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

7. Anemia: less oxygen, less warmth

Anemia means your blood carries less oxygen than usual, and that shortage can make hands and feet feel colder. Iron-deficiency anemia is a common type, but other causes include chronic disease or vitamin deficiencies. When oxygen delivery drops, peripheral tissues receive less fuel for generating heat. Typical accompanying signs are paleness, fatigue, and breathlessness on exertion; these clues help clinicians decide on testing. A simple complete blood count and iron studies can identify anemia and its likely cause. Treatment varies by type—iron supplementation for iron deficiency, dietary changes, or addressing blood loss sources—and often leads to improved warmth and energy. Because anemia can have many underlying reasons, evaluating unexplained cold intolerance with basic bloodwork is a practical step, especially when fatigue or other systemic symptoms are present. Addressing anemia also supports broader health, including immune function and physical stamina.

8. Medications, smoking and sedentary habits that reduce circulation

Certain medicines and everyday habits can narrow blood vessels or blunt circulation so extremities feel cold. Over-the-counter decongestants and some migraine drugs tighten vessels, and certain blood-pressure or heart medications may alter peripheral flow. Smoking causes persistent vasoconstriction and damages vessel linings, worsening coldness and raising long-term vascular risk. Extended sitting or crossing legs for long periods reduces muscle pump action that normally helps blood return from the feet. The good news is these are often modifiable. Talk with your clinician about medication side effects before stopping anything; sometimes an alternative drug or adjusted timing reduces symptoms. Quitting smoking is one of the most impactful changes for improving peripheral circulation and overall cardiovascular health. Simple movement breaks—standing every 30 minutes, marching in place, or ankle pumps—stimulate blood flow quickly and can be done anywhere. Small changes in daily routines often make a big difference to how warm your hands and feet feel.