Feeling cold while sweating can be a confusing experience. While sweating usually cools the body and cold sensations indicate a temperature drop, their simultaneous occurrence points to a complex physiological response.
The Body’s Thermoregulation System
The human body maintains a stable internal temperature through thermoregulation. The hypothalamus, a small region in the brain, acts as the body’s primary thermostat, constantly monitoring blood temperature to keep it within a narrow, healthy range, typically around 37°C (98.6°F).
When the body’s core temperature deviates from this set point, the hypothalamus triggers mechanisms to either produce or lose heat. For instance, if the body senses it is too cold, it can generate heat through shivering or increased metabolic activity. Conversely, when the body needs to cool down, it increases blood flow to the skin through vasodilation, allowing heat to escape, and activates sweat glands to produce sweat, which cools the body as it evaporates.
Why You Feel Cold and Sweat Simultaneously
Cold sweats, the simultaneous experience of feeling cold and sweating, arise from the body’s attempt to restore balance in response to internal or external stressors. This paradoxical reaction occurs because different physiological pathways can activate concurrently.
One key mechanism involves the “fight-or-flight” response, a primal reaction to perceived danger. During this response, adrenaline and other stress hormones flood the body, preparing it for intense physical action. This surge can lead to blood vessels near the skin’s surface constricting (vasoconstriction) to redirect blood to vital organs, contributing to a cold sensation, while sweat glands are simultaneously stimulated to release sweat. This sweating, even when feeling cold, helps manage potential rising internal temperature.
Another scenario where these symptoms coincide is when the body’s temperature set point is rapidly changing, such as during a fever. As a fever begins, the hypothalamus raises the body’s target temperature, causing sensations of cold and chills as the body tries to reach this new, higher set point. When the fever “breaks,” the hypothalamus resets to a normal temperature, but the body is still quite warm relative to this new, lower set point. To rapidly cool down, the body initiates profuse sweating, which can lead to a cold, clammy sensation as the sweat evaporates from the skin.
Common Causes of This Phenomenon
Several common conditions and situations can lead to feeling cold and sweating simultaneously. These include a fever breaking, where the body rapidly cools after its thermostat resets.
Shock, a serious medical condition where the body’s organs do not receive enough blood flow, also commonly presents with cold sweats. In response to severe injury or illness, the body prioritizes blood flow to vital organs, leading to reduced circulation in the extremities and skin, making it feel cold and pale. Simultaneously, the stress response associated with shock triggers sweating, resulting in cold, clammy skin.
Low blood sugar, or hypoglycemia, is another cause, particularly in individuals with diabetes. When blood glucose levels drop significantly, the body releases stress hormones like adrenaline to counteract the decline. These hormones activate sweat glands, leading to sweating, while also causing symptoms like shakiness and dizziness, which can be accompanied by a cold sensation.
Anxiety or panic attacks trigger the “fight-or-flight” response, releasing adrenaline. This causes increased heart rate, rapid breathing, and sweating, even if the person feels cold due to the intense stress.
Early stages of hypothermia, where the body loses heat faster than it can produce it, can also involve cold sweats. As the body attempts to generate warmth, it might shiver, but the overall heat loss can lead to a feeling of coldness, and involuntary sweating might occur as a dysregulated response. Additionally, certain medications, including some antidepressants, opioids, and diabetes drugs, can have sweating as a side effect, which, when combined with other factors, might contribute to feeling cold.
When to Seek Medical Attention
While cold sweats can be a temporary response to stress or a resolving fever, certain accompanying symptoms warrant immediate medical attention. If cold sweats occur alongside chest pain, pressure, or discomfort, especially if it spreads to the neck, jaw, shoulder, or arm, it could indicate a heart attack, which is a medical emergency. Difficulty breathing, shortness of breath, or wheezing also signals a need for urgent care.
Seek emergency medical help if cold sweats are accompanied by a change in consciousness, such as passing out, becoming unresponsive, or experiencing confusion, lethargy, or disorientation. Other concerning signs include a sudden rapid heartbeat, a weak pulse, severe pain of unknown cause, or signs of severe shock like pale skin, dizziness, or very low blood pressure.
For infants or elderly individuals, any sudden and unexplained occurrence of cold sweats should prompt medical evaluation.
If cold sweats are persistent, recurrent, or significantly disrupt daily life without an obvious cause, consulting a healthcare provider is advisable. This is particularly important if the symptoms are not clearly linked to common triggers like anxiety or a resolving fever. A medical professional can assess the situation and identify any underlying health issues.