High fever with cold hands and feet

During fever, the body may narrow blood vessels in the hands and feet while directing circulation towards central organs. Chills can make the skin feel cold even while the core temperature is raised. The symptom can also occur with dehydration or a serious infection. Outside an acute illness, recurring cold hands and feet may be associated with anaemia, iron deficiency, an underactive thyroid, or reduced circulation such as Peripheral Arterial Disease. The symptom alone cannot identify one diagnosis.

Measure temperature with a reliable thermometer, encourage small frequent drinks if the person is awake and able to swallow, and use light clothing and comfortable room ventilation. Avoid ice baths, vigorous rubbing, or piling on heavy blankets. Look at skin colour, breathing, alertness, and urine output. Do not start iron supplements or other treatment simply because the hands and feet feel cold; a clinician may need an examination and blood tests first.

Get emergency help for difficult breathing, fainting, new confusion, extreme sleepiness, a seizure, severe weakness, blue or mottled skin, or hands and feet that remain cold and clammy. Seek prompt assessment when fever is accompanied by a rapidly worsening illness, very little urine, repeated vomiting, or inability to drink. Babies, older adults, and people with poor circulation or significant medical conditions may need earlier advice.

Ask whether the temperature reading is reliable, whether your circulation and hydration need checking, and whether blood tests for anaemia or thyroid function are appropriate. Mention tiredness, breathlessness, weight change, numbness, pain when walking, heavy menstrual bleeding, and medicines that may affect circulation.