Is your body temperature out of whack?

Some people's inner thermostat runs a little higher or lower than average, so it's not always a cause for concern, but there are times when it could be, according to Mary W. Crowell, MD, an endocrinologist based at the Endocrine Center of Cape Cod – Hyannis.

“One of the things you have to distinguish is being cold and feeling cold or being hot and feeling hot. They're not always the same,” she said.

One thing to bear in mind is that while 98.6 is a “normal” body temperature, that’s just an average. “Ninety-five and a half or ninety-six is still within the normal range among healthy people,” she said.

Body temperature has to be interpreted in the context of what's going on with your health and seldom is a standalone indicator of a problem, she said.

“There's nothing wrong with having a body temperature of 97 as long as you feel okay and you have no other reason to think that there's anything wrong with you,” said Dr. Crowell. “The majority of significant issues with body temperature regulation are in the context of other symptoms. Most folks who have real issues with body temperature have other issues that alert them to another problem.”

Always feeling cold?

“True hypothermia, which is a cold body temperature, is a relatively uncommon thing,” she said. “It can be seen in a few specific disorders. But the sensation of cold intolerance is pretty darn common.”

As an endocrinologist, Dr. Crowell checks for thyroid disease when people feel cold.

“In those cases, it's typically fairly advanced disease and is associated with a lot of other symptoms: fatigue, achiness, swelling of the extremities, mental fog,” she said. “Using body temperature to diagnose thyroid disease on its own isn't going to work. It has to be in the context of other symptoms and it has to be backed up by biochemical testing to indicate low thyroid levels.”

Checking thyroid levels should be part of an annual routine physical exam for most people, she said.

Other endocrine disorders, including pituitary disease and adrenal disease, which are far less common than thyroid disease, also can cause cold intolerance.

That said, feeling cold is fairly common, Dr. Crowell said.

“Some people are more sensitive to cold. A lot of people have cold hands and feet, and that’s probably because there is some vasoconstriction (diminished blood flow) in the hands and feet,” she said.

Raynaud's syndrome, for example, is an autoimmune disorder that causes vasoconstriction of the hands. People with Raynaud's get white fingers when they're exposed to cold.

“Diabetic neuropathy can cause abnormalities in the nerves that help with vasoconstriction and vasodilation, so there isn't as much peripheral blood flow, and hands and feet feel cold,” she said,

Finally, vascular diseases, like peripheral arterial disease, can cause a sensation of coldness, she said.

Always feeling hot?

“The body is much better at dealing with cold temperatures than dealing with hot temperatures,” she said. “We can tolerate being cold. We shiver, we vasoconstrict. But we don't tolerate heat very well at all.”

Feeling hot is common for postmenopausal women, she said.

“I've had so many of my patients say, ‘Oh my gosh, I'm 78 years old. How could it be?’ The truth is, is that we think of hot flushing stopping within several years of menopause, but for the vast majority of women, there are symptoms of hot flushing that last for many years. So, most of the time in postmenopausal women, that hot sensation can be tied to postmenopausal estrogen changes.”

Other reasons people can feel continually hot, she said, include certain disorders like rosacea, which can cause flushing of the face that makes people feel hot. Carcinoid syndrome, which is a very rare neuroendocrine disorder, can cause flushing disorders, as can some neurologic disorders, including Parkinson's and MS.

Some medications, including blood pressure medications, can cause you to feel warmer as a side effect, she added.