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Why Do I Feel Hot (or Cold) All the Time?

As a family physician, I see patients every day with a variety of symptoms and conditions.

One complaint that I sometimes hear from patients is that they often feel either too hot or too cold all the time. Every body is different, so the answer to this question isn’t always the same. Here’s what you should know:

Why am I always hot (or cold)?

Feeling cold could be a symptom of several different conditions including anemia, a condition often caused by not having enough iron in your blood, and hypothyroidism, a condition in which the body does not make enough of the thyroid hormone to help it control basic metabolic functions.

On the other end of the spectrum, an overactive thyroid called hyperthyroidism can cause you to feel hot. When the body produces too many hormones it can affect the regulatory system and cause you to overheat. Another reason for feeling hot all the time may be linked to hormonal changes that accompany your menstrual cycle. Levels of the hormone progesterone increase during the latter half of your cycle, so you’re more likely to feel warmer than usual during the time you ovulate. Stress, pregnancy and menopause (i.e. hot flashes) also can cause the body to overheat.

When patients mention they either feel too hot or too cold, I usually assess their symptoms based on their age and gender. For example, for younger women who are of reproductive age I proceed to ask questions that relate to thyroid and anemia. We also may perform a pregnancy test in reproductive age women because of the hormonal shifts that occur during this time. For older women, I also think about thyroid disease, but I make sure to ask about menstrual history since menopause can produce hot flashes.

Other causes of feeling cold may include Raynaud's syndrome (a rare blood vessel disorder),  anorexia and B12 deficiency. Other causes of feeling hot may include stress, heavy caffeine use and being overweight.

Generally, female patients deal with temperature control more often than men, and the cause is usually metabolic-related, such as diabetes, thyroid disease or anemia.

What Can I Do?

I usually advise patients to make a separate appointment to discuss their symptoms. I will also ask them to write a diary about episodes relating to cold or heat intolerance (i.e. when do they feel symptoms or when do certain things trigger them?).

One thing that is really helpful to know is how long you’ve had symptoms. Some people say, "I’ve been cold or hot all my life, since childhood." So metabolic causes may not be the primary cause. Knowing other symptoms is also helpful to narrow down the diagnosis, especially when it can be one of two conditions. If you have ongoing symptoms, keeping a diary to log them will be really helpful and may guide us toward the right diagnosis. I typically suggest blood tests, so we can rule out some metabolic causes.

The body is a powerful thing, and it has a way of telling us when something is wrong. Feeling hot or cold all the time may be an indicator that there’s an underlying health issue you need to address. If you’re uncomfortable or have no idea what’s causing your symptoms, it’s best to schedule an appointment with your doctor. We can evaluate you and do a blood test, if necessary, to identify the issue and get you the right care. 

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