It’s normal to feel cold in the winter months, but some people feel cold throughout the year, no matter what the temperature. Is this something to worry about?

WellTuned spoke with Dr. Chris Andershock, a corporate medical director with BlueCross BlueShield of Tennessee, to find out more about why some people are always cold—and what they might need to do about it.

How long have you been cold?

Dr. Andershock: If you have extreme sensitivity to cold temperatures and experience pain, shivering and numbness, you may have cold intolerance. One of the first steps in assessing the issue is determining how long you’ve experienced it. Acute problems will usually resolve after two or three weeks. If your cold intolerance lasts longer than a month, it could be a sign of an underlying problem.

5 potential causes of cold intolerance

Dr. Andershock: Almost everyone experiences shivering or feeling cold at times during winter months. Some people with a chronic medical condition or are in poor health struggle with cold intolerance no matter what the temperature.

But there can be other medical causes of cold intolerance, such as:

1. Anemia

If you don’t have enough healthy red blood cells to carry oxygen throughout your body, you can feel cold, tired and weak. While there are many different kinds of anemia, iron-deficiency anemia is the most common. This occurs when your body doesn’t have enough iron to make hemoglobin, a protein in your red blood cells.

How to address it: Under your doctor’s supervision, you can take oral iron supplements and boost the amount of iron in your diet. Meat, fish and poultry are some of the most iron-rich foods, but you can also get some iron from plant-based foods. In some severe cases, iron infusions may be an option.

2. Peripheral artery disease

Cold feet? You might not be nervous. You could have peripheral artery disease (PAD). With this disease, your arteries narrow, which reduces blood flow to your extremities. Some people don’t experience any symptoms. Others experience muscle cramping, leg pain when walking, and coldness in the legs or feet.

How to address it: Your doctor might recommend lifestyle changes, like walking or quitting smoking. A treatment plan could also include medications to address cholesterol, lower your blood pressure or prevent blood clots.

3. Raynaud’s syndrome

Also known as Raynaud’s phenomenon, it is caused by spasms in the tiny blood vessels in the fingers and toes. When the vessels tighten up, blood flow is limited. This leads to cold skin, the pale color, and a pins-and-needles type of tingling. Most of the time, it affects fingers and toes, but it can also affect lips, earlobes, and the nose.

How to address it: Start by avoiding the trigger, which is cold stress. Stay as warm as possible, and wear gloves as necessary. Some people might also benefit from a calcium channel blocker if their symptoms persist.

4. Hypothyroidism

This condition occurs when your thyroid gland doesn’t make enough thyroid hormone to keep your body’s processes humming along normally. You may start to feel cold frequently, and your skin may get drier. You might get tired easily, and you may experience constipation.

How to address it: There’s no cure for hypothyroidism, but you can take synthetic thyroid hormone to help manage the condition.

5. Anorexia nervosa

Anorexia is an eating disorder in which someone loses an excessive amount of weight. They may have an intense fear of gaining weight, even if they’re severely underweight. Symptoms can include a yellowing of the skin, confusion, fatigue, loss of muscle and body fat, dry mouth, and an extreme sensitivity to cold.

How to address it: Anorexia is a serious medical illness, and treatment can be complex. Treatments can include medical care, nutrition counseling, psychotherapy and medication.

Will cold intolerance go away?

Dr. Andershock: The short answer is: it depends. If you identify and treat the underlying cause, it could reduce or eliminate the problem. Remember: your cold intolerance is not an illness. It’s a symptom.

I recommend talking to your health care provider about a staged approach to intervention. Everyone can modify their behaviors to some extent, so you can start there. Stay active, get plenty of rest, eat a healthy and balanced diet, and avoid cold stress. Exercise, since that increases your metabolism, and eat more protein. Make sure that you’re not deficient in the B-12 or B-6 vitamins, which can also influence metabolism.

If your cold intolerance persists or gets worse, contact your health care provider.

More from Dr. Andershock on WellTuned.

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.