Hypothermia occurs when your body temperature drops way below normal, causing 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. If more heat is lost than can be produced, hypothermia can occur. Normal body temperature is around 98.6° F; if your temperature drops to 95° F or below, you are hypothermic. Severe hypothermia can cause an irregular heartbeat, which can lead to heart failure and death. More than 700 deaths occur annually from hypothermia in the United States.

• Skin that is cold to the touch
• Shivering at first, then the absence of shivering
• Lethargy, drowsiness
• Weakness, clumsiness
• Irritability, combativeness
• Confusion, delirium, hallucinations
• Slow reflexes
• Seizure, stupor, or coma
• Slowed, shallow, or arrested breathing
• Slowed, irregular, or arrested heartbeat

Hypothermia can happen from accidental exposure to cold, to immersion in cold water, or to trauma from a serious accident. Wearing wet clothes can also contribute to hypothermia. Elderly people are especially susceptible, and hypothermia may develop over hours or days as a result of poor body heat regulation, not being able to properly sense the cold, or living in a cold environment in the winter. Diseases of the endocrine glands may also cause a decrease in heat production in the body.

Risk factors include:

• Exposure to cold
• Immersion in cold water
• Severe trauma, especially brain injury or burns
• Immobilization (not moving for long periods)
• Age-related physical problems. More than 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
• Dehydration
• Drugs such as alcohol, tranquilizers, sedatives, hypnotics, or antipsychotics
• Poverty, malnutrition, or homelessness
• Mental impairment (that causes someone to be unaware of cold)

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 911 immediately.

Prevention

You can usually prevent hypothermia by dressing warmly, taking precautions to stay warm and dry, and recognizing the early symptoms. If you plan to be outdoors for extended periods in cold weather, wear layers of insulated or moisture-wicking clothing, including a hat. Keep emergency supplies in your car when traveling. 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. If you have elderly family members or neighbors, check on them when it’s cold.

Treatment Plan

Mild hypothermia can be treated by warming the affected person. Get out of the cold and remove wet clothing and replace it with dry, warm clothing and blankets. Other techniques include using hot water bottles, warm baths, or heat packs placed under the arms and on the chest, neck, and groin. Do not warm the arms and legs directly; this can force cold blood back toward the heart. Do not apply heating pads or heating blankets, and don’t rub arms and legs.

Sharing body heat (lying with your skin touching the person’s skin) may help. The person can also assume the heat escape lessening position (HELP), sitting with knees bent upwards so they are against the chest. This helps keeps the body’s trunk warm.

In severe cases, if breathing and heartbeat have stopped, the person should not be considered dead until efforts have been made by health care professionals to warm the individual.

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 warm water.

Drug Therapies

In severe or complicated cases of hypothermia, intravenous drug therapy may be used.

Complementary and Alternative Therapies

Nutritional measures may 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.

Always tell your health care provider about the herbs and supplements you are using.

Nutrition and Supplements

These nutritional tips may help reduce symptoms of cold exposure:

• Eat warming spices in your foods, such as basil, ginger, turmeric, garlic, and cayenne.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
• Eat more hot soups made with fresh vegetables.
• Avoid refined foods such as white breads, pastas, and especially sugar.
• Avoid coffee and other stimulants, alcohol, and especially tobacco. Tobacco causes constriction of blood vessels and may increase susceptibility to hypothermia.
• Drink 6 - 8 glasses of filtered water daily. Hydration is very important in decreasing cold exposure problems.
• Exercise at least 30 minutes daily, 5 days a week.

Keeping your body healthy can help ward off hypothermia. The following supplements are for general health:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, folic acid, zinc, and selenium.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve immunity. Fish oil can increase the effect of blood thinning medications, talk to your doctor. Cold-water fish, such as salmon or halibut, are good sources. If you take blood-thinning medication, talk to your doctor before taking fish oil supplements (there is no problem with eating fish).
• Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, heart, and muscular support.
• Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care provider.

You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

These herbs may help prevent hypothermia. Do not give herbs or supplements to anyone who is already suffering from hypothermia.

• Panax ginseng (Panax ginseng) standardized extract, 100 - 200 mg twice daily, for preventing symptoms of cold exposure. You can also prepare teas from this herb.
• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory and cold protective effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Bilberry (Vaccinium myrtillus) standardized extract, 80 mg two to three times daily, for antioxidant and vascular system support.
• Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for antioxidant support and cold protection. Ginko can increase the effect of certainsome blood- thinning medications; talk to your doctor.
• Herbal teas may help in decreasing symptoms of cold exposure. Use herbs such as chamomile (Matricaria chamomilla), green tea (Camellia sinensis) and ginger (Zingiber officinalis).

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for hypothermia based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your 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.

People with mild hypothermia usually recover with no lasting damage. 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), frostbite leading to gangrene in the hands and feet, inflammation of the pancreas, fluid in the lungs, pneumonia, kidney failure, and heart irregularities.

People with severe hypothermia should be hospitalized; if necessary, cardiopulmonary resuscitation will be performed. A hypothermic patient should be transported very carefully and watched closely for an irregular heartbeat, which could be fatal. Normal body temperature in the elderly should be restored slowly, or permanent low blood pressure may result. All people with hypothermia must be closely monitored until their body temperature returns to normal.

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