Temperature Discrepancies Between Body Sides: When to Seek Help

There is a significant temperature difference between the right and left sides of the body?

Hello, doctor.
I would like to ask about the fact that the right side of my body (from the neck down to the right hand and right foot) is always colder than the left side.
I noticed this difference around the time the weather transitioned from autumn to winter, and this condition has persisted for about four months.
I have never been someone whose hands and feet get cold in winter.
Now, when I touch my left side, it feels normal and warm, while my right side feels extremely cold.
This issue is quite bothersome to me because no matter how many layers I wear, my right side always has an uncomfortable, chilly sensation.
Aside from the temperature difference, there are no changes in skin color, and I do not experience any other symptoms like pain or numbness.
Honestly, I am unsure if this situation is normal, but since it has never happened before, I find it quite strange.
Do you have any suggestions, doctor? Should I seek medical attention? If so, which department should I visit? Thank you, and I wish you all the best!

Xiao Pei, 20~29 year old female. Ask Date: 2017/01/13

Dr. Chen Taicheng reply Family Medicine

● It is recommended to first confirm whether there is an objective bilateral temperature difference in the body, for example, by measuring the axillary temperature on both sides or using a non-contact infrared thermometer.
If objective measurements show a difference of more than one or two degrees, it indicates a significant internal pathology.
● Typically, objective measurements do not reveal differences.
Based on your description, the difference arose with the cooler weather—many people experience cold hands and feet in cold weather: when exposed to cold, peripheral blood vessels constrict significantly due to sympathetic nervous system activity, leading to poor blood circulation in the extremities and causing them to feel cold.
Common systemic diseases such as anemia (particularly iron-deficiency anemia in women), hypothyroidism, poor cardiac and pulmonary function, smoking (which causes vasoconstriction), and certain medications (such as beta-blockers in antihypertensive drugs) can lead to cold extremities, which are generally symmetrical.
● If only the right side is affected, considering your age, autoimmune diseases (such as scleroderma, systemic lupus erythematosus, rheumatoid arthritis), vasculitis, and connective tissue diseases should be the primary considerations; a condition known as Raynaud's phenomenon may occur, where fingers turn white → blue (due to vasoconstriction and hypoxia) → and finally return to red (as blood flow resumes) when exposed to cold.
● Next, vascular narrowing or obstruction should be considered.
You can start by measuring blood pressure in the limbs; generally, a difference of less than 15 mmHg in systolic pressure between the two upper limbs is considered normal.
If the difference is greater, it may indicate obstruction on the side with lower blood pressure.
Furthermore, measuring the blood pressure in the ankle compared to the upper arm, known as the Ankle-Brachial Pressure Index (ABPI or ABI), is advisable.
If the ankle pressure is lower than the arm pressure (ratio <0.9), it suggests possible peripheral vascular disease or arterial obstruction.
● Additionally, spinal cord injuries may cause autonomic nervous system abnormalities (the sympathetic nervous system is part of the autonomic nervous system), and brain lesions or autonomic dysregulation may also present similar symptoms.
● Recommended order of consultation: Rheumatology (to rule out autoimmune and connective tissue diseases) → Cardiology (for cardiac and peripheral vascular obstruction) → Neurology (for autonomic nervous system, peripheral, and central nervous system issues).
Wishing you good health, Dr.
Chen Tai-Cheng, Family Medicine, Taoyuan Hospital.

Reply Date: 2017/01/13

More Info

It sounds like you are experiencing a concerning and unusual temperature discrepancy between the left and right sides of your body, particularly in your limbs. This condition, where one side of the body feels significantly colder than the other, can be perplexing and may warrant further investigation, especially since it has persisted for about four months.

Firstly, it is essential to understand that temperature differences between body sides can occur due to various reasons. These may include circulatory issues, nerve compression, or even conditions affecting the autonomic nervous system, which regulates involuntary bodily functions, including blood flow and temperature regulation.
1. Circulatory Issues: If there is a problem with blood flow to one side of your body, it could result in that side feeling colder. Conditions such as peripheral artery disease (PAD) can lead to reduced blood flow, causing one limb to feel cooler than the other.
2. Nerve Compression or Injury: Sometimes, nerve compression in the neck or back can lead to altered sensations in the limbs. For example, a herniated disc or spinal stenosis could potentially compress nerves that affect temperature sensation.

3. Raynaud's Phenomenon: This condition causes some areas of your body, usually fingers and toes, to feel numb and cold in response to stress or cold temperatures. It is characterized by episodes of reduced blood flow, leading to color changes and temperature differences.

4. Autonomic Nervous System Disorders: Conditions that affect the autonomic nervous system, such as complex regional pain syndrome (CRPS) or dysautonomia, can also lead to temperature discrepancies. These conditions can disrupt normal blood flow and temperature regulation.

Given that you have not experienced pain, numbness, or other symptoms, it is still advisable to seek medical attention. While the absence of these symptoms is a positive sign, the persistent cold sensation is unusual and should not be ignored.
When to Seek Help: You should consider scheduling an appointment with a healthcare provider, particularly a neurologist or a vascular specialist. A neurologist can evaluate for any nerve-related issues, while a vascular specialist can assess your blood flow and circulation.
During your visit, be prepared to discuss your symptoms in detail, including when they started, any changes over time, and any other relevant health history. Your doctor may perform a physical examination and could recommend diagnostic tests such as Doppler ultrasound to assess blood flow, nerve conduction studies to evaluate nerve function, or even imaging studies like MRI if necessary.

In summary, while temperature discrepancies can sometimes be benign, the duration and nature of your symptoms suggest that it would be prudent to seek medical advice. Early intervention can help identify any underlying issues and provide you with peace of mind. Remember to monitor any new symptoms that may arise and communicate them to your healthcare provider during your visit. Best wishes for your health and comfort!

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