And no, I'm not talking about the British TV show or a runaway bride. Are your feet always cold? Is your skin cool, clammy, or extremely dry? Many people experience the symptoms of cold feet on a daily basis, but ignore it thinking that it is a minor complaint. This is a mistake. If your feet are always cold and the symptoms are increasing, you should seek the advice of your podiatrist.

Cold feet can be a symptom of many different disorders including:

1. diabetes

2. hypothyroidism

3. anemia

4. peripheral neuropathy

5. coronary artery disease/aortic dissection

6. peripheral arterial disease

7. raynaud's phenomenon

8. side effect of heart medications for blood pressure and arrythmias

9. early frostbite

10. restless legs syndrome

11. tarsal tunnel syndrome

12. significant stress

None of these disorders are minor and cold feet can be one of the earliest symptoms.

A closer look at the symptom of cold feet by your podiatrist may include:

1. non-invasive arterial examination

2. neuropathy screening

3. Blood work including a rheumatoid panel, thyroid levels, and blood counts

More advances screenings are sometime warranted and can include:

1. an arteriogram

2. nerve conduction velocities

3. EKG or echocardiogram

The most common reason people have cold feet is poor circulation. This is usually described as peripheral arterial disease or hardening of the arteries. Peripheral arterial disease (PAD) is narrowing or blockage of arteries that results in poor blood flow to your feet. Clogged arteries in the legs and feet increase your risk for having a heart attack or stroke. Plaque buildup in the legs does not always cause significant symptoms, so many people can have severe circulation problems and not know it. People who do experience symptoms, such as cold feet, pain or cramping in the legs, often do not tell their doctos, because they believe they are a natural part of aging or due to another cause.

One in every 20 Americans over the age of 50 has arterial disease and it is estimated that over 8 million are undiagnosed. Early detection of circulation problems has been shown to save limbs and lives, so if you have cold feet or any of the risk factors you should undergo screening by your podiatrist yearly or more often if symptoms occur.

Your podiatrist should be able to address your cold feet and send you down the path to warmer days or at least to understanding why you have cold feet.

If all the screening exams are normal, you may just have genetically colder feet than the average. Wear socks to bed! Or you may be experiencing stress. Cold clammy skin can be explained by the release of the hormones, epinephrine and norepinephrine, and is a sympathetic response to stress. Your body is telling you to calm down!

Bottom line: If you are not impending marriage or haven't just finished a day of skiing, your cold feet are probably trying to tell you something! Listen to them!