Q: I am male, 89 years old, and in good health. I have cold feet and have had them for several years. I want to know if there is something I am overlooking that can help. My blood pressure is good and the only medicine I take is Lexapro for anxiety and Ambien CR for sleep. I hope you can help me. I wear compress hose which help some but they are uncomfortable to wear. Thank you very much.
A: Blood is pumped from the heart throughout the entire body to provide oxygen to tissues. In the absence of medical problems, our blood vessels are open and clear, allowing blood to flow without obstruction. When a medical condition, blockage, or damage to our blood vessels occurs, the blood cannot flow as well and oxygen isn’t delivered in sufficient amounts. The result may include shortness of breath, headache, pale skin, unsteadiness, loss of balance, cold feet, and more.
Vitamin B-12 assists with proper nervous system function and ensures that red blood cells are made. Because you are on prescription medication, you might speak with your physician to determine if he has tested you recently for any vitamin or hormonal deficiencies that could be related.
Diabetes can develop from a lack of insulin production in the body, or from the insulin produced being unable to perform its function properly. There are more than 16 million Americans diagnosed with diabetes and one fourth of them have decreased circulation to the legs and feet. Diabetes can lead to peripheral vascular disease.
Peripheral vascular disease (PVD) is damage to the peripheral blood vessels that carry blood to and from muscles in our extremities. With the presence of PVD, blood cannot flow through those vessels as efficiently as it once did. The result is pain that radiates down the leg, weak foot pulses, and cold feet. Individuals at increased risk for PVD include those with diabetes, hypertension, kidney or heart disease, smokers, and a history of stroke.
Raynaud’s phenomenon is constriction of blood vessels in the fingers and toes. With constriction, blood cannot, once again, flow properly. The extremities, especially the fingers, may turn white or blue when exposed to colder temperatures. Individuals with this Raynaud’s should take extra care to protect their extremities with warm gloves or socks and avoid going out of doors when temperatures are low.
Hypothyroidism results from the thyroid gland failing to produce sufficient specific hormones. There may not be symptoms in the early stages but as the disorder progresses, a patient may suffer from, along with other things, an increased sensitivity to cold and pain and stiffness of the joints.
Your Lexapro isn’t to blame for your cold feet but oddly enough, common side effects of the drug include drowsiness, a tired feeling and insomnia. Your Ambien CR can cause daytime drowsiness and may worsen depression. Despite the fact that your Lexapro shouldn’t enter the picture, it may certainly be worth your while to speak with your primary care physician to determine if he or she can switch you from Lexapro to another anti-anxiety drug for a trial period.
B-12 deficiency, diabetes and thyroid function can be confirmed or ruled out through simple blood testing ordered by a physician. Raynaud’s is commonly confirmed through visual examination. An ultrasound or arteriography can shed sufficient light on PVD. I recommend you make an appointment with your physician so you can get to the bottom of your cold feet (no pun intended) issue. In the interim, wear heavier socks, exercise, and eat well.
Readers who would like related information can order Dr. Gott’s Health Reports “Vitamins & Minerals” and “Thyroid Disorders” by sending a self-addressed envelope and $2 (for each report) US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from www.AskDrGottMD.com.
