Baby, it’s cold inside

It’s warm outside, yet you’re grabbing a sweater because you frequently feel cold. Is it in your head, or are you really experiencing a personal permafrost? Don’t worry; lots of older people feel cold, and it could reflect any of a number of potential causes.

A sophisticated thermostat

We all need to maintain a certain core temperature — about 98.6° F — to keep the body’s many systems and biological processes (like chemical reactions) in good working order. The body has a way to protect this temperature.

If the core temperature rises, such as during activity when the working muscles produce heat, the body gives off steam: we sweat, and our blood vessels widen, allowing body heat to radiate away from our skin.

If the core temperature falls, the body conserves heat in its core. “A network of very small blood vessels narrows, and less blood is delivered to the skin surface, where heat escapes,” explains Dr. David M. Nathan, director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital and professor of medicine at Harvard Medical School.

The aging effect

We don’t really know why some older adults feel cold all the time. Dr. Nathan says it’s unlikely that our core temperature changes as we age. But there could be other age-related explanations for why we feel cold.

One theory is related to inactivity. “You’re moving less, even walking slowly, and your muscles aren’t producing as much heat as they used to, so you feel cold,” says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Another theory is tied to age-related changes in appetite and weight. “If with aging you have a smaller appetite and don’t eat as much, you might lose fat or insulation,” Dr. Nathan says.

Underlying conditions

Sometimes you can feel cold because of an underlying condition, such as one of the following.

Anemia. “If you have anemia, you have fewer red blood cells to carry oxygen throughout the body, and that sometimes makes you feel cold,” Dr. Salamon says.

An underactive thyroid. The thyroid gland in the neck releases thyroid hormone, the master regulator of our metabolism (the biochemical processes in our body). “When thyroid hormone levels are low, the thermostat gets turned down and makes a person feel cold,” Dr. Nathan says.

Peripheral artery disease. Narrowed arteries in the limbs, which can occur in diabetes, result in reduced blood flow, which may cause the arms or legs to feel cold.

Raynaud’s phenomenon. In this condition, the reaction to cold gets exaggerated. “Blood vessels in the extremities — especially the fingertips — constrict, causing the fingertips to feel cold and turn blue or white because blood flow is reduced,” Dr. Nathan says.

Crossed wires

Another possible reason for feeling cold all the time is that your nervous system has changed a little, making the brain perceive that you’re cold. “Some conditions impair the autonomic nervous system, which controls your temperature reflexes. You can have abnormal periods of sweating and then cool arms and legs, because somewhere in your nervous system, the autonomic nerves are giving the wrong signals to the brain,” Dr. Nathan says.

An example is diabetic neuropathy, in which diabetes damages nerves, causing tingling in the legs and feet. It can also make you feel cold. “If nerves that control the small blood vessels don’t function normally, you may not be able to regulate the skin temperature in your feet and legs,” Dr. Nathan says.

Other conditions that can cause mixed temperature signals include chronic fatigue syndrome, multiple sclerosis, or Parkinson’s disease. But Dr. Nathan stresses that just because you feel cold, it doesn’t mean you have any of those conditions.

What you should do

If you experience coldness that interferes with your daily activities or sleep, talk to your doctor about it at your next appointment. “I might check for an underactive thyroid or anemia, just to make sure nothing is wrong,” Dr. Salamon says. “But it’s rare for an older person to say they’re hot all the time. It’s much more common to hear that they’re cold.”

What’s the prescription for warming up? Treating underlying conditions and being more active. “Walk as much as you can, if it’s safe for you, and exercise regularly if you don’t already,” Dr. Salamon says. “In the meantime, keep that sweater handy.”

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

My son, do not forget my teaching, but keep my commands in your heart, for they will prolong your life many years and bring you peace and prosperity. Proverbs 3:1-2 NIV

The wise in heart accept commands, but a chattering fool comes to ruin. Proverbs 10:8 NIV

I seek you with all my heart; do not let me stray from your commands. Psalm 119:10 NIV

Be strong and take heart, all you who hope in the Lord. Psalm 31:24 NIV

Teach us to number our days, that we may gain a heart of wisdom. Psalm 90:12 NIV

I will praise you with an upright heart as I learn your righteous laws. Psalm 119:7 NIV

Blessed are those who keep his statutes and seek him with all their heart. Psalm 119:2 NIV

Truly I tell you, if anyone says to this mountain, ‘Go, throw yourself into the sea,’ and does not doubt in their heart but believes that what they say will happen, it will be done for them. Mark 11:23 NIV

May these words of my mouth and this meditation of my heart be pleasing in your sight, Lord, my Rock and my Redeemer. Psalm 19:14 NIV

But be very careful to keep the commandment and the law that Moses the servant of the Lord gave you: to love the Lord your God, to walk in obedience to him, to keep his commands, to hold fast to him and to serve him with all your heart and with all your soul. Joshua 22:5 NIV

Your statutes are my heritage forever; they are the joy of my heart. Psalm 119:111 NIV

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