Cold feet: Understand how science explains

On the coldest days of the year, it’s common to feel your feet colder than the rest of your body.

For some people, the difference in temperature is such that, even using winter items, such as socks or slippers, the lower limbs remain cold.

According to experts, the sensation is usually normal, but it can also indicate the presence of some pathology.

The natural condition for feet, hands, earlobes and the tip of the nose to be, commonly, the coldest regions of the body is because they are extremities. This means that, many times, and for different reasons, they are less privileged places for blood circulation.

“One of the main functions of blood is to transport heat throughout the body”, explains cardiologist Bruno Caramelli, from the Brazilian Society of Cardiology (SBC). “The most distant regions, which are where there is terminal circulation — the fingers, the tip of the nose, the earlobes, the toes — are the most distant from the heart. This is where the blood “bounces back” through the veins to the heart. They are also regions that can survive longer without irrigation.

In cold environments or in atypical conditions, the body can take advantage of this ability using a defense mechanism called vasoconstriction.

“If the organism needs to lose less heat, it will close the vessels, so that the blood — which is what transports the heat — does not reach everywhere and thus has no heat dissipation. It is not possible to do this for the heart, for the lungs, for the brain, because they are vital organs, but I can do it for the terminal regions”, clarifies Caramelli.

In these cases, the recommendation is simple: stay warm. Rheumatologist Marco Rocha Loures, president of the Brazilian Society of Rheumatology (SBR), recalls that, in addition to using winter accessories, it is worth ingesting hot liquids, such as soups and teas.

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But not always having cold extremities is normal.

“When the hands and feet are very cold, with a very white or purplish color in relation to the body, and with the presence of tingling in the fingertips, you really need to look for a cause”, warns the president of the SBR.

According to Loures, when the symptoms are intense — including the possibility of wounds — the individual should seek care to undergo evaluations, monitoring and examinations.

“There are autoimmune pathologies, such as rheumatic diseases, for example scleroderma, sometimes polymyositis and some other autoimmune vasculitis, which can cause cold extremities.”

In Caramelli’s assessment, another way to know if there is a need to seek medical help is to notice if there has been a change in the body’s behavior.

“If you’ve been like this your whole life, it might be a trait of you, that’s who you are, keep warm. Now, the most important thing is to note if this has happened recently. If there was a change in behavior, it could be a sign of illness”, explains the cardiologist.

According to the doctor, cardiovascular complications can also cause cooling of the extremities, due to the use of vasoconstriction.

In the case of a hemorrhage, which is an atypical condition, “the pressure will drop, which means less blood to the vital organs. So the organism evolved evolutionarily, over millions of years, so that when there is blood loss, vasoconstriction will occur.”

Another case cited by Caramelli is heart failure, which is characterized by the inability of the heart to function properly.

“The heart pumps the blood badly, which does not reach the arms, the fingers. The organism does not know how to differentiate if what is happening is a hemorrhage and, therefore, the pressure is falling, or if the pressure is falling, because the heart is weak. So the answer is the same: it causes vasoconstriction”, he exemplifies.