Q: My tolerance to cold is very low, the temperature of my palms & fingers and feet & toes remains unusually low even in moderate/mild winters leading to chilblains/numbness. I am a male, 38 years old and suffering from this problem for many years. I am otherwise in reasonably good health and exercise regularly.

A:Ordinarily the limbs are kept warm by the blood supply in the arteries. In certain conditions the arteries are very sensitive to cold, and develop spasm. The hands and feet can become cold, and painful. Sometimes bony defects (such as cervical rib) or smoking lead to such sensitivity in the arteries. In many patients no cause can be found. You need to be seen by a vascular surgeon who will evaluate you for medical and surgical ways to relieve your symptoms.