Shivering below 70°F

I am currently having a problem with the temperature in my workplace. I find that if I am anyplace where the temperature is below 70°F, I shiver and am unable to keep warm, no matter what I do. I am going to try to get a note from my doctor to see if that will convince them to keep it at least 70°F, but I need some information so I can convince the doctor that this is valid.

They like to keep the temperature at 69°F in the winter and 73°F in the summer. Both of these are a problem for me; for the summer, I wear a jacket over my clothes to handle being cold. However, I find that no matter what I do, I am unable to combat the cold when it's 69°F inside. I currently wear polar-weight base layers, along with a long-sleeved shirt, a thick sweatshirt, and two pairs of wool socks. These base layers are meant to wear under your clothes outside when it's below freezing, and with all this stuff on, I end up shivering! They have also asked me to use a personal heater, but this has been a problem for me because I am very sensitive to wind, and it  dehydrates me. I can't drink more than I already do, so the heater can only be a temporary solution in case of emergencies.

For a little bit of history, I was diagnosed with beta thal minor about 6 years ago, and then shortly after with B-12 deficiency (probably pernicious anemia) and vitamin D deficiency. Since then, I've been building up my supplements, using Andy's list as a guide and generally getting better. I add one supplement at a time, since using a multivitamin has been problematic for me in the past. Here is where I currently am with supplements:

• B-12 5000 mcg cyanocobalamin
• D3 4,000 IU
• E 400 IU
• Magnesium 250 mg
• B-100 complex
• Folic Acid 800mcg total (400 mcg from B100 complex)

At my last test, I had these values, and my doctor doesn't test B-12 or vitamin D anymore because she says it would be high due to the supplements.

• RBC: 5.54 M/CUMM
• Hemoglobin: 11.7 G/DL
• Hematocrit: 379.5%
• MCV: 71.3 FL
• MCH: 21.1 PG
• MCHC: 29.6 G/DL
• RDW: 17.2%

The reason I bring this up here is because I found a study indicating that this exact same temperature causes cold pain in sickle beta thalassemia patients, and I'm wondering if maybe my combination of beta thal minor with another anemia or even vitamin D deficiency could be similar. I also have issues with the heat before other people, but I haven't determined the exact temperature for that, since it's rarely an issue.

Hi Rachel,

Has your doctor checked your thyroid?

Can you use a different type of electric heater at work that does not have a blower? Something that gives off radiant heat, perhaps.

Are you taking vitamin C? It's quite useful in promoting better circulation, which can help improve circulation, which should help with coldness, especially at the extremities?

I have a very bad thyroid and I have a hard time tolerating cold, regardless of what I do. I dress warm. You might also consider wearing something like Under Armour (there are other brands that are less expensive but do the same thing) under your clothing, which is very light fabric but retains heat quite well.  My son wore it when he played high school baseball in the spring, when the temp is often in the 40's. It works quite well.

Thank you so much for responding, Andy. There's so much to answer here.

Yes, my doctor has checked my thyroid, and she always says the tests look fine. I'm not sure exactly which tests are for thyroid, but my TSH was 2.43 uIU/mL. Are there any other tests I should be looking at?

I have used a radiant heater before; that's a really good idea. I had a foot rest heater that worked really well for me. I could try to get that or find another similar thing.

I haven't started taking vitamin C yet because I'm not sure when the best time is to take it. My ferritin levels were quite high, and I've changed my diet to keep my body from absorbing large amounts of iron, including avoiding vitamin C at meals as much as possible. I also eat every few hours, so when would I be able to take the vitamin C?

I've tried various different brands when it comes to base layers, but only things on sale until I figure out what works the best. My favorite was at Cabela's, but they've stopped selling it now. I have not yet tried Under Armour, but that might be worth trying. Like I said, I currently wear polar weight, which is the warmest you can get. I have a very warm shirt I like from Paradox.

Hi Rachel,
I also struggle with freezing all the time.  I’ve had vitamin D deficiency as well.  I was diagnosed about 6 years ago with Raynaud’s syndrome.  It can be quite painful, we have really harsh winters so I’ve had to get creative.  One thing that really helps me is disposable toe warmers with wool socks.  I also use heated clothing.  Milwaukee makes some. I also use a Dyson heater fan in my office, which has been a lifesaver.  My younger son is also extremely sensitive to the cold, but he does not have Raynaud’s.  He as a lower hemoglobin 9.5-10.5, and he is very slender.  I wonder if it’s common for thals to have temperature intolerances? I hope you find a good combo to keep yourself warm!

Crissy

I also struggle with freezing all the time.  I’ve had vitamin D deficiency as well.  I was diagnosed about 6 years ago with Raynaud’s syndrome.  It can be quite painful

Crissy,

My doctor has mentioned that I might have Raynaud's syndrome before, but when I looked it up, I saw a drastic line in the skin where the color changes. My skin doesn't get nearly as bad as that, just a little bluish under the nails. Could you tell me if your Raynaud's is as drastic as these images?

From what I’ve read, many people do not experience all three color changes.  For me, it most severely impacts my toes and when they are exposed they get dusky bluish, white and then red, which really burns.  As the years have gone on it impact my hands, nose and ears, but the color changes are not as noticeable.  My hands and feet feel like ice and my body feels cold unless I am in 73 plus degrees.  The toe warmers are the best thing for making me feel warm even when it’s really cold out or in my office.  I wear layers and heavy long cardigans too.  I was cold before I developed Raynaud’s, my kids joke that I am Elsa, haha.  Hope you get some relief.
Crissy

Rachel Martin, vitamin C should be taken separate from meals if iron is an issue. It won't add to iron absorption unless taken with meals that have veg sources of iron included.

There are other brands similar to Under Armour that may be less costly, too.

My wife has Raynaud's and her hands get very white when cold. I found some of the best winter gloves available for her and though they help a lot, her hands are still affected.

I've started up 500 mg Vitamin C in the mornings, since I don't eat vegetables in the morning. It's been warm here, and the heat at work has not gone down below 70°F in a while, so we will just have to wait and see how it goes. I can tell the circulation in my feet is getting better.

If at some point, someone turns the heat down again, I'm afraid that all of this will not be enough. I still want to try to get a doctor's note to help my case for the temperature at work. Is there anything I should know about getting a doctor's note for this?

I'm thinking that I don't have Reynaud's, since I don't see the distinct color changes, and my fingers don't really turn white. But that did give me the idea that I should take some pictures for my doctor to look at.

I guess the footrest I used to have isn't radiant heat, but I think I'll try one out anyway.

It probably isn't Raynaud's but the poor circulation found in thal minors that causes the cold extremities. Natural Vitamin E may also be of help in improving the circulation.

If the doctor has any knowledge of thalassemia and its effects on circulation, it would be easier to get a note. I have heard from many minors who have the same problem and it is obviously due to poor circulation caused by the effects of thalassemia on both the health of the blood vessels and also caused by the "debris" that is in the blood of thals. This debris is the by products of the inefficient erythropoiesis present in all forms of thalassemia. The debris hinders circulation and is the main cause of the hypercoagulable state found in thals.