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Dr Punam Krishan has given a warning to anyone who is using specific medications for heart issues or bad circulation. On today's (Nov 4) episode of the BBC's talk show Morning Live, the NHS GP encouraged people to visit a doctor if they experience certain symptoms while on the medication that might be confused with something else. As the weather gets colder, people are being told to be on the lookout for warning signs that can be easily missed because of the chilly temperatures. While it's normal to feel cold in winter, if you still feel cold or have cold hands and feet when you're inside or wearing warm clothes, you shouldn't ignore it - and the kind of medication you take can make you more susceptible to these 'hidden' issues. In a chat with presenters Gethin Jones and Helen Skelton, Dr Punman, the BBC Morning Live resident doctor, said: "In winter we do tend to feel the cold a lot more. Some people feel it more than others. We've all got different cold thresholds. But if you are feeling it when you're indoors, when you're layered up, when the heating's on and it's a new change, then it's worthwhile getting that checked out. "Sometimes, that kind of cold could be associated with an underlying condition. This isn't just about feeling a little bit cold. This is about it being something more than that shouldn't be ignored." She also said: "As we get older, we tend to lose our muscle mass, we lose our fat insulation, things that naturally keep us warm. Our metabolism also slows down." Dr Punam is a general practitioner working with the NHS in Scotland. She is well-known for her role as a resident doctor on a BBC daytime program. In addition to her medical practice, she serves as a media medic and a medical educator, and she has appeared on other BBC programs such as Laid Bare. Dr Punam said: "If you are feeling cold and it is accompanied with other symptoms, so things like pain, tingling, numbness, maybe weakness or stiffness in the body, maybe it's colour changes to your skin, then you need to speak to your doctor about that." She began by listing the most common ones she sees as a GP, starting with iron deficiency and anaemia. "If you have got low iron in your body, then you've not got enough healthy blood cells to be able to deliver oxygen to all the different parts of our body that we need. So blood flow in that case diverts to vital organs and your peripheries, your hands, your feet tend to feel the cold the most. It's a straightforward blood test, very easy to diagnose and very easy to treat, but something not to ignore." In terms of an underactive thyroid, the GP says it can "make you feel very cold and affect your temperature because your thyroid gland is responsible for your metabolism and body temperature". Another condition to be aware of is Raynaud's. "This is where you can get constriction of your blood vessels in the extremities," she said. It can affect your hands, tips of your toes, nose, ears, and even the nipples. It can also cause the skin to change to white and blue, and become "really tender". She added: "And when the blood flow starts to return, they get really throbbing pain and they become really hot. If you do recognise this and maybe your hands and feet go like this then speak to your doctor. Lifestyle changes and trigger management can really be helpful." She also cautioned those with heart disease, peripheral artery disease, and blood pressure problems that these conditions can impact blood circulation to your extremities. Additionally, diabetes—"particularly in its advanced stages"—can influence your nerves and blood vessels, leading to a sensation of extreme cold. Dr Punam went on to list the common medications that can affect your temperature regulation and why it is important to speak to a doctor about it. They include: Diuretics, commonly referred to as water tablets, are medications that help the body produce more urine to eliminate excess water and salt. Physicians typically prescribe them for individuals dealing with high blood pressure, heart failure, or fluid retention (oedema). These medications work by influencing the kidneys, prompting them to filter out additional salt and water from the bloodstream into the urine. While diuretics can cause a sensation of chilliness, particularly in the hands and feet, this is less frequent compared to other side effects, such as increased urination or dizziness. On the other hand, antidepressants may also cause a feeling of chilliness as they can disrupt the body's temperature regulation. This may manifest as an overall cold sensation, characterised by chills, or simply having cold hands and feet, a condition known as peripheral coldness. Vasodilators are effective in controlling blood pressure and treating conditions such as angina and heart disease. These medications may cause you to feel cold, as they increase blood circulation to your skin. This process helps your body dissipate heat and lower its core temperature. As blood is directed more towards the surface, you might experience a chill, particularly in your hands and feet, as more warmth escapes into the environment. Beta blockers are frequently prescribed for various health issues, including anxiety, high blood pressure, and palpitations. A common side effect of beta blockers is a sensation of coldness in the hands and feet, commonly referred to as cold extremities. This occurs because beta blockers can alter the blood flow to your extremities. The NHS says: "Side effects commonly reported by people taking beta blockers include cold fingers or toes (beta blockers may affect the blood supply to your hands and feet). Contact your GP if you're having symptoms that bother you or last more than a few days." Dr Punam warned: "So medications are big ones. If you started something recently, and maybe as a side effect have started noticing, 'actually I'm feeling cold all the time', it might be your medication, and we can change that for you." The NHS GP said: "Women tend to feel it much more, especially in midlife. And that's because our hormones are all over the place. Perimenopause and menopause can really throw your temperature regulation off. A lot of people talk about hot flushes, but in between those, when the oestrogen is low, we actually feel the cold a lot more. So it's something to be mindful of." She also stressed the importance of eating right and drinking plenty of water. "If you're skipping meals regularly, if your blood sugars are dipping, you're not hydrating yourself, your blood flow is going to be affected and you are going to feel chilly a lot more," she said. She also emphasised how vital it is to layer up. "People think when you've got a big bulky woolly jumper on, that's enough, but actually that's not an efficient way of keeping yourself warm. It's about thinking of those layers. like thin layers, layered up, those base layers make a massive difference. They trap the heat a lot better, so you're looking at your wool, your fleece, your thermal cotton, those kind of things." Making sure your environment at home is comfortable is another point she made, from daught excluders and rugs on floors, to thick curtains. "This is especially important if you have older adults, as the temperature should be set at least around 18 degrees," she said. For her final point, she said: "If you have got heart disease or if you've got problems with circulation, leg swelling, then elevating your legs if you're sitting up Nighttime as well can make a big difference as well as compression stockings. But as I said, if you are struggling a bit more, then do speak to your doctor about that."
