Cold Feet

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What are cold feet?

Having cold feet is often a normal condition, usually in response to cold temperatures or as a response to anxiety. In cold conditions, blood vessels in your feet and other areas, such as your nose, constrict to help minimize heat loss. This decrease in blood flow leads to decreased oxygen in these peripheral parts of your body, causing them to turn a bluish color, called cyanosis.


Cyanosis in cold weather is not serious and reverses rapidly when you warm up again. In stressful or anxious situations, your feet become cold when adrenaline prompts a decrease in the blood flow to peripheral areas of your body (such as your appendages and skin) to minimize blood loss from a potential injury.

At the same time, the perception of cold feet can also be a symptom of several conditions, including nerve damage (peripheral neuropathy), sometimes seen in diabetes (a chronic disease that affects your body’s ability to use sugar for energy), chronic alcohol abuse, or in certain vitamin deficiencies.

Cold feet can also be a symptom of poor circulation of the blood to these distant, or peripheral, parts of the body (peripheral artery disease, PAD, also called peripheral vascular disease, or PVD, which is a narrowing or blockage of arteries due to a buildup of fat and cholesterol on the artery walls, a condition which limits blood flow to the extremities). As this plaque builds up on the inner walls of an artery, it narrows the passageway for blood flow.

Rarely, cold feet can be a symptom of a serious condition. Seek immediate medical care (call 911) if you, or someone you are with, experience chest pain or pressure; loss of vision; paralysis or inability to move a body part; confusion; absent pulses in the feet; or shortness of breath.

Seek prompt medical care if you have slow-healing wounds or bruises on your feet and appear to have frequent skin infections. If you are being treated for cold feet from poor circulation, but symptoms remain persistent or cause you concern, seek prompt medical care.

What other symptoms might occur with cold feet?

Cold feet may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the cardiovascular system may also involve other body systems.

Cardiovascular symptoms that may occur along with cold feet

Cold feet from poor circulation may accompany other symptoms that affect the cardiovascular system including:

  • Bluish or pale tint to the skin (cyanosis)
  • Pain, heaviness and numbness in your legs
  • Pain in the legs, buttocks, thighs, calves and feet when walking
  • Pain that increases with muscle exertion and diminishes with rest

Neurologic symptoms that may occur along with cold feet

Cold feet may accompany symptoms that are related to the nervous system including:

  • Burning pain, particularly at night
  • Muscle weakness
  • Numbness or tingling in the arms or legs
  • Paralysis of a part of the body
  • Sensitivity to touch
  • Weakness (loss of strength)

Other symptoms that may occur along with cold feet

Cold feet may accompany symptoms that are related to other body systems including:

  • Cooler skin on one leg
  • Erectile dysfunction
  • Poor nail and hair growth on the affected limb
  • Slow-healing wounds or sores
  • Weak pulse in the affected legs and feet

Serious symptoms that might indicate a life-threatening condition

In some cases, cold feet may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Chest pain or pressure
  • Confusion or loss of consciousness, even for a brief moment
  • Loss of speech
  • Loss of vision or changes in vision
  • Paralysis or inability to move a body part
  • Shortness of breath

What causes cold feet?

Cold feet can be a symptom of several conditions, including nerve damage (called peripheral neuropathy), sometimes seen in diabetes (a chronic disease that affects your body’s ability to use sugar for energy), chronic alcohol abuse, or in certain vitamin deficiencies. Cold feet can also be a symptom of poor circulation of the blood to these distant, or peripheral, parts of the body.

Circulatory causes of cold feet

Cold feet may be caused by peripheral artery disease (PAD), also called peripheral vascular disease, (PVD), which is a narrowing or blockage of arteries due to a buildup of fat and cholesterol on the artery walls, a condition which limits blood flow to the extremities.

Neurologic causes of cold feet

Cold feet can also be caused by nerve damage (peripheral neuropathy) caused by:

  • Certain vitamin deficiencies

  • Chronic alcohol abuse

  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

Questions for diagnosing the cause of cold feet

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your cold feet including:

  • When do you perceive cold feet?

  • Has anyone in your family had a heart or blood vessel disease?

  • If you have leg pains with your cold feet, where do you feel these pains, exactly? What part of your leg? How is the pain affected by walking or climbing stairs? By exercising? By sitting or standing?

  • Do you smoke?

  • Do you have diabetes?

  • How is your diet? Can you describe typical meals you might have on an average day?

  • Do you have any other symptoms?

  • What medications are you taking?

What are the potential complications of cold feet?

Because cold feet can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Chronic pain

  • Gangrene

  • Increased risk of infection in the affected area

  • Loss of limb

  • Permanent nerve damage

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 26
  1. What is peripheral arterial disease? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/pad/pad_what.html
  2. Are cold purple feet caused by bad circulation? Livestron.com. http://www.livestrong.com/article/354403-are-cold-purple-feet-caused-by-bad-circulation/
  3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
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