Fever with cold hands and feet: what should you know?

During a fever, the body may narrow blood vessels in the hands and feet while the core temperature rises. Chills can make the skin feel cold even when the measured temperature is high. Persistent cold extremities between illnesses may also occur with anaemia, iron deficiency anaemia, hypothyroidism, or reduced circulation such as peripheral arterial disease. The combination does not identify one diagnosis, so the person's appearance, breathing, alertness, colour, and hydration matter.

Measure the temperature and observe the person rather than relying on touch alone. Offer fluids in small, frequent amounts and use light layers; remove wet clothing and avoid very hot baths, heating pads, or vigorous rubbing. Give fever medicine only according to the label or a clinician's instructions. Note the start of fever, episodes of shivering, skin colour, urine output, and whether hands and feet warm as the fever settles. Do not start iron supplementation without advice about the cause.

Seek emergency help for blue, grey, mottled, or unusually pale skin; difficult breathing; severe drowsiness; confusion; fainting; a seizure; or hands and feet that remain cold with marked weakness. Get prompt medical advice for a young infant, ongoing fever, repeated vomiting, very little urine, worsening pain, or a person with diabetes, circulation problems, or reduced immunity. A clinician may check circulation, blood count, thyroid function, infection signs, and hydration.

Ask whether the cold extremities fit the fever pattern, which examination or blood tests are needed, how to measure temperature accurately, and which medicine is suitable. Share medicines, pregnancy status, long-term conditions, colour changes, and any recent illness.