Dr. Jay,

I find that my hands and feet get cold very easily and very quickly.  This makes me avoid the outdoors during the winter months. Gloves and wool socks help sometimes but there are times when they don't.  What causes this and what can I do so that I can enjoy the outdoors?

From,
Cold hands, warm heart

Dear Cold hands, warm heart-

Your concern is a common one and I’m sure you’re not the only OASC member to have this. Your body is responding to the cold by vasoconstriction, that is, keeping blood away from your extremities and making sure the warm blood is going to your vital organs like your brain and heart. Even with the warmest of gloves and socks, for some, this can still be a problem. What to do about this?

There are several approaches. First, switch from gloves to mittens. Gloves are not as efficient as mittens are at retaining heat. Your feet and hands should stay dry to stay warm. Having sweaty feet can cool the feet in cases where you are not wearing wool/synthetic socks, especially if you take a break. However, most of the heat from your body does not escape from you hands and feet, but your head rather! The first easy suggestion is to make sure you are wearing a warm hat to keep yourself toasty. You can also add a balaclava or scarf to increase the insulation to your head. Even with these modifications, some people still find themselves with cold hands and feet.

I have also seen recommendations for use of warmers/heat packs in areas such as your wrists where your large blood vessels come closest to the surface. I have not seen studies documenting the effectiveness, but the vasoconstriction effect is under a complex control system and for some, may not to respond to well-placed warmers. Most heat packs are single use (i.e. disposable) so if this works for you, please look for the reusable hotpacks (http://www.hotsnapz.com or http://www.hot-pad.com).
You also need to make sure to stoke your metabolic fire. Are you consuming enough calories to create your own heat before heading out into the cold? For many of the OASC events, we’ll be generating a lot of heat, but it can be quickly lost when we stop for more than a minute or two. For those with cold hands/feet, put your layers on ASAP when we stop!

Some people have a condition called Raynaud’s Phenomenon. Although related to the normal vasoconstriction, this is a more severe version that can cause more pain, and even skin ulceration and gangrene. The classic symptoms are color changes of the fingers/toes, for example, from normal to white, then to blue and finally to red as normal blood flow returns. If this is happening on an adventure, please alert your Leader and see your Doctor!

Dr. Jay

Ask Dr. Jay is not intended to address specific questions concerning individual cases, so please keep your question general in nature. Questions and answers here are not a substitute for medical advice from your Physician. Please contact your doctor if you need medical advice or treatment, or have any questions regarding a medical condition.