Differential Diagnosis for Chronic Cold Feet

• Single most likely diagnosis
  • Poor circulation: This is often due to atherosclerosis, which is the narrowing or blockage of the arteries due to plaque buildup. It reduces blood flow to the feet, leading to cold feet.
• Other Likely diagnoses
  • Hypothyroidism: This condition, where the thyroid gland doesn't produce enough thyroid hormones, can lead to decreased circulation and cold intolerance, resulting in cold feet.
  • Anemia: A decrease in red blood cells or hemoglobin can reduce oxygen delivery to tissues, including those in the feet, making them feel cold.
  • Raynaud's phenomenon: A condition that affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips, causing them to turn blue or feel cold in response to cold temperatures or stress.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Peripheral artery disease (PAD): A serious condition where narrowed arteries reduce blood flow to the limbs, which can lead to critical limb ischemia if not addressed.
  • Deep vein thrombosis (DVT): A blood clot in a deep vein, typically in the legs, which can lead to pulmonary embolism if the clot breaks loose and travels to the lungs.
• Rare diagnoses
  • Buerger's disease: A rare disease of the arteries and veins in the arms and legs, which can lead to reduced blood flow, resulting in cold feet.
  • Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, and sometimes coldness, due to abnormal blood flow.