Causes of cold sweaty hands and feet

Sweat cools the skin as it evaporates. During stress, the nervous system can activate sweat glands in the palms and soles while narrowing skin blood vessels, making those areas feel cold and clammy. Heat, exercise, pain and low blood sugar can produce similar sensations. Persistent coldness may also occur with anaemia, iron deficiency anaemia or hypothyroidism. Reduced blood flow from peripheral arterial disease can make a foot feel cool and may be accompanied by pain on walking, colour change or slow-healing sores.

The symptom does not point to one diagnosis by itself. The timing, triggers, distribution and associated symptoms help a clinician decide whether testing is needed.

Move to a comfortable temperature, dry the skin, drink fluids and notice whether slow breathing reduces episodes linked to stress. Keep a record of sweating, temperature, colour changes, palpitations, tremor, fatigue, pain and medicines. Arrange a GP appointment when episodes are frequent, occur without an obvious trigger, disturb sleep, or come with weight change, breathlessness or persistent tiredness. A clinician may examine circulation and request blood tests; avoid self-treating with iron until a cause has been checked.

Call emergency services for cold clammy skin with chest pain, severe breathlessness, fainting, confusion or sudden weakness. Seek urgent assessment for a hand or foot that suddenly becomes cold, pale or blue, or develops severe pain, numbness or weakness. A new wound with spreading redness also needs prompt medical attention.

Could stress, a medicine, anaemia or thyroid disease explain this? Do my pulses and skin changes suggest a circulation problem? Which symptoms should lead me to emergency care?