There are several common reasons for feeling colder than normal. Dreamstime/TNS

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Q: I am cold all the time. Sometimes I get so cold that all I can do is take a really hot shower or bath.

It has gotten to the point where being so sensitive to the cold interferes with my work and life. What causes this problem, and what can I do?

A: While feeling colder than others around you is quite common, your symptoms are more pronounced than usual. Therefore, I would definitely suggest a visit with your doctor.

Here are some of the more common reasons for feeling colder than normal:

Low body weight. Both fat thickness and muscle mass assist in keeping us warm. Muscle activity generates heat and fat acts as insulation.

If you have lost a lot of weight recently or you have always been thin, you might be sensitive to ambient temperatures that would be comfortable for most people.

Skipping meals. Some people get cold when they skip meals or take in too few calories. The body conserves energy and produces less heat in response to fasting.

Being overly tired. Not getting enough sleep and feeling tired all the time may be contributing to the cold feeling.

An underactive thyroid (hypothyroidism). Feeling cold can be a symptom of hypothyroidism. A simple blood test for TSH (thyroid stimulating hormone) can determine if you have this problem.

Raynaud’s phenomenon. The normal response to cold temperatures is to shunt blood away from the skin to keep the internal organs warm.

In people with Raynaud’s phenomenon, that natural response is extreme. The tiny blood vessels get severely narrowed and markedly reduce blood flow to the skin, most often in the fingers and toes. One or more digits turn white or blue, temporarily.

People with Raynaud’s tend to be much more sensitive to even minor drops in air temperature than other people. In addition to wearing gloves and thick socks, they need to keep their core body temperature up by wearing lots of layers of clothing.

Q: Over the last couple of months, I developed night sweats. I am a 45-year-old male and consider myself healthy.

My wife says it has a cheesy smell. She is worried that I have a serious medical condition. What may be causing this?

A: Night sweats are very common, and most often the cause is not serious. Several large studies have found that anywhere from 30% to 40% of the general population report at least occasional night sweats.

The cheesy smell also is not unusual. Some Swiss researchers actually studied the smell of sweat in men and women. Sweaty men tended to smell like cheese, while sweaty women smelled like onions or grapefruit.

When a man experiences new night sweats, I start by asking about the temperature of the bedroom and the number and type of blankets used.

Assuming that this is not the issue, I would next want to know if you routinely soak through your bed clothes, have fevers during the day, and if you have been losing weight without trying.

Night sweats accompanied by fever and weight loss always require a full medical evaluation. You could have an infection, a non-infectious inflammatory disorder or cancer.

If your energy level is normal and you don’t have fever or weight loss, a serious cause is less likely. But some other possibilities should be considered:

• Sleep apnea — especially if you snore, are sleepy during the day, or both
• Anxiety
• A side effect of a medication, herb or supplement
• Low blood sugar (more likely in a person taking medicine for diabetes)
• An overactive thyroid (hyperthyroidism). In this case, usually there would be additional symptoms, such as weight loss despite a good appetite, rapid heartbeat, sweating during the day and feeling jittery
• A dramatic fall in testosterone level, such as from prostate cancer therapy
• Other rare hormonal disorders

You should see a medical professional to evaluate your symptoms. In the meantime, here are some things you can try to decrease the sweats:

• Keep the bedroom cool or open a window.
• Avoid spicy food, especially at night.
• Avoid alcohol for a while.
• Get up, towel off, and change bedclothes immediately as needed.

Quite often, no specific cause for night sweats is discovered. In these cases, the sweats usually go away on their own.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional information, visit health.harvard.edu.

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