Low body temperature can be an uncomfortable and painful symptom of hypothyroidism.

 In this article:

• How the thyroid regulates heat
• What is Basal Body Temperature (BBT)?
• What causes cold intolerance?
• Strategies to manage cold intolerance 

The thyroid gland is the body's equivalent to a home's thermostat. Heat regulation is one of the critical roles of the thyroid gland. As the body's thermostat, the thyroid sends signals (hormones) to generate heat from stored energy. When thyroid function is compromised, the body does not receive appropriate signaling to increase heat generation. Thus, for patients living with hypothyroidism, it is common to experience cold intolerance.  

How the thyroid regulates heat

Temperature regulation is one of the most important biological processes our bodies perform. Thermoregulation occurs primarily by thyroid hormones signaling various systems in the body to increase available energy resources. Typically, fat cells store energy. Specifically, brown fat cells play an essential role in converting T4 into the active form of T3. The body requires T3 to produce ATP (adenosine triphosphate), which is the active form of energy that is utilized by cells. ATP is essential for generating heat.  

Increasing body temperature also requires an increased need for oxygen. Consequently, the heart and cardiovascular system must function well to deliver oxygen-rich blood to various systems in the body for heat production. 

What is Basal Body Temperature (BBT)?

Basal body temperature (BBT) is the body's temperature when it is at rest. Typically, BBT is the lowest temperature your body will experience each day. While thyroid function tests are the primary tool for diagnosing hypothyroidism, BBT may be another way to assess for low thyroid. Indeed, some studies have found that people with symptoms of hypothyroidism may have normal TSH, T3, and T4 levels, but their BBT is lower than average.  

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Maintaining BBT is one of the most costly energy processes the body performs. Thyroid hormones regulate and determine how to utilize and expend energy. Therefore, when a person has hypothyroidism, their body is lacking in available energy to regulate temperature.

It is important to note that while thyroid hormones are the primary regulators of body temperature, many other hormones play a role in temperature regulation, too. For example, studies have found that insulin, glucagon, estrogen, progesterone, leptin, ghrelin, and epinephrine can temporarily impact basal body temperature. 

What causes cold intolerance?

People with hypothyroidism suffer from cold intolerance because they do not produce enough thyroid hormone to convert and utilize stored energy effectively. Therefore, there is less energy available to regulate body temperature compared to individuals with normal thyroid hormone levels. Indeed, when people with hypothyroidism experience cold temperatures, their bodies mount defense mechanisms to preserve heat, such as by drawing blood away from the hands and feet. For this reason, people with hypothyroidism are more likely to suffer from hypothermia, which can be life-threatening.

Strategies to manage cold intolerance

If you find that you are always colder than everyone else or you find yourself bundled up when the outside temperature does not warrant winter gear, it may be valuable to test your thyroid function. If your levels are evenly slightly irregular, it can create life-impacting cold intolerance. 

Ahead, a list of suggested strategies to improve the discomfort and pain caused by cold intolerance:

Thyroid medication can help regulate body temperature

If you have hypothyroidism or Hashimoto's, your body may require synthetic thyroid hormone to operate effectively. With thyroid hormone replacement therapy, your body will be able to use stored energy and convert it to ATP to increase your body temperature. Without thyroid medication, your body lacks the necessary signal to turn up the heat.

The first step to getting thyroid medication is to meet with a thyroid specialist to assess your thyroid levels. Your specialist will be able to determine the appropriate thyroid medication and dosage for you based on your symptoms, medical history, and lab results. Many times, the dose of thyroid medication will need to be adjusted to improve your thyroid function and relieve symptoms of hypothyroidism. 

Some people who live in seasonal environments with colder winters may need to adjust their thyroid medication to counteract the chill outside. It would be best to discuss any changes to thyroid medication with your doctor.

Enhance your sleep

If you have hypothyroidism, your thyroid gland is working overtime to try to maintain homeostasis. The high energy demands required by your thyroid to operate at sub-optimal levels leaves most people with hypothyroidism tired and sluggish. Furthermore, your body may need more rest in colder months to recover from the increased demands of thermogenesis. Try to improve your quality of sleep, as well as increase the number of hours you allow your body to rest. 

Many people with hypothyroidism find they cannot sleep at night because they are so cold. There are specific strategies you may want to try if you have sleep disturbance for cold intolerance: 

• Turn up the thermostat at night to prevent cold intolerance from waking you up.
• Layer on warm pajamas and bedding such as a down comforter and flannel sheets.
• Consider putting a heat pack near you for added warmth. A spouse or a pet can also make an excellent heater.

Avoid unnecessary exposure to cold

Plan your outings ahead of time by checking the weekly weather report. Similarly, turn the thermostat up to get more comfortable. If your place of work is unusually cold, see if you can get a space heater or increase the temperature in your area. You may need to get a note from your doctor to implement these strategies. If you cannot make environmental changes, consider bringing a hot bag that you can heat and place on your back or neck.

Eat healthful foods

Certain foods are considered thermogenic. That is, they create heat when food converts to energy. Thermogenic properties are in certain fruits and legumes, meats, dairy products, and spices. 

It is imperative to monitor your blood glucose as it plays a crucial role in maintaining body heat. Hypoglycemia, or low blood sugar, can further weaken your thyroid. 

Ensure you receive adequate amounts of foundational nutrients, including omega-3's, and vitamin D. Omega-3's are in certain fish, nuts, seeds, and dairy products. In winter months, vitamin D from the sun can be hard to come by, so you may need to consider taking supplemental vitamin D. 

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Create your own warmth

Soaking your hands and feet in warm water is a beautiful way to heat your entire body. Similarly, hot baths can also do more than increase your body temperature. They help with relaxation, joint pain, and reduce tension and stress.

Finally, make sure to dress for success (and by success, we mean warmth). Wear layers and make sure to keep your head, hands, and feet warm, especially in colder months.

There are many strategies that you can try to take away the pain and discomfort of cold intolerance. However, the most important element in treating your cold intolerance is to manage your hypothyroidism with the best thyroid medication for you. If you find that you are consistently the chillier than every other person in the room and you have other symptoms that may indicate an unhealthy thyroid, meet with your thyroid doctor to get rid of the chill.