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What Is Causing The Feeling Of Cold With Poor Circulation?

Posted on Tue, 6 Nov 2012

Question: What could be the causes of feeling very cold with very poor circulation - even when in warm environment. This is accompanied by profuse axilliary hyperhidrosis throughout the day. Raynauds symptoms last for 5-6 hours at a time and can be aggravated even when in warm environment wearing multiple layers. Thyroid levels appeared normal but nutrionist suggested I get T3 measures taken too. Am 25 year old man who is physically fit and active. Have taken antidepressants and long term antibiotics before but currently on no medication.

Answered by Dr. Anantharaman (2 hours later)

Hi,
Thanks for writing in.
I have reviewed your reports in detail. Your TSH is normal but you may still have central hypothyroidism so it is necessary that you get a simultaneous T4 and TSH. T3 as someone has informed you is not useful in your case because it could sometimes be increased rather than decreased in hypothyroidism and tends to confuse the picture. All the other tests you have got done are fine .

After looking at your symptoms I doubt if pursuing the T4 test is of any relevance to your problems. Hypothyroidism is never associated with increased sweating or hyperhydrosis.Do you feel anxious often and have palpitations too? The you should consult a psychiatrist and see if all your symptoms are because of an anxiety disorder. You will do very well on medications if indeed you have anxiety
Hope this helps
Regards
Anantharaman

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Anantharaman (16 hours later)

Thank you for your response. Given the nifidepine and l arginine treatments haven't been very effective for the poor circulation I wouldn't think the symptoms are purely Raynauds/ poor circulation and that there may be other factors at play.

I agree that the issue may be anxiety driven as have had a long history of OCD and flushing/ palpitations when nervous. I have been prescribed propanol for this condition. Would you recommend I take this even though it can have vasoconstriction side effects?

What other anti anxiety meidcations/ supplements would you recommend? I don't feel outwardly nervous but think the problem may be XXXXXXX rooted in my physche.

Answered by Dr. Anantharaman (4 hours later)

Hi,
Thanks for writing back.
Because of your Raynaud's, I wouldn't recommend the propranolol. As far as medications for anxiety are concerned there are several non sedating anti anxiety agents .Since I'm not an expert in the area I would recommend you XXXXXXX a psychiatrist who can give you a prescription.
Regarding your RAYNAUDS could you describe your symptoms in a little bit of detail so that I can give you some suggestions feel free to write back with details

Regards
Anantharaman

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Anantharaman (44 hours later)

Hi there, i get extremely cold hands and feet. My hands go purple with an orange dot below the right index finger. This happens both indoors and out on the slightest exposure to cool air. It takes considerable time for them to rewarm even when indoors. My feet sometimes stay cold all day. There is little pain on them rewarming though when this does happen. My hands, feet and especially axillae also get very sweaty when I am exposed to cold. Strangely i sweat very little when homeostatis is achieved and feeling warm and relaxed. I have had these symptoms for 10 years now and would like to achieve a cure. My symptoms tend to be worse in the mornings and slightly better after 7pm. Also when drinking alcohol they tend to be better, not sure is this is reducing the effects of an overactive sympathetic nervous system response/ vasoconstriction. I would appreciate any advice on medications to help regulate the nervous system and prevent this exaggerated response to cold/ stress. When in my early teenage years I had terrible OCD and very high levels of anxiety.

Answered by Dr. Anantharaman (3 hours later)

Hi,
Your symptoms are consistent with a primary RAYNAUDS' syndrome.I suggest you XXXXXXX either an immunologist or a cardiologist who is experienced in treating the disorder. There are other treatments for RAYNAUDS - losartan, Sildenafil or tadalafil all can be useful. You should have good symptom relief. There is a large inter individual variability in treatment for this condition you may benefit with one of these drugs you can try them one by one under medical supervision. Fluoxetine has been tried in individuals with RAYNAUD'S and depression. You should broach this with your treating primary and appropriate referral. Surgery is recommended only if there is pain and it does not get better with medication. Most people with RAYNAUDS are able to manage with medical treatments.
Regards
Anantharaman R

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar