Cold lower extremities

I’m experiencing the worst cold and I think numb, but cold and numb kind of feel the same to me, feeling from about my shins downwards (worst at my toes, which go greyish coloured). I’m constantly in blankets and wear down slippers. I buy those disposable stick on glove warmers and keep them in my slippers and with all of that I’m still uncomfortable. At my own house, I sometimes blowdry my feet, or put them in a warm foot bath (or just have a bath). I’ve brought this up to my Endo and a podiatrist and the Endo said it would show in my eyes and bloodwork first if it were a Diabetes issue, and the podiatrist said “you have cold feet”. Not helpful, and I wasn’t like this before a couple years ago, and it’s gotten more extreme. I feel like there has to be a solution. It’s worst when I’m sitting at my desk, it seems best when I’m laying in my bed.

Any suggestions on what type of doctor might be able to help me? I’m pretty sure my GP would refer me to anyone, if I asked for a specific referral.

I also know I had very severe reactions to Invokanna a few years ago and was hospitalized and very, very sick. I don’t know if there could be lasting damage from that, as I know it affected feet for a lot of people, but that was years ago (3ish)?

Or, can one just develop this type of cold sensitivity at 41 (now 43).


There are a lot of possible causes.

Can I ask a few questions? What are they testing in your blood-work?

  • Do they do a comprehensive metabolic panel?
  • Have they performed all the thyroid tests - T4, T3, and TSH?
  • How are your lipid levels?
  • What are your A1C’s generally?

It could possibly be a circulation issue. Do you have a cardiologist?

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  1. I don’t know what the first question means, I couldn’t find anything on my lab req that had the word “metabolic” in it.
  2. I get TSH and T4 Free tested
  3. Lipids are all in normal range
  4. 7.0 the last two A1C’s which were my best in about a decade (in which they were high 8’s-mid 10’s). Before that they were in the 6’s and 7’s.

EDIT: TSH and T4 Free are normal.

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There’s quite a few things that can cause cold sensation in the extremities.
High cholesterol
Poor circulation
B-12 deficiency
Autonomic neuropathy
This last one can cause a reduction of blood circulation by a lack of ability to increase blood flow to warm toes and feet, probably hands and fingers as well.

We often think of peripheral neuropathy as just the sensory nervous system forgetting that diabetes can damage any nerves.


A comprehensive metabolic panel (CMP) has a bunch of different tests in it. There is a lot of good overall information in it.

Are your thyroid levels good? As @CarlosLuis mentioned, it could be a thyroid issue.

And I think a cardiologist would be good to consult. As @CarlosLuis also mentioned, it can be caused by poor circulation in your legs.

There are a lot of different possibilities. It would help to have a proactive doctor who can work with you to find the cause.


I do not, but I will ask for a referral.

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I don’t know if I have anemia, but my ferritin is always low (at one point it was as low as 3). My GP just says I can take iron supplements “if I want to”. My cholesterol is normal. I’ve never had my vitamin B levels checked. I’ll bring the list to my GP and see if she can order me any tests or refer me. I’m actually not just cold there I get so cold throughout the day, my coworkers even complain about the office being too hot and I’m frozen. I just bought an electric blanket for my desk.


Do you have problems when eating gluten?

The reason I asked is because you mentioned low ferritin. Sometimes the problem with iron deficiency is not the person’s diet, but the ability to absorb the iron.

I’ve been tested for celiac and IBS, and I don’t have either. I don’t think I have gluten problems, but I have always had stomach issues my whole life without any explanation.

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Just something to consider, if you are getting plenty of iron in your diet, but still have low iron. Stomach issues can be a sign of things like that, where there are problems absorbing nutrients. I am not sure what the fix is for something like that.

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Hi @jo_jo ,

About all my wife’s family members (probably 7/9 members) have gluten issues, one is diagnosed celiac. The others noted improvement in the stomach issues and other issues by going gluten free, probably 10 years now.

You might try going completely gluten free for about 2 weeks. It might help the stomach, and quite possibly the cold feet. I think it’s worth a try.


Thanks, I will try! I’m not the best at avoiding bad foods, but I’m much better on Ozempic, so I’ll give it an effort.


Consult your GP. It sounds like a general issue that many of us experience as we age but there are lots of specific causes some of which have specific treatments. Specialists are useless at diagnosing these because the are specialists; they can’t see the problem for the specific part of our body that dominates their vision. GPs specialise in not specialising!


I have, but I will again, because it’s getting more severe. Was thinking the other day, that I’m going to bring a list of all the issues that have cropped up in the last 2-3 years and have her see if looking at it as a whole provides any insight.


Your doc could also order a doppler ultrasound of the vessels in your leg. This could be very telling if it is a circulatory issue. It could be a harbinger of cardio vascular disease. Do your legs feel colder when lying in bed? And what about during and after exercise? Is the feeling the same left and right, or is one worse than the other.

Autonomic neuropathy may also play a role. Did they measure free testosterone levels? Did they test to see if you have antibodies to T3/T4?

This is the fun part of being a diabetic, playing detective. We can all help by thinking of things it could be.

During the winter I get cold feet (since I was a puppy), and to combat it I place a piece of carpet on the floor with a pet bed heater on top. The warmth spreads up my legs.



In regards to iron levels. What counts as being in “normal” levels isn’t always optimum levels. (too much is also bad for you) My Mom had low thyroid symptoms, even getting a slowed heart rate and having to lay down before she collapsed. They finally went ahead and put her on thyroid meds and all the symptoms went away, And what doctors consider normal vary per doctors groups too. Since you were lower in iron levels, you might try some. Get ferrous bisglycinate, iron glycinate, ferrous gluconate which are good absorbing ones and they won’t constipate you, and you don’t have to take as much because they absorb better. Floradix or Floravital liquid is well known for it’s high absorption. Vitamin C, folate and B12 also help absorption. Do not get ferrous sulfate which is cheapest but very poor absorbing.

Neuropathy, we easily get it because of poorer circulation because our blood is thicker with higher sugar levels. That can cause damage. Think of it like water flowing through gauze, it flows easily. But then think of honey trying to flow through the same gauze, it’s much slower and your body doesn’t function as it should and can end up with damage. And think of thicker honey that might have to be squeezed through and in doing so over time the mesh holes become widened and stretched and damaged.

Another cause is spinal stenosis. I have that from several things going on with my back. Anything that narrows the spinal canal, cysts, disk bulging, thickening of the walls and it cuts down on spinal fluid flow which can cause poor circulation in the lower extremities, but also the arms etc depending where the problem is. The nerves can be compromised so you can get numbness, feel colder, more cramping too.

Sometimes it takes a few doctors to figure it out. You have to find the one that recognizes the symptoms and either knows who to send you too or they can diagnose and treat. To this day I remember a customer’s mom that had major arm shakes and after seeing an untold amount of doctors at Kaiser, he finally went outside the group to a specialist that was recommended. That doctor knew immediately what it was and it required an implant that would solve the problem. He went back to Kaiser and said my mom needs this surgery and I need to get an okay for it. Kaiser’s response? We have someone that specializes in that and does the surgery here. But not one doctor his mom had seen recognized what it was to send her to him. They were several stories of customers in my store of having to see a few doctors before they found an answer.

But you have to be persistent and keep asking who might be able to help. Sure people get cold feet, it doesn’t mean it’s always okay and the feet going gray to me is a definite sign of it’s time to get persistent.


Thank you for all of this information! I actually have been having pain in my sternum, and it’s right where my spine rotates due to my moderate Scoliosis (30 degree curve). The Physical Therapist I see for Scoliosis thought it might be having a play on the pressure at my sternum. I will ask about Spinal Stenosis. It’s only when all my symptoms are looked at as a whole that I might get some help, but I feel like new issues just keep cropping up, and I maybe get seen by a specialist, but they won’t even talk about the other issues. Only 1 physical therapist looked at me with a whole view perspective (even though I only went to her for shoulder pain) and she ended up diagnosing me with a genetic condition called Ehlers Danlos syndrome. My GP said something along the lines of okay, you have that, but there’s nothing that can be done about it. If an issue crops up, we treat that issue. But only when someone takes the time to look at everything will they even be able to properly help me IMHO. I haven’t had any help that has made an actual difference in the declining quality of my life, and I’m always getting the old “well, once you’re in your 40s…” line. It’s so frustrating.

I just started supplementing with ferrous gluconate, but no change yet (not sure how long it takes).


Push for a MRI, it will show what’s going on in your back and they are even better nowadays than they used to be. I have that numbness from the shins down but on the outside of my legs. It happened after an incident a few months ago. It was completely up and down my legs but has gotten better as it was my whole legs. But I have several issues with my back.