Cold Limbs

四肢不溫 / 四肢不温

Hands and feet that feel cold to the touch.

Quick Facts

Health Topic	Energy & Vitality
Also Known As	Cold hands and feet, Cold extremities, Icy limbs, Feeling cold in limbs, Cold arms and legs
Common Symptoms	Hands and feet, or the limbs more broadly, feel cold to the touch or to the person themselves. The cold may be constant or worse in cool environments, and is often paired with a preference for warmth, reduced energy, or a pale complexion. Some people also notice cold that climbs from the extremities toward the body.
Related TCM Patterns	Wind-Cold · Yang Deficiency · Kidney Yang Deficiency · Blood Deficiency · Blood Stasis · Qi Deficiency · Dampness · Qi Stagnation · Summer Heat · Cold Accumulation
Related Classical Formulas	Ma Huang Tang · Li Zhong Tang · Da Jian Zhong Tang · Fu Zi Li Zhong Tang · Huang Qi Gui Zhi Wu Wu Tang · Gui Zhi Tang · Dang Gui Si Ni Tang · Si Ni Tang · Si Ni San · Wen Jing Tang · Zhen Wu Tang · Shao Fu Zhu Yu Tang · Sheng Hua Tang · Shi Quan Da Bu Tang · Si Shen Wan · Ge Gen Tang · Huo Xiang Zheng Qi San · Ma Huang Fu Zi Xi Xin Tang · Da Qing Long Tang · Wu Zhu Yu Tang · Bai Du San · Xiao Qing Long Tang · Jing Fang Bai Du San · Xiang Ru Yin · Jiu Wei Qiang Huo Tang · Jin Gui Shen Qi Wan · Chuan Xiong Cha Tiao San · You Gui Wan · Ji Sheng Shen Qi Wan · Gui Ma Ge Ban Tang · Gan Jiang Ling Zhu Tang · Gui Zhi Shao Yao Zhi Mu Tang · Yang He Tang

Cold Limbs in Traditional Chinese Medicine

In Traditional Chinese Medicine, cold limbs are read through pattern rather than as an isolated finding. The same cold extremities may be associated with Yang deficiency, Wind-Cold, Blood deficiency, Blood stasis, Qi deficiency or dampness. Differentiation weighs whether the cold is accompanied by fatigue and preference for warmth, by external chills and body aches, by numbness or fixed pain, or by a heavy, sluggish feeling. Pulse quality, tongue appearance and the overall energy level help distinguish a deficient cold pattern from one involving exterior invasion or stagnation.

TCM Patterns Associated With Cold Limbs

The same presentation may be understood through more than one pattern. Pattern differentiation weighs the accompanying signs, not the symptom on its own.

Pattern	Common Features	Related Formulas
Wind-Cold風寒證Exterior Patterns	Chills that outweigh the fever, no sweating, a stuffy or runny nose with clear discharge, an itchy or scratchy throat rather than a sore one, body aches, and a cough with thin white phlegm. Symptoms often start abruptly after exposure to cold or wind. Tongue with a thin white coating; pulse floating and tight.	Ma Huang Tang Gui Zhi Tang Ge Gen Tang Da Qing Long Tang Bai Du San Xiao Qing Long Tang Jing Fang Bai Du San Jiu Wei Qiang Huo Tang Chuan Xiong Cha Tiao San Gui Ma Ge Ban Tang
Yang Deficiency陽虛證Deficiency Patterns	Aversion to cold, cold limbs, preference for warm drinks and clothing, and low energy that worsens in cold weather. There may be loose stools, clear copious urine, a pale puffy face, and reduced libido or lumbar weakness. The person feels better with warmth and worse with cold exposure. Tongue pale and possibly swollen with a white coating; pulse deep and weak.	Li Zhong Tang Da Jian Zhong Tang Fu Zi Li Zhong Tang Si Ni Tang Zhen Wu Tang Si Shen Wan Ma Huang Fu Zi Xi Xin Tang Wu Zhu Yu Tang Yang He Tang
Kidney Yang Deficiency腎陽虛證Deficiency Patterns	Cold lower back and knees, cold limbs, clear copious urine or frequent nocturia, and reduced sexual drive or premature ejaculation. Energy is low, especially in the morning or in cold weather, and stools may be loose. The face can look pale and slightly puffy. Tongue pale and swollen with a white coating; pulse deep and weak, especially in the chi position.	Jin Gui Shen Qi Wan You Gui Wan Ji Sheng Shen Qi Wan
Blood Deficiency血虛證Deficiency Patterns	A pale or sallow complexion, dry hair or skin, light-headedness on standing, blurred vision, and easy fatigue. In women the menstrual flow is often scanty and pale. Sleep may be light, and the hands and feet can feel numb when tired. Tongue pale and thin; pulse thin and weak.	Dang Gui Si Ni Tang Wen Jing Tang
Blood Stasis血瘀證Stagnation Patterns	Fixed, stabbing or piercing pain that does not move freely, often worse at night or with pressure. The complexion may look darker or purplish, and in women the menstrual flow can be dark with clots. Lips or nails may appear dusky. Tongue dark or with purple spots or congested veins under the tongue; pulse choppy or wiry and hesitant.	Shao Fu Zhu Yu Tang Sheng Hua Tang
Qi Deficiency氣虛證Deficiency Patterns	Easy fatigue, shortness of breath on mild effort, a soft or low voice, and spontaneous sweating with light activity. The complexion is often pale, and recovery after exertion is slow. There may be a tendency to catch external pathogens more easily. Tongue pale with a thin white coating; pulse weak or empty.	Huang Qi Gui Zhi Wu Wu Tang Shi Quan Da Bu Tang
Dampness濕阻證Damp Patterns	A heavy, sluggish body feeling, abdominal fullness, sticky sensation in the mouth, and reduced appetite. Stools may be sticky or incomplete, and the person often feels worse in humid weather. There can be oedema of the limbs or a greasy facial sheen. Tongue with a thick greasy white coating; pulse soft or slippery.	Huo Xiang Zheng Qi San Gui Zhi Shao Yao Zhi Mu Tang
Qi Stagnation氣滯證Stagnation Patterns	Distension, tightness or a constrained feeling in the chest, flanks or abdomen that comes and goes with emotion or stress. Frequent sighing, a sense that emotions are hard to move, and in women premenstrual breast or lower abdominal discomfort are common. Symptoms often ease after movement, expression or belching. Tongue may be normal or slightly dusky; pulse wiry.	Si Ni San
Summer Heat暑熱證Exterior Patterns	Fever or a strong sense of heat after exposure to hot weather, heavy sweating, thirst, and fatigue or heaviness of the body. There may be irritability, scanty dark urine, and a preference for cool drinks. Symptoms often start in high summer. Tongue red with a dry yellow coating; pulse rapid and possibly soft or large.	Xiang Ru Yin
Cold Accumulation寒積證Cold Patterns	Fixed cold pain in the abdomen that prefers warmth and worsens with cold food or exposure. There may be constipation or difficult stools, cold limbs, and a preference for warm drinks. The abdomen can feel hard or full on pressure. Tongue pale with a white coating; pulse deep and tight or wiry.	Gan Jiang Ling Zhu Tang