Constantly cold hands and feet could be a hidden health red flag, warn studies

Always have cold hands and feet? It may be more than just winter chill. Learn what CHHF, PAD, and vascular health can reveal about your body (Image: Pexels)

We’ve all experienced cold fingers and toes in winter, a quick chill that dissipates with a hot drink or a woollen pair of gloves. But what if the chill never really goes away? What if, even on a spring morning, your hands and feet remain ice-cold for hours?

What seems like a harmless, perpetually cold hands and feet, may in fact be a sign of deeper circulatory or vascular dysfunction. Medical research shows that a condition known as Cold hypersensitivity in the hands and feet (CHHF) and related vascular-regulation problems such as Raynaud's phenomenon (RP) can cause consistently cold extremities, sometimes even in warm environments.

Moreover, such vascular issues, or conditions like Peripheral Arterial Disease (PAD), as per the National Instiute of Heakth (NIH), may impair blood flow, reduce oxygen delivery to limbs, and increase the risk of more serious complications. So if your extremities stay icy despite warmth, it could be more than just cold weather, it may be your body’s alarm bell.

The term used by researchers for this persistent, disproportionate coldness is Cold hypersensitivity in the hands and feet (CHHF). It is described as a sensation of noxious cold in the extremities even at normal room temperature. Although CHHF may seem harmless, it is often associated with dysfunction of blood flow regulation—particularly in the smallest vessels supplying the skin.

In people with CHHF, says a study published in Nature, their blood vessels may over-react to minor temperature changes or stress, causing the vessels to constrict excessively and reduce blood flow to hands and feet. In some cases, persistent cold extremities may be a hint of more serious circulatory disease, such as Peripheral Arterial Disease (PAD). PAD involves narrowing or blockage of arteries due to fatty plaque build-up (atherosclerosis), which reduces blood flow to the limbs and can lead to cold, pale, or bluish extremities.

Additionally, research shows that people with impaired peripheral circulation are more likely to suffer cold-related injuries during colder seasons. Given the overlap of symptoms among different vascular and vascular-regulation disorders, experts argue that CHHF or persistent coldness should not be hastily dismissed as just “sensitivity,”, especially if accompanied by other signs such as numbness, changes in skin colour, or poor healing of sores.

Here’s what research says about persistent cold extremities

Vascular dysregulation and CHHF

• CHHF may be a form of what clinicians call “primary vascular dysregulation” (PVD) — where blood-flow regulation through small vessels is abnormal.
• In PVD/CHHF, increased constriction due to sympathetic over-activity, dysfunction of the vessel lining (endothelial dysfunction), and altered thermoregulatory control are implicated.
• Some studies find CHHF is common, especially among women and people with lower body-mass index.

Incomplete circulation, peripheral arterial disease (PAD)

• PAD occurs when arteries become narrowed or blocked, reducing blood flow to limbs. Cold, pale or bluish extremities, poorly healing wounds, and weakened pulses in the legs or feet are common signs.
• Importantly, PAD often remains undiagnosed because many patients do not show obvious pain when walking (the classic “claudication” symptom).
• Those with PAD appear to have a higher risk of cold-related injuries during colder weather, particularly when body fat is low or blood flow is already compromised.

Other associations and health implications

• CHHF has also been linked, in observational studies, to other chronic health issues — suggesting that persistent cold limbs could serve as a broader warning sign beyond just vascular discomfort.
• Research into treatments beyond warm clothing shows potential: a randomised trial in PLOS journal found that non-pharmacological therapies such as acupuncture and electro-acupuncture improved symptoms of CHHF and enhanced quality of life.

When should you worry, and when to check in:

It might be nothing serious, sometimes the body simply overreacts to slight temperature changes. Indeed, mild, transient cold hands are considered fairly normal. However, you should consider a medical evaluation if:

• The cold persists even in warm rooms or after prolonged warming
• You notice accompanying symptoms such as change of skin colour (pale, bluish, purplish), numbness, tingling, or slow healing of cuts on fingers or toes;
• You have risk factors for vascular disease — such as diabetes, smoking, high blood pressure or high cholesterol;
• Your hands or feet, often feel painfully, cold, or you experience, cramps or heaviness in legs while walking.

Gaining clarity often requires investigations such as vascular flow tests, evaluation of endothelial function, or screening for vascular disease.

FAQs on health risks of constantly cold hands and feet

Constantly cold hands and feet can be a sign of circulatory or vascular dysfunction. Conditions such as Cold Hypersensitivity in the Hands and Feet (CHHF), Raynaud's phenomenon (RP), and Peripheral Arterial Disease (PAD) can impair blood flow and reduce oxygen delivery to limbs, leading to more serious complications.

You should seek medical advice if the cold persists even in warm rooms or after prolonged warming, if you notice a change in skin colour, numbness, tingling, or slow healing of cuts on fingers or toes, if you have risk factors for vascular disease such as diabetes, smoking, high blood pressure, or high cholesterol, or if your hands or feet often feel painfully cold or you experience cramps or heaviness in legs while walking.

Yes, treatments beyond warm clothing are available. Non-pharmacological therapies such as acupuncture and electro-acupuncture have been shown to improve symptoms of Cold Hypersensitivity in the Hands and Feet (CHHF) and enhance quality of life.