Reasons Your Hands and Feet Feel Cold First — and What to Do About It

5. Diabetes and nerve damage that masks circulation problems

Diabetes affects both nerves and small blood vessels in the feet and hands, creating a double challenge for warmth and sensation. High blood sugar over time damages nerve fibers, producing neuropathy that can make feet feel numb, tingly, or cold even when surface temperature isn’t dramatically low. At the same time, small vessel damage reduces blood flow to the skin, compounding the sensation of chill. People with diabetes also have higher risk of infections and slower wound healing, so a cold, numb foot can hide a wound that becomes serious. Routine foot exams, good glucose control, and daily self-checks for cuts, blisters, or color changes are practical ways to reduce risk. A healthcare provider may run vascular tests or nerve studies when symptoms are new or concern exists. Simple daily habits—proper footwear, gentle foot movement, and protective socks—help maintain circulation, while medical interventions may be needed for significant blood-flow problems. If you have diabetes and you find numbness or persistent cold in your feet, mention it to your clinician so they can include vascular and neuropathy checks in your care plan.

6. Thyroid slowdown: low metabolism, low warmth

Your thyroid gland helps set metabolic pace, and when it runs slowly—hypothyroidism—many people feel cold more often. A lower metabolic rate reduces the heat produced by cells, so hands and feet can feel colder even if overall body temperature is normal. Other signs that point to an underactive thyroid include fatigue, weight gain, dry skin, and sensitivity to cold. Because hypothyroidism is diagnosed with straightforward blood tests that measure thyroid hormones and related markers, testing is often part of the evaluation when someone complains of persistent cold intolerance. Treatment with prescribed thyroid replacement typically restores metabolic balance and often improves cold sensitivity over weeks to months. If you notice new or worsening cold intolerance combined with tiredness or other changes, a primary care visit for basic blood testing is a reasonable step to check thyroid function and rule out treatable causes.