Now that the weather has officially taken a turn for the frigid, most of us are in for a few long months of freezing cold everything…including our feet. (Except for those of you reading this in Hawaii, in which case I’m extremely jealous.) The chill that seeps deep into your lowest extremities can be somewhat unavoidable, no matter how many pairs of fuzzy socks you wrap around your icicle toes.

For some people, though, this experience is more than just a seasonal phenomenon. If you find your feet are cold on a regular basis, you might be wondering why (especially when others around you are somehow able to walk around barefoot like it’s NBD).

According to Lynn Dudley, a certified physician assistant (meaning she is licensed and trained to diagnose illnesses and prescribe meds under the supervision of a doctor) at Turning Point Integrative Health Centers, you aren’t alone in experiencing chilly feet. “Cold feet, and hands for that matter, are a fairly common complaint in our office,” says Dudley.

So…why are my feet always cold?

First of all: “Most causes of cold feet are not serious,” reassures Dudley. Here are a few possible culprits behind your *literal* cold feet:

1. Poor circulation. Dudley says that good blood circulation is key to regulating your body temperature. “When your blood isn’t properly circulating throughout your body, your extremities will feel cold,” she says. Having crappy circulation can be caused by a number of different things, including pre-existing conditions like anemia or heart disease, or less-scary lifestyle factors like not getting enough exercise. “If you sit at a desk all day, you’re more likely to get cold feet,” she says.

2. Anxiety or high stress levels. You likely already know that anxiety can cause some pretty gnarly physical symptoms (sweaty palms, nausea, cold sweats, etc). But Dudley notes that a nervous system triggered by stress and anxiety goes into “fight or flight” mode, which means it will divert critical resources (for example, blood) toward vital organs at the expense of circulating blood to the extremities. “Some people with chronic anxiety will also have chronically cold feet,” Dudley adds.

3. Underlying metabolic issues. “One of the most overlooked causes of cold feet is hypothyroidism, or underactive thyroid,” says Dudley. “Since thyroid hormones control metabolism and body temperature, not having enough circulating thyroid hormones can lead to cold feet.” Dudley also says diabetes is a potential cause, as some people with diabetes eventually develop neuropathy (in other words, nerve damage) that causes disruptions to sensory pathways in the hands and feet and makes them feel cold, painful, or tingly.

4. Smoking and alcohol intake. Dudley says nicotine and alcohol are two major substances that impact the way our bodies regulate temperature through different mechanisms: tobacco constricts blood vessels (decreasing blood circulation), while alcohol increases heat loss through the body.

5. Raynaud’s syndrome. Raynaud’s syndrome is a condition that can occur on its own or alongside other autoimmune disorders, such as lupus or rheumatoid arthritis. Those with Raynaud’s experience blood vessel spasms that cause cold, discolored hands and feet.

When to consult a doctor about cold feet

This list of causes might sound scary, but chances are your case of cold feet is nothing more sinister than needing to walk around more often (or being super stressed). However, Dudley recommends consulting with a doctor for a more thorough evaluation if your cold feet are accompanied by any of the following symptoms, because it could mean something more serious is going on:

• Sores on your feet that take a long time to heal
• Extreme fatigue
• Unexplained weight changes
• Fever or joint pain

Home remedies for frosty feet

Once you’ve established that your cold feet are nothing worth sweating over, it’s time to get to work on warming your toes. To start, Dudley recommends the obvious: Bundle up! Dudley says that some people need more layers than others to stay warm, and dressing for warmth (fuzzy socks included) may be the simplest solution if your cold feet are more of a winter woe than an everyday occurrence.

Dudley says to avoid clothing that is too constricting or tight, as these fabrics restrict blood circulation. She also suggest switching out cotton socks for merino wool, which is a fiber that helps regulate body temperature. If this isn’t enough, consider trying sock liners or layering two pairs of your favorite fuzzy footwear.

Dudley is also a proponent of increasing physical activity: “Exercise is a great strategy to get your blood flowing more efficiently.” She recommends getting least 30 minutes of movement, five days a week in order to reap the health benefits of adopting a regular exercise routine (including, yes, warm feet). And if you’re a smoker or a heavy drinker…consider your frozen feet yet another good reason to quit.

Cold feet are a nuisance, but a little extra attention to wardrobe, activity level, and lifestyle may be all you need to fight back. So arm yourself with these toasty foot-warming tactics (and an understanding of when you should consult your doctor). Once your toes have thawed, they’re going to thank you.

Still got cold feet? You probably need these slippers in your life. And while you’re at it, you might to add some fleece everything to your wardrobe.