Can Anemia Cause Cold Hands And Feet?

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Understanding anemia

Anemia develops when you lack sufficient healthy red blood cells to transport oxygen to the organs and tissues in your body. Hemoglobin is the iron-rich protein found in your red blood cells. It is responsible for carrying the oxygen from the respiratory organs through the blood to the rest of the body organs, where it will take the carbon dioxide from and back to the lungs. So when you don’t have enough healthy red blood cells, for example, due to iron deficiency, you will have low hemoglobin levels, which will impact the amount of oxygen your organs receive. 

Anemia can occur if:

  • Your body doesn't produce sufficient red blood cells

  • You have blood loss from bleeding

  • Your body destroys red blood cells

  • Your red blood cells are not formed properly, or they die faster than they should

Anemia affects many people. The Centers for Disease Control and Prevention reports that about 3 million people in the US have anemia.¹

Anemia can be mild, moderate, or severe, and it can be acute or chronic. Mild anemia is common, often temporary and easy to treat. It may develop due to your diet or medications, but if left untreated, it may progress to moderate or severe. Acute anemia occurs when there is a sudden loss of red blood cells, often due to hemorrhage or something that causes abrupt destruction of these cells (hemolysis). Chronic anemia lasts for a long period and is difficult to treat. It often happens in people with long-term health conditions, particularly inflammatory autoimmune diseases or cancers. There are many types of anemia, and each has its own cause. 

Some common types of anemia include:

  • Iron deficiency anemia (due to low iron level)

  • Vitamin B-12 deficiency anemia (results from low levels of vitamin B-12 or folate), leads to abnormally large and unhealthy red blood cells that die fast

  • Hemolytic anemia (happens when red blood cells are destroyed quicker than the bone marrow can replace them)

  • Sickle cell anemia (inherited and severe hemolytic anemia that hinders the flow of red blood cells)

  • Aplastic anemia (develops when the bone marrow stops producing enough red blood cells)

Iron deficiency anemia is the most common type of anemia. Common symptoms of anemia include headache, shortness of breath, dizziness, cold hands and feet, etc.

What is iron deficiency anemia?

As mentioned before, hemoglobin is the oxygen-carrying protein inside the red blood cells, and it requires iron to be made. Iron deficiency anemia is a condition where there is a lack of oxygen-rich healthy red blood cells due to low levels of iron and, consequently, low levels of hemoglobin. People with iron deficiency produce fewer red blood cells. This shortage of iron causes iron deficiency anemia. 

The World Health Organization (WHO) reports that iron deficiency is the leading nutritional disorder across the globe. There are several risk factors for anemia. People who are at risk of anemia include:

  • Pregnant women and women with heavy menstrual bleeding

  • People with low iron vitamin b12 or folate intake

  • People who have gastrointestinal issues that may affect the absorption of nutrients

  • Those who donate blood often or bleed from a surgery

  • People with underlying health conditions such as kidney failure, cancer, or autoimmune diseases

  • People that are over 65 years

  • Those that take certain medications, such as aspirin

  • Those with high alcohol intake

Symptoms of anemia

People with iron deficiency lack oxygen in their bodies. Iron deficiency anemia can be mild at the beginning, and you may not notice the symptoms. However, if left untreated, it can cause symptoms and serious complications. Symptoms may vary depending on age, current health status, and how severe the anemia is.

Symptoms of iron deficiency include:

  • Weakness

  • Fatigue

  • Shortness of breath

  • Unusual pale skin

  • Headaches

  • Dizziness

  • Fast or irregular heartbeat

  • Brittle fingernails

  • Unusual cravings for dirt or ice called pica syndrome

  • Tingling in the legs

  • Damaged or dry hair and skin

  • Cold hands and feet

If you have any of these symptoms of iron deficiency, you should consult with your doctor as soon as possible to address the condition and avoid further serious complications.

Can anemia make your hands and feet cold?

Yes, anemia can cause you to feel generally colder than other people and have difficulty maintaining body heat, particularly in the extremities (hands and feet).

How does anemia cause the feeling of cold hands and feet?

Clinical studies show that iron deficiency anemia causes poor temperature regulation in humans.² It is the main reason iron-deficient persons cannot regulate their temperature during cold weather. Research suggests this could be a result of a number of factors:

  1. Poor thyroid functions that often occur in iron-deficient individuals. These can impact the body’s ability to produce heat.

  2. Issues with regulating heat loss rate. Because of the hypoxia (low oxygen) in the tissues resulting from the anemia, the body is fighting between trying to increase the amount of oxygen in these tissues by increasing the blood flow and trying to reduce the flow of the blood in the body to the extremities to maintain the body heat.

  3. Other issues with heat production. When the body tissues don’t have enough oxygen, they are unable to conduct certain heat production processes, such as increasing the metabolic rate.

  4. Anemia is also linked to blood circulatory issues and cardiovascular disease, especially if left untreated. These issues can affect the blood flow to the extremities. 

What are the other causes of cold feet?

Besides anemia, other conditions are likely to cause cold feet. They include:

Raynaud's disease

This is a medical condition that causes your body to overreact to cold or stress. In Raynaud's disease, blood vessels, particularly those in the extremities, constrict when your skin senses cold. When this occurs, blood can't flow to your hands and toes, resulting in cold feet. Cold temperatures or stress triggers Raynaud's disease.

Peripheral artery disease

This condition blocks or slows blood flow to your feet, causing them to feel cold.

Hypothyroidism (underactive thyroid)

Your thyroid produces hormones that affect plenty of your organs. These hormones help your body convert oxygen and food into energy. But when you have a low-functioning thyroid gland, your metabolism slows, and your body can't generate enough heat to maintain the body temperature. This can make your hands and feet cold.


If diabetes isn't treated properly, it can damage the nerves in your feet. Nerve damage impairs the body's temperature regulations. Your feet may be normal when you touch them, but they feel cold to you.

Poor circulation

Poor blood circulation, which happens due to conditions that affect the circulatory systems, such as atherosclerosis and heart disease, can also cause feelings of cold in the hands and feet. These conditions affect the blood flow and make it difficult for your body to maintain body temperature, especially in your extremities.

Ways to treat cold feet and hands

If you always feel cold in your hands and feet, here are ways you can treat them:

  • Put on thick clothes, hats, and socks to retain body heat

  • Move or stretch your feet

  • Quit smoking (tobacco causes tissue hypoxia and also constricts the blood vessels,  making it difficult for blood to circulate to your hands and feet)

  • Limit the amount of time you spend outside during cold weather.

  • Don't overstress yourself

  • Support the health of your red blood cells by eating food that is rich in iron, folate, and vitamin B-12

How to treat anemia?

Your doctor will use a physical exam, medical history, and blood test results to diagnose anemiaOnce your doctor confirms you have anemia, your treatment options will depend on the type and severity of the condition.

Ways to treat anemia include:

Taking iron supplements

For most mild to moderate anemia, you may have to take iron pills, vitamins, or medicines that stimulate blood cell production. You will probably be prescribed vitamin C as well, as it helps with iron absorption.

Eating iron-rich meals

Iron-rich foods include:

  • Red meat like pork, chicken, and beef

  • Seeds and nuts

  • Dark leafy vegetables like kale and spinach

  • Beans, peas, and other legumes

  • Seafood

Blood transfusion

Sometimes, your doctor can recommend a red blood cell transfusion to restore lost red blood cellsespecially in aplastic anemia.

The lowdown

Anemia, particularly from iron deficiency, is very common. One of its common signs is cold hands and feet. 

Consult your doctor if you feel you are having signs of anemia. Ensure you don't diagnose it yourself. Your doctor will set up a treatment plan that suits your healthcare needs.

Frequently asked questions

Are anemic people sensitive to cold?

People with anemia lack healthy red blood cells to transfer oxygen to their body parts, which impacts how the body produces and maintains heat and regulates heat loss. So yes, they are sensitive to cold.

When is someone said to be anemic?

A person has anemia when their hemoglobin value is less than 12.0 gm/dl for a woman and less than 13.5 gm/dl for a man.

What is considered severe anemia?

Severe anemia is when hemoglobin levels drop to 6.5 to 7.9 g/dL.

  1. Anemia or iron deficiency | Centers for Disease Control and Prevention (CDC)

  2. Iron and thermoregulation: A review (1996)

Other sources:

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