Hypothermia results from an abnormally low body temperature, which causes the
circulatory, respiratory, and nervous systems to slow down. Body temperature is
a balance between how much heat is produced and how much heat is lost, with the
brain acting as the thermostat. Severe hypothermia can cause an irregular
heartbeat, which can lead to heart failure and possibly death. Over 700 deaths
occur annually from hypothermia in the United States.
Signs and Symptoms
The following signs and symptoms accompany hypothermia:
Skin that is cold to the touch
Absence of shivering
Confusion, delirium, hallucinations
Seizure, stupor, or coma
Slowed, shallow, or arrested breathing
Slowed, irregular, or arrested
What Causes It?
Hypothermia can happen from accidental exposure to cold, to immersion in cold
water, or to trauma from a serious accident. In the elderly, hypothermia may
develop over hours or days as a result of poor body heat regulation, inability
to properly sense the cold, or living in a cold environment in the winter.
Diseases of the endocrine glands also may result in decreased heat production in
Who's Most At Risk?
The following factors can cause hypothermia:
Exposure to cold
Immersion in cold water
Severe trauma, especially brain injury or burns
Immobilization (not moving for long periods)
Age-related physical problems: half of all hypothermia-related deaths
occur in people over age 65
Pre-existing disease such as heart failure, pulmonary infection, other
toxic infections, or endocrine disorders
Drugs such as alcohol, tranquilizers, sedatives, hypnotics, or
Poverty, malnutrition, or homelessness
Social isolation or mental
What to Expect at Your Provider's Office
Severe hypothermia is a life-threatening condition. If you or someone you
care for is experiencing symptoms associated with hypothermia that cannot be
easily reversed, call the Emergency Assistance Number, 9-1-1, immediately.
Hypothermia can usually be prevented by preparing appropriately for
environmental conditions and by recognizing the early symptoms. If you plan to
be outdoors for extended periods in cold weather, wear insulated or layered
moisture-wicking clothing, including headgear. Avoid overexertion, eat enough
food, drink enough fluids, and do not drink alcohol. People who are prone to
hypothermia, such as the elderly or the homeless, can receive assistance from
social service agencies to help them find adequate housing, heat, and clothing.
Mild hypothermia can be treated by warming the person. Wet clothing should be
removed and replaced with dry, warm clothing and/or blankets. Other techniques
include using hot water bottles, warm baths, or heat packs placed under the arms
and on the chest, neck, and groin. In severe cases, if breathing and heartbeat
have stopped, the person should not be considered dead until efforts have first
been made by medical professionals to warm him or her.
At the hospital, the medical team will use heated intravenous fluids. The
person may be wrapped with blankets in a warm room or put into a large tub of
In severe or complicated cases of hypothermia, intravenous drug therapy may
Complementary and Alternative Therapies
Nutritional measures can help prevent hypothermia. Animal studies suggest
that Western and Chinese herbal therapies influence body temperature and may
help prevent hypothermia if used before, or just after, exposure to cold.
Depending on results from future scientific studies, they may also help treat
hypothermia. If you become hypothermic, avoid supplements and herbs, such as
ginseng, hawthorn, rosemary, and possibly cocoa seed and yellow Jessamine root,
that dilate your blood vessels and may worsen hypothermia. Similarly,
stimulation of specific acupuncture points may cause hypothermia.
Eating enough calories in the form of proteins and fats before and during
exposure to cold weather may help prevent hypothermia, particularly in the
elderly. If you expect to be exposed to the cold, carry high-calorie snacks,
such as protein bars and nuts. Regular intake of
fluids—water, juices, and electrolyte replacement
drinks—is important, too, and prevents dehydration.
Being dehydrated increases your risk for hypothermia. Do not wait until you are
hungry or thirsty to eat or to drink fluids. Don't drink alcohol or caffeine, as
these substances dilate your blood vessels and increase blood flow away from
your central core, causing it to cool down.
Ginseng (Eleutherococcus senticosus and Panax ginseng) has not
been studied in relation to hypothermia; however, it is known as an adaptogen (a
substance that helps to rebuild strength and regenerate the body after stress or
fatigue). It is used to increase resistance to adverse conditions such as
unusually cold climate. It may help prevent hypothermia in people who are
regularly exposed to extreme cold weather, in the elderly, and in those who are
weak or have a chronic disease.
An Indian herbal preparation containing Winter cherry (Withania
somnifera), Asparagus (Asparagus racemosus), Giant potato root
(Pueraria tuberosa), Velvet bean (Mucuna pruriens), Yam
(Dioscorea bulbifera), Elephant creeper (Argyreia speciosa), Long
pepper (Piper longum), and asphalt (a mixture of plant and microbial
waste products) was given to rats to control hypothermia. As a result, the rats
were better able to use fatty acids to generate extra energy and regulate their
body temperature. The early results from these rat studies raise questions about
whether this herbal combination may help prevent hypothermia in humans when used
before or after cold exposure, or help treat the early phases of hypothermia.
(Note: Although single herbs are available in health food stores, it is best to
get combinations of herbs from a practitioner trained in Ayurvedic medicine.
Ayurveda is the oldest existing medical system in the world, practiced primarily
Frequently, warming the extremities occurs after the warming of the core in
treating hypothermia. A Chinese herbal medicine, called TSGS-to in Japanese, was
tested in rats, and was effective in raising the heat radiating from the rats'
tails. The formula contained the herbs Angelica root (Angelicae radix),
Cinnamon bark (Cinnamomi cortex), Evodia fruit (Evodiae fructus),
Licorice (Glycyrrhizae radix), dried ginger (Zingiberis rhizoma),
Akebia (Akebiae caulis), Jujubae (Zizyphi fructus), Asiasarum
root (Asiasari radix), and Peony root (Paeoniae radix). The
researchers concluded that this particular combination of herbs may prove useful
for hypothermic patients whose extremities often remain cold despite warm
conditions and improved core temperatures.
Certain herbs used in Traditional Chinese Medicine (TCM) may cause
hypothermia. For instance, rats given Clerodenron fragrans (Ventenaceae)
became hypothermic in moderate and cold temperatures because their bodies
produced less heat. Also, rat studies show that TCM remedies used to treat
fever, such as Huang chin (Chinese Skullcap; Scutellaria baicalensis
George), may cause hypothermia.
There have been few studies examining the effectiveness of specific
homeopathic remedies. A professional homeopath, however, may recommend one or
more of the following treatments for hypothermia based on his or her knowledge
and clinical experience. Before prescribing a remedy, homeopaths take into
account a person's constitutional type. In homeopathic terms, a person's
constitution is his or her physical, emotional, and intellectual makeup. An
experienced homeopath assesses all of these factors when determining the most
appropriate remedy for a particular individual.
Aconitum — very useful remedy when
used just following exposure to cold, including in cases of shock and when
extremities are cold, tingling, or numb
Arnica — important homeopathic remedy
for first aid, particularly in the case of shock and following trauma
Carbo vegetabilis — for icy cold,
bluish skin, particularly when the person is weak, sluggish, close to fainting,
and short of breath
Cuprum metallicum — for bluish
discoloration of the skin accompanied by muscle cramps
Caution must be exercised when using acupuncture to treat fever. Stimulating
certain acupuncture points with needles can produce hypothermia by decreasing
the heat from metabolism (chemical processes in your body) and by dilating blood
vessels in the skin.
Massage should not be used in the case of hypothermia. Massage may dilate the
blood vessels on the surface of the body, drawing blood away from the core and
vital organs such as the heart and the brain. During hypothermia, this may cause
your circulatory system to collapse.
People with mild hypothermia have an excellent prognosis. However, people
with moderate to severe hypothermia can face serious complications and even
death. Children are more likely to recover from severe hypothermia than adults.
The mortality rate for hypothermia in the elderly is about 50%. There are many
possible complications from hypothermia, including hypoxia (lack of oxygen in
the tissues), gangrene in the hands and feet, inflammation of the pancreas,
fluid in the lungs, pneumonia, kidney failure, and heart
Those who have severe hypothermia should be hospitalized; if necessary,
cardiopulmonary resuscitation will be performed. A hypothermic patient should be
transported very carefully as there is a tendency toward irregular heartbeat
that could be fatal. Normal body temperature in the elderly should be restored
slowly, or permanent low blood pressure may result. All people with hypothermia
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Review Date: October 2000
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Elizabeth Wotton,
ND, private practice, Sausalito, CA.
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