5 medications that cause cold intolerance

In this article:

• What is cold intolerance?
• Linking medications and cold sensitivity
• Medications that cause cold intolerance
• Other factors
• Managing cold intolerance

In this article

• What is cold intolerance?
• Linking medications and cold sensitivity
• Medications that cause cold intolerance
• Other factors
• Managing cold intolerance

If you’re one of those people who “runs cold,” always layering on sweaters, bundling under blankets, or cranking up the thermostat, there could be a good reason: You might be taking a medication that makes you more intolerant to the cold. These medications—which include common drugs like beta blockers, antidepressants, and diuretics—change the way your body regulates heat, leaving you susceptible to feeling chilly even when everyone else around you is comfortable. Here are the six most common types of medications that cause cold intolerance, along with tips on how to manage this side effect.

What is cold intolerance?

Cold intolerance is a hypersensitivity to cold temperatures that affects your day-to-day life. Obviously, some environments are genuinely cold, and it’s normal for your body to respond by trying to get warm, but if you’re regularly the only person who feels cold when others around you don’t, you may be unusually sensitive or intolerant to cold.

Sometimes cold intolerance makes it difficult for you to warm up after becoming cold, for example, or leaves you shivering even when the temperature is mild. Other common symptoms of cold intolerance target your extremities, causing numbness, pain, tingling, stiffness, and skin changes like discoloration or swelling. 

Cold intolerance is fairly common, potentially affecting more than 40% of the population, with some people more likely than others to experience it. This includes women, people with certain health conditions, and people with a history of hand injury or corrective surgery.  

The surprising link between your meds and feeling chilly

If you’re constantly cold and wondering why, it might never have crossed your mind to consider your medications, but they can have an impact on your body temperature.

“Some medications can affect the systems that regulate your internal heat,” says Richa Mittal, MD, internist, obesity and lifestyle medicine expert, and founder of Radiant Health Dallas in Texas. “The body works like a thermostat, and some meds can nudge the thermostat up or down.”

How exactly do these medications alter your body’s thermostat? Per Dr. Mittal, they can:

• Slow down metabolism: Drugs that decrease your metabolic rate can cause your body to generate less heat overall.
• Restrict blood flow: By narrowing blood vessels and restricting blood flow, some medications can reduce the amount of warmth that reaches your skin, hands, and feet. 
• Cause loss of appetite: A lower caloric intake due to side effects like nausea or loss of appetite can cause a medication to make you feel cold, since your body needs the right amount of calories from food to stay warm.  

Finally, Sid Khurana, MD, a psychiatrist and co-founder of Psychiatry Connection, notes that medications can also alter your heart rate, body’s fight-or-flight response, or sweating, all of which can impact how your body regulates temperature.

5 classes of medications that can cause cold intolerance

These types of prescriptions are most likely to alter your reaction to cold temperatures.

1. Beta blockers

Blood pressure medications, such as beta blockers, have a reputation for causing sensitivity to cold. Beta blockers lower your heart rate and allow the heart to work less hard to pump blood; common beta blockers include Coreg, propranolol, and Toprol XL. 

However, beta blockers also cause peripheral vasoconstriction, which is the narrowing of smaller blood vessels. This can reduce blood flow, especially to your extremities, causing cold hands and feet.

2. Antidepressants

According to Dr. Khurana, most antidepressants raise the levels of serotonin and norepinephrine in your brain, which can indirectly affect your hypothalamus. Selective serotonin reuptake inhibitors (SSRIs), such as Zoloft and Paxil, work on serotonin levels, while selective serotonin and norepinephrine reuptake inhibitors (SNRIs), like Effexor and Cymbalta, work on both.

Why does this matter? Because the hypothalamus regulates your body temperature. Taking antidepressants can mess with the previously established settings of your body’s internal thermostat, Dr. Khurana says, triggering changes in sweating, heart rate, and metabolic rate. 

3. Diuretics

Diuretics increase urination by helping your kidneys flush out extra sodium and water, but this can lead to dehydration if you’re not replenishing your fluids. When you’re dehydrated, you have lower blood volume, which can reduce circulation and make you feel cold, says Dr. Mittal. Common diuretic medications include chlorthalidone, furosemide, and amiloride.

4. ADHD medications

Stimulant medications, which are often used to treat attention-deficit hyperactivity disorder (ADHD), can constrict blood vessels or reduce circulation, particularly to the extremities. Not only can this make you feel cold, but it could potentially trigger a condition called Raynaud’s phenomenon. 

People with Raynaud’s phenomenon experience coldness, numbness, and discoloration in their fingers and toes. Medications like Ritalin and Adderall are commonly associated with Raynaud’s phenomenon, though Vyvanse can also cause it. In these cases, Raynaud’s phenomenon tends to be temporary, resolving after the medication is discontinued.

5. Chemotherapy treatments

Cold intolerance or sensitivity is a common side effect of chemotherapy medications used to treat cancer, like oxaliplatin. Oxaliplatin can overexcite your nerves or even cause neuropathy, making coming into contact with cold environments or objects painful. Some cancer treatments can also cause side effects like anemia and dehydration (due to vomiting or loss of appetite), both of which can leave people feeling cold. Finally, some chemotherapy treatments cause cytokine-release syndrome, or a reaction to the infusion of drugs; this can lead to flu-like symptoms, including chills or feeling cold.

Other factors influencing cold sensitivity

While medications are a common cause of cold intolerance, an underlying health condition or even an individual characteristic, such as low body weight, may be to blame. Here are some other factors that can increase your sensitivity to cold. 

Health conditions

There are many health conditions that can trigger cold sensitivity, including fibromyalgia, anemia, atherosclerosis, and Raynaud’s disease. According to Dr. Mittal, low thyroid function and low estrogen (which is common in perimenopause and menopause) can affect temperature stability, as well as poor circulation, chronic inflammation, and autoimmune diseases.

Another possible cause? Low muscle mass. Dr. Khurana says the less muscle you have, the less heat you’ll produce, and the colder you get.

“When someone has low muscle mass, they get cold easily [because] muscle tissue is one of the main powerhouses of heat production,” he explains. Being inactive can cause low muscle mass, but some chronic medical conditions can cause it, too, like obesity, diabetes, cancer, and rheumatoid arthritis.

Nutrient deficiencies

Per Dr. Mittal, two nutrient deficiencies can contribute toward cold intolerance by causing anemia: iron and B12. Both nutrients support blood health, with B12 helping to make red blood cells and iron producing a protein called hemoglobin that red blood cells need in order to carry oxygen to other parts of your body. People with anemia often experience poor circulation, particularly in their extremities, which can lead to cold hands and feet.

Lifestyle reasons  

Your cold intolerance may not be caused by any medication, health condition, or deficiency. It could simply be a symptom of a temporary issue or a normal part of your body composition.

• Lack of sleep: Losing sleep can interfere with your body’s internal thermostat, says Dr. Khurana. It can make your body lose more heat than if you got a good night’s sleep. 
• Low body fat: Body fat is insulating, says Dr. Khurana, so you may feel cold often if you have a low percentage of body fat. Recent weight loss applies here, too. Dr. Mittal says this not only reduces your fat-insulating reserves but also your resting metabolic rate.
• Hunger or loss of appetite: When you’re hungry or have a low appetite, says Dr. Khurana, your body shifts into energy conservation mode, which can make you feel chilly.

Managing medication-induced cold intolerance

If your health provider has prescribed one of these medications to you, there’s a good reason. We don’t recommend stopping any medication without consulting your provider first, even if it’s causing an uncomfortable side effect, such as feeling cold.

However, there are some lifestyle changes you can make to manage medication-induced cold intolerance:

• Stay hydrated to maintain a healthy blood volume, including sipping on warm beverages like tea if it helps, says Dr. Mittal.
• Get enough sleep so your body can retain heat.
• Dress in warm layers during the day and at night so you’re prepared in case your medication makes you cold or hot, suggests Dr. Khurana.
• Eat a healthy diet, prioritizing nutrient-dense foods; per Dr. Mittal, it’s important to get enough calories, vitamins, and minerals if you’re on a medication that suppresses appetite.
• Practice strength and resistance training if you’re in danger of losing muscle mass, says Dr. Mittal.  

If medication-induced cold intolerance is making it hard for you to take part in your normal activities, talk to your healthcare provider. They may be able to switch you to a different drug within the same class that is less likely to trigger sensitivity. If not, they can work with you to manage your symptoms.