Hi, I wonder how you would use your rationality skills to solve this problem.
I’m very sensitive to cold and have been for at least 2-3 years. (I’m a 25 year old male).
This is manageable with (really) warm clothes, but sometimes very inconvenient.
I’ve seen multiple doctors about this, and the response I’ve got was basically “our tests indicate there’s nothing wrong with you, so there’s nothing I can do”. I’ve left multiple blood samples, and all the things that were tested are within normal (well, my trombocyte count is a bit low. Doubt it’s related to this).
I’m slightly underweight, and have a history of fatigue and depression.
I’m looking for both practical advice and general rationality advice on how to deal with a confusing health problem.
I’m in a similar situation, and am leaning toward it being a circulation issue. Would you happen to know what your last blood pressure measurements were?
My previous lead candidate was proto-diabetes, but the most recent tests suggest otherwise. The only comment made about my bloodpressure was by the trainee EMT, saying “I wish my bloodpressure was that low!”. I’ve been suspicious that the safe range for bloodpressure might be shifted a bit too far downward, since most people suffer from high bloodpressure-related conditions, but I’ll need to refind the evidence that pushed me in that direction.
Anyway, my current strategy is to try and get more/better exercise, fresh air and sunlight. Those are good ideas in general, and should have an impact if it’s circulation-related. It’s too early and I’m still struggling to get good exercise, and I didn’t think to try and quantify changes until… just now, so right now, this solution is experimental on my end.
There are a bunch of ways temperature is regulated. Blood circulation is on of the main ways the body regulates the temperature of the extremities. Blood moves very fast through the body and has therefore a relatively constant temperature.
The blood in your hand is warmer than the rest of the hand.
If there’s more blood in the capillaries in your hand than your hand gets warmer. Low blood pressure in the arterioles means that less blood flows into the capillaries. If muscle tissue is tense that also usually makes it harder for blood to flow into it.
I personally used to often feel cold five years ago but solved the issue for myself. There are days where something emotional is going on and my thermoregulation is messed up but that’s not my default. I do have done a bunch of different things, so I can’t give you a single solution.
Firstly an easy suggestion. Drink a lot. Drinking can increase blood pressure. There were weeks where I needed to drink 4-5 liters a day for my body to work at it’s peak. I would recommend you to try drinking 4 liters a day for a week and see whether that changes how you feel.
On of the main things I personally did was dancing a lot of Salsa. Salsa gave me a new relationship with my body. Part of Salsa is also having body contact and that allows me to feel which parts of the body of the woman I’m dancing with are warm and relaxed and which aren’t.
Good Salsa dancers are usually well circulated. On the other hand I do know woman who danced for years and didn’t solve issues like that in their body. Knowing dancing patterns doesn’t seem to be enough. In the Salsa sphere body movement classes seem like the produce such results but I don’t know whether they are optimal.
I do personally think that there’s a case that 5 Rhythms or Contact Improvisation is better for your purpose than Salsa. But to be open, the theory based on which I make that recommendation are not academic in origin.
Another thing that I believe but which does not come from an academic source is that the problem is likely emotional in origin. I consider it to be a self defense mechanism of the body. If they get removed I consider it likely that emotions will come up and that have to be dealt with. Based on what you wrote about severe trauma, I would recommend you to have professional help.
I appreciate you bringing attention to my blood circulation.
My hands and feet rarely freeze (I do wear warm socks and gloves in winter, though). My ears are very sensitive to cold, though, which could well be a symptom of poor circulation.
I personally used to often feel cold five years ago but solved the issue for myself. There are days where something emotional is going on and my thermoregulation is messed up but that’s not my default.
Another thing that I believe but which does not come from an academic source is that the problem is likely emotional in origin. I consider it to be a self defense mechanism of the body. If they get removed I consider it likely that emotions will come up and that have to be dealt with. Based on what you wrote about severe trauma, I would recommend you to have professional help.
The link between emotions and blood pressure as well as thermoregulation you describe sounds a lot like vasovagal response
In that case I doubt that is what I’m experiencing, since I haven’t noticed ANY correlation between my day-to-day emotional state, and how hot or cold I’m feeling.
So unless there’s a possibility of very long-term correlations, on the scale of months/years (which doesn’t seem to be what you’re describing), I doubt this particular mechanism is causing my cold sensitivity.
I am receiving therapy. Thanks for the suggestion.
The link between emotions and blood pressure as well as thermoregulation you describe sounds a lot like vasovagal response
I think the fact that vasovagal responses exist illustrate one well documented instance where there’s interplay between those forces.
In that case I doubt that is what I’m experiencing, since I haven’t noticed ANY correlation between my day-to-day emotional state, and how hot or cold I’m feeling.
I speak about repressing certain things for longer periods of time. Not something where you repress your trauma one day and don’t do it the next. You can do the change in a single day. Even in a minute but that’s not what happens most of the time.
My first tactic with confusing health problems is adjusting my diet, but I seem to be more affected by diet than the typical person, so your mileage may vary Taking a very complete multivitamin for a few days and seeing if you feel any different is an easy way to check for nutrition deficiencies, if your blood tests didn’t check for that (or only checked for a few usual suspects). If you do feel different, then you at least know you were deficient in something. You could also do an elimination diet for the most common food allergies, but that takes a lot of effort, so it might not be worth it if you and your family don’t have a history of food issues.
If you’re more sensitive to cold at some times than others, try to notice the fluctuation and see if it correlates with anything (especially stress, based on ChristianKi’s comment). Maybe try writing down how cold you felt and what you did that day? (I usually don’t write this sort of thing down, even though I know I should.)
My diet has had a random drift over time due to practical concerns, taste changing etc… and random diet adjustments don’t seem to have a noticeable effect. There might some specific nutritional strategies that would help—I don’t have enough information to choose one, though.
More data and more detailed observations seem like a good idea. There might have been some fluctuations, but I’m not noticing any obvious correlations (besides, you know, exposure to cold temperatures).
It’s possible. I don’t know.
I eat when I’m hungry, which is quite regularly (once per 3-4 hours, maybe 5), so I’m definitely not starving myself. And if I try to eat more, I feel unpleasantly full, and I feel less hungry later—so I don’t think it makes a difference.
I’m not sure how to check whether I’m eating enough save for counting calories (which seems complicated and unreliable).
I’m hoping I’ll gain some muscle mass by exercise, both for its own sake and because weight gain by other means doesn’t seem to be working for me (I suspect I naturally have a slim build).
Long underwear. Even if your legs don’t specifically feel cold, adding more insulation there helps the whole body. Your legs are a pair of huge heat exchangers, and there’s a limit to how useful it is to pile more layers on your torso if all your body heat can still leak out through your legs.
I’ve had something like that for the last 35 years or so. I just live with it. I suspect a connection with a serious illness I had back then, but I’ve never bothered to raise the matter with a doctor, because it doesn’t seem like the sort of thing that a doctor is likely to have any remedy for. I am also slightly built (BMI 19 to 20) and have occasional attacks of great fatigue, but not depression.
Thick woolly hats are good too. A lot of heat is lost through the head.
I do think that what you have can be caused by severe emotional trauma. If that’s the case it basically explains why the tests that doctors run come up empty.
There are defense mechanisms that the body can use in cases of trauma that lead to reduced blood circulation which in turn messes up temperature regulation and shows itself as low blood pressure.
That means that the first step would be to move to a safe environment where you aren’t constantly exposed to severe emotional trauma. Did you already make that step?
There are defense mechanisms that the body can use in cases of trauma that lead to reduced blood circulation which in turn messes up temperature regulation and shows itself as low blood pressure.
And these mechanisms don’t involve anything that would show up on medical tests?
His low blood pressure does show up in medical tests. The question of why the body set blood pressure at a certain point is largely unsolved.
In our academic system mainstream medicine doesn’t investigate psychological issues and psychology generally doesn’t investigate physiological issues like body temperature.
In my anecdotal experience, being underweight is correlated with being unusually susceptible to cold. Building some mass might help. Consider doing a more general strength program too.
I’m similar. I have found scarves to be both stylish and practical. The neck area is highly sensitive to cold. I’ve taken to toting a scarf if I am going to bring a jacket.
90⁄60 mmHg according to what a doctor told me during a measurement a month ago (though my journal says 98⁄60 for some reason).
105/60 in an another measurement a week before that.
The last one is TPO antibodies.
The parentheses are the reference ranges at my lab.
All values are within what is considered normal range. I’ve also had the thyroid physically examined (though palpation) and it appears there are no abnormalities (it’s not swollen or enlarged).
Your systolic is low, but I’m sure you’re well aware of that.
The thyroid panel looks normal, but there exists a bunch of people (including a few doctors one of whom, I believe, wrote a book) who think that hypothyroidism is seriously underdiagnosed and that it will not necessary show up in the TSH/T3/T4 tests. Google it up. I have no opinion on their claims.
There is also, of course, the non-answer that your thermoregulation set point just happens to be very low :-/
I doubt it’s a “thermoregulation set point” issue, since I haven’t always felt this way.
Thanks for pointing out the blood pressure thing. I hadn’t considered it might be related to cold sensitivity.
I have considered it might be a thyroid issue, and I am familiar with the controversy around thyroid disease.
Not completely trusting all the alternative claims—but I think there’s enough evidence to believe something might be going on.
I think I might try to get a prescription for thyroid hormone medication, and see if it improves my condition. I’ll probably try other options first, since there are potential side effects.
If you’re male you might also want to check your testosterone levels. And if your doctors and insurance are amenable, run a thorough hormones check in general.
Given that you were/are under much stress, I’d focus on the HTA axis.
In particular, try to get a 24-hour cortisol test—cortisol has a pronounced circadian cycle so one measurement taken at a single point in time might be misleading.
Your thermoregulation set point could have moved. In fact, I’d say that’s exactly what happened, since I get the impression your temperature is fairly stable. The problem is that it’s too low.
Very tentatively—maybe you should get your hormones checked. This is based on a weak hypothesis that if menopause can send body temperature too high erratically, maybe there’s a hormone problem which is keeping yours too low.
Hi, I wonder how you would use your rationality skills to solve this problem.
I’m very sensitive to cold and have been for at least 2-3 years. (I’m a 25 year old male). This is manageable with (really) warm clothes, but sometimes very inconvenient.
I’ve seen multiple doctors about this, and the response I’ve got was basically “our tests indicate there’s nothing wrong with you, so there’s nothing I can do”. I’ve left multiple blood samples, and all the things that were tested are within normal (well, my trombocyte count is a bit low. Doubt it’s related to this).
I’m slightly underweight, and have a history of fatigue and depression.
I’m looking for both practical advice and general rationality advice on how to deal with a confusing health problem.
I’m in a similar situation, and am leaning toward it being a circulation issue. Would you happen to know what your last blood pressure measurements were?
My previous lead candidate was proto-diabetes, but the most recent tests suggest otherwise. The only comment made about my bloodpressure was by the trainee EMT, saying “I wish my bloodpressure was that low!”. I’ve been suspicious that the safe range for bloodpressure might be shifted a bit too far downward, since most people suffer from high bloodpressure-related conditions, but I’ll need to refind the evidence that pushed me in that direction.
Anyway, my current strategy is to try and get more/better exercise, fresh air and sunlight. Those are good ideas in general, and should have an impact if it’s circulation-related. It’s too early and I’m still struggling to get good exercise, and I didn’t think to try and quantify changes until… just now, so right now, this solution is experimental on my end.
Thanks for sharing.
(just posted my blood pressure results in an another comment)
There are a bunch of ways temperature is regulated. Blood circulation is on of the main ways the body regulates the temperature of the extremities. Blood moves very fast through the body and has therefore a relatively constant temperature. The blood in your hand is warmer than the rest of the hand.
If there’s more blood in the capillaries in your hand than your hand gets warmer. Low blood pressure in the arterioles means that less blood flows into the capillaries. If muscle tissue is tense that also usually makes it harder for blood to flow into it.
I personally used to often feel cold five years ago but solved the issue for myself. There are days where something emotional is going on and my thermoregulation is messed up but that’s not my default. I do have done a bunch of different things, so I can’t give you a single solution.
Firstly an easy suggestion. Drink a lot. Drinking can increase blood pressure. There were weeks where I needed to drink 4-5 liters a day for my body to work at it’s peak. I would recommend you to try drinking 4 liters a day for a week and see whether that changes how you feel.
On of the main things I personally did was dancing a lot of Salsa. Salsa gave me a new relationship with my body. Part of Salsa is also having body contact and that allows me to feel which parts of the body of the woman I’m dancing with are warm and relaxed and which aren’t.
Good Salsa dancers are usually well circulated. On the other hand I do know woman who danced for years and didn’t solve issues like that in their body. Knowing dancing patterns doesn’t seem to be enough. In the Salsa sphere body movement classes seem like the produce such results but I don’t know whether they are optimal.
I do personally think that there’s a case that 5 Rhythms or Contact Improvisation is better for your purpose than Salsa. But to be open, the theory based on which I make that recommendation are not academic in origin.
Another thing that I believe but which does not come from an academic source is that the problem is likely emotional in origin. I consider it to be a self defense mechanism of the body. If they get removed I consider it likely that emotions will come up and that have to be dealt with. Based on what you wrote about severe trauma, I would recommend you to have professional help.
I appreciate you bringing attention to my blood circulation. My hands and feet rarely freeze (I do wear warm socks and gloves in winter, though). My ears are very sensitive to cold, though, which could well be a symptom of poor circulation.
The link between emotions and blood pressure as well as thermoregulation you describe sounds a lot like vasovagal response
In that case I doubt that is what I’m experiencing, since I haven’t noticed ANY correlation between my day-to-day emotional state, and how hot or cold I’m feeling.
So unless there’s a possibility of very long-term correlations, on the scale of months/years (which doesn’t seem to be what you’re describing), I doubt this particular mechanism is causing my cold sensitivity.
I am receiving therapy. Thanks for the suggestion.
I think the fact that vasovagal responses exist illustrate one well documented instance where there’s interplay between those forces.
I speak about repressing certain things for longer periods of time. Not something where you repress your trauma one day and don’t do it the next. You can do the change in a single day. Even in a minute but that’s not what happens most of the time.
My first tactic with confusing health problems is adjusting my diet, but I seem to be more affected by diet than the typical person, so your mileage may vary Taking a very complete multivitamin for a few days and seeing if you feel any different is an easy way to check for nutrition deficiencies, if your blood tests didn’t check for that (or only checked for a few usual suspects). If you do feel different, then you at least know you were deficient in something. You could also do an elimination diet for the most common food allergies, but that takes a lot of effort, so it might not be worth it if you and your family don’t have a history of food issues.
If you’re more sensitive to cold at some times than others, try to notice the fluctuation and see if it correlates with anything (especially stress, based on ChristianKi’s comment). Maybe try writing down how cold you felt and what you did that day? (I usually don’t write this sort of thing down, even though I know I should.)
Interesting perspective, thanks.
I am taking vitamins and have been for some time.
My diet has had a random drift over time due to practical concerns, taste changing etc… and random diet adjustments don’t seem to have a noticeable effect. There might some specific nutritional strategies that would help—I don’t have enough information to choose one, though.
More data and more detailed observations seem like a good idea. There might have been some fluctuations, but I’m not noticing any obvious correlations (besides, you know, exposure to cold temperatures).
This is a long shot, but is there a chance you’re eating less than you need?
It’s possible. I don’t know. I eat when I’m hungry, which is quite regularly (once per 3-4 hours, maybe 5), so I’m definitely not starving myself. And if I try to eat more, I feel unpleasantly full, and I feel less hungry later—so I don’t think it makes a difference.
I’m not sure how to check whether I’m eating enough save for counting calories (which seems complicated and unreliable).
I’m hoping I’ll gain some muscle mass by exercise, both for its own sake and because weight gain by other means doesn’t seem to be working for me (I suspect I naturally have a slim build).
At this point, I’d say it’s unlikely that you’re eating so little as to lower your temperature.
If you still want to test the hypothesis without counting calories, you could try a higher fat diet and see what happens.
Does your temperature ever get higher or lower?
Long underwear. Even if your legs don’t specifically feel cold, adding more insulation there helps the whole body. Your legs are a pair of huge heat exchangers, and there’s a limit to how useful it is to pile more layers on your torso if all your body heat can still leak out through your legs.
I’ve had something like that for the last 35 years or so. I just live with it. I suspect a connection with a serious illness I had back then, but I’ve never bothered to raise the matter with a doctor, because it doesn’t seem like the sort of thing that a doctor is likely to have any remedy for. I am also slightly built (BMI 19 to 20) and have occasional attacks of great fatigue, but not depression.
Thick woolly hats are good too. A lot of heat is lost through the head.
Did something happen 3 years ago? Maybe a major emotional trauma?
I’ve had a really bad childhood and experienced a lot of severe emotional trauma throughout my life since then, including at that time.
I do think that what you have can be caused by severe emotional trauma. If that’s the case it basically explains why the tests that doctors run come up empty.
There are defense mechanisms that the body can use in cases of trauma that lead to reduced blood circulation which in turn messes up temperature regulation and shows itself as low blood pressure.
That means that the first step would be to move to a safe environment where you aren’t constantly exposed to severe emotional trauma. Did you already make that step?
Yes, to the extent it’s realistically possible.
And these mechanisms don’t involve anything that would show up on medical tests?
His low blood pressure does show up in medical tests. The question of why the body set blood pressure at a certain point is largely unsolved.
In our academic system mainstream medicine doesn’t investigate psychological issues and psychology generally doesn’t investigate physiological issues like body temperature.
Yet, for some reason the intervening mechanisms don’t?
That would require running to see studies with big enough sample sizes to gather proxies for those proxies. There no money to run those studies.
Things that happen through complex patterns of neuron interactions are also not easy to study.
Thank you for all the comments and suggestions. :)
At this point I have made an appointment to have my hormone levels checked (as suggested by Lumifer and NancyLebovitz).
I also think my blood pressure and circulation is worth looking into.
I’m still processing a lot of the suggestions and ideas, and might make another thread on this in the future.
Do you do sports?
Not regularly.
I exercise at a gym (upper body strength program, started quite recently).
In my anecdotal experience, being underweight is correlated with being unusually susceptible to cold. Building some mass might help. Consider doing a more general strength program too.
I’m similar. I have found scarves to be both stylish and practical. The neck area is highly sensitive to cold. I’ve taken to toting a scarf if I am going to bring a jacket.
First question: what’s your blood pressure?
Second question: did you do a thyroid panel and what did it show?
Third question: did you measure your body temperature in controlled settings (e.g. first thing upon waking up before getting out of bed)?
Common causes of sensitivity to cold are low blood pressure and hypothyroidism.
90⁄60 mmHg according to what a doctor told me during a measurement a month ago (though my journal says 98⁄60 for some reason). 105/60 in an another measurement a week before that.
Thyroid panel:
P-TSH mIE/L 1.5 (0.3-4.2)
P-T4, free pmol/L 15 (12-22)
P-T3, free pmol/L 5.2 (3.1-6.8)
S-Ak, (IgG) TPO kIE/L 8 (<34)
The last one is TPO antibodies. The parentheses are the reference ranges at my lab.
All values are within what is considered normal range. I’ve also had the thyroid physically examined (though palpation) and it appears there are no abnormalities (it’s not swollen or enlarged).
I have not measured my body temperature.
Your systolic is low, but I’m sure you’re well aware of that.
The thyroid panel looks normal, but there exists a bunch of people (including a few doctors one of whom, I believe, wrote a book) who think that hypothyroidism is seriously underdiagnosed and that it will not necessary show up in the TSH/T3/T4 tests. Google it up. I have no opinion on their claims.
There is also, of course, the non-answer that your thermoregulation set point just happens to be very low :-/
I doubt it’s a “thermoregulation set point” issue, since I haven’t always felt this way.
Thanks for pointing out the blood pressure thing. I hadn’t considered it might be related to cold sensitivity.
I have considered it might be a thyroid issue, and I am familiar with the controversy around thyroid disease. Not completely trusting all the alternative claims—but I think there’s enough evidence to believe something might be going on. I think I might try to get a prescription for thyroid hormone medication, and see if it improves my condition. I’ll probably try other options first, since there are potential side effects.
If you’re male you might also want to check your testosterone levels. And if your doctors and insurance are amenable, run a thorough hormones check in general.
Thanks, these seem like good suggestions.
I’ve made a list of what I’ll try to have checked. Any comments?
DHEA-S
DHT
Estradiol
Estrone
PSA
Pregnenolone
Total and Free Testosterone
Sex Hormone Binding Globulin (SHBG)
Insulin like Growth factor (IGF-1)
Given that you were/are under much stress, I’d focus on the HTA axis.
In particular, try to get a 24-hour cortisol test—cortisol has a pronounced circadian cycle so one measurement taken at a single point in time might be misleading.
Your thermoregulation set point could have moved. In fact, I’d say that’s exactly what happened, since I get the impression your temperature is fairly stable. The problem is that it’s too low.
Very tentatively—maybe you should get your hormones checked. This is based on a weak hypothesis that if menopause can send body temperature too high erratically, maybe there’s a hormone problem which is keeping yours too low.
Thanks. A hormone check does seem like a good idea to me.