Figuring out cause behind feeling cold

DEAR DR. ROACH

>> My wife, 68, always feels cold.

She has mentioned this several times to her primary care physician, and the physician checks her blood to see if an increase in thyroid medication is warranted. The reading always comes back in the normal range, and the problem is not mentioned again until the next appointment. Meanwhile, my wife is uncomfortable most days of the week.

Is it possible that an increase in medication is warranted, even though her blood is normal? Might it be that normal for my wife is different than normal for other people? She has been on thyroid medication for at least 30 years, but this chilliness did not begin until she started warfarin after a heart valve replacement with a metal valve.

We keep our house at 69 degrees Fahrenheit during the day in winter. She dresses warmly. She is approximately 50 pounds overweight.

DEAR READER >> It’s not uncommon for people to feel cold at levels where most people are comfortable. It’s particularly common in middle-aged and older people.

Although low thyroid levels are certainly a cause for being cold, your wife’s doctor needs to be very careful not to overdo it.

Without the exact thyroid numbers, I can’t give specific advice, but the thyroid level doesn’t have to be much higher than the normal range before the risk of cardiac arrythmias, especially atrial fibrillation, starts to go up. That is a significant potential problem in a person with a prosthetic valve.

There are other medical causes for feeling cold, especially anemia, which should also be checked.

A friend of mine who is a physican has recommended cobra venom for my arthritis.

DEAR DR. ROACH >>

Have you heard of this? — M.G.

DEAR READER >> Cobra venom has been used in traditional Chinese medicine and in Ayurvedic medicine for many years, and there is evidence in animal models of effectiveness.

Clinical trials in Western medicine, some dating back to the 1940s, have generally failed to show a benefit of snake venoms in arthritis, although (perhaps surprisingly) there was not much toxicity.

I have read some promising research, but in absence of good data, I can’t recommend it.