still flowing into your feet, but because it's slowed down it causes them to experience less heat and feel cold in normal environments. It may also tingle and feel numb too.

Increased sensitivity

Not all cold feet are the result of changes to your body. Some are the result of changes to your mind. That is the case with increased sensitivity. Stress and anxiety make people more prone to feeling discomforts - discomforts that they may have had anyway. The mind essentially "dials in" to any discomfort and amplifies it. So, your feet may have always been a little cold once in a while, but anxiety causes you to notice it more.

People who are stressed may feel as if their walking or natural movement is strange, therefore they begin to walk improperly to alleviate this sensation. This frequently results in foot pain.

One of the body’s natural responses to stress or nervousness is to pump adrenaline into the bloodstream. As it circulates, adrenaline causes the blood vessels at the periphery to constrict, which decreases the flow of blood to the outermost areas of the body. This response reserves energy and prepares for any bodily harm that may happen, as a result of the high-stress situation.

Circulation Issues

Poor circulation can have a variety of causes. Living a sedentary lifestyle or sitting at a desk all day may reduce circulation to the legs and cause cold feet.

High cholesterol can lead to plaques forming inside the arteries that can reduce circulation to the legs and feet, leading to cold feet.

Some heart conditions can also cause cold feet, so a person should speak to their doctor about any existing heart problems or risk factors.

Smoking

Smoking tobacco products can also make it more difficult for the blood to reach every area of the body, so people who smoke may be more likely to complain of cold feet. Nicotine and other chemicals in cigarettes can cause acute blood vessel constriction as well as chronic blood vessel damage.

Anemia

Anemia can be due to many factors, including deficiency in iron, vitamin B12, or folate, or chronic kidney disease. Moderate to severe cases of anemia may cause cold feet. 

Diabetes Mellitus

People with diabetes may be at risk of circulation problems, such as cold feet or hands. In some people, diabetes can lead to diabetic peripheral neuropathy, a form of nerve damage. 

Hypothyroidism

Hypothyroidism is caused by an underactive thyroid gland, producing a low level of thyroid hormone, which has a negative impact on the body’s metabolism. The body’s metabolism affects circulation, heartbeat, and body temperature, so anything that impacts on thyroid function and causes hypothyroidism can lead to cold feet.

Prevention

The key to keeping your feet warm in cold weather is to keep your entire body warm. Dress in layers. Wear a hat, preferably one that covers your ears, because body heat escapes through the head. If you get wet, your body loses heat more rapidly; stay as dry as possible. Choose shoes or boots that provide insulation and protection, such as those made from leather and synthetic materials.

Keep moving. Stay hydrated with warm liquids. Drinking warm liquids in the winter improves blood circulation. Eat healthy.  

Avoid cigarette smoke. Be careful about certain drugs. Some drugs can cause peripheral blood vessels to narrow, including decongestants containing phenylephrine or pseudoephedrine, diet pills, migraine medications containing ergotamine, some herbal preparations, and some blood pressure medication.

Caffeine triggers Raynaud's in some people; try avoiding it for a while to see if that helps. Act quickly to end an attack. Once a Raynaud's episode starts, get warm as quickly as possible. Soak your hands or feet in warm (not hot) water. 

Manage stress. Relaxation techniques such as deep breathing and meditation may help decrease the number and severity of attacks. If emotional distress persists, seek help from a mental health professional.