Q. I feel extreme cold all the time except while sleeping. Kindly help.

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Nov 13, 2020

Hello doctor,

I am feeling extremely cold all the time, except for when I am sleeping. It feels like the thermometer in my body is broken, and it cannot regulate my body temperature. I cannot think of any triggering factors. I have been to my primary doctor, endocrinologist, and rheumatologist and checked for everything. Everything came back normal. Do you have any idea what could be causing this problem?

I have done specific tests like Thyroid antibodies, testosterone, TB gold, IGF, VitaminB12, Vitamin D, TSH, Free T4, Total T3, Cortisol, CBC, heavy metals, sedimentation rate, CRP, complete metabolic panel. All are normal.



Welcome to

I can understand your concern. According to your statement, you have been suffering from extreme cold feel all the time except during sleeping.

Feeling cold may have resulted from fever, long time exposure to a cold environment. Without fever and cold climate, it may also result from hypothyroidism, anemia, viral or bacterial infection, hypothermia, malaria, etc.

Hypothyroidism is one of the most common causes of feeling extreme cold all time. When the thyroid gland does not produce enough hormone for metabolism, it does not create enough heat production to make the body warm. If a person's body temperature falls too low from any causes, they cannot keep sufficient body temperature. This condition is known as hypothermia, which is a life-threatening condition.

Sometimes feeling cold occurs before a person gets a fever by viral or bacterial infections. If a person's Hb% is below normal, then the body cannot produce enough heat or keep body temperature and failed to make a person warm. This condition is known as anemia.

Again, a person suffering from malaria may feel extremely cold as it has three stages: cold, hot, and sweating. Treatment depends on causes. You make your body warm by wearing warm clothes, taking hot tea or coffee, eating red meats, oily or fatty foods, stopping fans or air conditioners, taking hot soup, etc.

Thank you doctor,

So what other tests should I do if it is a viral infection? My endocrinologist said I do not have hypothyroidism based on my tests and no anemia since my CBC is normal. Hot tea and wearing warmer clothes also do not work.



Welcome back to

The part of the brain which controls body temperature is called the hypothalamus. So any disorder in the adrenal gland or pituitary gland can cause the rapid heat loss and make you feel extremely cold.

Some medical conditions such as DM (diabetes mellitus), stroke, severe arthritis, Parkinson's disease, spinal cord injuries, poor nutrition, anorexia nervosa, etc., affect the body's ability to regulate temperature.

Again some medications like a beta-blocker, neuroleptics, antipsychotics, antidepressants, narcotics, pain medications, sedatives, etc., also can change the body's ability to regulate temperature. Alcohol consumption, substance drug-abusing can cause heat loss too.

So you should undergo MRI (magnetic resonance imaging) of the brain, CT (computed tomography) scan of L/S spine, RA (rheumatoid arthritis) test, RBS(random blood sugar), etc., to find out the underlying causes which are responsible for your suffering and then treat them accordingly.

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