Why are my hands and feet very hot at random times?

Question

Hello doctor,

I am a 19-year-old female. I weigh 170 pounds and am 5 feet 3 inches tall. I do not take any medications and have no known serious medical conditions that could be contributing to this symptom.

For the past few years, my hands and feet have been getting very hot at random times. They become so hot that they feel like they are burning, and even to the touch, they seem unusually warm. Sometimes it is only my hands, sometimes only my feet, and sometimes both.

This happens at completely random times, and I have not been able to identify any pattern or trigger. What could be causing my hands and feet to become so hot?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on the symptoms described, one possible explanation is a condition called erythromelalgia, which can cause episodes of intense heat, warmth, redness, and discomfort in the hands and/or feet. These episodes may occur randomly, last from minutes to hours, and are often more noticeable in the evening or at night.

However, several other conditions can produce similar symptoms, including:

Excessive blood vessel dilation (vasomotor instability).
Hormonal changes.
Thyroid disorders.
Nerve-related conditions affecting the small nerve fibers (small fiber neuropathy).
Less commonly, certain blood disorders.

Since these symptoms have been present for several years without other concerning features such as weakness, numbness, significant color changes, skin ulcers, or severe pain, a serious emergency condition is less likely. However, a proper medical evaluation is still recommended to determine the underlying cause.

The following tests may be helpful if they have not already been performed:

CBC (complete blood count).
TSH (thyroid-stimulating hormone) and free T4 (free thyroxine).
Blood glucose level and HbA1c (hemoglobin A1c).
Vitamin B12 level.
Iron studies.

During an episode, it may be helpful to take photographs of the hands and feet and note whether they become red, pink, or remain their usual color. This information can provide valuable clues and assist a healthcare professional in making an accurate diagnosis.

I hope this is clear, and if you have any questions at any time, please feel free to ask.

Thank you.