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8153805
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# Lifecoach: Stop suffering in the cold
## Our panel of experts answers questions on everything from sports drinks to
spatial awareness
![Cold feet and hands can be linked to many conditions][1]
Cold feet and hands can be linked to many conditions
12:11PM GMT 23 Nov 2010
[Comments][2]
**Q **_For some years now, as the weather gets colder, I have suffered from a
cold` left foot. This tends to occur when I have been sitting down for a
period of time. My left foot does not feel any colder to the touch, but the
sensation I have is that it is much colder. Massaging the foot does not make
any significant difference. If I stand up and walk around the cold sensation
is reduced. Sometimes it stops me from sleeping. I also suffer from arthritic
pain in my left hip and wonder if there is a connection? My GP has not been
able to come up with any explanation or remedy for this condition. _**P
Carter, Bedford**
**DR DAN RUTHERFORD WRITES: **
**A **Impairment of the main circulation to your left foot seems unlikely, as
it is no cooler to the touch than the right foot.
Additionally, one would expect the cold sensation to get worse with exercise
if blood was finding it hard to get through, not the reverse. This suggests
two main possibilities to me. One is that you have a type of "neuralgia", an
abnormal sensation arising from the nerves going down the leg to the foot.
Possibly there is irritation of these nerves from pressure from a bulging disc
in the spine - a problem similar to sciatica but not causing the more common
symptom of pain that one gets with sciatica.
Alternatively, you might be getting temporary spells of spasm of the small
arteries that supply blood to the foot - a condition like [Raynaud's][3] but
which is not severe enough to cause the skin to go white and become cold - the
classic signs of Raynaud's.
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Your GP can check that the main pulses in your left foot are normal. If they
are reduced, then further investigation is needed to see if there is some
blockage higher up. If the pulses feel fine, as seems likely, then it is a bit
more difficult to think what to do next.
Sometimes a bit of experimentation is needed to work out a diagnosis, so for
example it could be worth trying the effect of one of the medicines that we
use to relieve the symptoms of Raynaud's to see if it helps.
One of these is nifedipine, which works by encouraging small blood vessels to
open up. If that is no use then one might need to go back to the neuralgia
possibility and do some specialised tests of nerve function.
How far one tries to take the investigation depends a lot on how much this
problem bothers you and it may be difficult to come up with a definite
explanation.
**SARA STANNER WRITES: **
**A **Cold feet and hands can be linked to many conditions, including a poor
functioning thyroid, anaemia, Raynaud's, diabetes, lupus, rheumatoid arthritis
and high blood pressure, so it is always important to seek individual advice
from your doctor to rule out these problems.
Poor circulation is common, particularly among older people and those who
smoke, are overweight or physically inactive. Do any of these apply to you? If
so, dietary changes that might help include swapping foods containing a high
proportion of saturated fatty acids - which can raise blood cholesterol and
cause fatty deposits to build up on the artery walls and reduce blood flow -
with foods rich in unsaturated fatty acids.
This means opting for leaner meats, lower-fat dairy products, reduced-fat
spreads and oils rich in unsaturated fatty acids (olive, rapeseed oil or
sunflower oils). Watch out for salt, as a high intake can cause high blood
pressure.
Omega-3 fatty acids, such as EPA and DHA, can help to improve blood flow.
Supplements of these fatty acids have been shown to improve symptoms in
sufferers of Raynaud's, as well as those with inflammatory conditions such as
rheumatoid arthritis.
If you don't like oily fish, the best source of these fatty acids, you can buy
omega 3-enriched eggs. Meat contributes to our intake of the long chain
omega-3 fatty acids but vegetarians can get omega-3 in the form of alpha-
linolenic acid in rapeseed and linseed oils, walnuts, soya, tofu and green
leafy vegetables (supplements of DHA and EPA are also available for
vegetarians). Many vitamins and minerals are important for a healthy
circulation including calcium, potassium, magnesium, B vitamins, vitamin C and
E.
Eating a varied diet that contains plenty of wholegrains and fruit and
vegetables, as well as some low fat dairy products, lean meat, nuts, eggs
and/or pulses will provide all of these.
Some studies have shown garlic supplements improve blood flow and some people
report benefits from Ginkgo biloba, too.
**TONY GALLAGHER WRITES:**
**A **If your doctor has thoroughly examined you and been unable to come up
with any explanation or remedy for your condition then presumably he/she has
ruled out known possibilities including your arthritis contributing to your
cold foot.
Another possibility is Raynaud's disease, where temperature decreases, or
stress increases, causing small blood vessels in the body's extremities to
spasm. This affects circulation to the feet.
Also ruled out presumably is hypothyroidism, a condition caused by an
underactive thyroid. Another possibility, known as peripheral vascular
disease, is a form of diabetes, and reduces blood sugar and blood flow to the
extremities. I don't know if you smoke but obviously this could damage blood
vessels.
Some people just have cold hands and feet, and it isn't always classed as a
medical condition as such. In many cases, it means nothing.
You have said that if you stand up and walk around it helps. I don't know if
you exercise regularly or not but if you don't, it would be a good idea to
start. Walking or cycling indoors at this time of the year should help you
raise your core temperature and improve general circulation.
Although you have massaged your feet with little success, try massaging from
the calf muscles to the feet and this may help. Try also to massage your toes
with a circular motion and point and flex the feet too.
If you are someone who needs to sit or stand in one position for long periods,
make sure to get up and stretch periodically.
**Q **_Are sports drinks any better than water when you're exercising?_
**Kathy P, by email**
**TONY GALLAGHER WRITES: **
**A** Generally, water is perfectly adequate for keeping you hydrated during
exercise.
The main causes of dehydration are inadequate fluid intake, excessive
sweating, and not replacing fluid lost during and after exercise. If just two
per cent of body weight is lost as sweat it can impair performance.
Some people don't find water appealing, so they don't consume enough of it. A
way around this may be to eat water-filled snacks like grapefruit, carrots or
apples during the day.
Drinking water a couple of hours before a workout will give your kidneys time
to dispose of excess fluid. The recommended rate is a slow consumption of 5ml-
7ml per kilogram of body mass.
Sports drinks or energy drinks contain electrolytes, usually in the form of
sodium, chloride, and potassium, along with carbohydrates (sugars) and
calories. If you are exercising and sweat profusely you will lose a lot of
electrolytes.
While normal electrolyte loss can be replaced by drinking plenty of water and
an adequate diet, if you sweat buckets you may lose electrolytes that can't be
replaced by this alone. In such cases, aim to consume fluids with sodium to
help you stimulate thirst and retain the fluid. You may also need some
additional carbohydrate.
Sports drinks usually have a concentration of five to seven per cent. To make
your own, mix five tablespoons of table sugar with each litre of water. Add a
bit of sodium to boost absorption (1/3 of a teaspoon of salt per litre). Post
workout, aim to consume 1.5 litres for each kilogram of body mass lost as
sweat.
**Q **_I'm always banging my head on things - hanging lights, low ceilings,
cupboard doors. I do this even in my own (familiar) environment. I think my
eyesight is fine. Could I have a spatial awareness problem?_ **Peter F,
Maidstone**
**DR DAN RUTHERFORD WRITES: **
Assuming that you mean more than a chance run of accident proneness then yes,
it is possible. If it is a recent problem then one needs to think of an
underlying cause, although I must say the possibilities are not obvious!
First, get a proper eye check by an optometrist to ensure that there are no
gaps in your peripheral vision. Such blind spots may not be apparent if your
straight-ahead vision is normal. In glaucoma for example, loss of peripheral
vision is an early sign of the condition. If your vision is not the problem
then clinical examination of your nervous system would be the next step.
Send your questions and comments to The Sunday Telegraph, Life Coach, 111
Buckingham Palace Road, London SW1W 0DT; or email lifecoach@telegraph.co.uk
**SECOND OPINION ... A cough can be a ticklish thing **
The purpose of coughing, obviously enough, is to dislodge some irritant such
as the mucous and inflammatory cells associated with a chest infection. And
very effective it is, too.
The problem is what to do for those unfortunate people whose chronic cough has
persisted for weeks, or even months, and for whom there is no obvious
explanation and whose investigations, including a chest X-ray, reveal no
underlying cause.
This is no trivial matter, as I was recently reminded by a heavily pregnant
woman naturally concerned that her chronic cough of several weeks duration
might be harming her baby - or even induce premature labour.
It was striking, reflecting on her case, just how many possible culprits there
might be. Pregnancy predisposes to heartburn with acid reflux that can tip
over into the airways to irritate the lungs. She was taking medication for
raised blood pressure, the treatment of which includes a class of drugs known
as ACE inhibitors, notorious for causing a chronic cough as a side effect.
She had recently had some dental treatment - perhaps she inhaled some
microscopic debris into her lungs. Or had she developed some asthma- like
allergy resulting in chronic spasm of the airways?
Still, common things occur commonly and the commonest cause of a chronic cough
is persistent inflammation of the airways following a viral infection - for
which the treatment is a hefty dose of steroids. This did the trick and she
returned a few days later, effusively grateful.
There is a salutary lesson for anyone troubled by this - it may be necessary
to overturn many stones to get at the underlying cause.
* Contact: James.LeFanu@telegraph.co.uk
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