Most of us feel chilly from time to time, but for some people, feeling cold isn’t just occasional. It’s constant. They might need a sweater when others are comfortable or shiver even when the thermostat reads above 75°F. Being cold all the time may seem like a quirky personal trait, but it could be a sign that something deeper is going on inside the body.

Here are some reasons why someone might constantly feel cold and when to talk to a doctor.

* Anemia: low iron, low heat. Anemia happens when your body doesn’t have enough healthy red blood cells to carry oxygen to tissues. Without adequate oxygen, your metabolism slows, and you generate less heat. Because iron is essential for energy and heat production, iron-deficiency anemia is one of the leading causes of people feeling cold, especially among women and those with nutritional deficiencies.

* Hypothyroidism: a sluggish thyroid = cold body. The thyroid gland acts like the body’s thermostat, regulating metabolism. When the thyroid doesn’t make enough hormones (hypothyroidism), metabolism slows dramatically. Hypothyroidism affects women far more often than men and can see an increase with age. If feeling cold is paired with other symptoms above, thyroid testing is important.

* Poor circulation: heat can’t reach your extremities. If blood flow is restricted, your body has trouble delivering warmth to your hands, feet and nose. Circulation problems can make only certain areas feel cold, even when the rest of the body feels normal. Poor circulation should always be checked, especially in smokers or people with diabetes.

* Inadequate body fat. not enough insulation. Fat acts as a natural insulator to trap heat. When body fat percentage is too low, the body loses heat faster than it can produce it. In eating disorders, the body may also decrease thyroid hormone production and slow metabolism, compounding the cold sensitivity.

* Dehydration: water helps regulate temperature. Believe it or not, water is crucial for maintaining body temperature. Sweat, blood flow and metabolic reactions require sufficient hydration. Even mild dehydration can leave a person feeling unusually cold, especially in the hands and feet.

* Nutrient deficiencies beyond iron: Low calorie intake is one issue, but specific nutrient deficiencies can cause cold intolerance, too. People on plant-only or highly restrictive diets may be more vulnerable to these deficiencies if nutrition isn’t carefully planned.

* Diabetes: nerve and circulation changes. Diabetes can damage nerves over time, especially those that affect temperature sensation in the hands and feet. Coldness in the feet can be an early warning sign of diabetes or related complications.

* Chronic stress and anxiety: When you’re anxious or stressed, the body activates its “fight or flight” response, releasing adrenaline. That causes blood vessels in the skin to constrict, sacrificing warmth to protect vital organs. Chronic stress keeps the nervous system in constant overdrive, making coldness a common, lingering symptom.

* Age-related changes: As people age, their ability to regulate temperature changes. Muscle mass naturally declines, reducing heat production. Elderly adults may also eat less and have slower circulation. If an older adult suddenly becomes more sensitive to cold, medical evaluation is essential.

* Medications that reduce heat production: Certain drugs can interfere with metabolism, circulation or hormone balance. If cold intolerance starts after a medication change, speak with a provider.

* Hormonal imbalance in women: Estrogen plays a role in blood vessel function. Hormonal shifts, such as during menopause, pregnancy or menstrual irregularity can change how the body regulates heat. Conditions like polycystic ovary syndrome and perimenopause may also play a role.

* Sleep deprivation: body systems run colder. When you don’t sleep enough, your metabolism slows, stress hormones spike and body temperature regulation becomes inconsistent. Even one night of poor sleep can make you feel more cold-sensitive the next day.

* Infection or acute illness: Sometimes feeling cold is a sign your body is mounting a defense. When fever begins to rise internally, the body may trigger chills to generate heat. Feeling cold + feverish + general weakness is a sign to monitor closely.

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