Cold hands and sometimes feet?

Not sure what is causing it, but occasionally my hands and sometimes my feet will get really cold to the touch. The nails are not blue or anything, but defintely cold to the touch. I have full use of my hands/feet when that happens and no tinglyness or anything like that. Just cold. has nothing to do with blood sugars. For example, right now both are cold and I’m at 132 per Dexcom G6.

Any ideas?

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@BradP, get your thyroid tested. It could be a thyroid issue.

@BradP are there any color changes of the skin? Raynaud’s will do this, in varying degrees of color change. In some cases it is a stark difference; in others it is a totally different color; and in some cases it is definitely noticeable, but not as much as the stark difference.

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That’s what is weird. No changes in anything but temperature. No color change. No sense change. No nothing. usually I put my hands under my legs bewteen that and the chair or other warm spots in my body warms it up for a bit, but then goes cold again. Can’t even figure out what causes it. Seems to be at random.

I can ask my endo again to test TSH and TSH4 but last time I had it tested overa year ago it was fine. But then again, I wasn’t having cold hands then either.

@BradP it could be something connected with circulation.


I was thinking that too. Hopefully not the beginning of neuropathy. Who checks circulation? Endo? Someone else?

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I have had the same problem off and on for five years. It happens to me a few weeks out of the year. I’ve had my thyroid tested yearly for the past three years and my thyroid is fine. My TSH, T4 and T3 have come back normal. I was told that diabetes causes overall circulation problems over time.

a vascular surgeon would check for circulation. Some cardiologist also do this, but I have had both and feel much better being cared for by a vascular surgeon.

Damage due to diabetes. Diabetes affects micro blood vessels. Woman tend to have this issue more than men. I get cold hands and feet,too. Even with good control ,this is long term impact. Nancy50

C-peptide protects those small blood vessels but is not included in any external insulin. However, animal insulins used to have it.

I have the same problem with cold hands and feet. My Dr. told me 12 years or so ago when I first noticed it that it was Reynauld’s syndrome. Sometimes my fingers turn colors- red, white, darker. The doctor said to let him know if they turn black. I had tried a prescription (expensive) but didn’t like it, so now just deal with it. I am a t1, 52 years now! Diabetes, as has been mentioned, does cause damage like that.

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Unfortunately, it’s a rare endo who will order a full panel of thyroid test. The tests include:

  • Thyroid stimulating hormone (TSH), actually a pituitary hormone
  • Free T4 (FT4), storage hormone
  • Free T3 (FT3), active hormone
  • Reverse T3 (RT3), high RT3 indicates poor remote conversion FT4>FT3
  • Thyroid peroxidase antibodies (TPO), thyroid autoimmunity
  • Thyroglobulin antibodies (Tg), thyroid autoimmuntiy

Endos and many other doctors limit their efforts to measuring TSH and prescribing T4 (aka Synthroid, levoxothyrine). Endocrinologists often resent patients challenging their understanding of the thyroid system. They generally accept any lab values that fall into the lab normal range. Successful thyroid treatment means targeting optimal lab values and really listening to the patients’ symptoms.

I gave up on persuading my endos to order a full range of thyroid tests; the head of the department, the endo, and the PA all refused to work with me. And this is a well-respected regional medical center diabetes clinic!

For this reason I consulted a Naturopathic Physician who had a better understanding of how the thyroid works. I now work with an MD who is a functional medicine practitioner. Functional medicine is known for seeking the root cause of illness and not being happy merely treating a symptom.

Unfortunately, I am still struggling with cold feet every day. I underwent testing with a vascular surgeon and my circulation appears to be fine. Still experimenting with finding the optimal thyroid med dose. It’s a slow process that requires patience. My working hypothesis now is long-term damage to my peripheral nerves.

Two books that will help you understand how the thyroid works are Stop the Thyroid Madness by Bowthorpe and The Thyroid Patient’s Manual by Robinson. Knowledge is power.


I’m guessing circulation. The endo will check, but not extensively. Tell him about it.

I have Raynauds syndrome. My fingers go numb at any drop in temperature, even at 60F. In my case, yes, there is dramatic color change, white then if not resolved, purple. I will rub my fingers to try to get blood flowing. It helps a bit, but really heat is the best. It is not related to diabetes though. I think it is related to lupus, at least it is one of the symptoms my Dr said often occurs with lupus.

Are you sure the doc is an MD? This is precisely why I prefer DOs over MDs, usually. They’re very different approaches to medicine. This term “functional medicine” is new to me.

Yes, my doctor is a MD. I know it’s unusual. My doctor tired of just throwing drugs at symptoms and wanted to really help people. She set up a concierge model of practice and I pay a monthly fee in addition to paying for visits (remote for now) and lab tests. She believes that food is medicine and will recommend some supplements when needed.

She works with a physician assistant, functional nutritional therapy practitioner (FNTP), and a massage therapist. When she offered me a consultation with a nutritional therapist, I was suspicious as many encounters with dietitians taught me that they don’t really understand diabetes even though food plays a major role in living with the disease. The consult I did was a nice surprise.

Here are the values of the Nutritional Therapy Association.

The NTA’s philosophy centers on the idea that real health can be achieved through a holistic and individualized approach to nutrition and lifestyle. Our mission is to deliver a science-based education that fosters a community of confident holistic nutrition professionals who harness the power of real food and empower people to reconnect with the innate wisdom and unique needs of their bodies, thereby supporting lasting wellness.*

We believe that many of modern society’s health problems result from weaknesses in the body’s physiological foundations brought on by poor nutrition. We are dedicated to helping healthcare professionals and individuals reverse the negative effects of the modern diet through nutritional therapy. Our foundational, holistic approach focuses on the importance of a properly prepared, nutrient-dense, whole food diet paired with a well-balanced lifestyle.

Here’s info from the Nutritional Therapy Association, the agency that provides training for practitioners.

Throughout our programs, students learn a wide range of educational tools and techniques to identify and correct nutritional imbalances and deficiencies. Our courses cover scientific principles about how the human body functions, both anatomically and physiologically. We also honor the body’s innate intelligence and its incredible capacity to restore, regenerate, and correct itself — when given the tools and nutrients to do so.

Another Functional Medicine MD is Mark Hyman. If you do a YouTube search, you’ll find a great deal of content. Dr. Hyman is affiliated with the Cleveland Clinic.

I suspect that you may be able to establish a remote relationship with a functional medicine MD, if you want.


Here’s some background on the history of functional medicine. Although its roots go back to the 1990s, I was not aware of that term until the last five years. My daughter would listen to my doctor complaints and then ask me why I do not consult with a functional medicine practitioner.


@Terry4, would you mind sharing what meds you are trying for thyroid treatment? I am going to push my dr to run a full panel of the tests you’ve mentioned, but want to also go in with knowledge of any additional meds outside of Synthroid available for treatment. Many thanks - Jessica

@Jessica – I’m currently taking a natural desiccated thyroid med called NP thyroid. This drug is derived from the dried out thyroid glands of pigs. It contains T4, T3 and other thyroid components.

I changed insurance prescription plans this year and the new company’s formulary does not include NP Thyroid. It does cover levothyroxine (T4) and liothyronine (T3), so I just picked up a new supply and will switch over when my NP thyroid meds run out in a few weeks. I will take T4 + T3 every day.

Over the last few years, I have had my thyroid levels tested many times. My initial levels of free T4 were high while my free T3 was low. Reverse T3 was very high. What I learned is that FT4 (a storage form of the thyroid hormone) is converted to FT3, the active thyroid hormone, in peripheral tissue. If this conversion is impaired, RT3 tends to rise too high.

In my case, adding T3 directly is a way to address the FT4 to FT3 conversion deficiency. Anyway, that’s my understanding of my case while I think it’s best for anyone reading this to consult with their doctor. Be forewarned, however, that the average doctor is reluctant to add T3. This is most likely due to inexperience.

I’ve read of many anecdotal cases, mostly women, who experienced dramatic symptom relief when they added T3 to their regimen. Thyroid problems are much more common in women than men.

I initially thought that my cold feet were a symptom of insufficient thyroid hormone but I’m beginning to think there is another cause of this symptom.

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