A chilling time for some

MEDICAL MATTERS/Dr Muiris Houston: The recent cold snap was our first taste of freezing temperatures this winter

MEDICAL MATTERS/Dr Muiris Houston: The recent cold snap was our first taste of freezing temperatures this winter. During such periods, the cold seems to penetrate right through to the bone and it can be very hard to warm up, no matter how well wrapped up you might be.

Cold weather also makes accident and emergency departments much busier; icy patches contribute to falls, some of which result in fractures and those with angina and coronary heart disease will often find the cold makes their symptoms worse so there are a higher number of people than usual presenting with chest pain.

It was no coincidence that the Dublin accident and emergency departments became seriously overcrowded last week at the end of of a spell of extremely cold weather. With teaching hospitals working to 100 per cent capacity - and sometimes beyond - the system is easily tipped over by even a small additional demand for services.

While feeling the cold for a number of days is not in itself a sign of sickness, occasionally coldness and numbness are a sign of a more serious underlying disease.

READ MORE

Atherosclerosis - the furring-up of a person's artery walls with cholesterol and other substances - causes cold and cramps in the limbs. This tends to affect the legs in particular; although the blockage is in both extremities, it is usually more advanced in one limb.

The classic symptoms begin with a feeling of coldness in the affected foot. This is often worse at night and is soon accompanied by cramps. A patient will also notice pain after walking a certain distance.

Referred to as claudication pain, it is surprising how often its onset occurs at exactly the same walking distance. Doctors record this distance as an indicator of how severe the atherosclerosis is and with modern technology it is possible to measure the exact blockage point, and its severity.

Using a non-invasive ultrasound test, a technician can illustrate very clearly to both doctor and patient where the problem is. Almost everyone with peripheral blockages in their arteries is a smoker and it is quite amazing to see how symptoms improve if the patient can give up the dreaded weed. Aspirin also helps, but if the blockage is severe then a form of bypass surgery, similar to that carried out on the heart, is needed.

Persistent or recurring coldness in the fingers, toes and even the ears may be a sign of Raynaud's disease. If your fingers go white, then red with a feeling of numbness, tingling or burning, you are quite likely to have the condition, which affects women more than men.

Raynaud's causes vessels to go into spasm and is triggered by either touching something cold or by being outside in cold weather. It ranges from a mild condition to a disease that causes extreme pain with the risk of ulcers and gangrene.

The condition is hereditary and can start in childhood years or later. It may be a sign that there is an underlying autoimmune condition such as rheumatoid arthritis or scleroderma, a thickening of the connective tissue. You should see you family doctor for some blood tests even if symptoms are mild. Episodes may be helped by wrapping up warmly, using heat packs in your pockets to keep hands warm and drinking plenty of hot fluids. For severe cases, medication may be useful.

One of the most common symptoms of hypothyroidism is the feeling of coldness regardless of how high the temperature is. The thyroid gland, which is situated just below the Adam's apple, produces hormones that help regulate the body's metabolism.

In some cases the thyroid ceases to produce hormones while in others there may be a reduction in the amount of hormones being produced.

This can lead to a wide range of symptoms which can include fatigue, dry skin, weight gain, prolonged periods, thinning hair, pins and needles in the hands and a feeling of being cold all the time. Symptoms can vary in severity and a simple blood test will help confirm the diagnosis. More women than men suffer from hypothyroidism and it commonly occurs after pregnancy or at the menopause. The condition is very successfully treated with thyroid replacing medication.

Beta blockers, a type of medication commonly prescribed for the treatment of high blood pressure, angina and occassionaly migraine headaches, can have the side effect of causing limb coldness. Beta blockers work by blocking the action of chemicals in the brain that control heart rate and blood pressure. As a result they can cause a reduction in the blood circulating in the extremities. If you have been prescribed this medication and are experiencing cold extremities it would be wise to bring this to your doctor's attention.

Finally, try to avoid hospital accident and emergency departments unless you are seriously unwell. Most conditions benefit from at least an assessment by your GP. If in doubt, give your family doctor a call.