Temperature Sensitivity In Fibromyalgia

Temperature sensitivity affects many women with fibromyalgia, myself included. You can be cold all the time or hot all the time or alternate between being hot or cold.

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For over twenty-five years I had hot flashes and night sweats. I can’t tell you how many times I was totally embarrassed because I could not stop sweating. My hair and clothes would be drenched regardless of the outside temperature. Now I am freezing all the time.

Research shows that people with fibromyalgia have an inability to adapt to changes in temperature along with a lower pain threshold to both hot and cold stimuli. Julie at Counting My Spoons wrote about a study that examined the temperature thresholds for heat and cold in women with fibromyalgia compared to healthy women.

What Causes Temperature Sensitivity

Body temperature is regulated by the hypothalamus. The hypothalamus is a section of the brain responsible for hormone production. It is considered the link between the nervous system and the endocrine system.

The hypothalamus not only controls body temperature. It controls energy levels, the sleep cycle, muscular function, circulation, the gut and defense against infection.

Most fibromyalgia symptoms seem to be due to imbalances in the hypothalamus-pituitary-adrenal axis (HPA axis). These three glands work together to control hormone levels. Disruptions in the HPA axis seem to be at the core of fibromyalgia.

Thyroid hormones also play a role in regulating body temperature. An overactive thyroid (hyperthyroidism) can cause a person to feel too hot, while an underactive thyroid (hypothyroidism) can cause a person to feel too cold.

The thyroid gland is under the control of the pituitary gland. The pituitary gland itself is regulated by the hypothalamus. Anything that disrupts the HPA axis will also suppress thyroid function.

Certain medications interfere with the regulation of body temperature. Some drugs make you sensitive to heat, increasing the risk of heat stroke and some can lower body temperature.

Heat Sensitivity

Some heat sensitive people feel all-over heat sensations that seem to come from within their own body. Along with hot flashes, some people have problems with excessive sweating. Others may only have problems in their hands and feet, including puffiness and aching. Warm or hot weather can be unbearable with heat sensitivity.

To avoid getting overheated:

  • Keep your environment cool.
  • Wear soft, lightweight clothing that fits loosely. Stick to light colors in warm weather because dark colors absorb heat.
  • Stay hydrated. Make sure you always have a cold drink (water is best) to sip on.
  • Take a cool bath or shower. Sometimes just soaking your feet in cool water can help cool your body down.
  • Use cooling products such as a cold pack  or fan. Carry a small, hand-held, battery operated fan  with you when you go out.

When the weather gets warm, heat sensitive people with fibromyalgia often experience symptom flare-ups. Research has found that people with fibromyalgia exposed to hot temperatures report increases in: pain, headaches, fatigue, anxiety and depression. They are also more likely to have heat rashes and heat exhaustion or heat stroke.

Heat stroke is a medical emergency. Signs of heat stroke and immediate action to cool the overheated person while waiting for emergency treatment can be found on the Mayo Clinic website.

Cold Sensitivity

People who are cold sensitive often feel chilled to the bone and have a hard time warming up. The cold can be all over or just in your hands and feet. This symptom is usually worse during cold weather, but can occur at any time.

To prevent problems with cold:

  • Keep your environment warm.
  • Dress warmly, especially in cold weather. Keep your feet covered, wear socks and slippers.
  • Drink hot liquids and eat hot meals like soup and oatmeal.
  • Take warm baths or showers.
  • Keep a blanket handy or use a heating pad  or similar microwave products.

An unusual sensitivity to cold in the hands and feet with color changes in the skin sometimes occur in people with fibromyalgia. This condition is called Raynaud’s syndrome, also known as Raynaud’s phenomenon.

Sensitive To Both, Heat and Cold

Some people fluctuate between being hot and being cold. One minute you can be sweating with hot flashes and freezing the next. This can be very challenging. You have to be prepared for either scenario.

  • Dress in layers or have extra layers available.
  • For night sweats, wear moisture wicking sleepwear or use temperature regulating sheets.

Fluctuations in temperature can make your fibromyalgia feel worse. It’s important to plan ahead. You may have to spend most of your time indoors where you can better control the conditions.


Temperature sensitivity is a common fibromyalgia symptom. Most women with fibromyalgia report being extremely sensitive to cold and/or heat. Essentially, temperature sensitivity may be due to hormonal imbalances in the hypothalamus-pituitary-adrenal axis. Medications can also interfere with the regulation of body temperature.

For many years, I was hot all the time. The warm and hot weather was unbearable so I preferred cold weather. Now it seems as if the switch has been flipped and I am always cold. The hot flashes stopped when I stopped taking antidepressants and Lyrica. So either it was the medications or I made it through menopause. Now, if I could just get warm.

I’d like to hear from you. If you have fibromyalgia, are you sensitive to heat, cold or both? If so, do you have any tips that help? Please leave a comment below to share.

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