My fingers and toes freeze all year round, even in the summer. Despite the layering, I still feel cool—even when my teammates are sweating. why is that?
Jyothi Eregowda, via email.
Although you say you don’t know anyone who feels as cold as you, your experience is not uncommon.
It is completely normal for the body to react to a cold environment by reducing blood flow to the extremities – this maintains core body temperature, but leaves fingers and toes feeling cold.
However, there is a condition called Raynaud’s, in which blood flow to the fingers and toes is temporarily stopped due to spasms in the arteries that supply them, usually in response to cold temperatures.
Raynaud’s can lead to dramatic episodes and a very different reaction to cold.
People with certain autoimmune diseases — rheumatoid arthritis, scleroderma, and dermatomyositis — are more likely to develop Raynaud’s disease, but it can affect anyone.
However, my point is that the feeling of cold fingers and toes you describe is an inherited trait that is completely normal – simply put, we all experience cold differently.
And there is research to support this. A study of 894 pairs of twins, all healthy young adults, published in the journal Twin Research and Human Genetics in 2014 concluded that having cold toe/cold toe is usually an inherited trait.
Some experts refer to this condition as primary vascular dysplasia (PVD). It usually becomes noticeable around puberty, is more common in women and decreases with age. There is a suggestion that hormones (particularly estrogen) are somehow involved in a circulatory problem (i.e., a problem with regulating blood flow).
Incidentally, the study also noted a range of characteristics among those who experienced cold hands and feet: a lower feeling of thirst, a tendency to have low blood pressure and a higher incidence of migraines, for example, compared to those who didn’t have PVD. . The exact association with these other conditions is not warranted.
Whether any of these factors apply to you is something to consider, but please be assured, cold hands and toes do not affect your overall health.
My 90 year old mom has been on low dose antibiotics (125mg cephalexin) daily for about 2 years to prevent persistent urinary tract infections (UTIs) caused by a permanent catheter. The treatment has worked, and she is infection-free, but I worry about the long-term side effects.
Name and address provided.
Balancing the potential risks of long-term antibiotic treatment with the need to prevent recurrent UTIs can be a challenge.
When a permanent catheter is in place – after surgery in your mother’s case or because of incontinence for example, as you mentioned in your long post – urinary tract infections are an almost inevitable complication.
Bacteria usually colonize the tube that drains urine from the bladder, and these bacteria may travel to the kidneys, causing infection, and can lead to sepsis (a fatal blood infection that can travel around the body).
This is not a simple infection, which makes it a potential danger that should focus our thinking. The use of catheters – especially permanent or indwelling catheters – is the number one cause of UTIs. But studies comparing daily use of low-dose prophylactic antibiotics with treating infections as they arrive found no difference between the two approaches in terms of preventing complications such as sepsis.
As a result, the National Institute for Health and Care Excellence (NICE) recommendation is that routine prophylaxis in the form of low-dose antibiotics such as the one your mother would receive is no longer recommended. This also takes into account the risk of antibiotic resistance.
Instead, the recommendation is to seek medical advice if symptoms of a UTI appear (bladder pain or a high temperature, for example).
Although, given that your mother has felt fine for the past two years, without UTIs, on the small preventive dose of cephalexin, in my opinion, there is no reason for your mother to stop it for the time being.
In your longer post you said that she has persistent stomach pains, which you are concerned may be caused by the antibiotics. However, I doubt it – the most likely side effect of long-term antibiotic use is diarrhea.
She suggests giving her a daily probiotic, a form of beneficial bacteria, to ensure the antibiotic doesn’t cause undue disruption to her microbiome, the community of gut microbes associated with many elements of health.
I think this makes sense, and I also suggest adding prebiotic — a fiber found in many foods like oats, grains, leafy greens, and fruits that feeds the friendly bacteria in the gut.
You may already be incorporating these foods into your mom’s diet, but if you haven’t, it’s definitely worth doing.
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