Coumadin can cause cold feeling

Q. I have a family member who takes Coumadin and always complains of being very cold. Nothing she does externally helps to warm her up. I figure that the thinning of her blood causes the cold feeling. I just want to find out if you have any suggestions on how to help her counter this side effect. I know of others who also have this problem. Please help them if you can.

A. Coumadin does carry the side effects of cold intolerance and paresthesias, including feeling cold and chills. I suggest your family member speak with her physician. Perhaps a change in medication is appropriate. Other than that, she should wear layers and avoid going out in the cold or being in an air-conditioned building whenever possible.

Because you mention blood thinning as the cause, I would like to take this opportunity to talk about what Coumadin actually does. It is commonly thought that Coumadin and its generic form, warfarin, work by actually thinning the blood. This isn't true. Rather, these drugs are anticoagulants, meaning they cause the blood to be less “sticky,” making it harder for clots to form. The blood remains the same thickness and the amount of blood in the body remains the same. By failing to make the distinction, misconceptions such as this become commonplace.

Coumadin and other anticoagulant drugs being called “blood thinners” is somewhat of a pet peeve of mine, especially when physicians, trained to know better, do so.

Q. I had cluster headaches for 40 years, from age 20 to 60. I am now 66 and haven't had one for six years. The last time I had an attack, I went to an acupuncturist for a week of treatments. It cleared them right up. Before that, I had tried almost everything to no avail. Please pass this on to your readers.

A. Cluster headaches occur in clusters or cycles and can be most painful. I have previously written about them, and you can review my articles on my website, http://AskDrGottMD.com/cluster-headaches-debilitating.

Other treatment options include oxygen therapy, triptans (used for the treatment of migraines), local anesthetics, corticosteroids, lithium and nerve blocks. Acupressure, acupuncture, ginseng tablets and chiropractic manipulation may provide relief for some. It is also beneficial to maintain a normal sleep schedule and avoid smoking/nicotine and alcohol. These can trigger a headache during an attack period.

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