Hot feet, cold feet. Same feet, different feet

It’s winter here on the Sunshine Coast where we have weeks on end of perfect weather and walk around pretending to complain about how chilly the nights are. We are very spoiled.

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It’s also a time when a common conversation point comes up with our patients:

“Why are my feet so cold when I get into bed?”

“Why are my feet so hot when I get into bed?”

“Why are my feet so cold and I have to put on winter socks and ugg boots, whilst my partner walks around at night in a singlet and shorts and can’t sleep unless their feet are hanging out from under the doona?”

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Sometimes it’s obvious what the cause of these symptoms are, but other times it's a mystery in a pandora’s box. Most importantly though, these symptoms can be an indicator of underlying disease that warrants further investigation, and may be the first step in discovering an undiagnosed systemic condition.

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Cold Feet

If your feet feel cold all the time, but aren’t that cold to touch, its often considered to be poor micro-circulation. This is the ability of the very small arteries and capillaries to open and shut. The further blood travels from your heart the smaller the vessels become, like the roots of a tree, and this is why the periphery (hands and feet) are effected. If your feet feel cold and are cold to touch, it can indicate more systemic underlying conditions. The most common of these are peripheral vascular disease, diabetes, Raynaud's syndrome, and hypothyroidism.

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Hot feet

If your feet feel hot and burning all the time, but aren’t hot to touch, it's often due to nerve conditions. The most common causes of these are diabetes and nutritional deficiencies of the nerves resulting in poor conduction. Hot and burning feet can also be worse during pregnancy and menopause, if you have chronic kidney disease, or if you suffer from tinea. If your feet are unusually hot to touch, infection needs to be considered too.

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Treatment

The first step in appropriate treatment is working out the underlying cause; this can be done with assessment by your podiatrist and GP. Often times, particularly with diabetes, by the time you have these symptoms the underlying damage can be extensive and irreversible, so early diagnosis is important.

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In the meantime, cover up if your feet are cold! Hot feet are a little more difficult to manage, but a cold shower before bed and a magnesium supplement is a good place to start.