Sweating when you feel cold might seem confusing, as it’s typically associated with heat. This phenomenon, often called “cold sweats” or diaphoresis, involves feeling chilled or clammy while simultaneously producing sweat. Unlike the sweat that cools your body during exertion or in hot environments, cold sweats arise from internal physiological responses.
Understanding Body Temperature Regulation
The human body maintains a stable internal temperature through thermoregulation. This system is controlled by the hypothalamus, a region in the brain that functions like the body’s thermostat. The hypothalamus continuously monitors core body temperature, typically around 98.6°F (37°C), and initiates responses to keep it within a healthy range.
When the body becomes too warm, the hypothalamus signals for heat dissipation. This involves vasodilation, where blood vessels near the skin surface widen to increase blood flow and release heat, and the activation of sweat glands for evaporative cooling. Conversely, if the body senses it is too cold, the hypothalamus triggers mechanisms to conserve or generate heat. These include vasoconstriction, which narrows blood vessels to reduce heat loss from the skin, and shivering, where muscle contractions generate warmth.
The Paradox Explained: Why Sweating When Cold?
Despite normal thermoregulation, several biological scenarios can cause sweating even when feeling cold. One common instance occurs when a fever begins to resolve. During an infection, the hypothalamus resets its temperature set point higher to help fight off pathogens, causing the body to feel cold and shiver as it tries to reach this new, elevated temperature. As the fever breaks and the infection subsides, the hypothalamic set point returns to normal, making the body suddenly perceive itself as too hot, leading to sweating to release excess heat.
Another significant cause is the activation of the sympathetic nervous system, often known as the “fight-or-flight” response. When faced with stress, anxiety, fear, or intense pain, the body releases hormones like adrenaline. This response can simultaneously cause vasoconstriction, making the skin feel cold, and stimulate sweat glands to produce sweat. This dual reaction prepares the body for perceived threats.
Low blood sugar, or hypoglycemia, also triggers the sympathetic nervous system. When glucose levels drop below normal, the body perceives this as a stressor and releases adrenaline, leading to symptoms such as shaking, a rapid heartbeat, and sweating. This sweating results from the body’s stress hormone response.
Furthermore, conditions involving shock or hypoperfusion can induce cold sweats. Shock occurs when organs do not receive enough blood flow, often due to severe injury, infection, or cardiac issues. In such situations, the body prioritizes blood flow to vital organs, reducing circulation to the skin. Simultaneously, the body’s stress response activates sweat glands.
Common Scenarios Leading to Cold Sweats
Cold sweats can manifest in various everyday situations. A common experience is during the resolution phase of an illness, specifically when a fever begins to break. As the body’s internal temperature set point returns to normal, sweating helps shed the excess heat accumulated during the febrile state.
Anxiety and panic attacks frequently cause cold sweats due to the intense activation of the sympathetic nervous system. The surge of stress hormones can lead to both a chilled sensation and profuse sweating. Similarly, severe pain or injury can trigger this same fight-or-flight response, resulting in cold, clammy skin accompanied by sweating.
Individuals experiencing low blood sugar, such as those with diabetes, often report cold sweats as an early symptom of hypoglycemia. Nausea and vomiting can also be accompanied by cold sweats, as these conditions often involve a strong sympathetic nervous system activation. Even in the initial stages of hypothermia, the stress response can lead to a paradoxical combination of feeling cold and sweating.
When to Seek Medical Advice
While cold sweats can be a temporary response to common stressors, their persistent or unexplained occurrence warrants medical evaluation. Consult a healthcare professional if cold sweats occur frequently without an obvious cause.
Immediate medical attention is necessary if cold sweats are accompanied by other concerning symptoms. These include chest pain, shortness of breath, severe abdominal pain, sudden dizziness, or confusion. Unexplained weight loss, a fever without a clear source, or any sudden onset of cold sweats that significantly impacts daily life also prompt a medical consultation. These symptoms can indicate a more serious underlying health issue.