Why are you always cold? Take the quiz.

The most common explanation is a difference in basal metabolic rate: your body produces less heat at rest than the average person. Women are more likely to experience this because oestrogen promotes vasodilation in the extremities, increasing heat loss from the skin. People with lower body fat or muscle mass also produce and retain less heat. If the cold intolerance has been lifelong with no other symptoms, you may simply run cold naturally. If it is new or worsening, it is worth investigating with your GP.

Yes. An underactive thyroid (hypothyroidism) is one of the most common medical causes of persistent cold intolerance. The thyroid regulates metabolic rate, and when it underperforms, your body generates less heat. Other symptoms include unexplained weight gain, fatigue, dry skin, thinning hair, and constipation. Hypothyroidism affects approximately 1 in 20 women in the UK and is significantly more common in women over 60. It is easily diagnosed with a TSH blood test and treated with daily levothyroxine.

Iron deficiency anaemia is one of the most frequently overlooked causes of cold intolerance. When iron levels are low, oxygen delivery to tissues decreases, and the body prioritises vital organs over extremities, leaving hands and feet feeling cold. The WHO estimates iron deficiency anaemia affects approximately 33% of women of reproductive age globally. In the UK, nearly 1 in 4 women aged 19 to 64 have low iron stores, rising to 50% among women with heavy menstrual periods. A full blood count and serum ferritin test can confirm or rule out iron deficiency within days.

Raynaud's phenomenon is a condition where small blood vessels in the fingers and toes overreact to cold or stress, going into spasm and temporarily cutting off blood flow. During an episode, digits typically turn white, then blue, then red as blood flow returns. Up to 20% of women and 10% of men in the UK are affected. In 80-90% of cases it is primary Raynaud's with no underlying disease. The remaining 10-20% are secondary Raynaud's, linked to autoimmune conditions. If your fingers or toes regularly change colour in the cold, mention it to your GP.

Research published in Nature Climate Change in 2015 demonstrated that standard building thermostat settings are calibrated to the metabolic rate of a 40-year-old, 70kg man. Women prefer ambient temperatures approximately 2.5 degrees Celsius higher on average. Oestrogen promotes blood flow to the skin surface, increasing heat dissipation. Women also tend to have a higher ratio of body surface area to body mass, meaning more heat is lost relative to what is generated. These differences are physiological, not imagined.

Yes. Body fat acts as thermal insulation, and very low body fat reduces the body's ability to retain heat. People with a BMI below 18.5 are substantially more likely to report cold intolerance. Reduced muscle mass also lowers basal metabolic rate, which means less heat production. This form of cold sensitivity typically affects the whole body rather than the extremities specifically, and has been present since body weight was low.

Research published in Nature Climate Change (Kingma & van Marken Lichtenbelt, 2015) confirmed that women's thermal comfort zones are about 2 to 3 degrees Celsius higher than men's on average. This is partly due to lower basal metabolic rates, lower muscle mass, and different thermoregulatory priorities. A baseline difference in temperature perception is well established and physiologically normal. Whether your particular experience goes beyond this baseline is what this quiz helps assess.

In most cases, no. The majority of people who feel colder than those around them are experiencing normal physiological variation, lower body weight, or mild nutritional deficiency. However, persistent cold intolerance can indicate hypothyroidism or iron deficiency anaemia, both of which are easily tested for and highly treatable. Rarer causes include peripheral artery disease and autoimmune conditions. The quiz helps identify which category your cold intolerance most likely falls into so you can decide whether a GP visit is worthwhile.

Speak to your GP if cold intolerance is new, has worsened, or is accompanied by fatigue, unexplained weight change, hair or nail changes, heavier periods, or colour changes in your fingers and toes. A simple blood panel covering TSH, full blood count, and ferritin can rule out the most common medical causes within a single appointment. Cold sensitivity that has been lifelong with no other symptoms is rarely a sign of disease, but a check-in is reasonable if it is affecting your daily life.