Why is it that when I’m outside with friends in the winter, it seems I always feel colder than everyone else, even when I am dressed just as warmly? — Carmela V., Syracuse, New York
Different people’s bodies develop different cold tolerances. Your chilliness boils down to how well your body produces and retains heat.
When you’re in the cold, the network of blood vessels close to your skin’s surface retreats inward so you don’t lose heat. But you end up with cold fingers and toes. Some folks’ blood vessels make a deeper retreat (that may be you).
The body does try to help out by making you shiver: When muscles contract and release, they create heat and (hopefully) warm you up. But how much heat you lose — and how warm you stay — depends on lots of factors:
Body fat: The more fat right under the skin, the more insulated your body is and the less heat you give off.
Height: Generally speaking, the taller you are, more skin area your body has. That means more opportunity for heat to escape.
Age: Older bodies are less able to regulate temperature and are more cold-sensitive.
Sex: Vasoconstriction, that retreat of the blood vessels and resulting cold fingers and toes, happens more to women. Fluctuations in menstrual hormones also can make women more sensitive to cold at certain times of the month.
Underlying conditions: It’s possible that hypercoldness may indicate an undiagnosed disorder such as Raynaud’s phenomenon or an autoimmune condition such as Sjogren’s or Hashimoto’s (low thyroid).
So what can you do? If you’re concerned, talk to your doctor. Try building up your tolerance. There’s evidence that exposing yourself to the cold for 20 minutes a day and avoiding prolonged stays in warm rooms is effective.
Other research shows that exercising regularly boosts your resting metabolic rate, so your body produces more heat. First step: Getting 10,000 steps daily, and having two to three weekly sessions of strength building (more muscles, more warmth). Still chilly while outside? Run in place, or do 20 jumps.
My sister had breast cancer and needed a double mastectomy. After that and almost two years of chemo, she seems to be clear, but she won’t talk about how she’s feeling. She freaks out over little things, like home improvements and getting her car fixed. Does she have PTSD? — Betsy O., Falls Church, Virginia
Good question. Support and counseling for breast cancer patients (and many other cancer patients as well) has been going on for a long time. However, linking cancer patients directly to PTSD is long overdue: Many of the successful treatment options for PTSD can help cancer survivors get back to the lives they had before they were diagnosed and treated.
A new study from the National University of Malaysia, published in the peer-review journal of the American Cancer Society, CANCER, carefully monitored around 470 adults with different types of cancer for symptoms of PTSD at one month after diagnosis, six months out and then at four years post-diagnosis. The researchers found that 22 percent of the study participants had symptoms of PTSD at six months after diagnosis; by four years out, the percentage dropped to 6.1 percent. Unfortunately, that still meant that of the patients initially diagnosed with PTSD, almost one-third of them had persistent or worsening symptoms four years later.
Your sister should be evaluated by a therapist certified to treat PTSD. She can find a qualified psychiatrist at http://finder.psychiatry.org; she also can find a support group through the hospital where she had her surgery. Every hospital that treats breast and other cancers should have support groups.
If you want to understand more about the criteria for diagnosing PTSD, check out the info in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5;1) online at www.ptsd.va.gov; the definitions and questions used to help diagnose it are clearly explained.
Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is chief wellness officer and chair oftheWellnessInstitute at the Cleveland Clinic.