Feeling Cold After Head Injury: Understanding the Causes & Treatments for Cold Sensitivity

Feeling cold after head injury is not uncommon and can be a secondary effect from head trauma. This does not apply to feeling cold when the air conditioner is blasting or when you forget your jacket on a chilly day. Rather, when your environment and body are at a normal temperature but you frequently find yourself feeling cold, this could be a secondary effect of traumatic brain injury.

This article will explain why you might feel cold after head injury and what you can do to address this secondary effect.

Why Some Survivors Feel Cold After Head Injury

Around 13% of TBI patients report feeling persistently cold after a head injury or concussion. This symptom may be caused by damage to the parts of the brain that control the body’s temperature.

The human body possesses a complex thermoregulation mechanism that keeps it at a balanced temperature, generally around 98.8° Fahrenheit. This delicate process is controlled by the hypothalamus, the part of the brain in charge of numerous bodily functions.

The hypothalamus lies deep within the brain and communicates with the rest of the nervous system to help balance body fluids and control the release of hormones that play a part in temperature regulation. For example, when the body gets too cold, the hypothalamus releases hormones that cause blood vessels to shrink (called vasoconstriction). This traps the heat in your blood and preserves body temperature.

The hypothalamus can also respond to a change in body temperature by sending signals to various areas of the body to cause temperature-regulating reactions. These reactions include sweating in order to cool the body down, or shivering to generate heat and increase body temperature.

If the hypothalamus becomes damaged after a head injury, these processes, as well as others, could be disrupted. As a result, you might feel cold after head injury even when your environment is at a normal temperature.

Neuroendocrine Disorders and Cold Sensitivity

Another possible cause of cold sensitivity after a head injury is pituitary dysfunction. The pituitary is a gland in the brain that helps stimulate activity in the hormone glands throughout the body.

One important gland that the pituitary stimulates is the thyroid, a butterfly-shaped gland on the front of your neck. The thyroid gland produces several thyroid hormones that are critical for functions such as metabolism, growth, and body temperature regulation.

If the thyroid does not receive stimulation from the pituitary gland, however, it cannot produce these crucial hormones. This leads to hypothyroidism, which can cause the following problems:

• Increased sensitivity to cold, sometimes resulting in chills
• Concentration and memory problems
• Fatigue
• Unexplained weight gain
• Depression
• Constipation

Cold sensitivity is a common symptom of hypothyroidism. Therefore, if you are constantly feeling cold after head injury or concussion, it is possible that your thyroid is not functioning correctly.

Diagnosis & Treatment for Feeling Cold After Head Injury

The best way to address impaired thermoregulation (i.e. feeling cold after a head injury) is to determine the cause of your cold sensitivity. For example, if hypothyroidism is the problem, your doctor may prescribe synthetic thyroid hormones to help regulate your temperature.

On the other hand, if impaired thermoregulation is caused by hypothalamus damage, vasopressin may help. Normally, nerve cells in the anterior hypothalamus send signals to the pituitary gland to release vasopressin. Vasopressin has many important functions, one being lowering body temperature that is too high, such as during a fever.

If the hypothalamus is damaged due to brain injury, however, the body may not correctly interpret or process fever and will not release vasopressin. If this is the case, the elevated body temperature may not be regulated, and can result in feeling cold or chilled as the body tries to compensate. Taking vasopressin may be able to help counter that effect.

While your doctor may recommend medication if you struggle with feeling cold after head injury, your occupational therapist may also be able to help you through sensory retraining. This intervention is designed to help retrain the brain how to process sensory input.

Most clinical evidence analyzes the effect of sensory retraining on other sensory issues like numbness or pain. However, this intervention is non-invasive and requires no additional medication, so it could be worth exploring with your therapist to see if it can help with impaired thermoregulation.

Tips to Cope with Feeling Cold After TBI

As you work with your medical team to diagnose and treat the root cause of impaired thermoregulation, there are other steps you can take to temporarily warm your body up and improve comfort during daily activities.

Here are some extra tips to cope with feeling cold after head injury:

Dress in Layers

Dressing in a few light layers can keep you warmer than wearing a single heavy jacket. Three layers are usually the ideal amount. Try wearing something thin like a thermal undershirt, then a wool sweater over that, and a jacket on top. Wearing layers allows you to take some off easily if you get too hot, and keeps your body more insulated. Additionally, putting on a warm pair of socks can help reduce loss of body heat since the feet have a lot of circulation and may become cold more quickly.

Get Moving

Exercise helps raise your core temperature and provides temporary relief from feeling cold after head injury. In fact, nearly 85% of body heat is generated by muscle contractions.

The exercises you choose don’t have to be too strenuous, so focus on finding an exercise that is just enough to elevate your heart rate, such as taking a light walk. If you don’t have enough mobility to raise your heart rate through exercise, work with your therapists to improve mobility after TBI through targeted rehab exercises.

Understanding Impaired Thermoregulation After Head Injury

Cold sensitivity can occur after head injury for a number of reasons. For example, it could be a result of hypothalamus damage or even a sign of hypothyroidism.

Whatever the cause, there are remedies to help you feel less cold after brain injury.

Talk to your doctor about any medications that might help and ask your therapist about sensory retraining exercises. While you are waiting to learn the root cause of feeling cold after head injury, certain coping techniques such as exercise and warm clothing can be used to increase your core temperature and help you feel more comfortable.