Dr Bernadette Carr answers your questions on feeling cold and glandular fever

I feel cold most of the time — even when the weather is relatively mild. I’ve started wearing thermals which help, but my fingers remain cold. Could this be a circulation problem?

Feeling cold all the time may happen when you have an infection like the flu or it may be a sign of an underlying condition such as an underactive thyroid. Cold fingers may happen as a result of poor circulation or a condition called Raynaud’s phenomenon or exposure to a cold environment. Some people will experience cold hands as part of their normal temperature regulation and it can be entirely normal and common.

Raynaud’s disease is a condition which may cause your hands and fingers to feel numb and cold and it is as a result of narrowing or the small blood vessels supplying the area. The hands may turn white or blue or red and may be painful, these symptoms should not last long and should resolve on their own after minutes. In some more severe cases, symptoms may be more prolonged and distressing and may need to be treated with medication. However, most people will manage the condition themselves by wearing gloves or mittens and trying to avoid exposure of the hands and feet to cold weather. Smoking may be a cause of poor circulation and if your hands or feet have become pale or cold or painful it is very important to see your GP .

An underactive thyroid may also cause you to feel cold all the time. This may be associated with excessive tiredness, weight gain, hair loss, and issues with your digestive system. Your GP may diagnose hypothyroidism with a simple blood test and can easily begin treatment with a medication to supplement low levels of thyroid hormone. This condition may sometimes run in families so it is a good idea to discuss your symptoms with your doctor who may decide to do some investigations if appropriate.

My teenage son has been diagnosed with glandular fever and his doctor has advised a recuperation period of a few weeks. How serious is this illness and are there any side effects?

Glandular fever (or Infectious Mononucleosis) is caused by a viral infection called the Epstein- Barr virus. It is generally spread from person to person who are in close contact, generally it is spread by saliva from sharing glasses or from kissing or from coughing and sneezing.

This condition can happen in any age but is much more common in children and teenagers. Once infected with the virus, it may take up to two months for symptoms to appear. Good hygiene and hand washing are important to try to prevent spread of the condition.

Some people will have no symptoms at all as a result of glandular fever infection however some people will get mild or high fevers, extreme tiredness, and feel generally unwell.

In some people the feelings of tiredness may last for several months before they begin to fully recover, even after the infection has passed.

Sore throats and eyelid swelling may also occur as well as swollen glands in the neck and nausea and loss of appetite. A number of other mild bacterial and viral illnesses may also cause these symptoms. Symptoms will usually resolve on their own and most people make a full recovery.

Though rare, some serious complications may occur with the condition. These may include inflammation of the liver or spleen (which is an organ in the body involved in combatting infection) as well as prolonged depression.

If your doctor suspects glandular fever a blood test, called a monospot test, to confirm the presence of antibodies, may be carried out.

Treatment will be supportive including rest and fluids as well as avoiding alcohol and keeping the temperature down. Antibiotics are not recommended because the illness is caused by a virus.

People who have had glandular fever are unlikely to get it a second time and generally become immune for life.