Thyroid issues, vitamin deficiency, and even anxiety can contribute to cold hands and feet. Here are some possible causes — and what you can do.

Possible Causes: Thyroid issues, anemia, B vitamin deficiency, poor circulation, anxiety, Raynaud’s phenomenon

When a patient reports perennially cold hands and feet, “the first thing I think about is the thyroid,” says Amy Savagian, MD. Poor thyroid function is not the only reason for chilly extremities, but it is among the most common, especially for women.

The leading cause of thyroid ­issues in the United States is Hashimoto’s thyroiditis, a condition in which the immune system attacks the body’s own thyroid gland. Women are seven times more likely than men to have Hashimoto’s, and it frequently goes undiagnosed.

Other causes of cold hands and feet include anemia, a deficiency in iron or certain B vitamins, or generally poor circulation.

Anxiety can even play a role. “Anxiety can lead to contraction of the blood vessels,” says Savagian, making it harder for blood and oxygen to reach the body’s extremities.

A circulatory disorder called ­Raynaud’s phenomenon will sometimes constrict the small arteries in the hands and feet so severely in response to cold that digits go numb and turn pale or bluish. It can take up to 15 minutes for normal circulation to return. This disorder tends to disproportionately affect slender women, Savagian notes. While it might appear alarming, it is rarely serious enough to require medical treatment.

What You Can Do: Keep your core warm, suggests Savagian, because blood prioritizes the vital organs. Then get moving. When it comes to improving circulation, “exercise is incredibly beneficial for the peripheral arteries,” she notes. Studies have shown that fish-oil supplementation can also help ease Raynaud’s symptoms.

Avoid lifestyle triggers, such as smoking and excessive caffeine consumption, that cause the blood vessels to constrict. Manage stress and anxiety. If you suspect a vitamin or mineral deficiency, ask your doctor to run tests for iron and B vitamins.

If cold hands and feet are a persistent problem — and you experience other Hashimoto’s symptoms, such as fatigue, thinning hair, weight gain, and dry skin — consider ordering a thyroid test