Having chronically cold feet isn’t pleasant – neither for you nor for your partner when you snuggle up under the covers.

Why do you have them and what could you do about them?

You may suspect a circulation problem, but could be wrong, as there are many possible causes of chronically cold feet.

If it’s indeed poor circulation, it could be a common condition known as peripheral artery disease (PAD), in which narrowed arteries reduce blood flow to the arms or legs.

This is usually a sign of atherosclerosis, a buildup of plaque – fats, cholesterol and other substances – in the inner lining of the arteries, which can cause the arteries to harden and narrow, impeding blood flow.

How can you tell this is happening before the condition worsens and your symptoms broaden beyond cold feet to, for instance, leg pain when walking?

”If you want to know whether your arteries are at risk of plaque buildup, first consider whether you’re in a risk group,” says vascular surgeon Dr Siamak Pourhassan.

At increased risk, he says, are people who are overweight, smoke or used to smoke, have high blood pressure, elevated blood cholesterol levels, or a family member who had a heart attack or stroke before the age of 50.

A further risk factor is advanced age, especially 65 years or older.

There are also early warning signs of a possible circulation problem, including toenail fungus, hair loss on your toes or lower legs, and dry and cracked skin on your heels, the soles of your feet and between your toes.

”These signs should get your attention because they point to poor blood flow,” says Dr Pourhassan, an executive board member of the German Society for Vascular Surgery and Vascular Medicine (DGG).

Your general practitioner can test you for PAD, for example by assessing pedal pulses – the pulses felt at the arteries at the top of the foot and behind the ankle – or performing an ankle-brachial index (ABI), which compares the blood pressure in the ankle with the blood pressure in the arm.

Results that indicate reduced blood flow to the legs call for the expertise of a vascular surgeon.

”We then use ultrasound to examine the venous and arterial vascular system – both systems, in other words,” says Dr Pourhassan, referring to the veins, which carry deoxygenated blood back towards the heart, and the arteries, which carry oxygenated blood away from it.

The comprehensive exam is necessary, he explains, because “our blood vessels are a complex network connected to all organs and tissues and controlled in part by hormones and nerves.”

If narrowed arteries aren’t to blame for your cold feet, the culprit could be, among other things, an underactive thyroid gland, anaemia, low blood pressure, stress or diabetes-related nerve damage.

For people not in a risk group, Dr Pourhassan wouldn’t recommend a prophylactic vascular exam.

“To simply have your blood vessels checked – I don’t think it’s a good idea,” he remarks.

“Mini-plaques might be detected that are medically irrelevant but could worry you and even make you emotionally unwell.”

In the event your arteries are found to be increasingly narrowing though, you should become more physically active, he says.

Ideal options are to join a vascular sports group, cardio sports club or self-help group that meets for walking workouts.

If this isn’t possible, he suggests an alternative: “Go dancing! Dancing is one of the very best exercise programmes – not only for your cardiovascular system but also for your mental fitness and social well-being.” – dpa