Your blood pressure is split into two readings: your systolic blood pressure, which is the number on top, and your diastolic blood pressure, which is the number on the bottom. The American College of Cardiology and the American Heart Association defines normal blood pressure as a reading of less than 120 mmHg/80 mmHg, but it’s possible for your blood pressure to get too low. There’s no specific number that tips you into low blood pressure territory, according to the American Heart Association (AHA), but doctors tend to consider it dangerously low if you start to have symptoms like dizziness or lightheadedness, nausea, fainting, dehydration, blurred vision, and clammy skin, among others.
But you don’t need to experience extremely low blood pressure—and all of those symptoms we just listed—to feel cold from it, Sophia Tolliver, MD, MPH, a family medicine practitioner at The Ohio State University Wexner Medical Center and a clinical assistant professor of family medicine at The Ohio State University College of Medicine, tells SELF. “When your blood pressure is low, likely not enough blood is reaching your organs,” she explains. “Blood contains oxygen, so when your organs or extremities do not get enough oxygen, they can experience a cold sensation.”
If you have a home blood pressure monitor and you’re dealing with constant chilliness, it doesn’t hurt to take a few readings to see where you stand. And, if you’re on the lower side, talk to your doctor about what could be going on.
9. You have peripheral artery disease.
Peripheral artery disease (PAD) is a circulation issue where your arteries narrow, which reduces blood flow to your limbs, per the Mayo Clinic. When you develop PAD, typically your legs (less commonly, the arms) don’t get enough blood flow to keep up with their needs. That can cause a range of symptoms like painful cramping in one or both of your calf muscles after activities like walking or climbing stairs, numbness or weakness, and coldness in your lower legs or feet.
“The narrowing of these vessels means less blood and oxygen is reaching your extremities and can lead to a drop in temperature in these areas,” Dr. Tolliver says. This means you’ll most likely feel cold in your feet in relation to the rest of your body.
10. You have diabetes.
Diabetes is a condition that impacts how your body turns food into energy, per the CDC. The food you eat is broken down into glucose, or sugar, and released into your bloodstream. Your pancreas detects that this is happening and releases insulin, which shepherds blood sugar into your cells to use as energy. If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it creates as well as it should. As a result, you’ll have elevated blood sugar levels.
There are a few things about diabetes—and typically high blood glucose—that can cause you to feel cold, Dr. Tolliver says. Elevated blood sugar can cause circulation issues like PAD, mentioned above. In addition, peripheral neuropathy can occur when high blood sugar damages nerves in the body. In this case, your hands and feet might feel cold to you, but they’ll still be warm to the touch, per the Mayo Clinic. Diabetes can also impact your kidneys, causing them to make less of a hormone called erythropoietin, which can lead to anaemia. Fewer red blood cells means less oxygen getting to your extremities—a perfect storm for cold hands and feet, Dr. Tolliver says.
11. You’re dealing with vitamin B12 deficiency.
B12 is a water-soluble vitamin that plays a role in a slew of important health functions, including keeping your central nervous system happy and forming red blood cells, according to the National Institutes of Health (NIH). When you’re deficient in vitamin B12, you can develop anaemia—cue all the cold feelings—or even damage the small nerves in your body, which can also make you feel chilly, Dr. Ramirez Bustamante says. (If you’re curious, the NIH recommends that you aim to have at least 2.4 mcg of B12 a day, which you can get from sources like tuna, salmon, beef, and milk.)
So how can I stop feeling cold all the time?
If feeling cold—and asking yourself, “Why am I always cold?”—is a lifelong struggle for you, it’s probably nothing to worry about—you may just run a bit chillier than other people. Or if throwing on an extra layer seems to do the trick, that’s probably fine too, Aline M. Holmes, DNP, a clinical associate professor at the Rutgers University School of Nursing, tells SELF. But, if a constant chill is interfering with your life or it’s a new thing for you, she recommends talking to a health care professional.
Dr. Tolliver agrees. “The first step in thoughtful evaluation is to have a deeper conversation about your issue with your clinician,” she says. From there, you should be able get to the bottom of that perpetual frigid feeling—and get you back to a less chilly life.
This story originally appeared on Self.com.